• Title/Summary/Keyword: early pregnancy

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Fertility preservation for patients with gynecologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Sanghoon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Tak;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.175-180
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    • 2017
  • Fertility preservation plays a central role in cancer care since an increasingly large number of cancer patients are surviving as a result of improvements in diagnostic and therapeutic strategies. Physicians who take part in the initial diagnosis and management of gynecologic cancer should understand the importance of fertility preservation. Since indications for fertility preservation are limited to early-stage gynecologic cancer, a surgeon must carefully consider each indication. Before performing fertility-sparing surgery, health professionals should compare its oncologic and pregnancy outcomes with those of other standard treatments. Individualized treatment strategies should be delivered depending on the patient's situation, and physicians should provide timely information and appropriate counseling.

A Case of Spontaneous Uterine Rupture of the Unscarred Uterus in 14 Weeks Gestation (임신 14주에 발생한 비반흔 자궁에서의 자발성 자궁 파열 1예)

  • Kim, Jeong-Suk;Kim, Jin-Hee;Bae, Yeun-Kyoung;Park, Yoon-Ki
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.251-255
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    • 2004
  • Spontaneous uterine rupture of the unscarred uterus during the second trimester of pregnancy is rare, but it is a surgical emergency. Because it results in rapid deterioration of patient and high mortality despite of prompt operation and massive transfusion, early diagnosis and proper management are critical for optimizing patient care. We present a case of spontaneous uterine rupture with fetal death in 14 weeks gestation with a brief review of literatures.

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Initiating Smokeless Tobacco Use across Reproductive Stages

  • Begum, Shahina;Schensul, Jean J.;Nair, Saritha;Donta, Balaiah
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7547-7554
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    • 2015
  • Background: The use of smokeless tobacco (SLT) among women is increasing in India, especially among those with limited education and resources. Preventing the initiation of SLT among women is critical since it has known negative consequences for oral and reproductive health. Most research on tobacco initiation in India focuses on adolescents. This paper addresses the unrecognized issues of post marital initiation among women of reproductive age, highlighting the importance of reproductive stages in women's tobacco initiation. The objective is to examine the correlates of SLT initiation among low income women in Mumbai from pre-marriage through early marriage, first pregnancy and beyond, using case examples to illustrate initiation during each of these stages. Materials and Methods: In 2011-2012, cross-sectional community level survey data were collected from a representative sample of 409 daily SLT-using married women aged 18-40 years in a low income community in Mumbai. Information on socio-demographics, initiation by reproductive stage, types of tobacco use, childhood exposure to tobacco, learning to use, and initiation influences and reasons were collected through a researcher-administered survey. Univariate and bivariate analysis assessed factors influencing initiation of SLT use by reproductive stage. In addition 42 narratives of tobacco use were collected from a purposive sample of pregnant and non-pregnant married women addressing the same questions in detail. Narratives were transcribed, translated, and coded for key concepts including initiation of tobacco use. Results: Thirty-two percent of women initiated SLT use before marriage, 44% initiated after marriage but before pregnancy, 18.1% initiated during their first pregnancy and the remainder started after their first pregnancy. Mean age of marriage among women in this study was 16 years. Younger women (i.e. age at time of the interview of less than 30 years) were 0.47 [95% CI (0.32, 0.87)] percent less likely to initiate after marriage than women aged more than 30 years. Women who got married before 18 years of age were 2.34 [95% CI (1.40, 3.93)] times more likely to initiate after marriage than their counterparts. Childhood exposure was a predictor for initiating SLT use prior to marriage but not after. Women reporting tooth and gum pain were 1.85 times more likely to initiate after marriage than their counterparts. Husband and neighbours were the most significant influences on post-marital initiation. Narratives highlighted differences in processes of initiation pre and post marriage and during pregnancy. Conclusions: Most tobacco prevention interventions are directed to adolescents in school. This study suggests that especially for low literate or illiterate women, school based interventions are ineffective. To be effective strategies to prevent SLT initiation must reach women in urban areas at or immediately after marriage and during their first pregnancy. Messages must negate culturally rooted beliefs about the health benefits of SLT in order to prevent initiation and onset of daily use.

A Study on Fetal and Infant Mortality in Association with Population Quality: Report 1-Quantitative Analysis on Fetal Life (인구자질과 태생기.주산기.영아기 사망에 관한 연구: 제1보-태생기 생명현상의 수량적 분석)

  • 김정근;이승욱;이주열;김무채
    • Korea journal of population studies
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    • v.19 no.2
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    • pp.47-76
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    • 1996
  • This study was carried out to provide the basic information for the implementation of population quality policies by analyzing fetal life. The outcomes and process of all the pregnancies of women with spouses living in Gapyung-gun, Kyunggi province from November 3, 1993 through December 31, 1995 were analyzed. The results of the study are as follows: According to the fetal life table, the estimated probability of pregnancy outcome showed 53.5% of live birth, 14.5% of fetal death, 32.0% of induced abortion, which resulted in 46.5% of pregnancy wastage throughout gestation period. The curve of the estimated probability of pregnancy outcome by gestation weeks showed L shape in case of total pregnancy rate, induced abortion rate and fetal death rate. The estimated probability of fetal death was 21.9% in case that the induced abortion was excluded, which was 7.4% higher than the case that induced abortion was included. The expected duration of pregnancy was 22.9 weeks until the fourth week of gestation and then started to become the highest, 26.6 weeks at the tenth week. At the 11th week, it declined to decrease to 26.4 weeks. This is attributed to the fact that the pregnancy wastage including fetal death and induced abortion occurred in the early period of pregnancy. The establishment of appropriate policies to cope with this situation are needed.

