• Title/Summary/Keyword: Vaginal bleeding

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Prevention of Preterm Birth and Management of Uterine Contraction with Traditional Korean Medicine (조산 방지 및 자궁수축 관리의 한의학적 치료)

  • Kim, Eun-Seop;Jang, Eun-Ha;Kim, Nam-Hyoung;Jan, Sae-Byul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.4
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    • pp.24-33
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    • 2016
  • Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of Preterm Birth (PTB). Methods: It is a case report of a 38 year-old-woman hospitalized for irregular uterine contractions and cervical change at 33+3/7weeks of gestation. After 7 trials of IVF and artificial insemination, conception was successful via IVF with help of traditional Korean medicines. 2 TKMs were prescribed: Gami-danggui-san, and Antae-eum. 120 ml of Gami-danggui-san was given twice a day morning and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: As of 34+2/7 weeks of gestation, intermittent uterine contractions appeared (5-12 min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: Our report implies the potential of herbal medicine as a adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

A STUDY TO DETERMINE THE LEVEL OF OBSTETRIC KNOWLEDGE OF PREGNANT WOMEN AND POSTPARTUM MOTHERS (병원을 이용하는 임산부들의 산과적 지식정도에 관한 일 조사 연구)

  • 이선자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.81-91
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    • 1974
  • The purpose of this study was to investigate the level of obstetric knowledge of pregnant women and postpartum mothers, and to contribute the data to community health teaching program as well as maternity nursing. 385 pregnant women and postpartum mothers visited at or admitted to Seoul Adventist Hospital were sampled. The results of the study were as follows. 1. 97.9% of the subjects were between the age of 21 to 35, most of them (82.9%) were housewives with high school education and with a middle class family background. 2. The first symptoms of pregnancy were amenorrhea (70.4%), nausea & vomiting (23.9%), change of skin color (1.6%). 3. 77.9% of the subjects did not know how to deal with morning sickness. 4. 52.9% did not know when the sex determination of the fetus-occurs. 5. Concerning the fetus position; 77.1% of them believed it lies head down. head up (12.0%). and not knowing (10.9%). 6. 73.2% recognized the need for a well balanced food during pregnancy. 7. As to the dangerous symptoms during pregnancy: vaginal bleeding was considered the 1st, edema, the and, continuous abdominal pain, the 3rd. 82% of them would confer with physician in case of vaginal bleeding. As to the type of activities restricted by pregnancy: hard exercise was considered first, travel the second, and coitus during 1st and last trimester of pregnancy the 3rd. 8. 82.4% of them visited antenatal clinic at the second or third month of amenorrhea and 88.5% realized the regular physical examination imperative. 9. The purpose of urine test was recognized correctly by 44.7%, blood test: 89.4%, B. P. and weight check ; 69.9%. 10. The need of breast care during pregnancy was recognized by 76.9% of the subject. 11. 75.8% realized that prenatal exercise was needed. The higher the education the better the understanding of the need for it before delivery. 12. The concept of postpartum period was understood correctly by 54.4%. 13. The state of uterus after delivery was understood correctly by 49.1% only. 14, Regarding the management of colostrums: 48.3% knew it was to feed infants, and it was to squeeze and discard 43.4%. 15. Dealing with postpartum exercise; 67.8% answered it was needed, 9.1% not needed, not heard about 23, 1%.

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Changes of estrus signs and genital organs by hormomal induction of estrus in the bitch (인공발정유도견의 발정기 변화와 생식기의 변화)

