• 대한영상의학회지
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• 제83권5호
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• pp.1121-1127
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• 2022

임신 중 심부자궁내막증의 증상은 대부분 호전되는 것으로 알려져 있다. 그러나 심부자궁내막증과 관련하여 자궁동맥의 가성동맥류, 난소 또는 자궁동맥의 파열 및 탈락막화가 진행된 병변에 의한 복강내 출혈과 같은 심각한 산과적 합병증이 임신후반기에 드물게 보고되었다. 특히, 심부자궁내막증에 발생한 탈락막화가 진행될 경우 파열 및 출혈로 인한 심각한 모체/태아의 합병증이 발생할 수 있어 정확한 진단을 하고 임신 중 상태를 집중 감시하는 것이 필요하다. 그러나 이러한 경우는 매우 드물어 잘 알려져 있지 않으며, 저자들이 아는 한, 현재까지 보고된 심부자궁내막증에 의한 대량출혈은 모두 복강내출혈이 발생한 경우였다. 저자들은 임신 중 직장질부위 심부자궁내막증의 탈락막화가 진행되고 커지면서 질강내로 노출된 병변과 임신 후반기 병변에서 자연히 발생한 대량 질출혈의 증례를 보고하고자 한다.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.85-93
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• 2003

Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

• Journal of Chest Surgery
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• 제13권2호
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• pp.154-157
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• 1980

A twenty three year old, Primigravida and 32 week pregnant woman who has been complained dyspnea, chest pain, nausea and vomiting was admitted to this chest surgical department on Feb. 19, 1979. Physical findings were those of acutely ill appearance, decreased thoracic excursion and absence of breath sounds in the left hemithorax. Roentgen examination of the chest revealed reticular cystic densities in the left, particularly in lower lung field with collapse of the left lung. Correction of the diaphragmatic hernia was carried out with reduction and repair of the hernia through transperitoneal approach. On exploration, the defect of the diaphragm was 12 x 12 cm in size and was located posterolateral area of left diaphragm. Hernia contents were stomach, spleen, omentum and splenic flexure of large bowel. The baby was normal full term spontaneous delivered at 36th POD. Diaphragmatic hernia complicated by pregnancy is a rarity and mortality is extremely high. Therefore, the literatures have reviewed and the case is reported.

• 한국발생생물학회지:발생과생식
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• 제21권4호
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• pp.351-359
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• 2017

Implantation is a highly organized process that involves an interaction between a receptive uterus and a competent blastocyst. In humans, natural fecundity suggests that the chance of conception per cycle is relatively low (~30%) and two-third of lost pregnancies occur because of implantation failure. Defective implantation leads to adverse pregnancy outcomes including infertility, spontaneous miscarriage, intrauterine fetal growth restriction and preeclampsia. With use of advanced scientific technologies, gene expression analysis and genetically-engineered animal models have revealed critical cellular networks and molecular pathways. But, because of ethical restrictions and the lack of a mechanistic experiment, comprehensive steps in human implantation have still not been completely understood. This review primarily focuses on the recent advances in mechanisms of implantation. Because infertility is an emerging issue these days, gaining an understanding the molecular and hormonal signaling pathway will improve the outcome of natural pregnancy and assisted reproductive technology.

• Clinical and Experimental Reproductive Medicine
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• 제27권1호
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• pp.111-116
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• 2000

IVF-ET therapy was originally developed as a method for treating patients with absolute mechanical infertility for whom spontaneous conception is almost impossible. Objective: To report that the recent IVF-ET is now applied to couples not only untreatable tubal infertility but also peritubal periovarial adhesions, endometriosis, male-related or unexplained infertility. Material and Method: Case report. Result: We experienced 5 Pregnancies after unsuccessful IVF-ET attempt with additional non IVF-ET therapy or without therapy. Conclusions: The follicular puncture and ovarian enlargement may result in restoration of pituitary-ovarian axis and peritoneal environment in infertility patients.

• Clinical and Experimental Reproductive Medicine
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• 제20권2호
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• pp.149-156
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• 1993

Human chorionic gonadotropin(hCG) and intravenous immunoglobulin(IVIG) treatment were attempted as a novel therapeutic approach for unexplained recurrent spontaneous abortion(RSA). Forty-four and 3 women with a history of RSA were treated with hCG and IVIG, respectively, during pregnancy. Of these patients, serum blocking factor assay was performed before and after each treatment, in 15 patients; 12 cases with hCG and 3 cases with IVIG. The results were as follows: 1. Of 44 women who receive hCG during pregnancy, 24 delivered healthy infants at term, 10 patients suffered repeat abortion, and 10 women are still pregnant under 28 weeks. Over all success rate of hCG treatment was 70.6% (24/34). Although there is no statistical significance, absolute serm blocking level was decreased after treatment(N=12). 2. Of 3 women who receive IVIG during pregnancy, all 3 women are still pregnant under 28 weeks. Serum blocking level was increased after treatment, however, this increment was not statistically significant. Although no conclusion could be extracted from the patients who received IVIG, the therapeutic effect of hCG is comparable to that of the other therapeutic regimens, such as allogeneic leukocytes. It was postulated that actual etiology of unknown RSA would be classified as hormonal origin although combined etiologies are common in Korean women.