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The Study on Concentrations of Plasma Zinc and Copper of Nonpregnant and Pregnant in Korea (한국의 일부 가임여성과 임신부의 혈장내 아연 및 구리 농도에 관한 연구)

  • 하은정
    • Journal of Nutrition and Health
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    • v.26 no.3
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    • pp.347-356
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    • 1993
  • Plasma concentrations of zinc and copper were measured in 59 non-pregnant women and 105 pregnant women(12 ; early pregant, 93 ; late pregnant) to estimate and compare both groups and to detect the effects of iron supplementation on the plasma zinc and copper concentrations in the pregant women. The mean plasma zinc concentration of the early pregnant group was not significantly different with those of the non-pregnant group. But in contrast, the mean plasma zinc concentration of the late pregnant group was significantly lower than those of the non-pregnant and early pregnant group. Mean plasma copper concentration were significantly elevated in ealry pregnant group and doubled in late pregnant compared to non-pregnant. In Fe supplemented group, mean plasma zinc concentrations were lower and mean plasma copper higher than those of Fe non-supplemented group. It appeared that Fe supplementation had effects on the decrease of plasma zinc concentrations in pregnancy.

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The EST Study of the Peri-implanting Porcine Embryos (Peri-implanting 단계의 돼지배아 EST 연구)

  • Kwak, In-Seok
    • Journal of Life Science
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    • v.19 no.5
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    • pp.587-592
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    • 2009
  • A dramatic morphological change of embryos occurs at peri-implantation. Maternal and embryonic cross-talk during this period, initiated by signals from embryo(s), provides signals for maternal recognition of pregnancy and establishing and maintaining the pregnancy. However, the cellular, biochemical and genetic processes that direct embryo remodeling in mammalian species are not well studied or understood. In order to identify potential genes responsible for morphological change and cross-talk between embryo and uterus, an initial EST analysis was performed. A catalog of expressed genes (Transcriptome) from the d12 peri-implanting porcine embryos was constructed. Six clones were chosen from the initial ESTs for elucidation of their expression patterns during embryogenesis in early pregnancy. A number of these genes demonstrated unique expression profiles in a tissue, cell-type, and temporal fashion, indicating dynamic regulation of embryonic and endometrial gene expressions at different stages of pregnancy. Cross-talk between the embryo and endometrium of the pregnant uterus has provided a suitable micro-environment for the embryo's rapid and dramatic morphological changing process at the peri-implantation stage.

Clinical outcomes of three- or five-day treatment with clomiphene citrate combined with gonadotropins and a timed intercourse cycle in polycystic ovary syndrome patients

  • Bae, Sung-Ah;Joo, Jong-Kil;Choi, Jong-Ryeol;Kim, Sun-Suk;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.3
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    • pp.106-110
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    • 2015
  • Objective: This study aimed to investigate the effect of a new clomiphene citrate (CC) regimen on preventing thin endometrial lining in polycystic ovary syndrome (PCOS) patients receiving CC plus gonadotropin treatment with a timed intercourse cycle. Methods: A total of 114 women with PCOS were included in this trial. Patients were divided into two groups and treated in accordance with the controlled ovarian stimulation (COS) protocol. In group A, 104 COS cycles in 67 patients were included, and in each cycle 150 mg CC was given for three days, starting from day 3. In group B, 69 COS cycles in 47 patients were included, in which 100 mg CC was given for five days, starting from day 3. The thickness of the endometrium was measured on the day of human chorionic gonadotropin (hCG) injection. Timed intercourse was recommended at 24 and 48 hours after the hCG injection. Results: Additional doses of human menopausal gonadotropin and the number of days of hCG administration were not significantly different between the two groups. Endometrial thickness on the day of hCG administration was significantly larger in group A than group B (4$9.4{\pm}2.1mm$ vs. $8.5{\pm}1.7mm$, p=0.004). The pregnancy rate was significantly higher in group A than in group B (38.4% vs. 21.7%, p=0.030). Conclusion: Three-day CC treatment resulted in a significantly higher pregnancy rate than the standard five-day CC treatment in a timed intercourse cycle in PCOS patients. Facilitating adequate endometrial growth via the early discontinuation of CC might be a crucial factor in achieving a higher pregnancy rate.

