태반조기박리 ( Abruptio placentae ) 의 6년간 관찰 ( 1963 - 1968 )

강신명(SM Kang),김수자(SJ Kim),이경자(KZ Lee),이일준(IJ Rhee) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.8

Abruptio placenta is a serious complication in pregnancy when dealing with maternal death as well as fetal loss especially in the country having high incidence of toxemia. 1. We have encountered 34 cases of Abruptio placentae which occured among a total of 10,640 deliveries in Ewha Womens University Hospital, Seoul during the period of 6 years from 1963 to 1968, the incidence being one case per 330 deliveries or 0.32%. Although this incidence was considered relativity low both the maternal & fetal death rate were markdly high. 2. The leading causative predisposing factor of the abruptio pladentae in this series was toxemia occupying one-third(38%) of the cases. The other known cause was shortness of the umbilical cord(26%) including it`s strangulation. Indeed every efforts to prevent the toxemias of pregnancy are important at present among the numerous caucative factors. 3. The majority of placentae occured between age of 30&40, and more in multigravidas(88%). It was interesting to notice that more than one-half(56%) of the cases of abruptio placentae had a tendency of prematurity occuring from 27 to 37 weeks of gestation period. 4. Abruptio placentae with concealed hemorrhage was serious in it`s nature. However the fetal death rate were considered to be high(80%) even in the mild group which probably due to the delayed admission from the patient side. 5. The average amount of blood transfusion needed was 3 pints in the mild cases, and 6 pints or more in the severe cases. 6. About one-half(56%) of the abruptio placentae were treated by Cesarean section mostly for the severe cases with shock or for the fetal distress. The perinatal mortality was reduced to 53% in these section group. 7. The incidence of prenatal care undergone was very low(only 18%). Both quantative and qualitive prenatal care would be important to prevent abruptio placentae, and it should be warn if any toxemic state or sudden pain develops in multigravidas, over 30 year of age, particularly during 27-37 weeks of gestation. 8. The prognosis of the patient with abruptio placentae admitted in 4 hours after it`s onset was much fair than the delayed in which revealing the partial or less than one-half area of the placental detatchment with some hopeful(25%) fatal salvage. Therefore the abruptio placentae should be terminated promptly in 2~4~8 hours after the accident has occurred.

난소에 발생한 내배엽동 종양 1 예

오선민(SM Oh),윤본근(BK Yoon),김수자(SJ Kim),주인명(IM Ju) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.8

난소에서 발생하는 내배엽동 종양은 그히 악성 종양으로 아주 희귀한 생식세포 종양이다 저자등은 1983년 10월 22세된 처녀에서 1차적으로 발생한 내배엽동 종양을 경험하였기에 문헌 고찰과 아울러 보고하는 바이다 Endodermal sinus tumor is a rare and highly malignant germ cell tumor in both gonadal and extragonadal tissues We are experienced one case of endodermal sinus tumor arising in the ovary in 22yrs old nulligravida & report it with brief review of the literature

산후자간에 관하여 ( 1964.1 - 1966.12 )

우복희(BH Woo),조행원(HW cho),김수자(SJ Kim),이일준(IJ Rhee) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.7

Postpartum eclampsia is one of the serious complication during the puerperium although it is not common. We have encountered 13 cases of postpartum eclampsia which occured smong a total of 6040 deliveries in Ewha Womans University Hosptial, Seoul during the period from 1964 to 1966, the incidence being one case per 500 deliveries, Postpartum eclampsia constitues approximately 2.8% of all cases of Toxemia or 31% of all cases of eclampsia. Over all the incidencies were considered very high. 1. The majority cases (92%) of Postpartum eclampsia were occurred in the multiparas, and that never had prenatal cares (91%). Approximately 2/3 cases of Postpartum eclampsia have occurred after home delivery without modern obstetrical care (poor socio-economic group). 2. It is emphasized that careful Pstpartum care during first 5-10 days of puerperium shoud not be neglected to prevent or minimize these or other postpartum complications. 3. October is the peak month for Postpartum eclampsia in Seoul. This was similar to that of occurred in Miami area, although it is uncertain that whether or not it could be corelated with the mean temperature or the mean relative humidity. 4. The severity of Postpartum eclampsia depended on the degree of elevation of uric acid, and also the delayed occurrence appeared to be more severe with increased convulsion. 5. A careful study of family history seemed very important even in the puerperium since perfectely normotensive mother having family history of hypertension particularly on the parents side appeared to be a good candidates for the sudden onset of post partum eclampsia. 6. The mean weight of newborn baby from the mother of postpartum eclampsia was decreased approximately 650-850 Gm as compared with normaly expectant newborn weight, however there was no fetal death.

