The Journal of Korean Obstetrics and Gynecology (대한한방부인과학회지)

The Society of Korean Medicine Obstetrics and Gynecology (대한한방부인과학회)
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A Case Study of Gunggi-tang that induces Natural Expulsion in Missed Abortion

계류유산 환자의 자연배출을 돕는 궁귀탕가감(芎歸湯加減) 치험 1례

  • Received : 2017.07.26
  • Accepted : 2017.08.16
  • Published : 2017.08.25
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Abstract

Objectives: The aim of this study was to report a case of 43 year-old patient, diagnosed with missed abortion who previously failed to do spontaneous gestational sac expulsion in spite of 2 week-expectant-method, eventually succeeded with Traditional Korean Herb Medicine (TKHM) treatment only. Methods: In transabdominal sonography, gestational sac was not present at week 8. Due to the possibility of effect of medication on future pregnancy and post-surgery complications, D&C (Dilation & Curettage) as well as any other treatment was not done. Instead, she presented to our clinic. A combination of 2 main TKHMs was prescribed with 120-150 cc/dose (2 times per day for a week) : Gunggi-tang for helping expulsion of the dead fetus and placenta, and Wooseul-tang for treating retained placenta. Results: On day 6 of TKHM treatment, initiation of placenta expulsion was done. From day 8, hemorrhage started, lasting for 6 days. On day 10, placenta was expelled. On day 13, gestational sac and placenta were completely expelled. No infection, delayed bleeding, or pain was observed. After bleeding stopped, menorrhea started from week 7. Conclusions: This report implies a potential of TKHM as an optional and safe medication for the natural expulsion of conceptus in missed abortion.

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References

  1. The Society of Korean OB & GY. Korean Gynecology Vol. II. Seoul:Euisung-dang. 2012:418-43.
  2. Gemzell-Danielsson K, et al. Misoprostol to treat missed abortion in the first trimester. Int J Gynecol Obstet. 2007;99(Suppl 2):182-5. https://doi.org/10.1016/j.ijgo.2007.09.008
  3. Committee on Practice Bulletins-Gynecology and the Society of Family Planning. Medical Management of First-Trimester abortion. Practice Bulletin No. 143. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2014;123(3):676-92. https://doi.org/10.1097/01.AOG.0000444454.67279.7d
  4. AlSaad D, et al. Misoprostol for miscarriage management in a woman with previous five cesarean deliveries: a case report and literature review. Ther Clin Risk Manag. 2017;13:625-7. https://doi.org/10.2147/TCRM.S132294
  5. Hooker A, et al. Long-term complications and reproductive outcome after the management of retained products of conception: a systematic review. Fert Steril. 2016;105(1):156-64. https://doi.org/10.1016/j.fertnstert.2015.09.021
  6. Ben-Ami I, et al. Infertility following retained products of conception: is it the surgical procedure or the presence of trophoblastic tissue?. Eur J Obstet Gynecol Reprod Biol. 2014;182:132-5. https://doi.org/10.1016/j.ejogrb.2014.09.021
  7. Marwah S, et al. A comparative study to evaluate the efficacy of vaginal vs oral prostaglandin $E_1$ analogue (misoprostol) in management of first trimester missed abortion. J Clinical and Diagnostic Research. 2016;10(5):14-8.
  8. Waard M, et al. Management of miscarriage a randomized controlled trial of expectant management versus surgical evacuation. Hum Reprod. 2002;17(9):2445-50. https://doi.org/10.1093/humrep/17.9.2445
  9. Nadarajah R, et al. A radomised controlled trial of expectant management versus surgical evacuation of early pregnancy loss. Eur J Obstet Gynecol Reprod Biol. 2014;178:35-41. https://doi.org/10.1016/j.ejogrb.2014.02.021
  10. Wu H, et al. Misoprostol for medical treatment of missed abortion: a systematic review and network meta -analysis. Sci Rep. 2017;7(1):1664-72. https://doi.org/10.1038/s41598-017-01892-0
  11. Trinder J, et al. Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial(miscarriage treatment (MIST) trial). BMJ. 2006;332:1235-40. https://doi.org/10.1136/bmj.38828.593125.55
  12. Leladier C, et al. Mifepristone(RU 486) induces embryo expulsion in first trimester non-developing pregnancies: a prospective randomised trial. Hum Reprod. 1993;8(3):492-5. https://doi.org/10.1093/oxfordjournals.humrep.a138078
  13. Cho D, et al. Studies on Symptom, Pathology, Composition and Clinical Applications of Woman-related Disease Prescriptions in Bang Yahk Hap Peun. Korean Journal of Oriental Physiology & Pathology. 2004;18(6):1543-7.
  14. Huh J. Dong-Eui-Bo-Kham. Seoul:Bubinbooks. 2005:1190-255.
  15. Song Y, et al. A Case report of the general pain after childbirth with oriental medicine. Daejeon University Korean Medicine Research Center. 2011;20(1):111-7.
  16. Dong-Eui Medicine Research Center. BangYakHapPyun(方藥合編) Vol. 4. An-Yang:Dansam, 2006:717.
  17. Choi W, et al. Consideration in the interpretation of the Pyeongwi-san Prescription. Herbal Formula Science. 2015;23(2):225-33. https://doi.org/10.14374/HFS.2015.23.2.225
  18. Choi M. Dong's acupuncture. Seoul:Ilung Inc. 2003:50.
  19. Lee A, et al. Effects of Boheotang -gagam on milk production and factors related lactation in postpartum mice. J Korean Obstet Gynecol. 2016;29(1):35-52. https://doi.org/10.15204/jkobgy.2016.29.1.035
  20. Hwang D. Sinjeung Bangyakhappyeon. Seoul:Yeonglimsa. 2002:179.
  21. The Society of Acupuncture & Moxibustion Nationwide College of Oriental Medicine. Acupuncture & Moxibustion Medicine Vol 1. Seoul:Jipmundang. 1994:323, 382, 404, 667, 808.
  22. Kwon J, et al. A case report of pregnancy of infertility patient with thin endometrium. J Korean Obstet Gynecol. 2015;28(1):138-46. https://doi.org/10.15204/jkobgy.2015.28.1.138
  23. Rafi J, et al. Expectant Management of Miscarriage in View of NICE Guideline 154. Journal of Pregnancy. 2014;2014:824527.