2.Correlation of grayscale combined with color doppler sonography from histopathology in predicting retained products of conception
Jeptah Komiya-Padilla ; Leilani Go-Suva
Philippine Journal of Obstetrics and Gynecology 2019;43(3):22-30
Background:
Retained products of conception can be troublesome complications following miscarriages. Ultrasound has a significant impact in their diagnosis and with the advent of color doppler sonography can improve the assessment.
Objective:
The goal of this study was to evaluate the use of grayscale combined with color Doppler ultrasound findings and correlate with histopathology in predicting retained products of conception in a maternity hospital.
Methods:
This was a cross sectional prospective study of 109 patients who underwent transvaginal grayscale ultrasound with color Doppler to evaluate the presence of retained products of conception. Resistance index(RI) is measured in Pulsed doppler to assess the impedance of blood flow. The standard criterion was the histopathologic reports obtained during completion curettage.
Results:
Histopathologic results validated the presence of immature placental tissues in 93 (85%) patients and decidua in 16 (15%). Endometrial mass was greater with positive histopath results (p<0.05). Endometrial mass had a sensitivity of 83.9% in detecting retained products of conception. Thickened endometrium was detected in 71.4 % of women with positive histopath results, but only in 28.6% with negative histopath results. Color flow was confirmed in 85% with positive histopathology results.
Conclusion
The combination of an endometrial mass with vascular pattern had the highest positive predictive value in determining retained products of conception.
Abortion, Spontaneous
;
Decidua
;
Ultrasonography, Doppler, Color
3.Pregnancy-Related Cytologic Changes In Cervicovaginal Smears.
Yi Kyeong CHUN ; Hoi Sook JANG ; Hye Sun KIM ; Sung Ran HONG ; Jong Sun CHOI ; Ji Young PARK ; Jung Sook CHO ; Seok Ju SEONG ; Jae Hyug YANG ; Hy Sook KIM
Korean Journal of Cytopathology 2004;15(2):92-100
Due to insufficient clinical information, most cervicovaginal smears from pregnant or postpartum women have been screened without regard to pregnancy-related cytological changes. Here, we have reviewed 116 abnormal cervicovaginal smears from 103 pregnant and postpartum women. Initial cytological diagnoses revealed the following: 9 cases of high-grade squamous intraepithelial lesions (HSIL), 8 cases of low-grade squamous intraepithelial lesions (LSIL), 85 cases of atypical squamous cells of undetermined significance (ASCUS), and 14 cases involving atypical glandular cells of undetermined significance (AGUS). 31 cases, upon review, involved pregnancy-related cytological changes, comprising 25 cases of decidua cells, 4 cases of Arias-Stella reaction, and 2 cases of decidual cells coupled with Arias-Stella reaction. Interpretation errors were detected in 14 cases: 13 cases of decidual cells interpreted as either ASCUS favor reactive or ASCUS ruled out HSIL, and one case of Arias-Stella reaction was interpreted as ASCUS ruled out HSIL. Decidual cells and degenerated glandular cells with Arias-Stella reaction can result in diagnostic mistakes. In order to avoid misdiagnosis and unnecessary surgeries, both clinicians and pathologists must be aware of the pregnancy-related cytological changes. The clinician should also always inform the pathologist on the pregnancy status of the patient.
Decidua
;
Diagnosis
;
Diagnostic Errors
;
Female
;
Humans
;
Postpartum Period
;
Pregnancy
4.The Production of IL-1beta and PGE2by Human Decidual Cells aftr Incubation with LPS.
Young Ju KIM ; Kyung Eun LEE ; Eun Hee LEE ; Young Soo SON ; Jong Il KIM ; Jung Ja AHN ; Bock Hi WOO
Korean Journal of Obstetrics and Gynecology 1997;40(4):767-776
The mechanisms responsible for the onset of preterm labor in women are poorly understood. It is widely accepted that increased biosynthesis of PGE2 by intrauterine tissues seems to be a key event in the initiation of preterm parturition.However, the mechanisms for the increased PG formation during parturition have not yet been explained.Growing evidednce suggesis an association between intraamniotic infection and preterm labor. It is suggested that bacterial products can signal the increased PG biosynthesis associated with parturition, and that decidua can induce the onset of preterm labor by using inflammatory mediators(for example, IL-1beta) produced in response to bacterial invasion. The purposes of this study were to determine the effect of LPS on the production of IL-1beta and PGE2 and to determine the inhibitory effect of anti-IL-1beta and TGF-beta2 on the production of IL-1beta and PGE2 BY HUMAN DECIDUAL CELLS. The results were as follows : 1. The production of PGE2 AND IL-beta by decidual cells after incubation with LPS for 24 hours culture significantly increased in comparison with controls, respectively. 2. The production of PGE2 by decidual cells after incubation with il-1beta for 24 hours culture significantly increased in comparision with controls. 3. The production of PGE2 by decidual cells after incubation with LPS and anti-IL-1beta for 24 hours culture significantly decreased in comparision with LPS treated groups, respectively. 4. The production of PGE2 by decidual cells after incubation with LPS and TGF-beta2 for 24 hours culture significantly decreased, but IL-1beta production significantly increased in comparision with LPS treated groups. In conclusion, LPS may induce the formation PGE2 through IL-1beta, and LPS induced preterm labor may be prevented by anti-IL-1beta and TGF-beta2.
