Restless leg syndrome (RLS) is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs, occurring during periods of rest, evening and night. These symptoms can be improved by movement. There are two different phenotypes of RLS. One early-onset form starts before 36 years old. It has mostly a familial history, severe symptoms, and highly genetically determined. And it is a highly dependent to iron level of the brain. The other delayed-onset form starts after 36 years old, mostly secondary, without familial history, with a rapid evolution in two or three years. And it is associated with frequent low ferritin level of serum. Pathophysiology of RLS remains incompletely understood. However, advanced studies suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. Dopaminergic agonists are the treatment of choice, if the symptoms are severe. And iron therapy improves RLS symptoms in iron deprived patients. Early detection during pregnancy is needed because RLS gives an important impact on sleep efficiency and quality of life. Recently we have experienced a case of primary RLS patient diagnosed at 24+3 weeks, treated by dopaminergic agonist ropinirole and iron. We describe this case with a brief review of the literature.

Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of β-hCG and pelvic ultrasonography. The fallopian tube is the most common location for an ectopic pregnancy. Other types of ectopic pregnancy include cornual, ovarian, cervical, scar, and abdominal pregnancy. In very rare cases, the abdominal pregnancy may be retroperitoneal. The diagnosis is seldom established before surgery and therapy is surgical resection of the ectopic mass. A 26-year-old woman visited our emergency department with sudden massive vaginal bleeding. She had undergone curettage 3 weeks before. But the transvaginal sonogram of the cul-de-sac revealed no fl uid collection. She failed variable-dose methotrexate therapy. On laparoscopic operation, we found a cystic, conception-like structure in the retroperitoneum. Histology of resected structure showed chorionic villi. We describe this case with a brief review of the literature.

Sacrococcygeal teratoma (SCT) is a rare subset of germ cell neoplasm and occurs in approximately 1 in 35,000 live births. Most SCTs are benign, but about 20% are malignant. They originate from totipotent cells from Hansen's node or primitive germ cells, but the exact etiology remains uncertain. Antenatal diagnosis of SCT can be made by ultrasound. The fetus with SCT remains at high risk for perinatal complications and death. Perinatal mortality and morbidity are most strongly related to high-output cardiac failure because of arteriovenous shunting within the tumor, subsequent fetal hydrops, polyhydramnios, and preterm delivery. Recently we have experienced a case of immature SCT with hydrops and polyhydrmnios diagnosed by prenatal ultrasonography at 21+5 weeks, resulted in stillbirth. We describe this case with a brief review of the literature.

Placental infarction is a localized area of ischemic villous necrosis, resulting from interruption in maternal blood supply. These have been associated with postterm pregnancies, maternal hypertension, and anticardiolipin antibodies. Most are due to thrombotic occlusion of an uteroplacental artery. But, infarction in the basal layer of the placenta is very rare and characterized histologically by massive deposition of fibrin. The etiology remains uncertain. However, it has clearly associated with significant perinatal morbidity and mortality including stillbirth, preterm birth, and intrauterine growth restriction. This condition has been diagnosed by prenatal ultrasonography with hyperechoic areas along the maternal side, but extending through much of the placental tissue. Recently we have experienced a case of extensive infarction in the basal layer of the placenta diagnosed by prenatal ultrasonography at 17 weeks, resulted in stillbirth. We describe this case with a brief review of the literature.Keywords: Infarction in the basal layer of the placenta, Stillbirth

The thalassemias are a group of autosomal recessive genetic disorders of hemoglobin synthesis. The thalassemias are classifi ed into two main varieties, α-and β-, depending on which of the adult globin chain is produced in reduced amounts. The β-thalassemia is the homozygous and heterozygous state, and common in the Mediterranean region. Homozygous β-thalassemia is usually associated with severe anemia. β-Thalassemia minor, the heterozygous state, is characterized by hypochromia, microcytosis and an elevated of HgA 2 . No treatment is required for thalassemia minor, but it is important to exclude iron defi ciency anemia and postpartum genetic counseling. Recently, β-thalassemia minor keeps rising steadily in Korea due to the increase in international marriges. Recently we have experienced a vaginal delivery in a β-thalassemia minor Vietnam woman associated with mild anemia. We describe this case with a brief review of the literature.