• Title/Summary/Keyword: Spontaneous abortion

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Inferior Vena Cava Thrombectomy in a Patient with Antiphospholipid Syndrome - A case report - (하대정맥의 혈전증을 동반한 인지질항체 증후군의 수술적 치료 - 1예 보고 -)

  • Jang, Jae-Seok;Kwon, Oh-Choon;Lee, Sub;Kim, Seok
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.371-374
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    • 2009
  • A 36-year-old woman with a history of spontaneous abortion and photosensitivity was admitted to our hospital with periumbilical pain and lower extremity edema. The preoperative CT scan revealed massive inferior vena cava thrombus, which extended from the suprarenal portion of the vena cava to the hepatic vein. The laboratory data showed an elevated level of anticardiolipin antibody, which suggested the diagnosis of antiphospholipid syndrome. After medical management, she underwent an operation for removal of an vena cava thrombus by performing cavectomy and thrombectomy. After the operation, she has been taking oral anticoagulation and she is doing quite well at 9 months after her operation.

A healthy delivery of twins by assisted reproduction followed by preimplantation genetic screening in a woman with X-linked dominant incontinentia pigmenti

  • Kim, Myung Joo;Lyu, Sang Woo;Seok, Hyun Ha;Park, Ji Eun;Shim, Sung Han;Yoon, Tae Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.4
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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.

Anticoagulant Therapy in Pregnant Women with Mechanical Cardiac valve Prostheses (기계판막을 갖고있는 임산부에서 항응고요법)

  • 최순호;고광표;한재오;최종범;김경호
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.502-506
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    • 2000
  • Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.

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Impact of Advanced Maternal and Paternal Age on Perinatal Outcome (분만여성과 배우자의 출산연령이 산모와 신생아 합병증에 미치는 영향)

  • Lee, Min-Kyung;Shin, Hye-Sook;Lee, Yun-Jung;Kim, Ju-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.18 no.1
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    • pp.95-101
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    • 2012
  • Purpose: This study aimed to analyze the impact of advanced maternal and paternal age on perinatal outcome in Korea. Methods: We conducted a retrospective study involving 1,622 Korean women who delivered at M Woman Hospital from January to December 2010 and their spouses were included. We obtained obstetrics database which included demographic characteristics, medical and obstetrics history, course of the current pregnancy and advised perinatal outcome. Multivariable logistic regression was used to adjust for potential confounding variables. Results: Women giving birth age 35 or older were statistically significant in paternal age, gravidity, spontaneous abortion experience, method of conception, method of delivery, and multiple gestation compared to women aged <34 years. After adjusting for the confounding effects of maternal characteristics, women aged 35 or older were at increased risk for cesarean section delivery (adjusted OR 1.6, 95% CI 1.22-2.13) and preterm birth (adjusted OR 2.2, 95% CI 1.03-4.63). Conclusion: In this population of Korean women, advance maternal and paternal age is independently associated with specific adverse perinatal outcome, especially preterm birth and cesarean section delivery.

Impact of Prepregnancy Body Mass Index on Pregnancy Outcome in Women with a Singleton Conceived by Assisted Reproductive Technology and Spontaneously Conceived Pregnancy: A Case-Control Study (생식보조술을 받은 산모와 자연임신한 산모에서 임신 전 체질량지수가 임신 결과에 미치는 영향)

  • Kim, Ju-Hee;Shin, Hye-Sook;Park, Bo-Kyung;Yang, Kwang-Moon;Lee, Young-Ho;Ryu, Hyun-Mee
    • Journal of Korean Academy of Nursing
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    • v.42 no.4
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    • pp.517-524
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    • 2012
  • Purpose: To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy. Methods: A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital. Results: There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ${\geq}25$ was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group. Conclusion: The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

Success Rate of Tubal Sterilization Reversal (정부지원 난관복원수술의 성공율에 관한 연구)

  • Bai, Byoung-Choo;Park, Chan-Moo;Kwak, Hyun-Mo;Whang, Young-Whan
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.79-85
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    • 1993
  • Five hundred and fory-four women were provided government funded sterilization reversal services with technique of microsurgery at 15 reversal institutions designated by the Korean Association for Voluntary Sterilization since the inception of Female Reversal Program in 1981. A large majority of reasons for requesting reversal surgery was a loss of children, comprising 87.3%, and the mean interval between sterilization and reversal was 33.6 months. Two hundred and ninty-one of 418 women who were post-operatively followed up with the length of 11 months to 11 years, have experienced term dilivery or ,intra-uterine pregnancy, represented 69.6%. Eight cases have experienced ectopic pregnancy and 9 cases spontaneous abortion. The largest number of reversal clients were sterilized by the laparoscopic unipolar coagulation technique and the next largest group was sterilized by the laparoscopic banding technique, representing 59.8% and 28.9% respectively. The highest pregnancy rate, 80.9%, was shown in clients who had undergone laparoscopic banding technique while the lowest, 61.8%, was the group of laparoscopic bipolar coagulation. The most common site of the anastomosis was isthmic-ampullary portion and the next was isthmic-isthmic portion. The highest success rate, 77.8 %, was marked in the isthmic-isthmic anastomosis and the lowest was in the ampullary-ampullary anastomosis, representing 50.0%. A more than 60% of the clients became pregnant within 6 months of their reversal surgery, with the shortest interval being 1 month, the longest 39 months, and the mean 7.6 months. A large majority of the successful cases were pregnancy within 1 year of their reversal surgery, representing 82.1 %. The higher rate of pregnancy, 73.5%, was in the clients undergone reversal surgery within 36 months of their sterilization and the lower pregnancy rate, 64.1 %, was in the clients undergone reversal surgery longer than 37 months of their sterilization.

