A Case of Primary Ovarian Pregnancy / 대한산부인과학회지

Primary ovarian ectopic pregnancy has remained a rare event. It is difficult preoperatively to diagnose and differentiate ovarian pregnancy from hemorrhagic ovarian cyst and tubal ectopic pregnancy. However, improved diagnosis of acute hemoperitoneum of ovarian origin may reveal a higher incidence than reported earlier. The diagnostic criteria were described in 1878 by Spiegelberg, which comprise that the pregnancy is in the ovary and does not involve the tube. Ovarian pregnancy occurs within the ovary and on the corpus luteum, usually with rupture of the ovary and a massive hemoperitoneum. We report a relatively intact primary ovarian pregnancy with a brief review of the literatures.

Vaginal Bleeding Patterns on Continuous Combined Hormone Replacement Therapy using Micronized Progesterone in Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study is to evaluate the patterns of vaginal bleeding on continuous combined hormone replacement therapy (HRT) with micronized progesterone (MP), compared with medroxyprogesterone acetate (MPA) and to find any effects of body weight, body mass index, age of menopause, and duration of postmenopausal amenorrhea on these patterns of vaginal bleedings. METHODS: In continuous combined HRT using MP, 0.625 mg conjugate equine estrogen (CEE) and 100 mg MP were daily administered orally in 100 postmenopausal women. In continuous combined HRT using MPA, 0.625 mg CEE and 2.5 mg MPA were daily administered orally in 70 postmenopausal women. And we observed the vaginal bleeding patterns for six months after initiation of therapy. RESULTS: No vaginal bleeding or only slight vaginal spotting within 3 months were in 92 women (92%) in continuous combined HRT using MP. Only 8 women (8%) showed continuous bleeding for more than three months or heavy bleeding, so they stopped HRT or changed to other regimens. These were statistically significant lower rates of frequency of vaginal bleeding (35%) and drop out (8%), compared with the group using MPA (62.9%, and 42.9%) in our previous study. There were no statistically significant differences in the means of body weight, body mass index, and age of menopause between two treatment groups, but the mean of durations of postmanopausal amenorrhea was significantly longer in MP treatment group than that of MPA treatment group. In each treatment group, there were no statistically significant differences in the means of body weight, body mass index, duration of postmanopausal amenorrhea, and age of menopause according to the frequency of vaginal bleeding. CONCLUSION: Continuous combined HRT using MP showed less bleeding and better compliance than that using MPA.