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비장적출술에 의한 임신중 혈소판감소성 자반증의 치험 1 례
김성환,한세준,장하종,송창훈,손대언,문경란,박일옹,김구현,조상무 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.2
28세된 경산부가 임신 13주에 면역성 혈소판 감소성 자반증으로 진단되어 부신피질호르몬, 혈소판 수혈 등으로 치료하였으나 호전되지 않아 임신 27주 5일에 비장적출술을 시행하여 호전되었으며 임신 37주 3일에 체중 1.61kg의 여아를 질식분만하여 건강한 상태로 퇴원한 예를 체험하였기에 간단한 문헌고찰과 함께 보고하였다. Immunologic thrombocytopenic prupura during pregnancy is the most common autoimmune disease caused by early destruction of an autoantibody mediated maternal platelet by the reticuloendothelial system. It is of particular concern during pregnancy because the placenta actively transports IgG autoantibodies from maternal to fetal circulation. This may or may not cause thrombocytopenia in the fetus, as well as the major risk of central nervous system hemorrhage during vaginal delivery, and spontaneous abortion or postpartum hemorrhage in the mother. The various therapeutic methods that have been used are corticosteriod, splenectomy, platelet transfusin, immunosuppressive drugs, high dose immunoglobulin, and other. We have expreienced a case of immunologic thrombocytopenic purpura, diagnosed at the 13th week of pregnancy, and treated with splenectomy. The patient gave birth to intrauterine growth retarded female vaginally at 37 weeks 3days of pregnancy and the newborn was admitted to the newborn intensive care unit, but healthfully discharged. A brief review of the case and its literature is pressented.
홍석우(SW Hong),이미영(MY Lee),문진수(JS Moon),배도환(DH Pai) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.2
본 중앙대학교 의과대학 산부인과학교실에서는 임신 32주에 전전치태반으로 응급제왕절개술을 실시한 임산부에서 제 2아가 지장아였던 쌍태임신 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다 Fetus papyraceus is a rare and interesting condition occuring in multiple gestation We present a case of the fetus papyraceus in twin pregnancy with review of literatures
배란유도시 발생한 중증 난소과자극증후군에 대한 임상적 고찰
정기성,문용호,박경도,김홍필,정정은,박성우,김안택,오대출 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10
1990년 9월부터 1994년 6월까지 본원 산부인과에 입원하였던 10명의 중등도 및 중증 OHSS환자에 대한 증상, 검사상소견, 치료, 임신과의 연관성을 분석한 결과는 다음과 같았다. 1. 환자의 증상과 증후로는 모든 예에서 하복부동통 및 난소비대 및 복수, 체중증각 있었다. 흉수는 3예에서 있었으며 2예에서 경미한 PT(prothrombin time)의 지연이 관찰되었으나 치료를 요할 정도의 혈액응고장애는 관찰되지 않았다. 2. 전체 환자의 hCG투여시의 평균 혈중 E2농도는 9760.6 pg/ml이었으며 호나자의 검사상 이상소견으로는 8예에서 저알부민혈증과 저나트륨혈증이 발생하였다. 3. 수액요법과 전해질 불균형이 교정 그리고 질식초음파 유도하의 복수천자로서 별다른 합병증없이 모두 효과적인 치료가 가능하였다. 4. 10명의 환자중 9명(90%)에서 임신이 동반되어 있어서 OHSS와 임신과의 높은 상관관계를 보였으며 쌍태임신은 2명(20%)에서 나타났다. Ovarian hyperstimulation syndrome(OHSS)is an iatrogenic complication of ovulation induction agents used for ovulatory dysfunction. This reports is to review the records of 10 patients who were hospitalized for the management of severe ovarian hyperstimulation syndrome from September, 1990 to June, 1994. retrospectively. Treatment was conservative with infusion of plasma volume expander and electrolyte solutions. In 3 cases, transvaginal paracentesis was performed for symptomatic relief. The result were as follows: 1. The regimens for controlled ovarian hyperstimulation were hMG/hCG in 9 cases, CC/hMG/hCG in one case. 2. In all cases, abdominal patin, ovarian enlargement, ascites and weight gain were presented. There was no case of thromboembolism. 3. The mean age of 10 patients was 27 years. The duration from hCG injection to hospital admission was 15 dyas and the mean hospital day was 12 days. The mean preovualtory serum E2 level has 9760.6 pg/ml. 4. In 3 cases, paracentesis was performed under the transvaginal ultrasonographic guidances. An average amount of paracentesis per one time was 1660 ml. 5. 9 patients(90%) including 2 twin gestations were associated with conception. As a conclusion, severe OHSS was recevered with conservative treatment, including fluid therapy and correction of electrolyte imbalance, and transvaginal ultrasonography guided paracentesis without any serious complication.