Vaginal Birth after Cesarean Delivery: Predictable Factors for Success / 대한주산의학회잡지

OBJECTIVE: The purpose of this report is to determine the predictable factors for successful vaginal birth after cesarean (VBAC). METHODS: In this study, 382 women who attempted VBAC at Kyung-Hee university hospital were included. The medical records of them were reviewed retrospectively. Informations was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. RESULTS: The overall success rate was 76.5% (292 cases). Among variables, neonatal birth weight (odds ratio, 0.2; 95% confidence interval, 0.1-0.4), Bishop score at admission (odds ratio, 1.8; 95% confidence interval, 1.5-2.1 ; p<0.05), and history of vaginal delivery (odds ratio, 3.6 ; 95% confidence interval, 1.1-11.6 ; p<0.05) were significant. The Bishop score showed most significant relationship with successful VBAC. The Bishop score 5 at admission had a sensitivity of 47.4% and a specificity of 87.6% in the prediction of successful VBAC. Malpresentation as indications of previous cesarean delivery showed more tendency to succeed than others. CONCLUSION: Several factors such as birth weight, Bishop score at admission, and history of vaginal delivery may be used to predict the success of VBAC.

A Case of Synchronous Mucinous Tumor of the Ovary and Appendix / 대한산부인과학회잡지

The coexistence of mucinous ovarian and appendiceal tumors in associated with pseudomyxoma peritonei is well established. But, ovarian and appendiceal mucinous tumors occur without involvement of other organs is unusual. When the two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. The typical synchronous presentation of the ovarian and appendiceal tumors, their histologic similarity, the frequency of bilaterality of the ovarian tumors, the predominance of right-sided ovarian involvement. Adenocarcinoma of the appendix constitutes 0.2 to 0.5 percent of all gastrointestinal tumors and accounts for 6 percent of primary malignant lesion of the appendix. The authors experienced a rare case of synchronous tumor of ovary and appendix in 59 years old female patient who has suffered for 3-4 months from abdominal pain. Pathologic examination of the resected specimen revealed a synchronous mucinous type tumor of vermiform appendix and ovary.

A Case of Total Pelvic Exenteration for Recurrent Cervical Carcinoma Found after Simple Hysterectomy / 대한산부인과학회잡지

Pelvic exenteration is a salvage procedure performed for centrally recurrent gynecologic cancers. The procedure involve en bloc resection to a greater or lesser degree of all pelvic structures, including the uterus, cervix, vagina, bladder and rectum. It was first reported by Brunschwig in 1948 as an ultra-radical surgical treatment for advanced and recurrent cervical cancer. Most patients who are candidates for the procedure have a diagnosis of recurrent cervical cancer that previously has been treated with surgery and radiation or radiation alone. In some cases, patients with recurrent uterine, vulvar, or vaginal cancers may benefit from pelvic exenteration. Currently, operative mortality rates range from 3% to 5%, the rate of major perioperative complications is 30-22% and the overall 5-year survival rate is those patients who successfully undergo the procedure ranges from 20-50%. We experience a case of total pelvic exenteration for recurrent cervical carcinoma found after simple hysterectomy. It is presented with a brief reviews of literatures.