• Title/Summary/Keyword: Uterine rupture

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Uterine Rupture in the Pregnant Bitch

  • Kim, Hye-Jin;Jang, Jae-Young;Choi, Hee-Yeon;Kim, Hyun-Wook;Choi, Ji-Hye;Kim, Jin-Kyoung;Seo, Ji-Min;Lee, Min-Jung
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2007.05a
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    • pp.143-143
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    • 2007
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Vaginal Hemorrhage Associated with Decidualized Rectovaginal Deep Infiltrating Endometriosis during the Third Trimester of Pregnancy: A Case Report (임신 중 탈락막 변화를 동반한 직장질부위 심부자궁 내막증에서 발생한 대량 질출혈: 증례 보고)

  • Jeong-Won Oh;Eun Ji Lee;Yoon-Mi Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1121-1127
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    • 2022
  • Endometriosis-related symptoms are believed to be alleviated during pregnancy. However, pregnancy complications, such as pseudoaneurysm of the uterine artery, rupture of ovarian or uterine vessels, and intraabdominal bleeding from decidualized deep infiltrating endometriosis (DIE) lesion have been rarely reported. Owing to the potential risk of rupture and resultant life-threatening complications, proper diagnosis and close monitoring of decidualized endometriotic lesion are very important despite its low relative risk. Till date, massive vaginal bleeding from decidualized rectovaginal DIE during pregnancy has not been in English literatures. Here, we present the first case of spontaneous massive vaginal bleeding due to decidualized rectovaginal DIE that occurred in the late third trimester of pregnancy.

Reproductive Performance of Women with Uterine Anomalies (선천성 자궁기형 환자의 생식력에 관한 고찰)

  • Kim, Hak-Soon;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.137-144
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    • 1986
  • A reveiw of 85 patients with uterine anomalies was made in respect to the incidence, chief complaints, the reason of infertility, fetal wastage rate, pregnancy complications, fetal presentations and obstetric outcome after metroplasty from 1980 to 1985. The results were summarized as follows: 1. Incidence of uterine anomaly was 0.18% among all outpatients (85/48,240). 2. Of the 85 patients, there were 36 with bicornuate deformities (42.3%), 21 septate (24.7%), 18 uterus didelphys (21.2%), 8 arcuate (9.4%) and 2 patients with unicornuate anomalies (2.4%). 3. Uterine anomalies were diagnosed by hysterosalpingogram (54.1%), pelvic examination (14.2%) and other operative procedures. 4. Chief complaints were primary infertility (41.2%), secondary infertility (15.3%), repeated pregnancy loss (12.9%), antenatal care (11.8%) and menstural disturbance (10.6%), etc. 5. Twenty-nine patients with uterine anomalies had primary infertility. The cause of infertility was proved nonuterine in 26 cases and remained unknown in 3 cases. 6. The obstetric outcome of 104 pregnancies was spontaneous abortion in 51.0%, premature delivery in 11.50/0 and fetal loss in 57.7%. 7. Complications of 41 present pregnancies were threatened abortion (22%), premature rupture of membrane (12%) and premature labor (10%), etc. The frequency of abnormal presentation was 35.3% and 64.7% of deliveries was made by Cesarian section. 8. Metroplasty was performed in 13 patients who didn't have a baby because of repeated miscarriage and unknown cause of infertility. Subsequently 8 patients had 9 successful pregnancies: 6 patients had 7 healthy babies and 2 patients are now in pregnancy without any complications.

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A Case of Fetal Mummification and Lithopedion from a Bitch with Prolonged Gestation over about One Month (장기임신 개에서 발생한 태아미이라변성 및 석아의 1례)

  • 김용준;박영재;오홍근;한종현;이창민;강미선
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.238-242
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    • 2000
  • A six-year old bitch pregnant with prolonged gestation over about one month was ovariohysterectomied. The bitch was proved to be normal by physical and biochemical examination and had not a purulent vaginal discharge. A large firm mass was palpated in left caudoventral abdomen. Radiography identified the mass as a fetus. The abdominal ultrasono-graphy identified the fetus was dead. Caesarian section through the median raphe over linea alba was attempted. Adhensions were found between the uterus, stomach, spleen, urinary bladder, and abdominal viscera. Two fragments of bone were found in the abdominal cavity because of rupture of left uterine horn. Radiography and ultrasonography were proved to be of use to diagnose prolonged fetal mummification. Ovario-hysterectomy was considered to be choice of treatment to remove the prolonged mummified fetus.

