Effectiveness of Sengstaken-Blankemore tube to control postpartum hemorrhage / 대한산부인과학회지

OBJECTIVE: To evaluate the effectiveness and identify the role of interventional procedure of tamponade treatment with modified Sengstaken-Blankemore (S-B) tube on control of postpartum hemorrhage (PPH) unresponsive to conventional medical treatment. METHODS: This study was performed retrospectively on the clinical records of 90 patients who had experienced PPH at the department of Obstetrics and Gynecology of OO University Hospital from February, 2000 to September, 2005. We have actively applied tamponade balloon since 2004. As a result, tamponade balloon were applied to 17 patients. Medical records were reviewed such as clinical status, cause of bleeding, volume of balloon, duration of balloon, complication, success rate and additional treatment. RESULTS: We have overall success rate of tamponade balloon in 11 (64.7%) of 17 patients of PPH. The causes of bleeding were subinvolution of uterus (100%), uterine atony (80%) and abnormal placentation (20%) in order of success rate. There was no major complication related to the tamponade procedure. We had compared final treatment during two period (before tamponade use v.s after tamponade use). 15 (33.3%) received invasive procedure and 8 (17.8%) received hysterectomy before tamponade use. However 10 (22.2%) received invasive procedure and just 1 (2.2%) received hysterectomy after tamponade use. CONCLUSION: Tamponade with modified S-B tube is effective on PPH unresponsive to conventional medical treatment and cuts down additional invasive procedure when tamponade treatment failed.

Comparison of Hospital stay and Cost-effectiveness between Treatment Modalities in Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the hospital stay and cost-effectiveness between treatment modalities in ectopic pregnancy for proper management. METHODS: In this study, the authors studied 121 cases retrospectively who had been admitted and treated at Department of Obstetrics and Gynecology, Konyang University Hospital from February 1, 2000 to August 31, 2003. We analyzed clinical features, treatment modality, hospital stay and cost-effectiveness between each groups. One-way ANOVA test was used and p<0.05 was regarded as statistically significant. RESULTS: There was no difference in clinical features between treatment modalites. Of total 121 cases, operative procedures were done in 105 cases (explo-laparotomy in 58, laparoscopy in 43, dilatation and curettage in 4) and medical treatment in 16 cases (Multiple dose methotrexate protocol in 11, Single dose methotrexate protocol in 5). Average of length of hospital stay was 5.3 +/- 0.2 days in explo-laparotomy, 3.8 +/- 0.2 days in laparoscopy, 2.8 +/- 1.4 days in dilatation and curettage, 6.5 +/- 0.5 days in multiple dose methotrexate protocol, 2.4 +/- 0.4 days in single dose methotrexate protocol. According to treatment modality, there was significant difference in total cost and cost sharing. Total cost in explo-laparotomy (875,324 +/- 25,977 Won) was more expensive than that of laparoscopy (734,375 +/- 35,179 Won). But, cost sharing in explo-laparotomy (156,543 +/- 9,583 Won) was less expensive than laparoscopy (319,493 +/- 26,255 Won). Total cost and cost sharing in multiple dose methotrexate protocol (323,231 +/- 33,972 Won, 184,465 +/- 17,344 Won) was more expensive than that of Single methotrexate protocol (192,495 +/- 31,180 Won, 68,793 +/- 13,422 Won). CONCLUSION: Based on these results, it is very important that we should have an interest in ectopic pregnancy for early detection and proper management. Consequently, Achievement of precise decision and successful methotrexate treatment can be possible to decrease hospital stay and cost-effectiveness.

The Expression of p27kip1 and p57kip2 in Mouse Placenta During Gestation / 대한산부인과학회잡지

OBJECTIVE: This study was to investigate the expression of CDK inhibitors, p27kip1 and p57kip2 during the growth and differentiation of mouse placenta. METHODS: Total RNA and protein were extracted from placenta of mouse sacrificed at day 12, 14, 16, 18 post-coitum (p.c.), then semi-quantitative RT-PCR and western blotting of p27kip1 and p57kip2 was carried out, respectively. RESULTS: p27kip1 mRNA was highly expressed in 18 days p.c. then other groups. But, p57kip2 mRNA expression was high in 12, 14, and 16 days p.c., then decreased in 18 days p.c. p27kip1 expression pattern was similar with mRNA. But, p57kip2 was higher in 14 days p.c. than other groups. CONCLUSION: This result shows that p27kip1 may play a role in late period of mouse placental development, and p57kip2 may play a role in middle period of mouse placental development.