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지경석 ( Kyung Suk Chi ),김준수 ( Jun Soo Kim ),장은정 ( Eun Jung Jang ),허혁 ( Hyeok Heo ),황지영 ( Jee Young Hwang ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.7
자궁 외 임신 중에서 가장 드물고 심각한 합병증을 초래하는 자궁벽내 임신 2예를 경험하고, 복강경을 이용한 다양한 보존적인 수술방법으로 치료에 성공하였기에 본 저자들은 이를 문헌고찰과 함께 보고하는 바이다. We experienced two cases of the intramural pregnancy, the rarest form of ectopic pregnancy and a life-threatening condition, that were successfully managed through different techniques of uterus-preserving laparoscopic surgery, thus we present these cases with a review of the literature.
미산부의 과숙임신에서 유도분만 시 제왕절개분만율이 증가와 관련된 위험인자
지경석 ( Kyung Suk Chi ),김준수 ( Jun Su Kim ),장은정 ( Eun Jeong Jang ),심재철 ( Jae Chul Sim ),양회생 ( Hoi Saeng Yang ),이형종 ( Hyung Jong Lee ),하준영 ( Jun Young Ha ),황지영 ( Jee Young Hwang ),김도균 ( Do Gyun Kim ) 대한주산의학회 2006 Perinatology Vol.17 No.1
목적 : 본 연구는 미산부에서 과숙임신으로 인한 선택적 유도분만 시 분만 방법 결과와 관련된 인자들을 분석하고자 이 연구를 시행하였다. 방법 : 1997년 3월부터 2005년 3월까지 임신 41 완전주수 이후에 선택적 유도분만을 위해 입원한 미산부 331명을 대상으로 하였다. 관련된 인자들로 연령, 체질량지수, 임신주수, Bishop 점수, 출생체중, 태아 두위, 태아 성별을 조사하였다. 결과 : 산모의 평균연령은 제왕절개분만군에서 27.59±2.57세이고, 질식분만군에서 26.99±2.61세였으며, 임신주수는 제왕절개분만군에서 평균 290±3일(41+3주), 질식분만군에서 289±2일(41+2주)이었다. 임신 전 평균 BMI는 제왕절개분만군에서 20.42±2.36 m2/kg, 임신 후 26.70±2.82 m2/kg로 증가하였으며, 질식분만군은 19.92±2.05 m2/kg에서 25.75±2.67 m2/kg로 증가하였다. 분만 후 태아 몸무게는 제왕절개분만군에서 3460.31±358.22 g이였으며, 질식분만군에서 3363.95±361.22 g이였다. 태아 두위는 제왕절개군에서 34.59±1.18 cm이고, 질식분만군에서 34.03±1.33 cm였다. 제왕절개군 127명 중 38명(29.9%)의 분만된 신생아에서 합병증(들)으로 출생 후 바로 입원치료 했으며, 질식분만군 204명 중 24명(11.8%)에서 나타났다. 결론 : 본 연구는 산모의 체중이 증가할수록, 태아의 몸무게 및 두위가 클수록 선택적 유도분만 후 제왕절개분만의 빈도가 증가함을 알 수 있으며, 이에 따른 태아의 유병율이 증가할 수 있다는 것을 증명했다. 그러므로 선택적 유도분만 전 산과의사는 적절한 방법과 충분한 경험을 토대로 제왕절개분만과 관련된 위험인자를 평가해야 할 것이다. Objective: The purpose of this study was to evaluate the risk of cesarean section in nulliparous women who undergone induction at postterm pregnancy. Methods : The retrospective study was conducted from March, 1997 to March, 2005 by reviewing 331 nulliparous patients more than 41 weeks` gestation delivered after induction at our Hospital. The evaluated variables to assess the risk of cesarean section were maternal age, body mass index (BMI), gestational age (GA), Bishop scores (BS), fetal body weight (FBW), fetal head circumference (FHC) and fetal sex. t-test and x2-test were used to compare these categorical variables. Results: The study included 331 nulliparous singleton pregnant women undergoing elective induction for postterm pregnancy: 127 (38.4%) delivered babies by cesarean section due to induction failure, progression failure and fetal distress, whereas 204 (61.6%) delivered vaginally. The mean maternal ages were 27.59±2.57 in cesarean delivery group and 26.99±2.61 in vaginal delivery group. The average values of BMI at postterm in cesarean and vaginal delivery groups were 26.70±2.82 and 25.75±2.67 kg/m2. GA was 41.36±0.27 weeks in cesarean delivery group, whereas 41.20±0.19 weeks in vaginal delivery group. The average FBW and FHC were 3460.31±358.22 g and 34.59±1.18 cm in cesarean delivery group, compared to 3363.95±361.22 g and 34.03±1.34 cm in vaginal delivery group. Conclusion : The BMI, FBW and FHC have linked to the risk of cesarean delivery in nulliparous women who underwent elective induction. Thus, these information would provide the useful tools to assess the risk of cesarean section in postterm nulliparous patients for planning an induction.