Krukenberg종양 1 례

이정남(JN Lee),오선민(SM Oh),이연희(YH Lee),김수자(SJ Kim),주인명(IM Ju) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.5

There have been reported cases that the Krukenberg tumor had been primary ovarian carcinoma. But the Krukenberg tumor is generally believed metastatic. We have had an experience of a case of metastatic Krukenberg tumor from staomach and report the case contained with review of literature.

전치태반 ( Placenta previa ) 에 관하여 ( 1963 - 1968 )

강신명(SM Kang),이일준(IJ Rhee),이경자(KZ Lee),김수자(SJ Kim) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.8

Management of placenta previa is still a difficult one although expectant policy has been introduced for past 20 years in order to minimize the high neonatal mortality resulting from prematurity and intrauterine anoxia. The data to be presented are based on 73 cases of placenta previa seen among total deliveries of 10779 in Ewha Women`s University Hospital, Korea for past 6 years period. 1. Our incidence of placenta previa is considered somewhat high, 148:1 or 0.67%. It is unknown that whether or not this related to the frequency of induced abortion. 2. Placenta previa has occured more often in multigravidas(64.4%) than primigravidas or 4 times as frequent in primigravias as in multigravidas with para 4. 3. The frequent of toxemia associated with placenta previa was considered to be high, 17% or 3times the average incidence(Ewha) 4. About half(45%) cases of placenta previa was a sort of total placenta previa which was most serious one, requiring all(26 cases) Cesarean section and needed average 4 pints of blood transfusion. 5. Approximately half or 47.7% cases of placenta previa had delayed admission until labor pain occur following vaginal spotting has first time been noticed. More instructive prenatal education is emphasized. 6. The policy of waiting has been applied in the maximum of 41% cases of placenta previa. However there is a limitation that it seemed to be wise to perform the definitive operative delivery without delay more than 37th week of gestation becaue it prone to cause sudden, massive hemorrhage after that. 7. Vaginal delivery able been done in 1/5 cases of placenta previa which is all mild one requiring less than 2 pints of blood transfusion. 8. The majority cases(79.2%)of placenta previa, particularly all cases of total placenta previa (45% cases of sections)were treated by Cesarean sections and required more than 4 pints of massive, rappid blood transfusion. Of these sections 2 cases of Cesarean-hysterectomy were encountered inevitably in order to prevent uncontrolable hemorrhage. 9. A comparative study of low cervial Cesarean sections both to the anterior and posterior type of placenta previa(17&11 cases respectively) revealed no any differences either in view point of blood transfusion erquired or fetal loss corrected. Thus the potential risk of classical section seemed to be avoided. 10. Fetal mortality under the waiting policy is still limitted and high; 24% of loss in premature baby which is considered twice the average premature loss, and 3.4% loss(or 1.7% of corrected fetal loss)in term baby. There was no maternal mortality in this series. 11.A operative large sterized pads packing into the low segment to minimize the massive oozing is believed to be a life saving procedure and able to substitute any unexpectant hysterectomy. There was no significant postoperative infections in this procedure as aften seen in preoperative vaginal packing which is no longer been used.