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Visualization of unstructured personal narratives of perterm birth using text network analysis (텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.205-212
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    • 2020
  • Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

  • Bae, Sung Kyu;Kang, Seok Joo;Kim, Jin Woo;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.40 no.1
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    • pp.28-35
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    • 2013
  • Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction. Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery. Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

The effects of a maternal nursing competency reinforcement program on nursing students' problem-solving ability, emotional intelligence, self-directed learning ability, and maternal nursing performance in Korea: a randomized controlled trial

  • Kim, Sun-Hee;Lee, Bo Gyeong
    • Women's Health Nursing
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    • v.27 no.3
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    • pp.230-242
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    • 2021
  • Purpose: The purpose of this study was to develop a maternal nursing competency reinforcement program for nursing students and assess the program's effectiveness in Korea. Methods: The maternal nursing competency reinforcement program was developed following the ADDIE model. This study employed an explanatory sequential mixed methods design that applied a non-blinded, randomized controlled trial with nursing students (28 experimental, 33 control) followed by open-ended interviews with a subset (n=7). Data were analyzed by both qualitative and quantitative analysis methods. Results: Repeated measures analysis of variance showed that significant differences according to group and time in maternal nursing performance; assessment of and intervention in postpartum uterine involution and vaginal discharge (F=24.04, p<.001), assessment of and intervention in amniotic membrane rupture (F=36.39, p<.001), assessment of and intervention in delivery process through vaginal examination (F=32.42, p<.001), and nursing care of patients undergoing induced labor (F=48.03, p<.001). Group and time improvements were also noted for problem-solving ability (F=9.73, p<.001) and emotional intelligence (F=4.32, p=.016). There were significant differences between groups in self-directed learning ability (F=13.09, p=.001), but not over time. The three main categories derived from content analysis include "learning with a colleague by simulation promotes self-reflection and learning," "improvement in maternal nursing knowledge and performance by learning various countermeasures," and "learning of emotionally supportive care, but being insufficient." Conclusion: The maternal nursing competency reinforcement program can be effectively utilized to improve maternal nursing performance, problem-solving ability, and emotional intelligence for nursing students.

Epithelial to mesenchymal transition (EMT) of feto-maternal reproductive tissues generates inflammation: a detrimental factor for preterm birth

  • Menon, Ramkumar
    • BMB Reports
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    • v.55 no.8
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    • pp.370-379
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    • 2022
  • Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.

Combined Tubal and Interstitial Pregnancies after IVF-ET: a Case Report (체외수정 및 배아 이식 후 난관과 반대편 간질 부위에 동시에 생긴 복합성 자궁외 임신 1예)

  • Oh, Yoe-Un;Kim, Mi-Kyoung;Lee, Seo-Yeong;Kim, You-Shin
    • 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.

Gynecologic Application of the Pelviscopic Surgery (골반경수술의 부인과적 응용)

  • Koh, Seok-Bong;Lee, Jae-Yeoul;Lee, Young-Gi;Park, Yoon-Kee;Lee, Doo-Jin;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.127-134
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    • 1994
  • The aim of this study was to identify the usefulness of pelviscopy in treatment besides its diagnostic value. The advantages of pelviscopic surgery are low cost, rapid recovery, good cosmetic effect, low incidence of complication and postoperative adhesion. So most of the pelvic exploration in gynecologic patients are replaced by the pelviscopic surgery these days. Pelviscopic surgery was performed on 136 patients at the Department of Obstetrics and Gynecology, College of Medicine, Yeungnam University from May 1991 to July 1993. The results obtained were as follows : The age distribution of the patients was from 19 to 55 with age of 31.2 years, and the mean parity was 0.96, the most common indication of pelviscopic surgery was tubal pregnancy(66.9%), the second most common indications was ovarian cyst(10.3%) and the other indications were endometriosis, corpus luteum cyst rupture, parovarian cyst, foreign body, tubal ligation, hydrosalpinx, uterine myoma and diagnostic procedure. The main types of surgery were salpingectomy in 58.8% and salpingoophorectomy in 16.3%. The mean duration of hospitalization was 2.1 days without specific complications. According to these results, it was postulated that the pelviscopic surgery was a useful operative tool in gynecologic treatment and its application could be extended to many other areas of gynecology with safety by the development of surgical techniques and instruments.

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