BACKGROUND: In Korea, the breastfeeding (BF) rate of infants aged 6 months or more is drastically decreasing, and this phenomenon is particularly worrisome for the future health of the population. The present study aimed to identify an antenatal strategy for initiation and continuation of human BF, and to identify how Baby-Friendly Hospitals (BFHs) may positively influence the intention to breastfeed. METHODS: A total of 414 pregnant Korean antenatal women were surveyed using questionnaires to determine current knowledge of the benefits of human breast milk, whether they planned to breastfeed after delivery, to continue BF after reinstatement in the workforce, are willing to abide by rooming-in care for infants, and plan to give birth at BFHs. RESULTS: We found that planning room-in care, greater awareness of BF benefits for infant and mother, participation in antenatal education programs, and provision of BF facilities in the workplace were positively associated with plans for exclusive breastfeeding (EBF) and longer BF duration. The mothers who planned to give birth at BFHs also desired to breastfeed immediately after birth, implement in-room care, continue BF at their workplace, participate in antenatal BF educational programs, and were more aware of the benefits of BF. CONCLUSION: If the beneficial effects of BFHs were well known to individuals, these would enhance the success rate of BF in Korea. Antenatal education and consequent acquisition of better knowledge of the benefits of BF are important for increasing the rate of BF practices.
Breast Feeding* ; Female ; Humans ; Infant ; Intention* ; Korea* ; Milk, Human ; Mothers ; Parturition ; Prenatal Education ; Rooming-in Care

Diagnostic Errors ; Female ; Humans ; Hysterectomy ; Leiomyoma ; diagnosis ; surgery ; Middle Aged ; Tomography, X-Ray Computed ; Ultrasonography ; Uterine Neoplasms ; diagnosis ; surgery ; Uterus ; blood supply ; diagnostic imaging ; Venous Thrombosis ; diagnosis ; surgery

The purpose of this study was to investigate the feasibility of different fetal heart rate (FHR) ranges in the nonstress test (NST) and to better understand the meaning of mild bradycardia and/or tachycardia without non-reassuring patterns. We employed the heredity to show that mild bradycardia (100-119 beats per minute, bpm) and mild tachycardia (161-180 bpm) regressed to the normal FHR range (120-160 bpm). We used linear regression to analyze FHR data from FHR tracings recorded 10 min before (NST, as the predictor) and 10 min after vibroacoustic stimulation testing (as the dependent variable). Acceleration for 15 bpm-15 seconds (Acc1515) and deceleration for 15 bpm-15 seconds (Dec1515) in the NST were also analyzed for each group. The slope of the best-fit line was the largest in the mild bradycardia group and the smallest in the normal range group. Dec1515 was most prominent in mild tachycardia and both the mild bradycardia and tachycardia groups regressed towards the mean FHR range. Therefore, we propose that both mild bradycardia and tachycardia of FHR in non-acute situations (range between 100 and 180 bpm) are not regarded a pathologic signal for clinical use.
Acoustic Stimulation ; Bradycardia/physiopathology ; Female ; *Fetal Monitoring ; Heart Rate, Fetal/*physiology ; Humans ; Pregnancy ; Pregnancy Trimester, Third ; Regression Analysis ; Tachycardia/physiopathology

Several international initiatives have taken place with themes such as "Men as Partners in reproductive health". Furthermore, many articles have recently been published concerning men's preconception care before pregnancy. However, little attention has been paid to this field in Korea. The concept of preconception health and health care for men is very important for pregnancy outcomes, and furthermore, for the health of their future families. Men's contribution to the pregnancy is clear for planned pregnancy and also offers an opportunity for disease prevention and health promotion in men themselves. This paper reviews the important concept of men's health for preparing for pregnancy, and summarizes key component of a comprehensive approach to optimizing the preconception health status of men as expecting fathers. In fact, many clinicians including most obstetricians-gynecologists in Korea are not trained to provide preconception health and care for men. In addition, no consensus has been developed on basic guidelines for preconception care including the pregnancy planning for men and women, laboratory tests before pregnancy, vaccination programs, and much more information on preparing for a successful pregnancy. To improve preconception care for men in Korea, many barriers must be overcome, such as lack of national services, financing, organization, and men's and women's understanding of the importance of preconception health for their pregnancy. Therefore, much more research is needed on men's preconception care in Korea.
Consensus ; Delivery of Health Care ; Family Planning Services ; Fathers ; Female ; Health Promotion ; Humans ; Hypogonadism ; Korea ; Male ; Men's Health ; Mitochondrial Diseases ; Multiple Endocrine Neoplasia Type 1 ; Ophthalmoplegia ; Preconception Care ; Pregnancy ; Pregnancy Outcome ; Vaccination

Congenital malformations are a common cause of illness, handicapping conditions, and death. Errors of morphogenesis leading to congenital anomalies have many recognized causes, including specific single-gene mutations, chromosome imbalances, and the action of teratogenic agents. Most congenital anomalies, however, are of multifactorial origin, occurring by complex interactions between not yet well understood genetic and environmental factors. Two to six percent of the newborn babies worldwide, i.e., 3 to 9 million infants a year, suffer from major congenital anomalies and genetic diseases. However, a great deal of this misery could be avoided. In particular, preconception care is more important than prenatal care for prevention of congenital anomalies since as many as 30 percent of pregnant women begin traditional prenatal care in the second trimester (>13 weeks of gestation), which is after the period of maximal organogenesis. Women and their partners whose ethnic background, race, or personal or family history places them at increased risk of having a fetus with a genetic disease should receive appropriate counseling. Furthermore, certain laboratory tests of the infection status of couples may be helpful in assessing the risk for and preventing some complications during pregnancy. Preconception evaluation and appropriate counseling permits parents to make informed reproductive decisions and provides reassurance.
Continental Population Groups ; Counseling ; Family Characteristics ; Female ; Fetus ; Genetic Counseling ; Humans ; Infant ; Infant, Newborn ; Morphogenesis ; Organogenesis ; Parents ; Preconception Care ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Prenatal Care

