OBJECTIVE: The aim of this study is to investigate the effect of tamoxifen on endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer after chemotherapy. METHODS: Fifty-eight tamoxifen-treated postmenopausal breast cancer patients underwent periodically transvaginal ultrasonography twice a year for 2 years and then once a year. We analyzed the correlation between the sonographic endometrial thickness and the duration of tamoxifen therapy. RESULTS: The mean endometrial thickness of breast cancer patients before tamoxifen therapy was 4.68 mm. But the mean endometrial thickness increased to 5.03 mm at 6 months, 5.21 mm at 12 months, after which it slightly declined to 5.13 mm at 18 months. And then it increased to 5.15 mm at 24 months, and 5.24 mm at 36 months. There was a significant increase in endometrial thickness after tamoxifen therapy compared with before tamoxifen therapy (p<0.05). Overall, proliferative endometrium was the most common histopathologic finding (5/14) in tamoxifen-treated postmenopausal women who had endometrial thickness >or=5 mm. No cases of endometrial cancer were detected. CONCLUSION: Significant increase in endometrial thickness with the duration of tamoxifen therapy in postmenopausal tamoxifen-treated patients may be associated with a high risk of endometrial pathologies in these patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Pathology ; Tamoxifen ; Ultrasonography

Asymmetric crying face is caused by unilateral weakness of the depressor muscles of lower lip, which is most obvious during crying and is associated with other congenital anomalies, especially congenital heart disease. We experienced a case of asymmetric crying face after cesarean delivery in mother with hyperthyroidism and present it with a brief review of literature.
Crying* ; Heart Defects, Congenital ; Humans ; Hyperthyroidism* ; Lip ; Mothers* ; Muscles

PURPOSE: This study was performed to determine the prevalence and risk factor of hypotension among pregnant women undergoing elective cesarean section under regional anesthesia, and whether hypotension has any impact on neonate outcome. METHODS: Retrospective analysis of 440 mother-infant pairs after elective cesarean section under regional anesthesia. Data collection included information on maternal blood pressure during the cesarean section, cord blood pH and Apgar score. RESULTS: This study revealed that 20.5% of the mothers underwent a decrease in mean arterial blood pressure by ≥30% and 1.1% of the mothers underwent a decrease in mean arterial blood pressure by ≥50%. Hypotension was more severe among the mother in those with preoperative hypertension and high body weight. The occurrence of maternal hypotension during cesarean section were not found to predict any complications like low Apgar score, need for oxygen treatment, even though fetal cord blood pH. CONCLUSION: Despite a maternal hypotension during elective cesarean section under regional anesthesia, healthy term infants seem to tolerate decreased placental blood perfusion.
Anesthesia, Conduction* ; Apgar Score ; Arterial Pressure ; Blood Pressure ; Body Weight ; Cesarean Section ; Data Collection ; Female ; Fetal Blood ; Humans ; Hydrogen-Ion Concentration ; Hypertension ; Hypotension* ; Infant ; Infant, Newborn* ; Mothers ; Oxygen ; Perfusion ; Pregnancy ; Pregnant Women ; Prevalence ; Retrospective Studies ; Risk Factors*

Portal vein thrombosis complicating pregnancy is a rare occurrence. The etiology of portal vein thrombosis is highly diverse. A 31-year-old multigravida was diagnosed with acute portal vein thrombosis at 12 weeks of gestation by ultrasound examination. She had epigastric and left upper quadrant pain, but there was no significant medical or surgical illness in the past. Laboratory studies showed no evidence of a thrombophilia. She was managed with anticoagulants and labor was induced at 38 weeks because of premature rupture of membranes. She delivered a healthy neonate without any complications. It seems that the cause of this thrombotic event was the hypercoagulable state of pregnancy.
Adult ; Anticoagulants ; Humans ; Infant, Newborn ; Membranes ; Portal Vein* ; Pregnancy* ; Rupture ; Thrombophilia ; Ultrasonography ; Venous Thrombosis*

Herpes simplex encephalitis is the most common form of encephalitis, but herpes simplex virus type 2 (HSV-2) encephalitis is very rare during pregnancy. In immunocompetent patients, HSV-2 encephalitis is usually mild. With early diagnosis and prompt initiation of antiviral treatment, as well as enhanced neurocritical care, a favorable outcome can be expected in both mother and neonate. We report a rare case of maternal HSV-2 encephalitis diagnosed by polymerase chain reaction following appendectomy. The woman had no symptomatic genital lesion, and the infant was not infected.
Appendectomy ; Early Diagnosis ; Encephalitis* ; Encephalitis, Herpes Simplex ; Female ; Herpesvirus 2, Human* ; Humans ; Infant ; Infant, Newborn ; Mothers ; Polymerase Chain Reaction ; Pregnancy ; Simplexvirus ; Skin*

PURPOSE: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. METHODS: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. RESULTS: No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). CONCLUSION: Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.
Abscess* ; Biopsy* ; Biopsy, Needle ; Breast* ; Drainage* ; Female ; Humans ; Image-Guided Biopsy ; Lactation ; Needles* ; Suppuration ; Ultrasonography

Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. The most common cause of maternal death in Korea is complications related to the postpartum period (obstetric embolism), accounting for 37.5%, while complications of labor and delivery (uterine atony, PPH, etc.) were the second most common cause, accouning for 21.9%. The effective treatment of PPH often requires multidisciplinary intervention. When managing PPH, multiple interventions (medical, mechanical, invasive, and nonsurgical and surgical procedures), which require different levels of skill and technical expertise, may be used to control bleeding. The healthcare provider needs to begin resuscitative efforts quickly, establish the cause of the hemorrhage, and possibly enroll the assistance of other care providers, such as an obstetrician, anesthetist or radiologist. Avoiding delays in diagnosis and treatment will have a significantly impact on sequelae and chances of survival. This review discusses the causes, identification, management, prevention and prediction of PPH.

OBJECTIVES: To compare the systematic evaluations in hospitalization of mildly preeclamptic women whose placental dysfunction was exacerbated with those whose placental dysfunction was not exacerbated. METHODS: There were seventy six mildly preeclamptic women after systematic evaluations in hospitalization, in which twenty eight women showed exacerbated placental dysfunction. Outcome markers considered suggestive of exacerbation of placental dysfunction included oligohydramnios (amniotic fluid index less than 5 cm), clinical diagnosis of intrapartum fetal distress and progression to severe preeclampsia. A clinical diagnosis of fetal distress was made when the monitoring revealed recurrent late, persistent tachycardia with loss of variability or prolonged decelerations. RESULTS: There were no significant differences in the amount of 24 hours urine protein, the concentrations in serum protein, creatinine, aspartate transaminase and alanine transaminase and hematocrit. But in exacerbated group, the concentrations of serum albumin and urine creatinine and creatinine clearance were significantly lower and the concentrations of serum uric acid and lactate dehydrogenase were significantly higher than not exacerbated group. CONCLUSION: In mildly preeclamptic women diagnosed after systematic evaluation in hospitalization, we must give attention to those whose concentrations of serum albumin and urine creatinine and creatinine clearance are low and concentrations of serum uric acid and lactate dehydrogenase are high.
Alanine Transaminase ; Aspartate Aminotransferases ; Creatinine ; Deceleration ; Diagnosis ; Female ; Fetal Distress ; Hematocrit ; Hospitalization* ; Humans ; L-Lactate Dehydrogenase ; Oligohydramnios ; Pre-Eclampsia ; Pregnancy ; Serum Albumin ; Tachycardia ; Uric Acid

OBJECTIVE: To determine whether the beneficial effects of a single course of antenatal corticosteroids for neonatal morbidity change with time METHODS: A retrospective chart review was performed of women who received a single complete course of antenatal corticosteroid and delivered a viable singleton infant between 26 and 35 weeks of gestation. Patients were divided into 1 of 3 groups on the basis of the interval from first corticosteroid dose to delivery (48 hr~7 days, 8~14 days and > or =15 days). Neonatal morbidities were compared between each groups. RESULTS: Two hundred three pregnancies were included, of which 78 women delivered at 48 hr-7 days, 65 women delivered at 8~14 days and 60 women delivered at > or =15 days. The 3 groups were similar in clinical characteristics and indications for antenatal steroids and delivery. Neonates delivered within 7 days had a lower incidence of receiving ventilatory support for more than 24 hours than 8~14 days group (32.1% vs 50.8%, P=0.023) and > or =15 days group (32.1% vs 51.7%, P=0.02). But there were no significant differences between the groups in ventilator days, surfactant use, oxygen dependency at 36 weeks of gestation, oxygen dependency at 28 days after delivery, intraventricular hemorrhage, necrotizing enterocolitis, sepsis and length of hospital days. There were no periventricular leukomalacia and neonatal death in all groups. CONCLUSION: Neonates delivered more than 7 days after first corticosteroid dose needed more short-term ventilatory support, but there were no differences in other neonatal outcomes.
Adrenal Cortex Hormones ; Dependency (Psychology) ; Enterocolitis, Necrotizing ; Female ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular ; Oxygen ; Pregnancy ; Retrospective Studies ; Sepsis ; Steroids ; Ventilators, Mechanical

Uterine rupture during pregnancy does not occur frequently, but is associated with high rates of maternal and perinatal morbidity and mortality. As a non-invasive and conservative approach, high-intensity focused ultrasound (HIFU) has received attention from both gynecologists and patients for the treatment of fibroids, especially women who wish to preserve uterus. However, there are not enough studies about complication and prognosis related pregnancy after HIFU. We present a case of uterine rupture that occurred in second trimester who had been HIFU 3months before pregnancy.
Female ; Humans ; Leiomyoma ; Mortality ; Pregnancy ; Pregnancy Trimester, Second* ; Prognosis ; Ultrasonography* ; Uterine Rupture* ; Uterus