  • Yu, Il-jeoung;Kim, Yong-jun
    • Korean Journal of Veterinary Research
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    • v.36 no.3
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    • pp.719-729
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    • 1996
  • To investigate changes of estrus signs and genital organs in the bitch by hormonal induction of estrus, fourteen bitches of nulliparous and multiparous(2nd-5th) were grouped into diestrus and anestrus according to their estrus cycle. The hormonal treatments were divided into four groups: group A($PGF_2{\alpha}+PMSG+hCG$) and group B(PMSG+hCG) in diestrus bitches and group C(GnRH+FSH+hCG) and group D(PMSG+hCG) in anestrus bitches. The external signs of proestrus and estrus as well as the vaginal smear findings and natural breeding as estrus detection were investigated in all the experimental groups. Also, genital organs were examined at two months after the hormone treatment. The bitches in anestrus showed 100% of male attraction, vaginal bleeding and vulvar swelling as proestrus signs after the hormonal treatment for estrus induction and they showed higher numerical value of signs than the bitches in diestrus. The group A showed the lowest value in proestrous signs of all the groups. The bitches in anestrus treated with GnRH+FSH showed 100% of positive estrus by vaginal smear findings and 75% of natural breeding as estrus detection index and these values were the highest of all the groups. Pregnancy was recognized in only group C and the conception rate was 7.14% in al the experimental animals. Of the side effects after the hormone treatment, external findings of continous male attraction, continous external swelling and purulent exudate were recognized in all the experimental groups and the bitches in diestrus showed higher value of the findings than the bitches in anestrus. Of the changes of genital organs after the hormone treatment, hypertrophy of uterine horn, sanguineous exudate and purulent exudate as uterine findings were recognized in all the groups and these findings were shown more in the bitches in diestrus than in those in anestrus. These results indicated that group C showed the highest value of all the experimental groups in external signs of estrus and estrus detection and also pregnancy was recognized only in that group, consequently, that the hormonal treatment of group C would be the most effective for estrus induction, and also indicated that bitches in anestrus were more suitable than bitches in diestrus for the induction of estrus. In addition, side effects in external genital organs and uteri after hormone treatment were shown more in the bitches in diestrus than in those in anestrus, indicating that bitches in anestrus would be of choice for estrus induction.

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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Relationship between Vaginal Cytology and Reproductive Hormone during the Estrous Cycle and Optimal Mating Time in Beagle Dogs (비글개에서 발정 주기 및 교배 적기 동안 질세포상과 번식 호르몬의 관계)

  • Lee K.C.;Kang H.G.;Cheun H.M.;Kim I.H.
    • Journal of Embryo Transfer
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    • v.21 no.2
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    • pp.109-119
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    • 2006
  • This study was conducted to examine relationship between vaginal cytology and reproductive hormones during the estrous cycle and to provide basic data to estimate for ovulation time and optimal mating time in 6 beagle dogs The duration of proestrus, estrus and diestrus were $8.5{\pm}1.4,\;10.0{\pm}1.4\;and\;54.0{\pm}2.8$ days at pregnant respectively, and $7.9{\pm}2.1,\;9.5{\pm}0.7\;and\;62.0{\pm}11.3$ days at non-pregnant respectively. The duration of interestrous intervals were $246.2{\pm}24.5$ days at pregnancy, and $175.3{\pm}34.5$ days at non-pregnancy. The duration of interestrous intervals at pregnancy was longer than that of non-pregnancy. A characteristic features of vaginal cytology during the estrous cycle were the high proportion of superficial cell, anuclear cell and erythrocyte in proestrus and estrus, parabasal cell, small intermediate cell and leukocyte in diestrus, and parabasal cell and small intermediate cell in anestrus, respectively. Cornification index (CI) in proestrus and estrus were significantly higher than that of CI in diestrus and anestrus. Plasma progesterone concentration was below 1.0 ng/ml at the first day of vulval bleeding at pregnancy and non-pregnancy, and then it was above 2.0 ng/ml at Day -2 in all bitches. When plasma progesterone concentration was first increased above 4.0 ng/ml, it was the second day after the first day of male acceptance. Plasma progesterone concentration showed above 40 ng/ml on Day $20{\sim}22$ in all bitches, and then it was gradually decreased until Day 35. Plasma progesterone concentration at pregnancy was higher than that of non-pregnancy from Day 35 to Day 63. Plasma estradiol-$17\;{\beta}$ concentration was above 9.0 pg/ml at the first day of vulval bleeding, and it showed 26.4 pg/ml on Day -2. When it was timed from the first day of male acceptance (Day 0), plasma estradiol-$17{\beta}$ concentration showed a peak on Day 0 and plasma progesterone concentration was first increased above 4.0 ng/ml on Day 2 which was the third day after plasma estradiol-$17{\beta}$ peak. CI was first increased above 80 and 90% on Day -1 and Day 1, respectively. CI was maintained above 80% from Day -1 to Day 8 (10 days) and above 90% from Day 1 to Day 6 (6 days), respectively. CI was maintained above 80% from Day 0 to Day 8 (9 days) and above 90% from Day 1 to Day 6 (6 days), respectively. Plasma progesterone concentration was first increased above 4.0 ng/ml on the second day after the day which CI was first increased above 90%. In conclusion, beagle bitches ovulated on the second day after the day which CI was first increased above 90% and on the day which plasma progesterone concentration was first increased 4.0 ng/ml, and it was estimated that the optimal mating time was the day which the second day after CI was first increased above 90% and plasma concentration was between $2{\sim}25ng/ml$. The measurement of plasma progesterone was used to determine of and accurate ovulation time and the optimal mating time, but vaginal cytology is low-priced and simple method to estimate estrous cycle, optimal mating time and ovulation time.