Decidua
;
Dinoprostone
;
Female
;
Humans*
;
Interleukin-1beta
;
Obstetric Labor, Premature
;
Parturition
;
Pregnancy
;
Transforming Growth Factor beta2
5.Availability of Maternal Serum CA 125 in Diagnosis of Abruptio Placentae.
Seoung Min LEE ; Gi Hong KIM ; Hak Joon KIM ; Young Woo SEO ; Jeong Ho RHEE ; Jong In KIM
Korean Journal of Obstetrics and Gynecology 1997;40(4):747-750
The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.
Abruptio Placentae*
;
Decidua
;
Diagnosis*
;
Female
;
Hemorrhage
;
Humans
;
Placenta
;
Pregnancy
;
Sensitivity and Specificity
;
Uterine Hemorrhage
6.The Production of IL-1beta and PGE2by Human Decidual Cells aftr Incubation with LPS.
Young Ju KIM ; Kyung Eun LEE ; Eun Hee LEE ; Young Soo SON ; Jong Il KIM ; Jung Ja AHN ; Bock Hi WOO
Korean Journal of Obstetrics and Gynecology 1997;40(4):767-776
The mechanisms responsible for the onset of preterm labor in women are poorly understood. It is widely accepted that increased biosynthesis of PGE2 by intrauterine tissues seems to be a key event in the initiation of preterm parturition.However, the mechanisms for the increased PG formation during parturition have not yet been explained.Growing evidednce suggesis an association between intraamniotic infection and preterm labor. It is suggested that bacterial products can signal the increased PG biosynthesis associated with parturition, and that decidua can induce the onset of preterm labor by using inflammatory mediators(for example, IL-1beta) produced in response to bacterial invasion. The purposes of this study were to determine the effect of LPS on the production of IL-1beta and PGE2 and to determine the inhibitory effect of anti-IL-1beta and TGF-beta2 on the production of IL-1beta and PGE2 BY HUMAN DECIDUAL CELLS. The results were as follows : 1. The production of PGE2 AND IL-beta by decidual cells after incubation with LPS for 24 hours culture significantly increased in comparison with controls, respectively. 2. The production of PGE2 by decidual cells after incubation with il-1beta for 24 hours culture significantly increased in comparision with controls. 3. The production of PGE2 by decidual cells after incubation with LPS and anti-IL-1beta for 24 hours culture significantly decreased in comparision with LPS treated groups, respectively. 4. The production of PGE2 by decidual cells after incubation with LPS and TGF-beta2 for 24 hours culture significantly decreased, but IL-1beta production significantly increased in comparision with LPS treated groups. In conclusion, LPS may induce the formation PGE2 through IL-1beta, and LPS induced preterm labor may be prevented by anti-IL-1beta and TGF-beta2.
Decidua
;
Dinoprostone
;
Female
;
Humans*
;
Interleukin-1beta
;
Obstetric Labor, Premature
;
Parturition
;
Pregnancy
;
Transforming Growth Factor beta2
7.Availability of Maternal Serum CA 125 in Diagnosis of Abruptio Placentae.
Seoung Min LEE ; Gi Hong KIM ; Hak Joon KIM ; Young Woo SEO ; Jeong Ho RHEE ; Jong In KIM
Korean Journal of Obstetrics and Gynecology 1997;40(4):747-750
The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.
Abruptio Placentae*
;
Decidua
;
Diagnosis*
;
Female
;
Hemorrhage
;
Humans
;
Placenta
;
Pregnancy
;
Sensitivity and Specificity
;
Uterine Hemorrhage
8.Expression of Estrogen Receptor and Telomerase Activity in Chorionic Villi and Decidua of Early Human Gestation.
