Effect of weight gain during the pregnancy on success of vaginal birth after cesarean delivery (VBAC) / 대한주산의학회잡지

PURPOSE: To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). METHODS: The study compared clinical features taken from 112 patients who tried VBAC at our institute from January 2001 through December 2006. There were divided into two GROUPS: 92 patients for the success (82.1%) and 20 patients for the failure group (17.9%). Excluding 36 patients with no BMI data, we constructed Receive-operating characteristics (ROC) curve to make the optimum BMI value for the prediction of success of VBAC. Based on the BMI 26 or more, two groups of patient were surveyed the interrelation between weight gain and success of VBAC. RESULTS: Between success and failure group, the weight gain during pregnancy showed significant differences which are 11.2+/-4 kg of the success group and 13.2+/-5 kg of the other one (p<0.05) A survey on the availability of the BMI date to estimate success of VBAC, the criteria with the standard BMI 26 is not statistically valuable (p=0.837). By comparing normal weight and overweight based on BMI 26, some factors showed statistically significant discrepancies: number of prenatal visit, maternal weight gain, maternal weight at the time of delivery, use of oxytocin and birth weight. CONCLUSION: BMI value of 26 has limitations in using as an estimate criteria on success of VBAC. Patients, however, who had relatively small scale of weight gain, showed significant clinical factors to increased success rate of VBAC.

Clinical analysis of tension free vaginal tape combined with hysterectomy / 대한산부인과학회지

OBJECTIVE: This study was performed to evaluate the efficacy, safety and complications of tension-free vaginal tape (TVT) combined with total hysterectomy under general anesthesia. METHODS: Retrospective comparison of 76 women treated by TVT procedure with total hysterectomy from January 2003 to December 2003. All patients had undergone preoperative evaluation including history taking, physical examination, pelvic examination, 1-hour pad test and urodynamic test, and then were operated under general anesthesia. There were 65 patients combined with LAVH (laparoscopic assisted vaginal hysterectomy), 6 patients combined with VTH (vaginal total hysterectomy) and 5 patients combined with TAH (total abdominal hysterectomy). RESULTS: The mean follow up and hospital day were respectively 13 months (range 6-18 months) and 7.6 days (range 6-15 days). Objective and subjective success rate were respectively 97.4% (cured 92.1%, improved 5.3%) and 97.4% (cured 88.1%, improved 9.3%). Preoperative and postoperative 1-hour pad test were respectively 36.4 gm and 4.1 gm (p<0.001). Complications were bladder perforation (6.6%), voiding dysfunction (7.9%) and overactive bladder syndrome (7.9%). CONCLUSION: Conclusively, the cure rate was 88.1% in the TVT combined with hysterectomy when performed under general anesthesia.

Clinical analysis of Paclitaxel and Platinum in Recurrent Carcinoma of the Uterine Cervix / 대한산부인과학회지

OBJECTIVE: This study was performed to evaluate the efficacy and the toxicity of paclitaxel and platinum in patients with recurrent cervical carcinoma. METHODS: Twenty nine patients were treated with paclitaxel 135-175 mg/m2 and cisplatin 50-75 mg/m2 or carboplatin at AUC 5 every 3 weeks for a maximum of six courses from January 2001 to January 2004. RESULTS: A total 134 cycles with paclitaxel and platinum were administered. Ten patients (34.2%) achieved an objective response, including four complete responses (13.6%) and six partial responses (20.6%). Overall survival was 13.2 months, and the response and non-response group were 23.2 and 8.1 months, respectively (p=0.01). Clinical response according to recurrent site was significantly different (p=0.048) but, survival was not (p=0.22). Grade 3 or 4 granulocytopenia in 75.9% of patients was developed and one expired due to neutropenic sepsis after first cycle chemotherapy. CONCLUSION: The combination of paclitaxel and platinum seems relatively well tolerated and has 34.2% response rate in patients with recurrent cervical cancer. Further study for this combination chemotherapy and prognostic factor should be needed.