The incisional hernia through trocar site is an uncommon complication of gynecologic laparoscopy. Its incidence is less than 1% and most of them are occurring through 10 mm trocar site. Small bowel herniation through 5 mm trocar site is very rare. Furthermore, 5 mm trocar site bowel herniation with drain tube in situ has not yet been reported. We present a case of small bowel herniation through 5 mm trocar site with drain tube in situ and its reduction by laparoscopy with a brief review of literature.
Drainage ; Hernia ; Incidence ; Laparoscopy ; Surgical Instruments

A 29-year-old woman presented with secondary amenorrhea, primary infertility, and virilization, which had developed over the past 2 years was suspected to have a virilizing tumor at her left ovary. Her serum testosterone level was markedly elevated (380 ng/dL). Left salpingooophorectomy was performed, and histopathological examination revealed a thecoma of the left ovary. The postoperative serum testosterone level returned to 65 ng/dL. The patient did not have regression of virilism soon. However, the patient had a normal menstruation 29 days after surgery and gave birth to a baby 13 months after surgery.
Adult ; Female ; Humans ; Menstruation ; Ovarian Neoplasms/blood/*complications/*surgery ; Ovariectomy ; Pregnancy ; Pregnancy Outcome ; Testosterone/blood ; Thecoma/blood/*complications/*surgery ; Virilism/blood/*etiology/surgery

INTRODUCTIONThere is no consensus on the extent of lymphadenectomy and the appropriate patients for lymphadenectomy in low-risk patients with endometrial cancer. This study aimed to evaluate the feasibility and effectiveness of laparoscopic lymphadenectomy for low-risk patients with endometrial cancer.

MATERIALS AND METHODSFrom January 2004 to May 2008, we reviewed the medical records of 28 patients with low-risk, endometrial cancer; endometrioid type, grade 1 or 2, and with a depth of myometrial invasion of less than one-half of the myometrium. All patients underwent laparoscopically-assisted staging surgery.

RESULTSThe median age and body mass index were 56 years (range, 28 to 75) and 25.5 kg/m(2) (range, 21.3 to 37.2). The median operating time, estimated blood loss, and length of hospital stay were 142 minutes (range, 110 to 410), 215 mL (range, 100 to 700), and 7 days (range, 3 to 19), respectively. No conversion to laparotomy was noted. The median number of harvested lymph nodes was 21 (range, 10 to 48) pelvic nodes and 12 (range, 4 to 21) para-aortic nodes. One (3.6%) patient presented pelvic lymph node metastasis and 2 (7.1%) presented isolated para-aortic lymph node metastasis. The complication rate was 14.3%. No recurrence in the vaginal vault, distant metastasis, port site metastasis was noted up to the last follow-up.

CONCLUSIONSystemic pelvic and para-aortic lymphadenectomy should be considered in all low-risk patients with endometrial cancer until it is concluded to be clinically insignificant through large-scale prospective research in the future. However, it will be difficult to explain statistical differences in survival rates according to lymphadenectomy, because the increase of the survival rate resulting from lymphadenectomy will fall within the margin of statistical error.

Adult ; Aged ; Carcinoma, Endometrioid ; pathology ; surgery ; Endometrial Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Middle Aged ; Neoplasm Staging ; Retroperitoneal Space ; surgery ; Retrospective Studies

The authors report a rare case of retroperitoneal leiomyosarcoma in a 49 year-old woman, with a palpable mass in the left lower abdomen. There is a large neoplasm which was soft and movable, looking a pelvic mass. Abdominal and pelvic CT scan showed a 11.0x9.2x7.5 cm-sized lobulated heterogenous enhancing mass with multifocal necrotic portion near the left ovary. Laparotomy and resection of the mass was performed. Microscopic examination revealed 15 mitoses per 10 high power fields. She was diagnosed as primary leiomyosarcoma originated from the left common iliac vein, stage I (IB). The best treatment of these neoplasms is complete surgical excision, and no therapeutic benefit has been derived from chemotherapy or radiotherapy. Though metastases are occasional, local recurrences can be taken into consideration and, after a careful tumoral re-staging, they can be resected once more. Therefore, careful follow-up is necessary on the basis of neoplastic grading, extension and involvement of the adjacent structures.
Abdomen ; Drug Therapy ; Female ; Humans ; Iliac Vein ; Laparotomy ; Leiomyosarcoma* ; Middle Aged ; Mitosis ; Neoplasm Metastasis ; Ovary ; Radiotherapy ; Recurrence ; Retroperitoneal Space ; Tomography, X-Ray Computed

Placenta increta is a life threatening complication of pregnancy, causing severe post-curettage bleeding. It is usually presented in the postpartum period with hemorrhage during difficult placental removal. It is especially rare in the 1st and 2nd trimesters, which is not easy to find and diagnose. We have confirmed a case of placenta increta after emergency hysterectomy due to severe vaginal bleeding following the dilatation and curettage during the 1st trimester of her pregnancy. So we report it with a brief case history and review of the concerned literatures.
Dilatation and Curettage ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Placenta Accreta* ; Placenta* ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First* ; Uterine Hemorrhage