A Case of Venous Thrombosis developed in a woman taking Oral Contraceptives with Antithrombin III, Protein C and Protein S deficiencies / 대한산부인과학회지

Oal contraceptives are one of the most frequently used methods of hormonal contraception. In general, oral contraceptives have proven to be safe for most women. However, the risk of deep vein thrombosis and pulmonary embolism are increased in women taking oral contraceptives. We have experienced a case of a woman who had superior mesenteric venous (SMV) and portal vein thromboses on taking oral contraceptives with antithrombin III, protein C, and protein S deficiencies.

A Case of Heterotopic Pregnancy in a Natural Cycle / 대한불임학회지

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.

A Case of Pelvic Actinomycosis / 대한산부인과학회잡지

Actinomycosis is a chronic, progressive, suppurative disease which present some difficulty in establishing a correct preoperative diagnosis. Because pelvic actinomycosis has variable nonspecific clinical manifestations. Actinomyces species are gram-positive, non-acid fast, anaerobic bacteria that exhibit branching filamentous growth. After trauma, surgery, or other infection that alter the host's mucosal barriers, these organism advance to invade surrounding tissues and organs. Recent reports have demonstrated an increased incidence in women using Intrauterine device (IUD). It is accounted that IUD cause chronic intrauterine infection, tissue injury, and act as nucleus for parasitic infestation. We have experienced a cause of pelvic actinomycosis in a 37-year-old woman using IUD and report it with brief review of literature.

Clinical study of Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: Ectopic pregnancy can still cause maternal death, though we have undergone it frequently. So, we survey 80 cases ectopic pregnancies treated our hospital for early detection and proper management. METHODS: In this study, the authors studied retrospectively 80 cases which had been admitted and treated at the department of Obstetrics and Gynecology, National Police Hospital from Jan. 1, 1991 to Dec. 31, 2000. RESULTS: Incidence of ectopic pregnancy was one in 68 normal deliveries for 10 years, 63.7% of cases occurred in 25~34 years-old age group, and 52.6% of patients had previous abdominal surgery including cesarean section. Average interval of tubal ligation was 6.5 years between the onset of ectopic pregnancy and tubal ligation. Lower abdominal pain was the most common clinical symptom developed in 91.3% of the patients. Average interval between the onset of symptom and LMP was 7.6 weeks. Most ectopic pregnancies were tubal pregnancies and salpingectomy was done in 56.3% of the patients. CONCLUSION: According to our study, ectopic pregnancy occurred most frequently in women in their reproductive age and one of most important prognostic factors is time between onset of symptom and arrival of patient at hospital. We must make our efforts to preserve utero-ovarian function in treatment of patients with ectopic pregnancy.

Effect of Peritoneal Fluid with Endometriosis on Mouse Embryo Development in vitro / 대한산부인과학회잡지

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.

Effect of Peritoneal Fluid with Endometriosis on Mouse Embryo Development in vitro / 대한산부인과학회잡지

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.