Thalassemia is hereditary disease characterized by impaired production of the normal globin peptide. Beta-thalassemia, a common disorder in Central Africa, the Middle East, and Southeast Asia, has been rarely reported in Korea. It should be considered in the differential diagnosis of hypochromic, microcytic anemia. The genetic subtypes among the different ethnic groups vary; this may pose challenges in prenatal diagnosis or genetic counselling. During pregnancy, women with thalassemia will often show more significant anemia. Recently we have experienced Korean pregnant woman with beta-thalassemia associated with anemia. We describe this case with a brief review of the literature.
Africa, Central ; Anemia ; Asia, Southeastern ; beta-Thalassemia* ; Diagnosis, Differential ; Ethnic Groups ; Female ; Genetic Diseases, Inborn ; Globins ; Humans ; Korea ; Middle East ; Pregnancy ; Pregnant Women* ; Prenatal Diagnosis ; Thalassemia

Ectopic pregnancy is an implantation of the fertilized ovum on a place except the endometrium. Most of the ectopic pregnancies are located at the fallopian tube. Few cases of retroperitoneal hematoma associated with ectopic pregnancy have been reported on previously; in each the retroperitoneal space had been the site of implantation. In contrast, we treated a patient with an ectopic pregnancy that implanted in the tube and then perforated through into the retroperitoneal space. To our knowledge this is very rare case of retroperitoneal hematoma caused by a ruptured tubal pregnancy.
Endometrium ; Fallopian Tubes ; Female ; Hematoma ; Hemorrhage* ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Retroperitoneal Space ; Zygote

Fetal growth restriction (FGR) occurs due to various reasons and is associated with increased fetal and neonatal mortality and morbidity. FGR has been defined as having birth weight less than the 10th centile. The first clinically relevant step is the detection of true FGR, pathological small fetuses, associated with signs of abnormal placental insufficiency and poorer perinatal outcome. The role of obstetric management is to identify growth restricted fetuses at risk of chronic hypoxia in uterus, to monitor their wellbeing, and to deliver when the adverse outcome is imminent. The purpose of this document is to review the FGR with diagnosis, antenatal surveillance tools, and guidance for management and timing of delivery.
Anoxia ; Birth Weight ; Fetal Development* ; Fetus ; Humans ; Infant ; Infant Mortality ; Placental Insufficiency ; Prenatal Diagnosis ; Uterus

Although liver diseases in pregnancy are rare, they can seriously affect mother and fetus. Although any type of liver disease can develop during pregnancy, it is difficult to identify features of liver disease in pregnant women because of physiological changes. Physiologic changes of pregnancy can be confounding with the symptoms of liver diseases. It can not only complicate mother's life but also burden life of fetus to growth restriction. We describe an uncommon case of acute hepatitis with disseminated intravascular coagulation and clinical chorioamnionitis coincidentally in mid-trimester pregnancy. She experienced the development of acute hepatitis of unknown causes. She presented with fever, maternal tachycardia, and fetal tachycardia. We decided termination of pregnancy because of 16 weeks' gestation. After termination, she was managed about acute hepatitis. So we report our case with a brief reviews of the literature.
Chorioamnionitis ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Fever ; Hepatitis* ; Humans ; Liver Diseases ; Mothers ; Pregnancy* ; Pregnant Women ; Tachycardia

Gestational trophoblastic disease is an abnormal proliferations of trophoblastic tissue during pregnancy. Persistent gestational trophoblastic tumor develops in about 20% after evacuation of complete mole. Following evacuation of hydatidiform mole, the interpretation of serial serum human chorionic gonadotropin (hCG) regression patterns is important in monitoring the course of the disease. Because it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. We describe an uncommon case of complete hydatidiform mole in a 48-year-old woman, who has presented to us with complaints of bleeding. She experienced after the evacuation of a complete mole and no decreased in hCG levels over four consecutive serum hCG measurements. The patient underwent hysterectomy due to leiomyoma. Finally, pathologic diagnosis was confirmed persistent gestational trophoblastic disease.
Aged ; Amyotrophic Lateral Sclerosis* ; Anesthesia ; Anesthesia, Intravenous* ; Chorionic Gonadotropin ; Diagnosis ; Female ; Gestational Trophoblastic Disease* ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hysterectomy ; Leiomyoma ; Methods ; Middle Aged ; Muscle Relaxation* ; Pregnancy ; Propofol ; Trophoblastic Neoplasms ; Trophoblasts

Sheehan's syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. Usually, it is the result of severe hypotension caused by massive hemorrhage during or after delivery. A 40-year-old woman who had been performed cesarean section delivery was complicated by hemorrhage due to uterine atony. After transfusion and hysterectomy, she is gradually recovering her general condition. On 16th day after operation, she visited emergency room in critical condition with nausea, vomiting, and general weakness and laboratory finding was hyponatremia. So, we medicated her with hydrocortisone and thyroxine. Sheehan's syndrome should be considered in the differential diagnosis of hyponatremia in the early postpartum period.
Adult ; Cesarean Section ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Hydrocortisone ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Hysterectomy ; Nausea ; Necrosis ; Pituitary Gland ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Thyroxine ; Uterine Inertia ; Vomiting

