병원 분만한 임산부의 혈색소치에 관하여

이우영(WY Lee),강경화(KH Kang),박둘임(Dl Park),민보은(BE Min),신경숙(KS Shin) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

저자들은 1979년 12월 1일부터 1980년 2월 10일까지 일신부인병원 산과에 내원 분만한 임산부 1002명을 대상으로 임신말기의 혈색소량을 측정하고 얻은 결론은 다음과 같다. 1. 임산부의 임신말기 평균혈색소치는 11.5gm/dl인데 반하여 정상 비임부의 평균혈색소치는 12.8 gm/dl이었다. 2. 임산부의 임신말기 평균혈색소치 11.0 gm/dl이하는 41.8%이었고 이 중 8.0 gm/dl이하는 1.6%이었다. 3. 임산부에 있어서 빈혈의 발생빈도는 합병성질환 특히 자간증 및 전자간증 폐경핵등의 만성소모성 질환을 가진자, 다산 그리고 고령산모에서 높아다. 4. 임신중 주기적인 산전 진찰을 혈색소량의 증가를 가져오고 빈혈의 발생빈도를 저하시킬 수 있었다. Anemia of pregnancy is a common complication in patients from poor socio-economic conditions and is important because it is associated with increased maternal and perinatal morbidity and mortality. A study on Hb levels in pregnancy was done on 1002 patients whose pregnancies were over 26 weeks gestation delivered at Il Sin Womens Hospital between 1st.Dec. 1979 and 10th Feb. 1980. In 694 women pregnancies were uncomplicated but 308 pregnancies were complicated by eclampsia, preeclampsia and other toxemias, syphilis, renal disease, pulmonary Tbc, diabetes and heart disease. Few large studies of Hb levels of pregnant women in Korea are available. The study results are as follow; 1. The mean hemoglobin level in the third trimester of pregnancy were 11.5 gm/dl compaired to a mean level of 12.8gm/dl in a comparable group of non pregnant women. 2. The Hb was below 11.0 gm/dl in 41.8% of the study group, including 1.6% whose Hb was below 8.0gm/dl. 3. A high incidence of anemia in the third trimester of pregnancy was present in patients with preeclamsia and eclampsia high pariety, pulm. Tbc. and with increasing age in complicated pregnancies. 4. The effect of antenatal care, on low hemoglobin level in complicated pregnancy and no regular antenatal care. The benefit of antenatal care in shown in the high incidence of low Hb and complications of pregnancy in those with only 1 or 2 antenatal visits before delivery compaired to those with regular antenatal care.

자궁선근증에 대한 임상적 고찰

이우영(WY Lee),허필형(PH Hur),이창석(CS Lee),최인호(IH Choi),김수평(SP Kim) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.8

