Placenta percreta is a life-threatening complication of pregnancy, and it is very rarely noted to occur in the first trimester. We present here a case of placenta percreta with a missed abortion that occurred at 12 gestational weeks. During curettage, hysterectomy was required due to the heavy bleeding. On operative finding, hemorrhagic placental tissue in the lower uterine segment. It is extending into the myometrium and periuterine soft tissue. Histological examination revealed features of placenta percreta.
Abortion, Missed ; Animals ; Curettage ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Mice ; Myometrium ; Placenta Accreta* ; Placenta* ; Pregnancy ; Pregnancy Trimester, First*

Lack of mullerian development (Mayer-Rokitansky-Kuster-Hauser Syndrome) is characterized by absence of apparent vagina and/or uterus, normal secondary sexual characteristics, normal reproductive hormonal profile, and a relatively common cause of primary amenorrhea about 1 in 4,000 female births and also cause of primary infertility. Management for these women comprise of construction of neovagina for sexual life. In 1985, the first report of a successful pregnancy through the uterine surrogacy was made. It is being possible for these women to have new opportunity of getting her own genetic offspring. Since ovarian activity is completely preserved in patients, controlled ovarian hyperstimulation is similar to any other IVF case that is with urinary or recombinant gonadotropins following GnRH agonist down regulation. Genetic offspring can be achieved by cellection of oocytes from the genetic mather, in-vitro-fertilization by the genetic father, and placement into a surrogate carrier. We have experienced a case of successful surrogate pregnancy in a patient with congenital absence of vagina and uterus.
Amenorrhea ; Down-Regulation ; Fathers ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Oocytes ; Parturition ; Pregnancy* ; Uterus ; Vagina

Iniencephaly is an abnormality in cervical vertebra associated with an excessive lordosis of the cervicothoracic spine and neural tube closure defects. The incidence is one of 1,000 to 10,000 live birth. The pathogenesis is unknown. It is possible that iniencephaly is a primary defects in fetal cervical development and the resulting lordosis cause a failure of neural tube closure. Specific sonographic findings are over extended fetal head, very short and modified thorax, generally shortened fetal long bones and frequent associating anencephaly and meningomyelocele. Fetal alpha-fetoprotein elevation may be present. Iniencephaly, when diagnosed in utero, is almost always lethal. We experienced a case of iniencephaly in a fetus of intrauterine pregnancy at 17 weeks diagnosed by prenatal ultrasonography who was terminated because of ultrasonic demonstration of other multiple anomalies. Thus, we report a case with brief review of the literature.
alpha-Fetoproteins ; Anencephaly ; Animals ; Fetus ; Head ; Incidence ; Live Birth ; Lordosis ; Meningomyelocele ; Neural Tube ; Neural Tube Defects* ; Pregnancy ; Spine ; Thorax ; Ultrasonics ; Ultrasonography ; Ultrasonography, Prenatal*

Postpartum endomyometritis is an important cause of maternal morbidity, especially after cesarean delivery. The management of postpartum endomyometritis is primarily medical with surgical intervention only occasionally required. But the gas forming abscess rarely happens, making the medical treatment difficult and needing emergency hysterectomy. We present a case of post-cesarean delivery endomyometritis complicated by intrauterine gas formation penetrating myometrium, which could not be managed by medical treatment, so finally needed emergency hysterectomy.
Abscess ; Animals ; Emergencies ; Endometritis* ; Female ; Hysterectomy ; Mice ; Myometrium ; Postpartum Period

OBJECTIVE: To evaluate female sexual function after colpoperineoplasty. METHODS: Women who visited regional clinic for colpoperineoplasty from June. 2004-Aug. 2004. filled in FSFI (The Female Sexual Function Index) questionnarie before and 4 months after surgery. Six weeks after surgery, they start pelvic muscle training with HMT 2000 (Korea, electric stimulator). RESULTS: Frequency of coitus, sexual desire, arousal, lubrication and orgasm was increased after colpoperineoplasty. Percentage of patients who had coitus more than once a week increased from 18% to 63%. In sexual desire, about 18% felt sexual arousal more than or about half the time before surgery, but increased to 45% after surgery. In sexual arousal, percentage of who felt sexually aroused during more than half of sexual activity increased from 34% before surgery to 69% after surgery. In Lubrication, percentage of who became lubricated during more than half of sexual activity increased from 44% before surgery to 82% after surgery. Who reached orgasm more than half of sexual activity increased from 29% before surgery to 70%. CONCLUSION: Colpoperineoplasty increased female sexual activity.
Arousal ; Coitus ; Female* ; Humans ; Lubrication ; Orgasm ; Sexual Behavior

OBJECTIVE: To investigate whether fetal microchimeric cells were detected in ovarian tissues with pelvic endometriosis. METHODS: Ovarian tissues with endometriosis were obtained from five women who had at least one live-born son and who underwent enucleation of endometriotic cyst or oophorectomy after a diagnosis of endometriotic cyst. Control tissues were obtained from five women with endometriosis who had no pregnant history. Tissue sections were analyzed with fluorescence in situ hybridization for the presence of fetal cells, defined by X and Y chromosome. RESULTS: Fluorescence in situ hybridization using paraffin-embedded ovarian specimens was performed successfully. Male cells were found in ovarian tissues from all five patients. No male cells were found in ovarian tissues from all five controls. CONCLUSION: Fetal microchimeric cells, possibly from feto-maternal cell trafficking were detected in ovarian tissues with endometriosis were obtained from women who had prior male pregnancies. Further study is necessary to understand the role of persistent fetal microchimeric cells in the progression of endometriosis.
Chimerism* ; Diagnosis ; Endometriosis* ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Male ; Ovariectomy ; Pregnancy ; Y Chromosome