Uterine arterial pseudoaneurysm is a very rare condition usually associated with postpartum hemorrhage. It almost never occurs after cervical conization; however, since ruptured pseudoaneurysm could be life threatening, we should consider the possibility of vascular injury such as pseudoaneurysm when we find a patient with vaginal bleeding after the process of surgical operation. Emergency arterial embolization is a well established therapeutic option to control the ruptured pseudoaneurysm. This is a case report of uterine arterial pseudoaneurysm causing intra-abdominal bleeding followed by cervical conization, which was successfully treated by uterine artery embolization.
Aneurysm, False* ; Conization* ; Emergencies ; Hemorrhage ; Humans ; Postpartum Hemorrhage ; Uterine Artery Embolization ; Uterine Artery* ; Uterine Hemorrhage* ; Vascular System Injuries

Struma ovarii is a rare, monodermal and highly specialized teratoma, composed entirely or predominantly (>50%) of thyroid tissue. Presenting symptoms are not specific. Despite containing thyroid tissue, only 5% of struma ovarii have features of hyperthyroidism. Therefore, preoperative diagnosis of struma ovarii is difficult. Recently, the authors experienced a case of struma ovarii found in a young woman who presented with known pelvic mass and dysmenorrhea. A transabdominal ultrasonography and computed tomography detected a 16-cm sized multiloculated mass in pelvic cavity. She underwent laparoscopic unilateral ovarian wedge resection. The final histopathologic diagnosis was struma ovarii of the mature cystic teratoma. Therefore, we report this rare case with a brief review of the literature.
Diagnosis ; Dysmenorrhea ; Female ; Humans ; Hyperthyroidism ; Struma Ovarii* ; Teratoma ; Thyroid Gland ; Ultrasonography

OBJECTIVE: Absence of dysplasia in the excised specimen following loop electrosurgical excision procedure (LEEP) for treatment of cervical intraepithelial neoplasia (CIN) 2/3 is an occasional finding of uncertain clinical significance. We evaluated several factors including age, liquid-based Pap (LBP) test, human papillomavirus (HPV) load before treatment, and HPV typing as predictors for absence of dysplasia. Absence of dysplasia in LEEP specimens was analyzed in terms of factors for recurrent disease after LEEP conization METHODS: In total, 192 women (mean age, 39.3+/-8.4 years; range, 24 to 70 years) with biopsy-proven CIN 2/3 were treated by LEEP conization. Age, LBP test, histological grade, HPV load, and HPV DNA typing were evaluated as possible predictors of the absence of residual dysplasia or recurrent disease. RESULTS: Of the LEEP specimens, 34 (17.7%) showed no dysplasia in preoperative biopsies from patients with proven CIN 2/3. Low HPV load (<100 relative light units [RLU]) was significantly related to the absence of dysplasia in LEEP specimens, using logistic regression. Margin involvement and high HPV load (> or =400 RLU) were significant factors for recurrence. CONCLUSION: Absence of dysplasia in LEEP specimens occurred in 17.7% of our specimens. Prediction of the absence of dysplasia in LEEP specimens was associated with low HPV load. Residual/recurrent disease after LEEP was associated with a positive resection margin and high viral load, and was not associated with absence of dysplasia in LEEP specimens. Even if there is no dysplasia in conization specimens, close follow-up for residual/recurrent disease is needed.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization ; DNA Fingerprinting ; Female ; Follow-Up Studies ; Humans ; Light ; Logistic Models ; Recurrence ; Viral Load

Vasomotor symptoms start about 2 years prior to menopause in women who are approaching menopause, and early menopause symptoms appear including emotional disturbance and anxiety, followed by physical changes such as vaginal dryness, urinary incontinence and skin wrinkles. As time progresses, osteoporosis, cardiovascular diseases, and dementia occur consecutively. Hormone therapy is primarily considered for the relief of menopause symptoms in postmenopausal women. However, as hormone replacement has emerged as a therapy that increases the potential risk of thrombosis, cerebral infarction and breast cancer, complementary and alternative medicine has drawn much attention. This study aimed to examine the types and effects of evidence-based complementary and alternative therapies that are currently used.
Affective Symptoms ; Anxiety ; Breast Neoplasms ; Cardiovascular Diseases ; Climacteric* ; Complementary Therapies ; Dementia ; Female ; Humans ; Infarction ; Intracranial Thrombosis ; Menopause ; Osteoporosis ; Postmenopause ; Skin ; Urinary Incontinence