Sei Kwang KIM ; Young Nae JUNG ; Kyu Hyun PARK ; Hyun Cheol CHUNG ; Young Kwon CHANG ; Ja Young KWON ; Jeong Yeon KIM ; Sang Wook BAI ; Ki Hyun PARK ; Dong Jae CHO ; Chan Ho SONG
Korean Journal of Obstetrics and Gynecology 2001;44(10):1804-1811
OBJECTIVE: To investigate whether there is any differences between normal pregnancy (NP) and spontaneous abortion (SAB) regarding estrogen receptor (ER) expression and telomerase activity (TA) in the chorionic villi and decidual tissues. METHODS: Chorionic villi and decidual tissues were obtained between 6 and 9 weeks' gestation from 14 patients with SAB and 17 normal pregnant women who have undergone an elective abortion. All tissue samples were assayed for ER with enzyme immunoassay and also TA was analysed using telomeric repeat amplication protocol. RESULTS: A significant decrease in ER expression (2.81+/-2.77 fmol/mg of protein; p<.001) was demonstrated in SAB group compared to that of NP group (4.56+/-1.85 fmol/mg) in decidua. However, no significant difference in ER expression in chorionic villi was found between the two groups. SAB group showed significantly lower levels of TA than that of NP group in both chorionic villi (21.4% vs. 82.4%; p=.002) and deciduas (7.1% vs. 52.9%; p=.009). CONCLUSION: Our results suggest that decreased level of ER expression in deciduas might cause decidual senescence and eventually, spontaneous abortion.
Abortion, Spontaneous
;
Aging
;
Chorion*
;
Chorionic Villi*
;
Decidua*
;
Estrogens*
;
Female
;
Humans*
;
Immunoenzyme Techniques
;
Pregnancy*
;
Pregnant Women
;
Telomerase*
9.Isolation and characterization of mesenchymal stem cells from human amnion and decidua.
Young Sun YOON ; Hyun Chul JEONG ; Jong Ha HWANG ; Hyun Jun JEE ; Oye Sun SEOK ; Jung Youn JO ; Yun Joung KIM ; Jae Kwan LEE
Korean Journal of Obstetrics and Gynecology 2008;51(11):1269-1279
OBJECTIVES: The purpose of this study is to isolate a population of multipotent cells from human amnion and decidua, respectively. METHODS: Human placentas (gestational age, 30~42 weeks) were obtained after vaginal or cesarean deliveries. Amnions and deciduas were divided mechanically. The collected cells from the amnion and decidua were cultured. Cultured cells were immunophenotypically characterized. The adipogenic, osteogenic and neurogenic differentiation capacities were tested, and their growth kinetics were analyzed. RESULTS: We successfully isolated MSCs from both the amnion and decidua. The phenotype of MSCs cultured from different fetal and maternal parts of the placenta was comparable. The growth kinetics of MSCs derived from amnions and deciduas were similar. Isolated MSCs were differentiated into various cell lines such as adipogenic, osteogenic, myogenic and neurogenic cells. CONCLUSIONS: The human amnion and decidua could be an excellent source of MSC because they are easily obtainable after delivery and showed a higher expansion capacity than that of MSCs from adult bone marrow.
Adult
;
Amnion
;
Cell Line
;
Cells, Cultured
;
Decidua
;
Durapatite
;
Female
;
Humans
;
Kinetics
;
Mesenchymal Stromal Cells
;
Phenotype
;
Placenta
10.Clinical observation on treatment of primary dysmenorrhea with acupuncture and massage.
Li-Li LIN ; Cun-Zhi LIU ; Bi-Yu HUANG
Chinese Journal of Integrated Traditional and Western Medicine 2008;28(5):418-420
OBJECTIVETo observe the clinical therapeutic effect of acupuncture massage for primary dysmenorrhea and its influence on prostaglandin F2alpha level in menstrual fluid.
METHODSNinety patients with primary dysmenorrhea were assigned equally to the acupuncture group, the massage group and the control group (oral administrated with Somiton tablet). The treatment course was 3 menstrual cycles. The effect in relieving menalgia was evaluated using numerical rating scale (NRS) before and after treatment and change of PGF2alpha content in menstrual fluid was tested as well.
RESULTSThe NRS score was 0.60 +/- 0.67 in the acupuncture group and 0.53 +/- 0.63 in the massage group respectively, significantly lower than that in the control group, which was 2.30 +/- 1.73 (P < 0.01). The PGF2alpha level after treatment was significantly lower in the acupuncture group (176.58 +/- 17.85 ng/L) and the massage group (171.32 +/- 17.15 ng/L) than that in the control group (220.56 +/- 54.47 ng/L), respectively (P <0.01). There showed no difference in the two aspects between the acupuncture group and the massage group (P >0.05).
CONCLUSIONAcupuncture and massage has a reliable therapeutic effect on primary dysmenorrhea, which is superior to that of Somiton tablet, and its mechanism might be exerted by regulating PGF2alpha level in menstrual fluid.
Acupuncture Therapy ; Decidua ; metabolism ; Dinoprost ; metabolism ; Dysmenorrhea ; therapy ; Female ; Humans ; Massage