한국인 임산부에 있어 뇨중 Estriol에 관한 연구

양영호(YH Yang) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.2

Determination of urinary estriol as a measure of placental function and intrauterine frtal well-being has been evaluated in obstetrics and has proved to be diagnostic value. To the aauthor`s knowledge, there has not been a report of urinary estriol excretion in pregnancy and some complicated pregnancies as well. Comparison with the results of various author`s is also done. It is also designed to evaluate clinical applicability and practicability. Material and Method Subjects were 241 pregnant women who were registred in prenatal clinic of the department of obstetrics of Yonsei Univeersity College of Medicine. 308 determinations were carried out from the 20th week to 45th week of gestation. Determination of urinary estriol excretion was carried out by the modified Brown`s method(1957) with a 24 hour`s urine specimen. A total of 80 complicated pregnancies were tested as follows; 1. 28 cases of toxemia of pregnancy(severe form of preeclampsia and eclampsia)and hypertension. 2. 6cases of pyelonephritis. 3. 6cases of hydatidiform mole. 4. 14cases of known intrauterine fetal death and 7cases of intrauterine fetal death that occurred during treatment of complications after admission. 5. 18cases of overdue. 6. 2cases of anencephalus. In twelvw of 161 normal pregnancies, urinary estriol value has been followed biweekly from 20th week`s gestation to term. Conclusion The results of urinary estriol excretion determination that are carried out are summarized as follows; 1. In normal pregnancies, there was a gradual increase in urinary estriol excretion and mean value of urinary estriol was 4.3mg/24hrs at 20th week gestation and 28.9mg/24hrs at term. 2. When pregnancy was complicated with hypertension, toxemia ro pyelonephritis, the urinary estriol excretion level was lower than normal pregnancy. 3. If the value of urinary estriol excretion at term is less than 4.0mg/24hours, intrauterine fetal death can be diagnosed and if more than 12mg/hour, fetal well-being can be diagnosed. 4. Urinary estriol excretion was markedly decreased in the hydatidiform mole and anencephalus. 5. Urinary estriol excretion was decreased in overdue pregnancy and the normal loweir limit of the urinary estriol excretion was 12.0mg/24hours. 6. Urinary estriol excretion of 12mg/24hours or more at term suggested mature fetus.

Prostaglandin F2a의 만삭유도분만에 관한 임상적 고찰

양영호(YH Yang),오기석(KS Oh),박영동(YD Park),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.8

1. 유도분만 35레중 그 성공률은 초산 13례, 경산 17례로 각각 77%, 94%이었다. 2. 유도-만출간의 평균소요시간은 초산이 7시간 9분, 경산이 3시간 45분이었다. 3. 평균 최대주입용량은 초산 5.4, 경산 3.8 ugm/min이었다. 4. 진통촉진군 15례 전례에서 분만 성공하였으며, Oxytocin과 비슷한 결과를 보이고 있다. 5. 주입중 산모의 혈압, 맥박 및 체온의 변화는 관찰할 수 없었으며, 1례에서 Uterine hypertonus를 볼 수 있었고, Apgar score는 전례에서 1분후 8 이상이었다. 6. 경한 오조와 주입부위 정맥염이 각 1례씩 있었으나, 주입을 중단할 정도로 심하지는 않았 다. 1. Successful induction was 77% in primigravida (13 of 17 case) and 94% in multigravida (17 of 18cases) 2. All patients in hte easy category were successfully induced and delivered. 3. Mean induction delivery time in primigravida was 7 hours 9 minutes and that in multigravida was 3 hours 45 minutes 4. Mean maximal infusion dosage in primigravida was 5.4ug/min and that in multigravida was 3.8 ug/min. 5. all patients requiring augmentation of labor were successfully delivered. 6. Uterine hypertonus was observed in 1 patient 7. Mild nausea (1patient) and phebitis at injection site (1 patient) were observed, but they were spontaneously disappeared without specific management. 8. the condition of the newborn was generally good with one minute Apgar score of 8 or more in all cases

융모막 융모샘플링(C.V.S)이 임산부 혈청 alpha-Fetoptrotein치에 미치는 영향에 관한 연구

양영호(YH Yang),김도형(DH Kim),김창규(CK Kim),이명선(MS Lee),이창훈(CH Lee) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.12