비면역성 태아수종 1 례

주인명,김수자,이강우,이명희,박금민,오현애,윤대두,김선자 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

저자들은 1990년 10월 28일 17세 초산부로부터 임신 44^+1주에 제왕절개술로 분만된 신생아에서 부검상 전신부종과 흉강, 심낭 및 복강내 삼출액 축적을 보였던 비면역성 태아수종 1에를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Nonimmune hydrops fetalis is defined as a pathologic and generalized abnormal accumulation of serous fluid in the entire body tissue and cavities unassociated with erythroblastosis. With the widespread introduction of immunoprophylaxis, there is a decline in rhesus isoimmunization and nonimmune hydrops fetalis (NIHF) becomes increasingly important. NIHF now accounts for 80% of all hydropic fetuses and its contribution to the perinatal mortality increased up to 3%. Now we report a case of NIFH with generalized edema, pericardial and pleural fluid accumulation and ascites found at autopsy. No other deformity was found.

Holoprosencephaly를 동반한 Prune-Belly Syndrome 1 례

주인명,김수자,이강우,이명희,오현애,윤대두,김선자,고영균 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7

저자들은 다발성 선천기형 및 태아 곤란증의 의진하에 반복 제왕술을 통하여 분만되어 5분만에 사망한 신생아의 부검소견상 뇌의 심한 분화 및 형성부전을 보이는 Holoprosencephaly, 폐형성부전, 생식기 및 항문의 무형성, 비장, 췌장의 무형성을 동반한 요로기형과 복벽의 결손을 가진 prune-belly syndrome 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The Prune-belly syndrome is the most common term for congenital absence, deficiency or hypoplasia of the abdominal musculature accompained by a large hypotonic bladder, dilated and tortuous ureters and bilateral cryptochidism. This full-blown syndrome, which was associated with alobar holosencephaly with hydrocephalus, hypoplasia of lung and libs, markedly dilated cyst with hypertrophied muscular layer, mild hydroureter, polycystic kidney, colon atresia, agenesis of pancreas, spleen and genital organ and equinovalgus and genuvalgus, has been carefully observed in accordance with review of references.

자궁내 태아사망을 초래한 제대협착 1 례

주인명,김수자,이강우,윤대두,김선자,고영균,이운희 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9

저자들은 1993년 3월 29세 초산부에서 자궁내 태아사망을 초래한 제대협착 1례를 경험하였 기에 문헌적 고찰과 함께 보고하는 바이다. Umbilical cord structure is a very rare complications of cord abnormalitis. An extreme focal deficieney in whartons jelly, torsion external circumferrential pressure, excessive fetal motion, and postmortem artifact due to autolysis beginning at the fetal end of the cord were suggested as underlying causes predisposing the the cord stricture. We were experienced one case of the intrauterine fetal death secondary to stricture of the umbilical cord in a 29-years primigravida, and this case was presented with brief review of the literatures.

임신을 동반한 난관염전 1 례

주인명,김수자,이강우,이명희,김지수,윤재영,오현애 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.10

본 증례의 원인적 요소로서는 다발성 난소낭종과 그리고 임신으로 인한 골반울혈, 자궁비대 및 급격한 체위변동으로 인하여 발생되었다고 생각되며 문헌적 고찰과 함께 보고하는 바이다. Acute pelvic pain is a common symptom encountered by the gynecologist. Torsion of the tube should always be considered in acute abdominal pain. Acute diagnosis and prompt treatment can prevent of complications, such as necrosis of the ovary and tube, peritonitis, shock, and rarely death. Torsion of the fallopian tube have been repotered not infrequently, this complication in pregnancy seems to be relatively rare. We experienced a case of torsion of the fallopian tube in pregnancy and report it with brief review of the literature.

임신 중절수술과 L/S후 발생한 골반방선균증 1 예

주인명,김수자,이강우,고영균,이운희,조현득 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

Actinomycosis is a chronic suppurative and granulomatous disease characterized by formation of multiple abscesses and sinus tracts. Actinomyces species are gram-positive, non-acid fast anaerobic bacteria that exhibit branching, filamentous growth. They are normal inhabitants of the human gastrointestinal tract, in both oropharynx and bowel. Actinomyces israelii is the most common agent in human disease. In most instance, pelvic actinomycosis is related to IUD and the colonization rate appear to increase with the duration of IUD. The relatively high cervicovaginal actinomyces colonization rate suggests that all patients with IUDs should undergo annual cytologic smear, with specific attention given to the presence of actinomyces. The authors are experienced a case of pelvic actinomycosis and reported with a review of literature.