Résumé
Pelvic organ prolapse complicating pregnancy is a rare clinical condition and its incidence is one in 10,000~15,000 deliveries. It is associated with multiparity, low socioeconomic status, inadequate perinatal care, maternal malnutrition, previous abdominal surgery, and weakness of pelvic muscular and connective tissue. It can cause cervical dystocia, which leads to cervical laceration, uterine rupture, maternal and fetal death. We experienced a case, first in Korea, of cervical swelling that developed during labor, prolapsed beyond the vaginal introitus and thus obstructed the birth canal. The patient underwent cesarean section and subsequently received MgSO4 topical therapy and resulted in complete resolution. We report this case with a brief review of literature.
Sujets)
Femelle , Humains , Grossesse , Césarienne , Tissu conjonctif , Dystocie , Mort foetale , Incidence , Corée , Lacérations , Sulfate de magnésium , Malnutrition , Parité , Parturition , Prolapsus d'organe pelvien , Soins périnatals , Classe sociale , Rupture utérineRésumé
Torsion of the fallopian tube is an uncommon cause for acute low abdominal pain in female that is difficult to diagnose. Because it has no pathognomonic clinical symptoms or laboratory findings, a high index of suspicion is important when there is history of pelvic pathologic conditions or surgery. The early diagnosis and surgical treatment of the disease are mandatory to preserve oviduct.
Sujets)
Adolescent , Animaux , Femelle , Humains , Douleur abdominale , Diagnostic précoce , Trompes utérines , OviductesRésumé
Pulmonary lymphangioleiomyomatosis is a rare disorder of unknown cause and characterised by hamartomatous proliferation of smooth muscle occurring in women of reproductive age exclusively. It causes dyspnea, recurrent pneumothorax, chylothorax, hemoptysis and respiratory failure eventually. Chest radiographs show diffuse interstitial infiltrates and cysts of uniform size, and pulmonary function tests often show airflow limitation with increase in residual volume. Hormonal factors are thought to play a role because it generally affects premenopausal women, but there is no definite treatment yet. We present an unusual case of pulmonary lymphangioleiomyomatosis during normal pregnancy with a review of literature.
Sujets)
Femelle , Humains , Grossesse , Chylothorax , Dyspnée , Hémoptysie , Lymphangioléiomyomatose , Muscles lisses , Pneumothorax , Radiographie thoracique , Volume résiduel , Tests de la fonction respiratoire , Insuffisance respiratoireRésumé
OBJECTIVE: This study was performed to investigate the effect of metformin treatment and insulin resistance in the patients with polycystic ovary syndrome. METHODS: Twenty three patients with polycystic ovary syndrome were included at Seoul National University Hospital from September 2001 to September 2003. Metformin was administered at daily 1,500 mg for 3 months to these patients. Then restoration of regular menstruation or recovery of ovulation was evaluated and insulin resistance was compared between the responder and the non-responder before and after metformin treatment. RESULTS: Eleven patients (47.8%) showed a significant improvement in menstrual or ovulation cyclicity whereas twelve patients had no change. There was no statistically significant difference in the insulin resistance between the responder and the non-responder before and after metformin treatment. CONCLUSION: In non-obese patients with polycystic ovary syndrome, metformin treatment seems to be effective to improvement of menstrual or ovulation cyclicity irrespective of insulin resistance expressed as glucose-to- insulin ratio and HOMA.
Sujets)
Femelle , Humains , Insulinorésistance , Insuline , Menstruation , Metformine , Ovulation , Périodicité , Syndrome des ovaires polykystiques , SéoulRésumé
OBJECTIVE: We used nucleated erythrocytes in maternal blood for prenatal determination of the fetal gender as the preliminary experiment for the screening of fetal genetic status and the BclI DNA polymorphism in an attempt to clarify the origin of erythrocytes in maternal blood. METHODS: In seventeen pregnant women, venous blood was withdrawn and the nucleated erythrocytes were recovered by magnetic activated cell sorting (MACS) and immunostaining. After isolation of nucleated erythrocytes by micromanipulation, we performed nested PCR for amelogenin gene to identify the fetal gender and performed BclI DNA polymorphism to clarify the origin of erythrocytes. RESULTS: We could amplify the minute DNA in a single cell by primer extension preamplification and nested PCR of amelogenin gene in 94 (48.7%) cells and could identify the fetal gender by 58.8%. BclI DNA polymorphism revealed that the several cells, which did not reveal the specific band of Y chromosome in spite of the pregnancy of male fetuses, must be the cells from mother. CONCLUSION: Through this study, we could conclude that several nucleated erythrocytes in maternal blood circulation can originate from mother, therefore we must develop the new method to identify the nucleated erythrocyte of fetal origin. Considering that we must apply for the larger number of pregnant women to screen, the procedure was multi-step and complex. Therefore, we must design the new scheme to utilize the nucleated erythrocytes in maternal blood.