1974년 1월 1일부터 1978년 12월 31일까지 만 5년동안 가톨릭의과대학 부속성모병원 산부인과에서 시행한 자궁적출술 총 1,007예중 자궁선근증 136예에 대하여 임상 및 병리조직학적 관찰을 하였던 바 다음과 같은 결론을 얻었다. 1. 자궁선근증의 발생빈도는 13.5%이었다. 2. 호발연령은 40세에서 49세였으며, 평균연령은 42.6세이었다. 3. 경산부의 발생율이 미산부보다 7.5배로 높았다. 4. 자궁선근증을 가진 자궁은 정상자궁보다 더욱 그 무게가 증가되었으며, 136예의 3분의 1에 해당하는 예에서 81~120gm의 사이에 있었다. 5. 자궁선근증의 경우 분만회수의 증가에 따라 자궁의 무게도 크게 증가하였다. 6. 전 136예의 5분의 1에 해당하는 예에서는 아무런 증상을 호소하지 않았고, 골반내동통, 월경통, 월경과다등이 주요증상을 이루었다. 7. 수술전 진단의 정확도는 10.3%이었으며, 수술후 육안적진단의 정확도는 22.8%이었다. 8. 합병질환중 자궁근종이 26.5%로 가장 많았고 골반내막증은 8.1%를 보였다. 9. 자궁내막 소견은 증식기가 68.4%, 분비기가 14.0%를 나타냈다. This is the report of a retrospective study of 136 consecutive instances of adenomyosis among 1,007 hysterectomies, identified histologically at the St. Mary`s Hospital of Catholic Medical College during the 5 year period from January, 1974 through December, 1978. The results of clinicopathologic analysis were summarized as follows. 1. Routine pathologic examination of the 1,007 uteri revealed with adenomyosis in 136 specimens, and incidence of 13.5%. 2. The highest age incidence was in 40 to 49 years of age group, an incidence of 55.9% and the mean age was 42.6 year old. 3. Adenomyosis was more likely to occur in the parous woman than non-parous woman, such as 88.2% and 11.8% respectively. 4. A uterus containing adenomyosis weighs on the average more than a normal uterus, the most prevalent uterine weight was from 81 gram to 120 gram, an incidence was 35.2%. 5. The correlation of uterine weight and parity in adenomyosis was parallel, that is, more weight in higher parity. 6. Nearly one-fifth of the 136 patients analyzed for this report had proffered no symptoms of adenomyosis, an incidence of 19.1%. 7. Pelvic pain, dysmenorrhea, and menorrhagia were the common symptom of adenomyosis, an incidence of 38.2%, 33.8% and 31.6% respectively. 8. Only 14 of the 136 patients(10.3%) showed a preoperative diagnosis of adenomyosis. 9. Thirth-one patients(22.8%) in this study were diagnosed as adenomyosis postoperatively by surgeons. 10. Myoma was the most common associated lesion in adenomyosis, an incidence of 26.5%. 11. External endometriosis was found in 8.1% of cases in this study. 12. Proliferative endometrium was the most frequent endometrial finding of adenomyosis, an incidence was 68.4%.

Prostaglandin E1 투여에 의한 유도분만에 있어서의 혈중 스테로이드 및 단백질호르몬의 변화

김경태(KT Kim),이우영(WY Lee),정민섭(MS Chung),허필형(PH Hur),이진우(JW Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.2

결론 임신 말기의 산모에게 PGE2를 매시간 1정씩 6회 경구 투여하여 산모 형중의 스테로이드 및 단백 호르몬에 미치는 영향을 관찰하 기 위하여 자연분만 산모 40예와 PGE2 유도분만 성공산모 52예 및 PGE2 유도분만 실패산모 20예에서 분만 경과의 시간에 따른 혈중 progesterone, estradiol, cortisol, hCG b-Subunit 및 hPRL의 변동을 측정 관찰하여 다음과 같은 결과를 얻었다. 1. 자연분만 산모에서 혈중 progesterone은 진통 시작후 3시간 까지 증가한 후 분만시 까지 감소하였고, 혈중 cortisol은 진통 이 경과함에 따라 점점 증가하였으며 estradiol, hCG b-subunit 및 hPRL은 변동이 없었다. 2. PGE2 유도분만 성공삼모에서는 자연분만 산모와 비슷한 호르몬의 변동을 보였다. 3. PGE2 유도분만 실패 산모에서는 유의한 호르몬의 변동은 없었다. 4. PGE2 투여후의 혈중 estradiol값은 PGE2유도분만 성공 산모에서 실패 산모보다 유의하게 높았다. 5. 이상의 관찰로 미루어 PGE2경구 투여로 유도분만이 성공된 산모에서는 자연분만과 비슷한 혈중 호르몬 변동을 보여주었고 진 통 유발시의 혈중 호르몬 변화와 기전도 유사한 것으로 사려된다. In order to measure the effect of oral prostagkandin E2(PGE2) on the serem level if steroid peotein hormones during labor of term pregnant woman PGE2 tablets (0.5mg) were administered orally six times with hourly interval to women in their full term period of pregnancy for induction of labor, and observations were made on the changes of serum level of progesterone, estradiol, cortisol, hCG b-xubunit and hPRL in 52successful cases, 20 unsuxxessful cases of PGE2-induction and 40 cases of spontaneous labor for comparison. 1. Serum progesterone of the women of spontaneous labor increased initially for 3 hours from the onset of labor and then decreased until the time of delivery, while the serum cortisol showed continued increase with the lapse of time. There was no significant change in serum estradiol, hCG b-subunit and hPRL. 2. In the successful cases of PGE2-induction, pattern of hormonal changes were quite similar te those of the women of spontaneous labor. 3. No significant hormonal change was observed in the group of unsuccessful cases of PGE2-induction. 4. The values of serum estradiol were significantly higher in those of successful PGE2-induction than in those of unsuccessful one. 5. From the above findings, it can be concluded that the successful cases of PGE2-induction show aimialr hormonal changes to those of spontaneous labor, and the change as well as mechanism of the hormones during are also similar.