연세대학교 의과대학 산부인과학교실에 산전유전질환 진단 및 치료적 임신중절을 목적으로 내원한 56명의 환자중 27명을 대상으로 융모막 융모셈플링을 실시하엿으며 융모채취전후 MSAFP치를 측정하여 이를 임신주수, 융모채취량, 카테터 삽입회수와 비교분석하여 다음과 같은 결론은 얻었다. 1. 임신 6-12주의 주수별 MSAFP치의 중앙값은 각각 3.0, 3.0, 3.0 , 3.0, 3.7 , 5.9, 10.0 IU/ml 이었다. 2. CVS를 시행한 27예중 18예에서 (59.3%) 20%이상의 MSAFP증가를 보였고, 이중 50%이상 100%미만은 15예로 55.5%, 100%이상은 13예로 48.1%의 빈도를 보였다. 3. CVS 후의 MSAFP로부터 태아모체성 출혈량을 계산하여 60ul이상 3예, 100ul 1예의 결과 를 보였다. 4. 채취된 융모양이 많을수록 MSAFP가 증가하였다. 5. 같은 양의 융모채취에 대해 카테터 삽입회수 3-4회인 군에서 1-2회인군에비해 MSAFP의 증가폭인 컸다. 본연구결과 CVS 후의 태아모체성 출혈을 주소하기 위하여는 CVS에 충분한 경험을 가진 산 부인과 의사와 초음파 및 유전학실험실 요원간에 긴밀한 협조하에 가능한한 최소한의 카테 터 삽입회수와 검사에 필요한 최소량의 융모채취가 필요하다고 사료된다. FMH during CVS may contribute in subsequently raising the chance of abortion and even cause maternal Rh isoimmunization . Detection and quatitation of FMH could be made by determining the changes in MSAFP level by enzyme immunoassay before and 15 minutes after CVS. CVS was perfomred in 27 patients for prenatal genetic diagnosis using a flexible plastic catheter introduced transcervically under real-time ultrasonography guidance . MSAFP levels were analyzed comparatively according to their gestational weeks, amounts of villi sampled and the frequency of catheter-pass. Fifty-nine percent of these patients had an increaed MSAFP levels by 20 per cent or more. Such a rise was thought to reflect crossing of fetal blood through intervillous space upon performing CVS, A prospective correlation was obtained. The group given three to four catheter-passes had more elevated levels of MSAFP than the group given only one or two passes . In three of these patients more than 60 ul of fetal blood was transferred with only one of them presumed with more than 0.1ml of expected volume of FMH. To minimize the chance of FMH during CVS, a least amount of villi should be obtained for diagnosis with as few catheter-pass as possible.

한국에 있어서 융모막 융모 샘플링의 산전 유전진단 이용에 관한 첫 임상적 결과

양영호(YH Yang),이명선(MS Lee),박용원(YW Park) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.2