정연정 ( Yeon Jung Jung ),지경석 ( Kyung Suk Chi ),김준수 ( Jun Soo Kim ),김경원 ( Kyoung Won Kim ),김도균 ( Do Gyun Kim ),양회생 ( Hoe Saeng Yang ),심재철 ( Jae Chul Sim ),장태정 ( Tae Jung Jang ),황지영 ( Jee Young Hwang ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.8
We experienced 3 cases of early stage tubal cancer incidentally recognized during the operation and diagnosed pathologically after surgery of the tubo-ovarian abscess, the symptomatic adenomyosis, the myoma with adnexal cyst patients, so we report our cases with a review of the literature.
분만 진통 없이 발생한 보행 장애를 동반한 치골 결합 관절 분리
장은정 ( Eun Jeong Jang ),지경석 ( Kyung Suk Chi ),김준수 ( Jun Soo Kim ),김도균 ( Do Gyun Kim ),양회생 ( Hoe Saeng Yang ),심재철 ( Jae Chul Sim ),황지영 ( Jee Young Hwang ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.4
We experienced a case of diastasis of the symphysis pubis accompanying severe pubic pain and serious gait disturbance, which was developed at 34 weeks gestation before labor pain in 36-year-old primiparous woman, who has experienced previous cesarean section at her first pregnancy due to pelvic pain before onset of labor, so we report a case with a review of the literature.
정연정 ( Yeon Jung Jung ),지경석 ( Kyung Suk Chi ),김준수 ( Jun Soo Kim ),허혁 ( Hyeok Heo ),황지영 ( Jee Young Hwang ),김도균 ( Do Gyun Kim ),양회생 ( Hoe Saeng Yang ),심재철 ( Jae Chul Sim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12
Intrauterine contraceptive device (IUD) is the most common contraceptive method in the world, but it exists a little risk of uterine perforation and even more severe risk such as a perforation of intra-abdominal organs. In this case, the patient recognized that the previously inserted IUD was translocated but she was asymptomatic without any management. After insertion of the second IUD, she visited our hospital for lower abdominal pain. The abdominal X-ray finding and transvaginal sonography revealed one translocated IUD in peritoneal cavity and another IUD in intrauterine cavity. Thus, we report a case with the laparoscopic diagnosis of small bowel perforation by a previously inserted IUD and its removal by segmental resection of small bowel after mini-laparotomy, along with the brief review.
김준수 ( Jun Soo Kim ),지경석 ( Kyung Suk Chi ),장은정 ( Eun Jung Jang ),황지영 ( Jee Young Hwang ) 대한주산의학회 2007 Perinatology Vol.18 No.3
We experienced a pregnancy with a situs inversus totalis fetus in an overt diabetic woman, which was recognized by obstetric ultrasonography during the mid- trimester and this case is presented with a review of the literature.