Black Cohosh and St. John's Wort (GYNO-Plus(R)) for Climacteric Symptoms

PURPOSE: This study was conducted to investigate the efficacy of black cohosh (Cimicifuga racemosa) and St. John's wort (Hypericum perforatum) in women with climacteric symptoms, and to assess their effects on vaginal atrophy, hormone levels, and lipid profiles. MATERIALS AND METHODS: In this double-blind randomized, placebo-controlled, multicenter study, 89 peri- or postmenopausal women experiencing climacteric symptoms were treated with St. John's wort and black cohosh extract (Gynoplus

Transabdominal embryofetoscopy in 6 cases of first trimester prenatal diagnosis for congenital anomalies / 대한산부인과학회잡지

OBJECTIVE: To demonstrate the efficacy of first trimester embryofetoscopy for prenatal diagnosis of congenital anomalies in continuing pregnancies. METHODS: Under ultrasound guidance, six patients at 12+6-14+6 weeks of gestation underwent endoscopic procedures. Indications included history of 2 recurrent major genetic syndromes, history of cleft lip/palate in 2 cases, each one of the patient itself and the previous fetus and each family history of syndactyly and polydactyly. A 1 mm semirigid fiberoptic endoscope with a 18 gauge examination sheath and a single-chip digital camera were used for transabdominal embryofetoscopy. RESULTS: Excellent visualization of the external fetal anatomy was obtained in 83% of cases (5/6) with the duration of procedures ranging 15 to 40 minutes. A diagnosis of Meckel-Gruber syndrome was made at 13+1 weeks of gestation by visualizing postaxial polydactyly and an occipital encephalocele. Subsequently the pregnancy was terminated. Three full-term infants were delivered with no gross limb or facial abnormalities. Amniotic fluid leakage after the procedure occurred in 2 cases resulting in termination of pregnancy. CONCLUSION: Our experiences confirm the efficacy of embryofetoscopy for early diagnosis in the first trimester of pregnancy. Procedure-related risks are to be established by multicenter studies.

Two Cases of Ectopic Pregnancy Implanted in the Previous Cesarean Section Scar Treated with Dilatation and Evacuation after Vaginal Misoprostol / 대한산부인과학회잡지

Implantation of a pregnancy within the scar of previous cesarean section is the rarest form of ectopic pregnancy. If diagnosed early, treatment options are capable of preserving the uterus and subsequent fertility. However, delayed diagnosis and treatment can lead to uterine rupture, hemorrhage and maternal morbidity. We present two cases of ectopic pregnancy developing in the previous cesarean section scar in which successfully treated with dilatation and evacuation after vaginal misoprostol.

A Case of Heterotopic Pregnancy after Ovulation Induction / 대한산부인과학회잡지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, classically was considered a exceedingly rare obstetrical phenomenon. But nowadays the natural incidence is increasing and especially in association with assisted reproductive technologies, such as use of variable methods for ovulation inductions, in-vitro fertilization and embryo transfer, and gamate intrafallopian transfer. In spite of the difficult early diagnosis, which is potentially dangerous to the mother and fetus, the maternal mortality, morbidity and fetal loss is low when the diagnosis is made in timely fashion and proper management is achieved. The presence of a intrauterine pregnancy dose not exclude the possibility of a extrauterine pregnancy, and in women associated with assisted reproductive technologies, the possibility of a heterotopic pregnancy should be considered. We report a case of a heterotopic pregnancy following ovulation induction and intrauterine insemination with brief review of literature.