1. 샘플링의 적응증은 모성연령증가가 전체의 40%로 가장 많았으며 염색체 이상의 아이를 분만한 기왕력이 20%, 그밖의 선천성 기형아를 분만한 기왕력이 18.2% 등의 순서였다. 2. 융모 샘플링의 성공률은 총 55예 중 41예로서 93%로 나타냈다. 3. 임신주수는 7-12주에 시행하였으며, 이중 9-10주가 54.5%로 가장많았고, 7-8주가 25.5%, 11-12주가 20%였다. 4. 카테터 삽입횟수는 1회가 10예, 2회 23예, 3회가 19예, 4회 3예이었다. 5. 채취된 융모은 양은 0-4mg이 4예, 5-10mg이 32예, 10-15mg이 16예, 15mg이상이 3예이었 으며 한 개의 slide glass당 metaphase수는 5-10mg이 8.5개, 10-15mg이 15.4개, 15mg이상이 17.0개로서 채취된 융모의 양이 많을수록 metaphase수도 다소증가하였으나 융모의 양은 많 아도 형태가 불완전했던 2예에서 metaphase수가 적었고, 5mg의 적은 양으로도 양질의 충분 한 metaphase를 얻는 등의 예외가 발견되었다. 6. 염색체이상은 3예로서 47, XX, +21.0이 1예, 45,XO 가 1예 46,XX inv(9) (p11q13)이 1예있었 다. 7. 샘플링후의 자연유산율은 총 55예중 2예로서 3.6%였으며 이중 1예의 핵형이 46,XX inv(9) (p11q13). 이었다. 이상의 연구결과를 종합하면, 임신초기 융모막 융모샘플링에 의한 산전 유전검사방법은 비 교적 안전하고 진단에 신뢰성이 있으므로 양수천저에 대치될 것으로 사료된다. CVS has the potential of becoming an attractive alternative to midtrimester genetic amniocentesis; it require much shorter waiting time for results than amniocentesis, thereby lessening both physical and psychological burdens on the patients should therapeutic termination be carried out. In this study the success rate of CVS subsequent fetal karyotypes, results of choromosomal analysis, and pregnancy outcome after CVS were evaluated. Chorionic villi were obtained by transcervical aspiration through a flexible plastic catheter under realtime ultrasound duidance. Direct chromosome preparation using modified method of Simoni. et al (1983, 1984) was employed. The study group consisted of 55 women who opted for fetal genetic screening in 7 to 12 weeks gestation with various indications for CVS. Success rate was 93 percent. Majority of cases (52, 94.5%) required two or three aspirations. It seemed that the higher the amout of chorionic villi thus obtained , the larger the number of emtaphase cells scored per slide. Fetal karyotypes obtained in 51 cases revealed normal in 48 cases (94.0%) and abnormal in 3 cases (6.0%) . The abnormal cases were one case each of 47, XX, +21.0, 45,XO and 46,XX inv(9) (p11q13). Fetal loss occured in 2 cases (3.6%) one of which being the case of 46,XX inv(9). The study confirms the safety and accuracy of CVS, and indicated that CVS may be adopted, perhaps in place of amniocentesis, for prenatal genetic diagnosis. The study was the first endeavor of its kind in Korea.

자궁난관조영술상 자궁형태가 불임에 미치는 영향

전종영(JY Jun),양영호(YH Yang),안동원(DW Ahn),천영철(YC Chun),김재욱(JU Kim) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

1974년 1월부터 1977년 12월까지 만 4년간 불임을 주소로 연세대학 의과대학 산부인과 외래로 내원하여 자궁난관조영술을 시행한 예중 양축난관이 정상이며 다른 불임의 원인을 발견할 수 없었던 117예를 대상으로 자궁난관조영술을 사용하여 Hay의 분류방법으로 자궁상을 분류하여 다음과 같은 결과를 얻었다. 1. 원발성 불임은 61예이며 속발성 불임은 56예이었다. 2. 연령분포와 불임기간은 양군에서 큰 차이가 없었다. 3. 자궁기형의 발생빈도를 보면 원발성 불임군에서는 62.3%이었고 속발성 불임군에서는 55.4%로서 이중 경한 자궁기형의 발생빈도는 원발성 불임군의 자궁기형에서는 68.4%, 속발성 불임군의 자궁기형에서는 77.4%로 나타났으며, 원발성 불임군과 속발성불임군에서 자궁기형의 발생빈도에 큰 차이가 없는 것으로 보아 자궁난관조영술에 의한 자궁기형, 특히 경한 자궁기형은 원발성 불임의 원인이 되지 않는 것으로 보이나 더 많은 예의 추후 연구가 필요한 것으로 사료된다. Presented is a series of 61 primary infertility patients and 56 secondary infertility patients with patent Fallopian tubes and no obvious cause for infertility. The uterine contour in hysterosalpingography was classified by Hay`s classification. The results revealed 62.3% and 55.4% uterine amonalies, and 68.4% and 77.4% minor anomalies among uterine anomalies in primary and secondary infertility patients respectively. The results do not show that a cause and effect relationship has been established between uterine anomalies, particularly minor uterine anomalies and primary infertility because there is no significant difference in incidence of uterine anomalies between primary and secondary infertility patients.