Health Status, Reproductive Health Problems, and the Degree of Prenatal Management in Married Working Women (기혼 취업여성의 건강상태, 생식건강상태 및 산전관리상태)

  • Kim, Jeung-Im;Han, Seung-Hyun
    • Women's Health Nursing
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    • v.10 no.3
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    • pp.226-234
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    • 2004
  • Purpose: This study was to examine health status, reproductive health problems and the degree of prenatal management in working women. Method: The subjects were 902 married working women among 2,000 women selected by cluster sampling. The work area was classified to product factory, school, office, etc. After an Informed consent was obtained, participants were asked to fill out a self-administered questionnaire. The instruments included a questionnaire, parity check list, menstrual problems and gynecologic problem check list. Result: Many women have experienced menstrual cycle change during the past year. There was a significant difference in general health, menstrual regularity, reproductive health and prenatal management by occupation type. 40.6 percent of the subjects have gynecological problems such as menstrual cycle change, perineal inflammation, irregular vaginal bleeding, amenorrhea, ovarian/uterine disease, infertility, or abortion. Prenatal care was received in only 28.5% of the total subjects. In addition, 16.3% answered they had experienced low birth weight babies. Conclusion: We can conclude that working woman have changes in menstruation cycle and in reproductive health status. Therefore, we suggest that some occupational characteristics may affect subject's reproductive health, these should be clear and avoided as much as possible.

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Composite Tumor of Adenocarcinoma and Small Cell Neuroendocrine Carcinoma of the Uterine Cervix -A Case Report- (자궁 경부의 선암과 혼합된 신경내분비 소세포 암종 - 1 증례 보고 -)

  • Park, Hye-Rim;Lee, Yong-Woo;Park, Young-Euy
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.111-120
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    • 1990
  • Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed an ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structures or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyrophilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neurosectetory granules.

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Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy

  • Lee, Jae-Yeon;Hwang, Kyu-Ri;Won, Kyu-Hee;Lee, Da-Yong;Jeon, Hye-Won;Moon, Min-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.4
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    • pp.174-177
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    • 2014
  • Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

3 Case Reports of Uterine Fibroid treated by Herbal medicine based on Shanghanlun provisions (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 한약 투여 후 호전된 자궁근종 3례)

  • Jung, Myung-Ju;Ryu, Hee-Chang
    • 대한상한금궤의학회지
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    • v.7 no.1
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    • pp.29-43
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    • 2015
  • Objective : The purpose of this paper is to report the improvement of 3 patients with uterine fibroid treated by herb medication based on Shanghanlun disease pattern identification diagnostic system. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', they were diagnosed with Taeyang-byung, Yangmyung-byung. They took different herb medications more than 8 weeks according to their diagnosis. The size of uterine fibroid was estimated by ultrasonography. Results : The size of uterine fibroid reduced from 3.94cm to 2.55cm on first patient, 5.20cm to 4.86cm on second patient, 12.63cm to 7.77cm on third patient. Conclusions : Herb medication not only reduced the size of uterine fibroid but also improved symptoms such as dysmenorrhea, vaginal bleeding, pelvic discomfort, fatigue. In addition, this is the first case report treating the uterine fibroid with herb medication of shanghanlun in Korea.

Left Common Iliac Artery Rupture due to Hidden Blunt Trauma (Suspected Dildo-Masturbation Injury via Endovagina): A Case Report (내재된 둔상으로 인한 좌측 총 장골동맥 파열에 따른 출혈성 심정지 (질 내 경로를 통한 자위 행위로 인한 손상 의심): 증례보고)

  • Kyoung, Kyu Hyouck;Kim, Mi Jin;Choi, Byung Ho;Hong, Jung Seok;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.211-214
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    • 2014
  • A 34-year-old woman experienced a sudden cardiac arrest after complaining of abdominal pain. The cause of that serious event was a hidden hemorrhagic shock. On computed tomography of her pelvic area, we found that her left common iliac artery had been ruptured. No bone fractures were observed. Her angiography showed neither atherosclerosis nor an aneurysm of the artery. Because spontaneous ruptures of the common iliac artery are rare, we suspected, based on her husband's statement, that a hidden blunt trauma to the artery had occurred via an endo-vaginal route due to dildo masturbation. Unfortunately, she died without recovery, in spite of our having controlled the bleeding by using an angiographic endovascular stent-graft.