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宋尙煥,李俊煥,張世勳,鄭台默,최인준,尹起湖 中央醫學社 1941 中央醫學 Vol.10 No.4
Recently cervical pregnancy, admittedly of rare occurrence, has been increasinglyreported. In 1945, Studdiford stated that less than 50 cases were reported in the world literatures. This is one of the ectopic gestations in which fertilized ovum takes place the implantation and development within the mucosa of endocervical canal, endometrial cavity remaining empty. Several authors have presented the criterias for cervical pregnancy, on clinical and pathological evidence. A case of clinically and pathologically proved cervical pregnancy, a 25 year-old Korean housewife, gravida II, para 0, based on the criteria by several authors, is reported, because of its rare occurrence and also our first experience of this type of ectopic pregnancy. The initial symptoms and signs -were amenorrhea for 12 weeks, a transient lower abdominal discomfort and intermittent sudden massive uterine bleeding for 15 days. The uterus was about 8 weeks gestation size in soft consistency. The uterine cervix was soft and the cervical os was partially dilated. Hysterectomy was performed. Crossly the uterus measured 12x 6x 4cm., the cervix was expanded, the endocervical canal showed friable hemorrhagic necrotic area with hemorrhagic mass in the antero-lateral portion, 1. 5cm. above the exocervix to the isthmico-cervical level. The thinnest cervical wall measured up to 0. 2cm. in thickness. The histopathology of the specimen showed hemorrhagic necrosis of the cervical wall with degenerated chorionic villi and organizing hemorrhage. The uterine cervix showed chronic cervicitis and relatively marked squamous metaplasia. The endometrium showed a moderate degree of subacute type of inflammation. With these pathological findings, the pathogenesis of cervical pregnancy in this case might be equivocally correlated with the theories of delayed implantation (Studdifod, 1945, Greenhill, 1955) and of chronic cervicitis(Lucci, 1961). A brief review of literature is also made in order to consider the interest of this pathogenesis and the criteria of clinical and pathological evidence, and also to arouse the interest of physicians when they are dealing with painless massive uterine bleeding, which is readily confused with other obstetrical and gynecological. emergency cases, missing the chance of treatment.
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이계용(KY Lee),장세훈(SH Chang),정태묵(TM Chung),송상환(SW Song) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.7
The Study was carried out retrospectively based on the clinical charts of patients who had 241 Cesarean seations performed, and 246 new borns including 5 pairs of twins delivered at Dept. of Obst. & Gyn., Yonesei University Cllege of Medicine, from January 1,1962 to December 31, 1996. The results were as follows: 1.Cesarean section rate was 7.4% for the period. 2. The indications for Cesarean section were that cephalo-pelvic disproportion was the most prevalent and 30.3%, repeat section 29.9%, antepartum hemorrhage (Placenta previa and abruptio placentae) 10.0%, malpresentation 12.8%, cervical cancer was 2.5% and so on. 3. In type of operation, low cervical section was 86.6%, classic 7.9%, and Csearean hysterectomy was 4.5%. 4. The average pelvic diameters by Colcher-sussman X-ray pelvimetry in disproportion cases were 10.39 Cm. and 12.30 Cm. in antrerio-posterior and transverse dimeters of pelvic inlet, 10.59 Cm. and 9.57 Cm. in anterio-posterior and transverse diameters of mid pelvis and 6.98 Cm. and 9.48 Cm. In posterior sagital and transverse diameters of pelvic outlet respectively. 5. The types of anesthesia until the baby was delivered were local, spinal, and general anesthesia respecively 7.0%, 50.2% and 42.8%. 6. In new borns, 14.6% had low birth weight, and 4.47% of total births had Apgar score 0, 12.6% Apgar sore 1-5, and heavier babies had higher scores. 7. Perinatal mortality was 6.69% and the half of those were premature babies. 8. Puerperal infection was 17.77% in cases with membrane ruptured, and 10.80% in cases with mombrane was intact when Cesarean section was decided respectively, and was 12% in average. 9. Maternal deaths accured in two cases corresponding to 0.83% of mortality and were caused by a hypofibrionogenemia and septicemia complications respectively.
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