임산부 말초혈액에서 중합효소연쇄반은 ( PCR ) 을 이용한 태아의 성염색체 분석과 이의 산전유전 진단응용

송찬호(CH Song),양영호(YH Yang),김인규(IK Kim),김동욱(DW Kim),김미순(MS Kim),유향숙(HS Yoo),이미화(MH Lee) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.3

산전유전검사를 받을 임산부 22예를 대상으로 이들의 말초혈액을 채취하여 Y chromosome-specific ZFY gene DNA sequence와 Y chromosome 단완의 DYS 14 locus에 위치한 Y-specific sequence를 nested polymerase chain reaction assay법으로 증폭하여 산전 태아 성(fetal sex)판정을 시도하여 다음과 같은 결과를 얻었다. 1. ZFY 유전자의 primer인 Z1, Z2 및 Z3, Z4를 이용한 중합효소연쇄반응 결과, 여아 및 남아를 임신한 전예에서 양성띠가 나타나 비특이성을 보였다. 2. Y-chromosome DYS 14 locus의 sequence primer인 Y1.5, Y1.6 및 Y1.7, Y1.8 primer를 이용한 중합효소연쇄반응 결과, sensitivity는 76.9%, specificity는 55.5%였으며, positive 및 negative predictive value는 각각 71.4%와 62.5%였다. 이를 임신주수별로 분석하여 보면 임신 초기, 중기 및 말기의 positive predictive value는 각각 66.6%, 66.6%와 80%로, negative predictive value는 각각 50%, 50% 및 100%로 나타났으며, 임신 9-16주에는 여아를 임신한 임산부 중 남성 특이의 band가 나타나는 경우가 6예중 3예, 남아를 임신한 임산부 중 남성특이의 band가 나타나지 않는 경우가 7예중 3예로 낮은 신회도를 보였으나 임신 18-40주에는 남아인 경우 1예를 제외하고는 남성 특이 band가 나타났으며, 여아인 경우는 모든 예에서 198 base pair의 남성 특이 band가 나타나지 않았다. 저자들은 본 연구에서 모체 말초혈액에서 중합효소연쇄반응(PCR)을 이용한 태아의 성판정은 임신후기에는 가능하나 임신초기에 있어서는 그 신뢰도가 낮은 것으로 생각 된다. 따라서, 임신 초기 모체혈액내에 있는 태아세포만을 선별적으로 구별할 수 있는 방법을 이용하여 Y1.5, Y1.6 및 Y1.7, Y1.8 primer를 이용 PCR을 하면 정확한 태아의 성판정이 가능할 것으로 사료된다. 본 연구는 연세대학교 의과대학 교수연구비에 의해서 이루어짐 (1994년도). Objectives : Detection of Y-chromosome specific gene in the maternal circulation has clinical importance because of its potential usefulness in determining fetal sex in mothers with severe X-linked disorders such as classic hemophilia A and Duchenne`s muscular dystrophy. Numerous attempts have been made to identify Y specific gene in bloods of mothers bearing male fetuses, however, the results have been controversial. Therefore, we have investigated the use of a nested polymerase chain reaction assay for the detection of a fetal specific Y-chromosome sequence. Methods : Y chromosome specific ZFY gene DNA sequence(using Z1, Z2 and Z3, Z4 primers) and Y chromosome sequence in DYS 14 locus (using Y1.5, Y1.6 and Y1.7, Y1.8 primers) have been identified by an in vitro enzymatic deoxyribonucleic acid amplification method in peripheral blood specimens of 22 pregnant women with gestational ages of 9 to 40 weeks. Results : All women bearing male or female baby were positive for the ZFY gene. Thirteen fetuses were confirmed as males by amniocentesis or chorionic villi sampling, and 10 of these were positive for the Y chromosome specific sequence in DYS 14 locus using Y1.5, Y1.6 and Y1.7, Y1.8 primers(sensitivity 76.9%), however, 4 of the 9 cases diagnosed as females were also positive(specificity 55.5%). Positive and negative predictive values were 71.4% and 62.5%. In terms of the gestational age, positive predictive values of 66.6%, 66.6% and 80% were obtained for the first, second and third trimesters, respectively. The corresponding negative predictive values are 50%, 50%, and 100%, respectively. Conclusion : Fetal sex determination by PCR employing maternal peripheral blood is usually possible in late pregnancy. It is less reliable in early pregnancy. It appears that using a method separating fetal cells from maternal blood and then by running PCR on these cells with Y1.5, Y1.6 and Y1.7, Y1.8 primers could make a fairly accurate fetal sex determination.