Pregnant Women's Gait of Stair Decent with Different Treads (임신기간 중 계단의 단너비에 따른 임산부 보행)

  • Hah, Chong-Ku;Ki, Jae-Sug;Jang, Young-Kwan
    • Journal of the Korea Safety Management & Science
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    • v.11 no.2
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    • pp.103-110
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    • 2009
  • The purpose of this study is to suggest a proper tread of stairs using kinematic factors and moments of the lower-limb joints in the stair decent with the 3 different treads with boimechanical method in ergonomics. 9 subjects (body masses; $59.41{\pm}7.49$, $64.03{\pm}6.65$, $67.26:{\pm}7.58$, heights; $160.50{\pm}6.35$ ages; $31.22{\pm}2.99$; parity; $1.67{\pm}0.71$) participated in three experiments that were divided by physiological symptoms (the early (0-15 weeks), middle (16-27 weeks) and last (18-39 weeks). and they walked at self-selected pace on 4 staircases 3 trials. As extending the pregnancy period, cadence was shorter but cycle time were longer more and more. As extending treads of stair decent during pregnancy, speed, stride lengths and cycle time were increased. As extending the treads of stair decent, hip and ankle moments increased but knee moments decreased in sagittal plane. There were increasing or decreasing of moments by means of treads. These changes may account for relation between the treads of stair and moments in pregnant women. The main changes of pregnant women were joint moments and kinematic factors during pregnancy period because pregnancy makes them physical changes. It is possible that joints have connection with compensation each other to maximize stability and to control gait motion. In conclusion, we suggest that the tread of stair is longer than 26cm tread. and exercise programs to improve muscle activity were necessary where joint moments were small.

The effect of vitamin C on the gene expression profile of sperm protamines in the male partners of couples with recurrent pregnancy loss: A randomized clinical trial

  • Hamidian, Saeideh;Talebi, Ali Reza;Fesahat, Farzaneh;Bayat, Mohammad;Mirjalili, Ali Mohammad;Ashrafzadeh, Hamid Reza;Rajabi, Mahya;Montazeri, Fateme;Babaei, Saeid
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.1
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    • pp.68-76
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    • 2020
  • Objective: Since sperm abnormalities are known to be a major reason for recurrent pregnancy loss (RPL), any defects in DNA structure and chromatin condensation can place embryos at risk in the early stage of development and implantation. As antioxidants such as vitamin C may play a protective role against the destruction of protamine genes in sperm chromatin, this study was conducted to evaluate the effects of vitamin C on chromatin and the expression of protamine genes in the male partners of couples with RPL. Methods: Twenty male partners of couples with RPL were selected as the intervention group and received vitamin C supplementation (250 mg daily for 3 months). Healthy fertile men (n = 20) were included as controls. Sperm chromatin, DNA integrity, and the expression levels of protamine genes were evaluated before and after treatment. Results: Significant differences were found in sperm morphology, protamine deficiency, and apoptosis between the two groups and before and after vitamin C administration. A significant change was found in mRNA levels of PRM1, PRM2, and the PRM1/PRM2 ratio after treatment. Conclusion: Daily oral administration of vitamin C may improve human sperm parameters and DNA integrity by increasing protamine gene expression levels in the male partners of couples with RPL. The beneficial effects of vitamin C supplementation as an antioxidant for the male partners of couples with RPL could lead to improved pregnancy outcomes in these cases.

Influence of Oxygen Consumption on Pregnancy Rates of Hanwoo Calves following Embryo Transfer

  • Kim, Hyun;Bok, Nan-Hee;Kim, Sung-Woo;Do, Yoon-Jung;Seong, Hwan-Hoo;Kim, Jae-Hwan;Kim, Dong Hun;Kim, Min-Kyu;Ko, Yeoung-Gyu
    • Journal of Embryo Transfer
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    • v.29 no.3
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    • pp.257-264
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    • 2014
  • Recently, several approaches have been used to measure the oxygen consumption rates of individual embryos, but relationship between oxygen consumption and pregnancy rates of Hanwoo following embryo transfer has not yet been reported. In this study, we investigated the correlation between oxygen consumption rate and pregnancy rates of Hanwoo embryo using a SECM. In addition to, the expression of apoptosis-related genes was determined using real-time PCR by extracting RNA according to the oxygen consumption of in vivo embryo. First, we found that the oxygen consumption significantly increased in blastocyst-stage embryos (blastocyst) compared to early blastocyst stage embryos, indicating that oxygen consumption reflects the embryo quality (Grade I). The oxygen consumption or GI blastocysts were significantly higher than those of GII blastocysts ($10.2{\times}10^{14}/mol\;s^{-1}$ versus $6.4{\times}10^{14}/mol\;s^{-1}$, p<0.05). Pregnant rate in recipient cow was 0, 60 and 80% in the transplantation of embryo with the oxygen consumption of below 10.0, 10.0~12.0 and over $12.0{\times}10^{14}/mol\;s^{-1}$, respectively. Apoptosis regulatory genes, Hsp-70.1 were significantly increased in over-10.0 group than below 10.0 group but in Caspase-3, Bax and P53 gene, there was no significant difference. In conclusion, These results suggest that measurement of oxygen consumption maybe help increase the pregnant rate of Hanwoo embryos.