A Case of Blind Ending Megaureter: Preoperatively suspected of Adnexal Tumor / 대한산부인과학회잡지

A pelvic mass in women may be gynecologic in origin or it may arise from the urinary tract or bowel. Nonovarian or nongynecologic conditions may be confused with uterine or ovarian mass. The rare congenital megaureter should always be kept in mind as a possible cause of a pelvic mass. Congenital megaureter showed various clinicopathological features and frequently associated with ipsilateral or controlateral upper tract anomalies. Early meticulous imaging surgical correction will lead to excellent result. We experienced a rare case of blind ending megaureter which was suspected adnexal tumor in twenty seven-year-old woman. Here we present the case with brief review of literatures.

A Case of Uterine Fibroids Necrosis after Transarterial Embolization for Treatment of Uterine Fibroids / 대한산부인과학회잡지

Uterine fibroids are the most common benign tumor of the female genital tract. Traditional therapy for symptomatic fibroids has been either myomectomy or hysterectony, depending on whether futhur fertility is desire. A promised new altermative therapy-embolization of the uterine arteries- is now available. A 29 year-old woman was diagnosed of uterine fibroid by ultrasonogram and other techniques. We have experienced one case of uterine fibroid necrosis after transarterial embolization. Now we report a case of uterine artery embolization for treattement of uterine fibriods with a brief review.

The Controlled Study between The Group Used Highly purified FSH and The Group Used FSH/hMG in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: It is known that normal follicular growth and pregnancy are possible using Follicular stimulating hormon(FSH) alone during controlled ovarian hyperstimulation(COH) for IVF-ET. The purpose of this study was to compare and analize the results of COH for IVF-ET between a group using only FSH-HP and a group using FSH/hMG METHOD: 111 cycle of the total 280 COH for IVF-ET cycles belonged to the FSH-HP group, and the FSH/hMG group accounted for remaining 169 cycles. The amount of gonadotropin administered, the duration of hormonal therapy, the number of embryos transfered, the endometrial thickness, and the pregnancy rate were compared between the two groups and statistically analized using the t-test. p values less than 0.05 deemed statistically significant. RESULT: There were no statistical differences on the amount of gonadotropin administered, the duration of hormone therapy, number of oocytes retrieved, nor the endometrial thickness between the two groups. However,the serum E2 level was significantly lower, and the number of embryos of high quality(GradeIandII) significantly higher in the FSH-HP group. In pregnancy rate, FSH-HP group shows higher than FSH/hMG group(38.8% VS 34.2%). but the difference was not large enough to be considered statistically significant. CONCLUSION: The results of this study show that compared to using FSH/hMG, treatment with FSH-HP alone allowed the retrieval of more embryos of high quality, and although not statistically significant, achieved a higher pregnancy rate, thus indicating that it can be used as an effective method for COH.

A Clinical Study on Cesarean Hysterectomy / 대한산부인과학회잡지

This study analyzed the outcome of 26 cases of cesarean hysterectomy performed at Wonju Christian Hospital, College of medicine, Yonsei university during 15 years from January, 1982 to May, 1996. There were 27,602 deliveries during this period. Cesarean hysterectomy was performed in 11 of 10,373 cesarean section(0.11 %) and in 15 of 17,229 vaginal deliveries(0.09 %). The age of patients varied from 20 to 48. Indications for emergency cesarean hysterectomy were uterine atony (46.2 %), uterine rupture(26.9 %), and placenta accreta(19.2 %). The relative risk of emergency hysterectomy was 1.22(95 % confidence interval 0.56 to 2.65) for cesarean deliveries, 1.91(95 % confidence interval 0.73 to 4.98) for prior cesarean deliveries and 20.56(95 % confidence interval 10.85 to 38.95) for placenta previa. The patients who had cesarean hysterectomy received from 750 ml to 11,500 ml of blood transfusion with a mean of 3,500 ml. No significant differences in length of operating time, amount of blood loss and postoperative complications were found between total abdominal hysterectomy and subtotal abdominal hysterectomy. In about 1/2 of total patients (46.2 %), there were no operative complications. Maternal death was found in 1 case. Hemorrhage still remains main cause of maternal mortality, the decision of hysterectomy must be conjunction with maternal life saving and free from various dangerous sequalae. So in this study, clinical evaluation for cesarean hysterectomy and an attempt to identify risk factor that might pridict those patients likely to require emergency hysterectomy was made.