Two Cases of the Uterine Torsion at Term Pregnancy / 대한산부인과학회지

Torsion of pregnant uterus is defined as rotation of more than 45 degrees about the long axis of the uterus. Double or bicornuate uterine malformation is common cause of uterine torsion in animal group. Torsion of the human pregnant uterus especially at full term, is very rare. The reason for the occurrence of uterine torsion during pregnancy is not known, but abnormal fetal presentations, uterine myoma, and other uterine anomalies are known to be more frequent in patients with uterine torsion; maternal age, parity, and gestational age seem to play no apparent role. Symptoms of torsion of the pregnant uterus include disclosing of the cervix, abdominal tenderness, vaginal bleeding, shock, urinary symptoms and intestinal complaints. As uterine torsion may be fatal to both the fetus and the mother, promptness of the diagnosis and subsequent emergency laparotomy are essential. In this report, the authors present two cases of torsion at full-term pregnant uterus with unilateral renal agenesis, double uterus, and a transverse fetal presentation with a brief review of the literature.

A Case of hypercalcemia caused by metastasis of cervical carcinoma to the right acetabulum / 대한산부인과학회지

In cancer patient, hypercalcemia may develop. The mechanism is local osteolysis by metastasis of cancinoma, or secretion of hormone such as PTHrP (parathyroid hormone related peptides). Bone metastasis in carcinoma of uterine cervix is uncommon. In this report, we present a case of hypercalcemia caused by metastasis of cervical carcinoma to the right acetabulum with a brief review of the literature.

A case report: A case of fibroepithelial polyp on vulvoperineal area / 대한산부인과학회지

A case of fibroepithelial polyp on vulvoperineal area is described. Her age is 20 year old and the tumor measured 9 cm in its largest diameter and was connected to the left labium majus. This case is very unusual in that almost all reported vulvar fibroepithelial polyps are small and sessile, and should distinguish from malignant cancer. We have experienced an unusually large vulvoperineal mass that was surgically excised and histologically diagnosed as benign fibroepithelial polyp and present this case with a brief review of literature.

The Validity of Generally Accepted Contraindications for Total Vaginal Hysterectomy / 대한산부인과학회잡지

OBJECTIVE: A number of preexisting clinical conditions are generally accepted as contraindications for total vaginal hysterectomy. The purpose of this study was to evaluate the validity of these contraindications. METHODS: The TVH-A group consisted of 230 patients who have undergone vaginal hysterectomy. These patients (1) had a large uterus (>280 gm), (2) were either nulliparous or had no previous vaginal delivery, or (3) had a history of previous abdominal or vaginal operation. The TVH-B group was composed of patients who did not present with any contraindications when they underwent vaginal hysterectomy. Patients of the TAH group underwent abdominal hysterectomy. The records for all patients were analyzed according to age, weight, parity, primary diagnosis, uterine weight, duration of operation, blood loss, analgesia, hospital stay, and postsurgical complications. RESULTS: No significant difference in age and weight was observed between the three groups. The average number of vaginal deliveries performed was lower in the TVH-A group. Uterine myoma, carcinoma in situ, and adenomyosis were common preoperative diagnoses in all groups. The most common contraindication for total vaginal hysterectomy in the TVH-A group was history of previous operation (54.8%); large uterus (44.8%) and nulliparity (21.3%) ranked second and third, respectively. Durations of operation, hospital stay, and pain were longer, bleeding volume was greater, and incidence of postoperative complications was higher in the TAH group than in the other groups (p<0.01). Previous cesarean delivery did not affect various operative characteristics among women undergoing vaginal hysterectomy (p<0.01). CONCLUSION: Our data indicate that a history of previous operation, large uterus, and nulliparity rarely constitute contraindications to vaginal hysterectomy.

A Case Of Intraperitoneal Hemorrhage Of Intraligamentous Pregnancy / 대한산부인과학회잡지

The incidence of ectopic pregnancy has been increasing for many years and ectopic pregnancy is still a leading cause of maternal death although its mortality is reduced significantly with improved early diagnosis and treatment. Intraligamentous pregnancy, a subset of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentous pregnancy is hardly ever made prior to laparotomy. We experienced intraligamentous pregnancy with hemoperitoneum. So we presented a case with brief review of literature.

A Case Of Intraperitoneal Hemorrhage Of Intraligamentous Pregnancy / 대한산부인과학회잡지

The incidence of ectopic pregnancy has been increasing for many years and ectopic pregnancy is still a leading cause of maternal death although its mortality is reduced significantly with improved early diagnosis and treatment. Intraligamentous pregnancy, a subset of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentous pregnancy is hardly ever made prior to laparotomy. We experienced intraligamentous pregnancy with hemoperitoneum. So we presented a case with brief review of literature.