파열후 지속된 흔적 자궁각임신 1예

오원섭(WS O),이근영(KY Lee),신재진(JJ Shin),이우영(WY Lee) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.11

A case of ruptured rudimentary horn pregnancy in a 30 years old, multiparous woman is presented. The pregnant rudimentary horn was ruptured spontaneously without any complications, the pregnancy was carried to last trimester, and the fetus was alive as a abdominal pregnancy. The pregnancy was terminated by laparotomy in delivery of a living male infant, weighting 2.25kg with maternal survival. Some of the factors associated with a rudimentary horn pregnancy are reviewed.

병합임신 2례

구본구(BK Koo),조창묵(CM Joe),이우영(WY Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.4

본원 산부인과에서는 과거 8년간 병합임신 2례를 경험하였는 바, 그중 1예는 파열형 난관임신으로 우측 난관임신 수술후에야 병합임신이 진단되어 임신만삭까지 지속 정상 분만한 경우이고, 다른 1예는 파열형 좌측 난관임신으로 좌측 난관절제술과 동시에 영구피임 목적으로 우측 난관절제술을 시행한 환자에서 수술후 정기진찰시 병합임신으로 진단된 경우이다. Combined intrauterine and extrauterine pregnancy refers to impregnation of the ectopic and uterine ova within a short time of each other and is an uncommen clinical entity. Its incidence is approximately 1 in 30,000 pregnancies. The preoperative diagnosis of simultaneous intrauterine and extrauterine pregnancy is rarely made. Frequently the intrauterine pregnancy is not recognized even at the time of operation since it is known that a certain degree of uterine enlargement occurs in ectopic pregnancy alone. Two cases of heterotopic pregnancy which we have experienced in our hospital from December 16, 1971 to December 15, 1980 are presented, with a brief review of the literatures.

산후초기에 발생한 후복막출혈 1례

정도영(DY Chung),김경락(KL Kim),조헌성(HS Cho),이우영(WY Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.4

Retroperitoneal hemorrhage complicating pregnancy is as a rare vascular accident, usually fetal to both mother and infant, especially if the hemorrhage is of splenic or renal origin. It may occur unfortunately any time in pregnancy or puerperium, but a correct preoperative diagnosis is seldom made. Prompt surgical intervention and a little good fortune will be save the lives of the patients. We experienced a case of massive retroperitoneal hemorrhage from spontaneous rupture of left renal artery in early postpartum and presented the case with a review of the literature.

태반혈관종 4례

박정대(CD Park),최종렬(JY Choi),구본구(BK Koo),이우영(WY Lee) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.2

결론 저자들은 지난 10년 동안 본 한강성심병원 산실에서 처치한 분만 15,312예중 태반 혈관종 4예를 경험하였기에 보고하는 바이다. 1. 빈도는 Marchetti의 1/3,500과 비슷한 1/3,800이었고, 2. 위치는 4예중 2예는 모체면의 변연부에 2예는 모체면의 중앙 즉 제대 부착부위에 인접하여 위치하였다. 3. 형태는 2예는 Machetti 가구분한 암적색의 세포형,2예는 청적색의 혈관형이었다. 4. 크기는 3예에서는 계란크기 이상이고 1예가 계란크기 이하였다. 5. 합병증으로는 3예가 조산 및 양수 과다증을 동반하였고 1예는 태아 가사상태에 있었으며 다른 합병증은 볼 수 없었다. In this paper,4 cases of chorioangioma associated with polyhydroamniosis are pres-ented and the literatures related to this type of tumor are reviewed briefly.