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The study of the stress degree and Qi-stasis of infertile women (불임 환자의 스트레스와 기울(氣鬱)에 대한 연구)

  • Kwon, Su-Kyung;Lee, Eun-Jung;Choi, Eun-Mi;Kang, Myung-Ja;Park, Jong-Hoon;Kim, Jong-Woo;Lee, Hui-Young
    • The Journal of Korean Obstetrics and Gynecology
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    • v.18 no.4
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    • pp.165-182
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    • 2005
  • Purpose : To investigate the stress degree of infertile women and its correlations with Qi-stasis. Methods : 162 women, enrolled for treatment at oriental hospital, completed Infertility Stress Scale, Stress Response Inventory and Qi-stasis questionnaire. Their demographic features and infertility-related factors were recorded. 137 infertile women and 25 normal subjects were analyzed. Results : 1. 43 infertile women(33.86%) among the sample group were diagnosed as Qi-stasis. 2. There were close score correlations among Infertility Stress Scale, Stress Response Inventory, and Qi-stasis(p=.000). 3. Experience of Assisted Reproductive Technology (ART), possibility of spontaneous pregnancy, coitus frequency, whether the spouse is the eldest son or not had the influences on Infertility Stress. Abortion experience had influences on stress response and Qi-stasis. 4. It was revealed that Infertile women(n=137) had significantly higher scores of 'Infertility Stress' and subscales such as 'sexual satisfaction', 'marital satisfaction', 'familial adjustment', 'social adjustment' as well than control group(n=25). Conclusion : The results provide that the stress degree of infertile women had significant correlations with Qi-stasis and show the possibilities of oriental medicine treatment for stresses of infertile women.

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Maternal Plasma Homocysteine Levels and Pregnancy Outcomes (임신 분기별 모체의 혈장 호모시스테인 농도와 임신결과)

  • 안홍석
    • Korean Journal of Community Nutrition
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    • v.9 no.4
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    • pp.483-490
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    • 2004
  • Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.

Incontinentia Pigmenti with Multiple Missing Teeth : Case Reports (다수의 치아결손을 동반한 색소실조증 환아의 치험례)

  • Choi, Shinae;Kim, Youngjin;Nam, Soonhyeun;Kim, Hyunjung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.180-187
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    • 2015
  • Incontinentia pigmenti, also called Bloch-Sulzberger syndrome, is a rare X-linked inherited dominant disorder that affects females, but causes spontaneous abortion of prenatal males. Incontinentia pigmenti is a systemic disease with clinical features similar to ectodermal dysplasia, including congenitally missing teeth. The pathogenesis is related to gene mutations in NF-kappa-B essential modulator on chromosome Xq28. Incontinentia pigmenti is caused by a defect in the developmental stage of organs originating from the ectoderm or mesoderm and involves the skin, eyes, hair, teeth and central nervous system. This report discusses the management of three cases of 3 to 5 years old females with incontinentia pigmenti and accompanying multiple missing teeth. The cases had sparse hair, and showed oligodontia and anomalous crowns with supplementary cusps in the posterior teeth and conical anterior teeth. Removable space maintainers were applied, achieving improved esthetics, recovery of mastication and increased self-esteem in the patients.

Pregnancies by In Vitro Fertilization and Embryo Transfer (체외수정과 배이식에 의한 임신성공예에 관한 연구)

  • Ku, Pyong-Sahm;Yoo, Dong-Wha;Lee, Kyu-Won;Rha, Joong-Yul;Hong, Sung-Bong;Bae, In-Ha
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.121-127
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    • 1986
  • We have reviewed 59 cases of patients amoung 65 cases who underwent IVF and ET with reasonable indications irom 1984 and the results as follows. 1. Major indications for IVF and ET were tubal factor (40.7%), unexplained infertility (25.4%), endometriosis (15.3%), failed AID and AIH (10.1 %), and sperm abnormality (8.5%). 2. For superovulation of human oocytes, l00mg of clomiphene citrate and 75 IU of HMG used. The monitoring of oocyte maturation was bone by ultrasound examination and serum 17-${\beta}$ estradiol, LH values. The peak $E_2$ value was 956.36${\pm}$702.13 pg/ml. 3. The oocytes were obtained by laparoscopy 24-36 hours after the injection of HCG. 4. The mean numbers of follicles at laparoscopy was 3.06 and the successful rate of laparoscopy was 79.7%. 5. And 165 follicles were aspirated from which 98 oocytes were recovered, 59.4% of all follicles had at least one oocyte aspirated. 21.4% of the eggs were mature, 52.0% were moderate, 26.5%. were immature. 6. 67.3% of oocytes were cleaved and were transferred at 4-6 cell stages. 7. Four pregnancies including one chemical pregnancy and one spontaneous abortion were established by ${\beta}$-subunit, u-hCG and ultrasound examinations.

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