• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.129-136
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• 2009

The incidence of ectopic pregnancy is increased since in vitro fertilization-embryo transfer (IVF-ET) has started. And because of the possibility of combined pregnancy after IVF-ET, bilateral adnexal area and other portion of pelvis should be examined carefully by transvaginal ultrasonography during follow-up period. The rate of combined pregnancy after IVF is estimated to be as high as 0.2~1%. Since the incidence of combined pregnancies is markedly higher with IVF, special attention to this possibility after ET is warranted. According to a recent report, the occurrence of interstitial pregnancy is estimated to be 1:3600 for all pregnancies achieved with IVF. The prevalence of interstitial pregnancies is 2~4% of ectopic pregnancies. Interstitial pregnancies tend to be diagnosed later than most other ectopic pregnancies, and if uterine rupture occurs, the resulting hemorrhage can be severe. Currently, about 2% to 3% of interstitial pregnancies are thought to carry a maternal death, which is twice that of other tubal gestations. We report a case of simultaneous left tubal and right interstitial pregnancies after IVF-ET with a brief review of literature.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.217-221
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• 2024

Retroperitoneal ectopic pregnancy is a rare form of ectopic pregnancy. Owing to its rarity and nonspecific symptoms, diagnosing retroperitoneal ectopic pregnancy at the initial presentation poses a significant challenge. Typically, the diagnosis relies on non-radiation imaging modalities, such as ultrasonography and MRI, whereas CT is infrequently used. Herein, we report a rare case of a retroperitoneal ectopic pregnancy, which was diagnosed using CT.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.221-227
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• 1985

Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.

• Clinical and Experimental Reproductive Medicine
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• v.34 no.2
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• pp.133-137
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• 2007

Abdominal pregnancy is a very rare form of ectopic pregnancy following IVF-ET procedure. Because the symptoms of abdominal pregnancy is not typical, it is difficult to diagnose early and the mortality rate is higher than other ectopic pregnancies. Liver, spleen, omentum and diaphragm are main implantation sites of abdominal pregnancy. We reported an unusual first case of an etopic pregnancy on uterosacral ligament following in vitro fertilization and embryo transfer with brief review of literature.

• Development and Reproduction
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• v.11 no.1
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• pp.1-11
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• 2007

Specific endometrial preparation should occur during periimplantation period. That is a progress of serial differentiation and is absolute in implantation of embryo and successful pregnancy. Remodeling of tissues shown during embryogenesis is regulated by various factors including extracellular matrix (ECM). Marked changes during pregnancy are including embryo migration, decidual response, and differentiation of placenta in placental animals including human. These changes to successful implantation in embryo and uterus have to prepare the competence for attachment of embryo and uterus, and invasion defense of uterus. During these changes, ECM dramatically changes for maintaining the uterine and embryonic functions. The major component of most connective tissue is collagens. It is very complex and hard to explore the mechanisms for ECM modulation. Recently using high throughput methodology, PCR-select cDNA subtraction method, microarray, many candidate genes have been identified. Steroid hormones have fundamental role in implantation and maintenance of pregnancy. Dermatopontin, a regulator of collagen accumulation, is regulated spatio-temporally in the uterus by primarily progesterone through progesterone receptors at the time of implantation. Modulation of extracellular matrix is critically regulated by cascade of gene net-works which are regulated by cascade of sex steroid hormones. Pathological regulation of uterine extracellular matrix reported in diabetic patients. To know the extracellular modulation is essential to understanding implantation, feto-placental development and overcome the paths involved in female reproduction. Though ECM composed with very various components and it is complex, the present review focused on the fate of collagens during periimplantation period.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.237-240
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• 1985

Abdominal pregnancy is one of the rare but extremely harzardous complications of childbearing. The diagnosis of the abdominal pregnancy is rarely made before surgery and the management of it also has many difficult problems. I experienced a case of abdominal pregnancy developed after the previous unilateral adnexectomy and it was a suspicious primary abdominal pregnancy as though did not fulfilled the Studdiford's the following criteria for primary abdominal pregnancy. 1) normal tubes and ovaries with no evidence of recent or remote injury, 2) absence of any evidence of uteroplacental fistula, and 3) presence of a pregnancy related exclusively to the peritoneal surface and young enough to eliminate the possibility of secondary implantation following primary nidation in the tube. And now I present a case with brief review of literatures.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.3
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• pp.261-266
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• 2010

Diagnosis of heterotopic pregnancy could be delayed because of insufficient clinical symptoms. Many clinician mistook the symptoms associated with ectopic pregnancy for the symptoms of complicated normal intrauterine pregnancy. The incidence of heterotopic pregnancies has been increased because of the use of various ovulation induction and assisted reproductive technologies. We experienced a case of bilateral tubal pregnancies and intrauterine twin pregnancy in polycystic ovary syndrome woman conceived after ovulation induction by clomiphene citrate. We report this case with a brief review of the literatures.

• Clinical and Experimental Reproductive Medicine
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• v.33 no.1
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• pp.69-69
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• 2006

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult due to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.275-278
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• 2000

A 3-year-old yorkshire terrier was examined because of the green-like vaginal discharge. Abdominal ultrasonographs revealed dead fetuses in the abdominal cavity. Surgical exploration revealed fetuses located in the region of the uterine wall, the omentum, the ileum, and the upper right side of the liver respectively. Fetal structures were removed and an ovariohysterectomy was performed. The abdominal cavity was flushed with warm saline and then the incision closed. These fetuses were at different stages of development. It was suggested that the development of the fetuses apparently continued in extrauterine pregnancy until the blood supply became inadquate for further growth.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).