한국인 선천성 이상질환이 의심되는 환자에 대한 세포유전학적 연구

김진경(JK Kim),양영호(YH Yang),황동훈(DH Hwang),노성일(SI Rho),조주연(JY Cho) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

1974년 1월부터 1980년 5월까지 연세대학교 의과대학 부속병원 산부인과 유전학 연구실에서 선천성 이상이 의심되는 환자 428명에 대하여 세포유전학적 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 다운증후군이 76예였으며 21번 염색체의 3배성이 69예, 모자이시즘이 7예였다. 2. 터너증후군이 13예였으며, 45,X가 7예, 모자이시즘이 6예였다. 3. 클라인펠터증훈군이 17예였으며, 47,XXY가 14예, 46,XY/47,XXY가 2예, 48,XXYY가 1예였다. 4. 원발성무월경이 62예였으며, 60세에서 46,XX,2예에서는 46,XY를 나타내었다. 5. 간성이 75세였으며 정상 염색체양상을 나타내었다. 6. 뇌성마비아동이 98예였으며, 정상 염색체 양상을 나타내었다. 7. 생식기관이외에 선천성 기형이 있었던 경우가 81예였으며 모두 정상 염색체 양상을 나타내었다. 8. 에드워드증후군이 1예 있었으며, 46,XY,+18염색체 양상을 나타내었다. 9. Cri du Chat증후군이 1예 있었으며, 46,XX,5P-의 염색체 양상을 나타내었다. 10. 기타 종질중격과 중복자궁이 각각 2에씩 있었으며, 정상 염색체양상을 나타내었다. As the cytogenetics developed, cytogenetic study in Korea has also developed progressively. However, cytogenetic studies in Korea were merely studies on normal chromosome pattern or simple studies of several genetic disorders or cases reports. This study is a systematical cytogenetic analysis of 428 cases where congenital disorders were suspected and referred to our cytogenetic laboratory in the Department of Obstetrics and Gynecology, Yonsei University Medical Center, from Jan. 1974 to May 1980. The results were as follows; 1) Downs syndrome was found in 76 cases, consisting of 69 cases(90.79%) of primary 21 trisomy and 7 cases of mosaicism. 2) Turners syndrome was found in 13 cases, consisting of 7 cases(53.85%) of 45,X and 6 cases of mosaicism. 3) Klinefelters syndrome was found in 17 cases, consisting of 14 cases(82.35%) of 47,XXY, 2 cases of 46,XY/47, XXY and 1 case of 48,XXYY. 4) Primary amenorrhea was found in 62 cases, consisting of 60 cases(96.78%) of 46,XX and 2 cases of 46,XY. 5) Intersex was found in 75 cases, consisting of 45 cases(60%) of 46,XY and 30 cases of 46,XX. 6) Cerebral palsy was found in 98 cases and all cases were normal karyotype. 7) Congenital anomalies excluding the reproductive organ was found in 81 cases were normal karyotype. 8) Edward syndrome was found in 1 case, karyotype was 46,XY, +18. 9) Cri-du Chat syndrome was found in 1 case, karyotype was 46,XX, 6P-. 10) Longitudinal vaginal septum and double uterus were found in 2 cases each and all cases were 46,XX.

Congenital Tdrenal Hyperplasia 에 기인한 여성반음양환자 치유 1예

박금자(KZ Park),양영호(YH Yang) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.1

1983년 4월 본 대학에서 congenital adrenal hyperplasia로 인한 여성 반음양 1예를 치유하였기에 문헌고찰과 더불어 보고하는 바이다. The most common single cause of female pseudohermaphroditism is the adrenogenital syndrome, resulting from congenital virilizing adrenal hyperplasia. Prompt recognition and treatment of the associated adrenal imblance ane most important. If the condition is not treated, the virilization continues into adulthood. This report will be presented an experience with a case who was female hermaphroditism due to congenital adrenal hyperplasia at Yonsei University College of Medicine, on April, 1983.