OBJECTIVE: The aim of our study is to evaluate the prevalence and related risk factor of pelvic organ prolapse in the general Korean population. METHODS: The study population considered of 713 women who were seen for routine gynecologic health care. Pregnant or women within 6 weeks postpartum were excluded. General biographic data were collected regarding obstetric history, medical history, and surgical history. Pelvic organ support was measured and described according to the Pelvic Organ Prolapse Quantification (POP-Q) staging system. Univariate analyses of categorical data were performed with x2 test. RESULTS: The subjects had a mean age of 41.6 years (18-72), weight 55.8 kg (40-83), height 158.7 cm (138-177), body mass index (BMI) 22.3 kg/m2 (15.7-32), waist circumference (WC) 72.3 cm (58-91), and median parity was 2 (0-6). In the 713 women with a uterus, the rate of anterior vaginal prolapse was 27.6%, uterine prolapse 2.0%, and posterior vaginal prolapse 25.4%. The overall distribution of pelvic organ prolapse quantification system stages were as follows: stage 0, 68.3%; stage 1, 19.9%; stage 2, 11.2%; and stage 3, 0.6%. Age, parity, BMI, WC, pelvic floor muscle score, menopausal status and delivery mode were significantly associated with presence of prolapse. CONCLUSION: The prevalence of any degree of prolapse is 31.7%. Prevalence of anterior and posterior vaginal prolapse is higher than uterine prolapse. There was a statistically significant trend toward increased POP-Q system stage of support among women with many of the historically quoted etiologic factors for the development of pelvic organ prolapse.
Body Mass Index ; Delivery of Health Care ; Female ; Humans ; Parity ; Pelvic Floor ; Pelvic Organ Prolapse* ; Postpartum Period ; Prevalence* ; Prolapse ; Risk Factors* ; Uterine Prolapse ; Uterus ; Waist Circumference

OBJECTIVE: To compare the clinical results between total laparoscopic Hysterectomy (TLH) and total abdominal hysterectomy (TAH). METHODS: 100 cases of TLH and 95 cases of TAH, which were performed at Pocheon CHA university from January 2001 to September 2004. We analyzed the results with regard to patient's characteristics (age, parity), uterine weight, operative time, blood loss, hospital stay and complications. RESULTS: There were no differences in terms of patient's age, parity, main operative indication and total operating time between the 2 groups. The mean uterine weight of TAH group was larger than TLH (291 +/- 239 gm for TLH, 404 +/- 174 gm for TAH, p<.05) group. The estimated blood loss was significantly lower for TLH (239.00 +/- 155.63 mL) than for TAH (333.68 +/- 228.4 mL) (p<.05). The length of hospital day was significantly shorter for TLH (6.78 +/- 1.70 day) than for TAH (7.39 +/- 1.49 day) (p<.05). Post-operative complications in the TLH group were dysuria in 2 cases, major hemorrhage requiring transfusion in 4 cases, trocar site hematoma in 1 case and bowel injury in 1 case. Post-operative complications In the TAH group were major hemorrhage requiring transfusion in 7 cases, wound infection in 3 cases and bowel injury in one case. CONCLUSION: The present study demonstrates that, given adequate training in laparoscopic surgery, TLH may replace TAH in most patients who require a hysterectomy, showing clear advantages of shorter hospitalization and the acceptable complication rate.
Dysuria ; Female ; Hematoma ; Hemorrhage ; Hospitalization ; Humans ; Hysterectomy* ; Laparoscopy ; Length of Stay ; Operative Time ; Parity ; Surgical Instruments ; Wound Infection

OBJECTIVE: To explore the association of the CYP 1A1 gene polymorphism with the risk of endometriosis in a Korean population. DESIGN: Case-control study METHODS: Two-hundred fifty two Korean women with surgically or histologically diagnosed endometriosis of stage I-IV (ASRM, 1997) were recruited, and 203 women with no evidence of endometriosis served as controls. CYP1A1 gene MspI polymorphism was analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. RESULTS: There was no significant difference in the genotype or allele distribution of CYP1A1 gene polymorphism between patients with endometriosis and controls. And when classified by stage, there was also no significant difference in the genotype and allele distribution of CYP1A1 gene MspI polymorphism between patients with stage I-II or stage III-IV endometriosis and controls. CONCLUSION: These results suggest that CYP1A1 gene MspI polymorphism is not associated with the risk of endometriosis in the Korean women.
Alleles ; Case-Control Studies ; Cytochrome P-450 CYP1A1* ; Endometriosis* ; Female ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

OBJECTIVE: To evaluate the relationship between the calcitonin receptor (CTR) gene AluI polymorphism, serum calcitonin levels, bone mineral density (BMD) and bone responsiveness to hormone replacement therapy (HRT). METHODS: The CTR AluI polymorphism were determined by restriction fragment length polymorphism (RFLP) in 433 postmenopausal Korean women. Among these women, 306 women received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin and calcitonin levels were measured by immunoassay and BMD at the lumbar spine and proximal femur by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: The CTR genotype frequencies were 81.3% for CC, 17.5% for CT, and 1.2% for TT. No significant differences in BMD at the lumbar spine and proximal femur and their annual percentage changes after HRT were noted among CTR genotypes. There were no significant differences in the levels of calcitonin or bone turnover markers and their 6 month percentage changes after HRT among CTR genotypes. The CTR genotypes were not distributed differently between HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year) or between women with normal BMD and women with low bone mass. CONCLUSION: The CTR AluI polymorphism is not associated with BMD and bone responsiveness to HRT in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density* ; Calcitonin* ; Female ; Femur ; Genotype ; Hormone Replacement Therapy* ; Humans ; Immunoassay ; Osteocalcin ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitonin* ; Spine