Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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The Prevalence of Deciduosis and the Relationship with Endometriosis in Fertile Women during Cesarean Delivery

가임 여성에서 제왕절개술 동안 Deciduosis의 유병율과 자궁내막증과의 관계

  • Kim, Min-Joung (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kim, Hyun-Jung (Mizpark Women's Hospital, Seoul St. Mary's Hospital) ;
  • Song, Jae-Yen (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kim, Sue-Yeon (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Chung, Jae-Eun (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Jo, Hyun-Hee (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kim, Jin-Hong (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kim, Jang-Heub (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Lew, Young-Ok (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kwon, Dong-Jin (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Kim, Mee-Ran (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul) ;
  • Lim, Yong-Taik (Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Seoul)
  • 김민정 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 김현정 (미즈파크여성병원) ;
  • 송재연 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 김수연 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 정재은 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 조현희 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 김진홍 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 김장흡 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 유영옥 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 권동진 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 김미란 (가톨릭대학교 의과대학 산부인과학교실) ;
  • 임용택 (가톨릭대학교 의과대학 산부인과학교실)
  • Published : 2009.06.30
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Abstract

Objective: To investigate the prevalence, the distribution of deciduosis, and the relationship with endometriosis in fertile women during Cesarean delivery. Methods: In this study, pelvic tissues suspicious for ectopic deciduas were taken for biopsy during Cesarean section from 154 parturients of full term pregnancy from January 1990 to December 2003. And then those patients were followed up till April 2008. Results: Tissues from 94 parturients (94/154, 61%) were evaluated histopathologically, and ectopic decidua was observed in 70.2% (66/94). Ectopic sites were ovaries only (65/94, 69.1%), ovaries and uterine serosa (12/94, 12.8%), uterine serosa only (9/94, 9.6%), and pelvic serosa. Twenty seven (27/66, 40.9%) parturients had past history of diagnosis and treatments for endometriosis. We have tried to connect 39 (39/66, 59.1%) patients who had never been diagnosed for endometriosis but pathologically confirmed for deciduosis, and 18 patients were able to contact by phone. Twelve patients (12/18, 66.6%) showed no symptoms of endometriosis and had not received any treatments for endometriosis. Conclusion: We can conclude that most of incidental cases confirmed pathologically for deciduosis during pregnancy do not symptomatically progress.

목 적: 임신 능이 확인된 가임 여성에서 다능성 세포가 화생되거나 이전에 존재하던 골반 내 자궁내막증으로부터 발생하는 deciduosis의 발생빈도와 분포, 자궁내막증과의 관계를 알아보고자 하였다. 연구방법: 1990년 1월부터 2003년 12월까지 만삭임신에 이른 154명에서 제왕절개술시 의심되는 병변에서 조직검사를 시행하여 deciduosis의 빈도를 조사하였다. 결 과: 여러 다른 장기의 ectopic decidua는 94명 (94/154, 61%)에서 조사되었고, 이 중 66명 (66/94, 70.2%)에서 조직 검사상 deciduosis로 진단되었다. 발생빈도는 난소 (65/94, 69.1%), 난소와 자궁장막 (12/94, 12.8%), 자궁장막 (9/94, 9.6%), 복막 (2/94, 2.1%) 순이었다. 이 중 27예 (27/66, 40.9%)는 임신 전에 이미 자궁내막증으로 진단받아 다른 치료를 받았던 경력이 있던 여성이었고, 39예 (39/66, 59.1%)는 임신 전 자궁내막증으로 진단받지 않았던 경우였다. 임신 중에 deciduosis로 조직학적 확진을 받았지만 자궁내막증의 기왕력이 없었던 38명을 대상으로 2008년 4월 전화연락을 시도한 결과 통화 가능했던 18명 중 12명 (66.6%)이 다른 증상이 없어 특별한 치료 없이 지내고 있었다. 결 론: 본 연구에서 임신 시 조직학적으로 deciduosis가 확인된 대부분의 경우 자궁내막증으로의 진행은 없었다.

Keywords

References

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