• 대한한방부인과학회지
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• 제28권2호
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• pp.120-132
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• 2015

Objectives : This study aims to assess whether Korean medical treatment in infertile couple is effective on clinical pregnancy. Methods : Korean medical treatment using herbal medicine, acupuncture and moxibustion was performed to thirty-one women and one man of infertility from March 2013 to April 2015. Results : After the treatment, nine patients (eight women and 1 man) of infertility became pregnant (28.13%) in thirty-two patients. In nine patients with pregnancy, five patients became spontaneous pregnant. Two patients became pregnant with in vitro fertilization (IVF), and other two patients became pregnant with intrauterine insemination (IUI). Factors influenced pregnancy assessed a shorter duration of infertility. After the treatment, survey of satisfaction in Korean medical treatment in infertility was done. Out of thirty-two patients, convenience and reliability of Korean medical treatment was reported by who had an experience of sterilization surgery. After the assessment, seven patients who had an experience of sterilization surgery and beame pregnant were having more convenience than twelve patients who were not pregnant despite sterilization surgery. Conclusions : This study suggests Korean medical treatment is useful for infertile women and men, in reverse proportion to shorter duration of infertility.

• Clinical and Experimental Reproductive Medicine
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• 제41권4호
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• pp.168-173
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• 2014

The purpose of this study is to report a successful twin pregnancy and delivery in a female patient with X-linked dominant incontinentia pigmenti (IP) who underwent assisted reproductive technology followed by preimplantation genetic screening (PGS). A 29-year-old female with IP had a previous history of recurrent spontaneous abortion. A molecular analysis revealed the patient had a de novo mutation, 1308_1309insCCCCTTG(p.Ala438ProfsTer26), in the inhibitor of the kappa B kinase gamma gene located in the Xq28 region. IVF/ICSI and PGS was performed, in which male embryos were sexed using array-based comparative genomic hybridization (aCGH). After IVF/ICSI and PGS using aCGH on seven embryos, two euploid male blastocysts were transferred with a 50% probability of a viable male pregnancy. The dizygotic twin pregnancy was confirmed and the amniocentesis results of each twin were normal with regard to the mutation found in the mother. The patient delivered healthy twin babies during the 37th week of gestation. This case shows the beneficial role of PGS in achieving a successful pregnancy through euploid male embryo gender selection in a woman with X-linked dominant IP with a history of multiple male miscarriages.

• 대한지역사회영양학회지
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• 제13권6호
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• pp.903-911
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• 2008

The purpose of this study is to provide basic data for preventing preterm delivery in the aspects of blood pressure and hematic parameters. The blood pressure, hematic parameters, relationship between hematic parameters and nutritional intakes and pregnancy outcomes were compared between a preterm delivery group and a normal term delivery group. The results obtained are summarized as follows. Diastolic blood pressure was statistically higher in the preterm delivery group. White blood cells (p < 0.005) and alanine amino transferase (p < 0.05) of 3rd trimester in pregnancy were statistically higher in the preterm delivery group. Alkaline phosphatase (p < 0.0001) and lactate dehydrogenase (p < 0.05) were statistically lower in the preterm delivery group. Inverse relationships between niacin, vitamin B6 and zinc intakes and bilirubin (p < 0.05) were shown. Vitamin A intakes (p < 0.05) were significantly negatively correlated with blood protein, but zinc intakes (p < 0.05) were significantly positively correlated with blood protein. Vitamin B6 intakes (p < 0.05) were significantly negatively correlated with blood albumin. Calcium intakes (p < 0.005) and iron intakes (p < 0.05) were significantly positively correlated with blood lactate dehydrogenase. Also, vitamin A intakes (p < 0.05) were significantly positively correlated with blood glucose. Normal spontaneous vaginal delivery (p < 0.005) was statistically lower in the preterm delivery group. Birth weight (p < 0.0001) and birth length (p < 0.005) of the neonates were all statistically lower in the preterm delivery group.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.228-232
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• 2016

Objective: The aim of this study was to investigate the impact of pretreatment with transdermal estradiol ($E_2$) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles. Methods: A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal $E_2$ versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded. Results: A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal $E_2$ and OCP groups, respectively. Patients in the OCP group had a longer duration of COS ($10.7{\pm}1.63days$, p< 0.01) than the $E_2$ group ($9.92{\pm}1.94days$). Patients in the OCP group also required higher cumulative doses of gonadotropins ($2,657.3{\pm}1,187.9IU$) than those in the $E_2$ group ($2,550.1{\pm}1,270.2IU$, p= 0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups. Conclusion: Our findings suggest that compared to OCPs, pretreatment with transdermal $E_2$ is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.