No abstract available.
Gestational Sac*

No abstract available.
Gestational Sac* ; Ultrasonography*

OBJECTIVE: The purpose of this study is to verify the correlation between gestational sac volume (GSV) from automatic tracing mode the VOCAL-imaging program and gestational age and to construct the nomogram of gestational sac volume as the new biometric parameter in early pregnancy. METHODS: The cross-sectional study has been conducted in 242 uncomplicated singleton pregnancies. 47 cases were excluded due to early pregnancy failure, fetal malformations, elective abortion, age discrepancy, etc. In 195 uncomplicated singleton pregnancies from 5 to 12 weeks' menstrual age, gestational sac volume, mean sac diameter and crown-lump length were measured for the assessment of gestational age. Gestational sac volumetry was carried out with automatic method and manual method of the VOCALTM (Virtual Organ Computer- aided AnaLysis) for the comparison between two methods. The collected data were analyzed for mean, standard deviation, 90% reference interval, 5th, 50th and 95th percentiles of gestational sac volume, mean sac diameter and CRL, and the nomogram were constructed. RESULTS: Polynomial regression analysis demonstrated the statistically significant positive correlation between gestational age and gestational sac volume by automatic tracing mode (R2 0.826, p<0.001), gestational sac volume by manual tracing mode (R2 0.844, p<0.0001), mean sac diameter (R2 0.763, p<0.0001) and crown-lump length (R2 0.950, p<0.0001). The 5th, 50th and 95th percentiles of the gestational sac volume were calculated and the nomogram was tabulated. In determining gestational age, the standard deviation (SD) of gestational sac volume by automatic tracing mode is 5.6 days, the SD of gestational sac volume by manual tracing mode is 5.2 days and the SD of MSD is 6.6 days. CONCLUSION: we can conclude that three-dimensional GSV with automatic tracing mode of the VOCAL-imaging program can be used as the new biometric measurement in determining gestational age. Gestational sac volumetry with automatic tracing mode of the VOCAL-imaging program have been proven available and convenient method and it can be recommended in 5-7 weeks' of gestation, when CRL is not clearly visualized.
Cross-Sectional Studies ; Gestational Age* ; Gestational Sac* ; Nomograms ; Pregnancy

OBJECTIVE: This study was performed to evaluate the efficacy of treating of unruptured ectopic pregnancy by systemic and transvaginal local administration of methotrexate. METHODS: We reviewed the medical records of 32 patients who were treated with methotrexate from June 1995 to October 1999. Among the patients, 14 were treated by ultrasound-guided transvaginal local injection and 18 were treated by systemic intramuscular administration. Success rate of the treatment was examined for each group, and the cases of methotrexate failure were characterized and compared with the success group. RESULTS: The success rate was similar between the transvaginal (85.7%) and the systemic (77.8%) groups. There were no differences in initial serum hCG levels, size of gestational sac, fetal cardiac activity between the success group and failure group. CONCLUSION: The results of this study suggest that there is no difference in efficacy between systemic and transvaginal local methotrexate administration, and there are no useful parameters in identifying the risk for the failure of methotrexate treatment.
Female ; Gestational Sac ; Humans ; Medical Records ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVE: To evaluate the efficacy and predictors of success of methotrexate (MTX) treatment in selected cases of unruptured tubal pregnancies. METHODS: This study was retrospectively performed in 36 women who had diagnosed unruptured tubal pregnancies. Patients received intramuscular MTX. Serial beta-hCG measurement was performed weekly, and success was defined as the achievement to beta-hCG concentration of 10 mIU/mL without surgical intervention. Surgical intervention was performed for presumed tubal rupture. Pretreatment serum concentration of beta-hCG, the size of tubal mass and gestational sac by transvaginal ultrasonography were measured to evaluate the predictors of MTX therapy. RESULTS: 29 patients (81%) were successfully treated by MTX systematic treatment. There were not significant differences in the patient's age, parity, gestational age and the size of tubal ectopic mass, but significant differences in the gestational sac size and serum beta-hCG concentration between success group and failure group of MTX treatment. The mean time for achieving successful treatment was 33.8 days. The success rate of systemic MTX was significantly decreased and resolution time was prolonged if the initial pretreatment serum beta-hCG was 10,000 mIU/mL or gestational sac size was >or=1 cm. CONCLUSION: Pretreatment serum beta-hCG concentration and gestational sac size are important predictors of success of MTX treatment in women with unruptured tubal pregnancy.
Female ; Gestational Age ; Gestational Sac ; Humans ; Methotrexate* ; Parity ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies ; Rupture ; Ultrasonography

OBJECTIVE: To evaluate the effectiveness of CC+FSH or CC+hMG in intrauterine insemination (IUI) cycles for the treatment of infertility. METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days followed by hMG or FSH. A single IUI was performed at 36 h after hCG. Clinical pregnancy was classified if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: The overall clinical pregnancy rate was 19.1% per cycle (17/89) and 21.5% per patient (17/79). More clinical pregnancies were recorded in CC+FSH (23.1%, 6/26) than CC+hMG cycles (17.5%, 11/63), but this difference was not statistically significant. No differences were found in age, duration of infertility, follicle size, levels of estradiol (E2) on the day of hCG injection and total motile sperm counts between pregnant and non-pregnant groups. However, more ampules of gonadotropins were used in pregnant group than non-pregnant group (p<0.05). CONCLUSION: Combination of CC and hMG may economically be more effective to induce ovulation for IUI compared to CC and FSH.
Clomiphene* ; Estradiol ; Female ; Gestational Sac ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Ovulation ; Pregnancy Rate* ; Pregnancy* ; Sperm Count ; Ultrasonography

Although recently the incidence of heterotopic pregnancies are increasing because of assisted reproduction, heterotopyic pregnancies were rare with an incidence of 1 per 30,000 pregnancies. In this presentation, we describe a case of combined intrauterine and cervical pregnancy after artificial abortion. The patient was treated by local injection of methotrexate directly into gestational sac under the guidance of sonogram after systemic methotrexate treatment. The gestational products were removed by dilatation & currettage due to persistent vaginal bleeding on the next day. So we report a case with a brief review of the literatures.
Dilatation ; Gestational Sac ; Humans ; Incidence ; Methotrexate ; Pregnancy* ; Pregnancy, Heterotopic ; Reproduction ; Uterine Hemorrhage

Cervical pregnancy is a life threatening, rare type of ectopic pregnancy. Hysterectomy was considered as the only treatment for cervical pregnancy. In 1982, as a conservative treatment of ectopic pregnancy, local injection of methotrexate was tried by Tanaka et al. We reviewed a case of sucessful treatment of cervical pregnancy after 45 days from direct local injection of methotrexate into gestational sac under the guidance of vaginal ultrasonogram in department of obstetrics and gynecology, Korea university hospital.
Female ; Gestational Sac ; Gynecology ; Hysterectomy ; Korea ; Methotrexate* ; Obstetrics ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy