Tae Bok Song

Analysis of High-Risk Infant Births and Their Mortality: Ten Years' Data from Chonnam National University Hospital

Prematurity and low birth weight are major factors associated with neonatal morbidity and mortality, and their incidence is not decreasing despite an annual decrease in the total number of live births in Korea. The objective of this study was to establish a strategy to reduce neonatal mortality by analyzing the clinical characteristics of high-risk infant births along with their mortality and causes of death. We retrospectively surveyed the medical records of infants born at Chonnam National University Hospital and of patients admitted to the neonatal intensive care unit (NICU) for 10 years from October 1999 to December 2008. Premature and low birth weight infants were almost half of the live births, and their NICU admission rate increased with increases in the numbers of outborns and multiples. Also, their mortality decreased dramatically over the past 10 years. About 60% of deaths occurred within 1 week of life, and the causes of death were mostly related to prematurity. Perinatal asphyxia was the major cause of death in infants less than 1 week old, whereas sepsis was the major cause after 4 weeks of age. The major cause of death was sepsis in premature or low birth weight infants and perinatal asphyxia in term or normal weight infants. The major cause of death was sepsis in inborns and perinatal asphyxia in outborns. Our results suggest that medical personnel training for immediate postnatal care including neonatal resuscitation, infection control, and a systematic team approach to regionalization are all needed to reduce the mortality rate.

Successful pregnancy and delivery of a patient with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) during pregnancy is a rare condition. Only a few cases have been reported in the literature. CAH patients has lower pregnancy rate compared to normal women. A 27-year-old nulliparous woman, a diagnosed case of 21-hydroxylase deficient simple virilising form of classic CAH visited. She got pregnant spontaneously without any trial of assisted reproductive technology. At the age of 12, she underwent clitoral resection and vaginoplasty. She took dexamethasone or prednisolone after operation. She delivered healthy singleton female baby by cesarean section. Four years later, she delivered healthy singleton female baby by repeat cesarean section. Two female babies have shown normal external genitalia. Here, we report a case of successful pregnancy and delivery in a patient with CAH.

A case of tubo-ovarian abscess in a pregnant woman

Tubo-ovarian abscess in pregnancy is extremely rare. In this report, we present a patient who had asymptomatic tubo-ovarian abscess during pregnancy. It was diagnosed incidentally immediately after vaginal delivery. Emergency laparotomy was followed and surgical findings included a 4 cm-sized, right, ruptured tubo-ovarian abscess with massive purulent contamination of the whole pelvic cavity. Right salpingo-oophorectomy and massive irrigation were performed.

A case of suburethral myoma of the vagina in pregnancy

자궁 근종은 가장 흔한 여성 생식기 종양이나 질에 발생하는 경우는 드물다. 질에 발생한 근종은 일반적으로 질의 전벽에 발생하며 방광류나 자궁 탈출증 등과 같은 다양한 여성 생식기 질환들과 구분이 쉽지 않다. 특히 임신 중에 발생하는 경우는 매우 드물며, 임신 중 자궁 근종의 진단과 임신에 대한 영향이 초음파의 사용에 의해 많이 알려진 반면에 질에 발생한 근종은 그렇지 않다. 본 저자들은 처음에 방광류로 진단받은 산모의 제왕절개 분만 및 질 전벽 봉합술 후 다시 돌출된 질 전벽 종괴에 대해 질식 근종 절제술을 성공적으로 시행하였다. 임신 중 요도하부 질 전벽에 발생한 근종 1예를 경험하였기에 간단한 문헌 고찰과 함께 이를 보고하는 바이다.