임신중절에 관한 임상적 고찰

곽현모(HM Kwak),양영호(YH Yang),오기석(KS Oh),황민철(MC Whang) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.6

1962년 1월부터 1973년 8월까지 연세대학교 의과대학 산부인과에 입원한 총 483명의 임신중 절을 한 환자를 대상으로 조사분석하여 다음과 같은 결론을 얻었다. 1) 임신중절 실시율이 30∼39세에서 가장 높았다. 2) 초회임신을 중절시킨 것이 31%였고 평균분만 회수는 3.5였다. 3) 임신중절을 임신 12주전에 시행한 것이 70.2%, 13주 이후는 29.8%로서 대부분 소파수술 이었다. 4) 합병증 발생빈도는 임신 12주 전에는 13%, 13주 이상에서 17%로 임신주수가 상승함에 따 라 증가함을 볼 수 있다. To determine the chracteristics and complications. 483 patients undergoing abortion at Yonsei University Medical Center from January 1, 1962 to August 31, 1973 were analyzed. Most of patients had pre-existing medecal condition, incomplete or inevitable abortions. The obtained result are as follows : 1) The majority(67.21%) of the women studied were between 30 and 39 years of age, parity was 4.5 and 31% had parity 0. 2) The majority(70.2%) of patients aborted were in the first trimester of pregnancy. 3) Most of pregnancies(86.54%) were terminated by a "single method used" D & C. 4) The incidence of comlpications varited with gestational age : 13% in the first trimester and 17% in the 2nd trimester, increasing with advancing pregnancy.

자궁외 임신에 대한 임상통계학적 고찰

김흥균(HK Kim),양영호(YH Yang),송찬호(CH Song),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.7

1. 빈도 : 자궁외임신의 분만수에 대한 빈도는 1:22였다. 2. 호발연령 : 호발연령은 25-34세로서 60.3%가 이 연령층에 속하엿다. 3. 불임자는 5.3%이었고, 미산부가 25.7%이었고 총 환자의 39.8%가 한번 이상의 자연유산을 54.6%가 한번 이상의 인공유산을 경험하엿다. 4. 불임기간은 평균 3년 11개월이었고 9년 이상이 11.6%이었다. 5. 기왕력은 반복자궁외임신 12.6%를 포함해서 개복수술이 22%였고, 골반내결핵은 2.5% 질 염은 3.8%, 자궁경부염 1.1% 골반내염증 4%이었다. 6. 증상은 하복부 복통이 91.5%, 성기출혈이 73.1%, 골반부위 증압감이 16.1%, 오심구토가 14.4% 현기증이 12.9%, 견통이 14예에서 있었고 내진시 부속기 종류가 53.6%, 하복부압통이 89.6% 내진시 동통이 58.7%, 하복부경직이 15.5%에서 잇엇다. 7. 최종월경과 증상까지의 기간은 평균 6.8주이었다. 8. 백혈구수는 파열된 자궁외 임신에서 현저히 증가되었다. 9. 더글라스와 천자는 95.9%에서 적중하였다. 10. 착상부위는 난관이 93.9%, 난소가 1.6% 잔류자궁각이 3.7%, 복막이 0.5%, 자궁경부가 0.4%이었고 난관임신에서는 난관채가 17.4%, 팽대부가 71.1% 협부가 10.8%, 간질부가 0.7% 이었다. 1. Hospital incidence of ectopic pregnancy was 1 in 22 deliveries. 2. Ectopic gestation was found to occur most frequently in the age group, ranging from 25 to 34 years (60.2%) 3. Nulligravida was 5.3% nullipara 25.7% and multipara 56.4% of total 4. Average length of sterility was 3 years 11 months and 11.6% (72 cases) had 9years or more sterility. 5. Histories of previous artificial and spontaneous abortion were noted in 54.6% and 39.8% respectively. 6. 186 cases (22%) had previous abdominal surgeries. Among them 108 cases were repeated ectopic pregnancies and 48 cases were appendectomies. Pelvic tuberculosis was noted in 2.5% (21cases) vaginitis cervicitis and pelvic inflammatory disesase were detected in 3.8% (33cases) 1.1% (9cases) and 4% (34 cases) respectively. 7. On symtomatology, lower abdominal pain was encountered in 91.5% (786cases) vaginal bleeding or spotting in 73.1% (628 cases) bearing down sensation in 16.0% (138 cases) nausea and vomitting in 14.4% (124 cases) fainting in 12.9% (111 cases) and shoulder pain in 14 cases 8. Adnexal mass, usually tender was palpated in 53.6% (450 cases) and lower abdominal tenderness was noted in 89.6% (752 cases), 58.2% (488 cases) complained of pain on mortion of cervix and 15.5% (130 cases ) had abdominal rigidity. 9. The average interval between L.N.M.P and onset of symptoms was 6.8 weeks. 10. W.B.C count was considerably increased in ruptured cases