Hormone replace therapy and changes in mammographic density in postmenopausal women / 대한산부인과학회지

OBJECTIVE: To evaluate the changes in mammographic density by different types of hormone replace therapy (HRT) in postmenopausal women. METHODS: A total of 150 postmenopausal women who received same HRT regimen for 1 year were classified as the four groups according to the regimen of HRT; 1) daily conjugated equine estrogen (CEE) 0.625 mg+medroxiprogesterone acetate (MPA) 2.5 mg (CEE/MPA-continuous, n=42), 2) daily CEE 0.625 mg+MPA 10 mg on days 1-12 (CEE/MPA-cyclic, n=28), 3) daily CEE 0.625 mg (CEE only, n=40), 4) daily tibolone 2.5 mg (Tibolone, n=40). And 40 women were allocated as control group. The changes in mammographic density in each group were compared with before and after HRT for 1 year. RESULTS: The increase in mammographic density after 1 year of HRT was significantly higher in CEE/MPA-continuous group and CEE/MPA-cyclic group compaired with control group (p<0.05), and was not observed in CEE only group and tibolone group. CONCLUSION: Our results suggest that greater increase of mammographic density in postmenopausal women was significantly associated with estrogen/progestin combination therapy.

A Case of Cornual Pregnancy Complicated with Intraligamentary Pregnancy / 대한산부인과학회잡지

Cornual pregnancy, which is a rare form of ectopic pregnancy, is an implantation of embryo in the intramural portion of a fallopian tubes. The incidence of cornual pregnancy is reported to be between 2-4% of all tubal pregnancy, about 1% of ectopic pregnancy, and occurs once for every 2,500 to 5,000 live births. Because the greater distensibility and vascularlity of this site lead to rupture at a latter gestational age and rapid intraperitoneal hemorrhage, cornual pregnancy causes serious maternal mortality and morbidity. Intraligamentary pregnancy, also a form of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentary pregnancy is hardly ever made prior to laparotomy. The incidence of intraligamentary pregnancy is reported to be about once for every 245 all ectopic pregnancy, and about once for every 49,000 to 184,000 all pregnancy. We have experienced an extremely rare case of right cornual pregnancy complicated with right intraligamentary pregnancy which was proven by histopathologic diagnoses in a 34-year-old woman and report it with review of literatures.

A Case of Heterotopic Pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare condition with an estimated incidence of 1 in 30,000 pregnancies. The incidence of heterotopic pregnancies have increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. Common sites of extrauterine gestation are salpinx, cornus and cervix of uterus, ovary, and abdomen in order of incidence. Early detection of heterotopic pregnancy is very difficult and is often more difficult in the case of abdominal pregnancy. However, to avoid high maternal morbidity, mortality, and loss of pregnancy, one should always take this into consideration and should conduct careful and thorough gynecologic evaluations. We have experienced a case of abdominal pregnancy following termination of intrauterine pregnancy in a 23-year-old unmarried woman and report it with brief review of literatures.