골반경수술 70 예에 대한 고찰

김두순(DS Kim),김유곤(YK Kim),조용수(YS Cho),남성원(SW Nam),장봉림(BR Jang),이우영(WY Lee),박양서(YS Park) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.11

Seventy cases of pelviscopic operation were performed at Hallym University Hospital from July 1991 to June 1992. The results of this study were summarized as follows. 1.Age ranged from 21 to 53years and the great incidence occured in 26 to 35years group. 2. The mean number of parity was 0.9 and two times and below was 94.4%. 3. The most common clinical indication was tubal pregnancy 28 cases(40.0%)and other indications were ovarian tumor 10 cases(14.3%), pelvic adhesions 9 cases(12.9%) among 70 cases. 4. Types of surgery were salpingectomy 23 cases(32.9%); adhesiolysis 9 cases (12.9%); adexectomy 7 cases(10.0%);fimbrioplasty 6 cases(8.6%) in decreasing order. 5. The mean duration of hospitalization was 3.0 days. 14 cases discharged from hospital at the operation day, 25cases(35.7%),in a day , 10cases (14.3%)in two days and 49 cases(70.0%)in three days.

원발성 후복막 장액암 1 예

이우영,조숙,고승권,황성욱,김준미,박지현,원영석,이정례,지용일 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

저자들은 세계적으로 드물며, 우리 나라에서도 보고된 예가 없는 후복막에 발생한 원발성 장액성 암종 1예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Primary retroperitoneal serous carcinoma is extremely rare tumor. It is histologically identical to ovarian serous papillary carcinoma but without any evidence of ovaries, pancreas, gallbladder, appendix or abdominal origin. Histogenesis of this neoplasm remains uncertain. Ectopic ovarian tissue or coelomic metaplasia of retroperitoneal mesothelium has been proposed as its origin. We experienced a case of primary retroperitoneal serous carcinoma in an 53-year-old woman. Therefore, we present this case with a brief review of the literature.

Misoprostol을 사용한 초기 및 중기 임신중절 13 예 보고

이우영,조숙,고승권,박성민,임문환,황성욱,박지현,김우성,원영석,이정례 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

본 연구에서는 1997년 3월부터 1997년 9월까지 인하병원 산부인과를 방문하여 misoprostol로 치료적 유산을 시행한 13명의 환자를 통하여 다음과 같은 결과를 얻었다. 1. misoprostol은 의사의 처방 하에 적절히 사용하면 초기 및 중기 임신의 임신중절 약으로 사용할 수 있지만 불완전 유산을 나타내는 경우가 있으므로 때로는 자궁 소파 술등 산과적 처치를 요한다. 2. 초기 및 중기 임신중절 13예에서 평균 miso prostol 948.62 g이 사용됐으며, 처음 삽입 시간부터 유산까지의 평균 시간은 10.76시간이었다. 3. 부작용은 구토[23%], 고열[15%], 자궁파열[8%]의 빈도로 나타났다. 4. misoprostol의 사용은 다른 방법에 비해 유산과 관련된 이환을 줄이고 치료에 대한 경비를 줄인다. Misoprostol is an inexpensive synthetic prostaglandin[PG]E1 analogue [methy1 11, 16-dihydroxy-16 methyl-9 oxoprost-13E-en-1-oate], marketed as an oral tablet, which is stable at room temperature and is available for the prevention and treatment of nonsteroidal antiinflammatory drug induced gastric and duodenal ulcers. Intravaginal as well as oral administrations of misoprostol have been shown to effect cervical ripening and induction of labor. Our study reveals that the use of intravaginal misoprostol 800 g for medical abortion is at least as effective as more infectious, risky laminaria and metreurynter and is a promising method for medical abortion. Based on our study, it is tempting to conclude that misoprostol is as safe as other abortifacients, but the number of patients was too small to establish safety conclusively. Future studies should further clarify improved dosing regimens, efficacy and safety. Lastly, another problem is the potential of misoprostol to be used as an illicit first or second trimester abortifacient. Physicians should be worry about patient initiated requests for the drug and close monitoring should be considered if misuse of misoprostol becomes a problems.