• Perinatology
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• v.29 no.4
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• pp.195-197
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• 2018

As intervention techniques have been developed recently, minimal invasive treatment for uterine myoma using uterine artery embolization is receiving attention increasingly. Uterine rupture occurs rarely, but once it occurs, it may cause fatal results in both mother and fetus. Although the relationship between uterine artery embolization for treatment of uterine myoma and uterine rupture has not been clearly revealed yet, a case implying that the embolization for treatment of uterine myoma can be a risk factor of uterine rupture like previous caesarian delivery or myomectomy.

• Journal of Nutrition and Health
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• v.17 no.1
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• pp.50-59
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• 1984

This study was performed to investigate the placental transfer and the human fetal utilization of amino acids at term of pregnancy. The plasma levels of 23 free amino acids in both the umbilical circulation ( umbilical vein and artery ) and the uterine circulation ( uterine vein and iliac artery ) of 34 pregnant women were measured at delivery by the cesarean section. In the umbilical circulation, 9 amino acids ( alanine, lysine, valine, leucine, arginine, isoleucine, ornithine, cystine, ${\alpha}-aminobutyrate$ ) were significantly higher and 2 amino acids ( glutamate, aspartate ) were significantly lower in the umbilical vein than in the umbilical artery. In the uterine circulation, alanine, tyrosine and methionine were significantly lower in the uterine vein than in the iliac artery. Glutamate was significantly lower in the uterine vein than in the iliac artery. According to these results, the origin of fetal plasma amino acids was discussed in terms of the metabolic conversions which would occur in the Placenta and the fetal utilization of amino acids was estimated.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.4
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• pp.97-110
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• 2021

Objectives: This study was performed to review the research trends in the relationship between primary dysmenorrhea and doppler indicies of uterine artery. Methods: The search for related papers used 'Pubmed', a reserch engine in the America National Library of Medicine and Korean studies Information Service System (KISS). Used searching terms were 'primary dysmenorrhea', 'menstrual pain' in all cases. And among these studies, we searched by using key word 'uterine artery', 'doppler indices', 'doppler parameters', 'pulsatile index', 'resistance index'. Results: Overall 49 studies, 8 studies were finally selected to this study. There were 6 controlled studies and 2 randomised-controlled studies. In all 8 studies, transvaginal ultrasound was used to measure the resistance of uterine blood vessels. All of these studies reported that in patients with primary dysmenorrhea, hemodynamic values of uterine arteries measured by Doppler ultrasound were significantly higher than in normal subjects. Conclusions: According to the results, it was found that there was a positive correlation between the pain level of primary dysmenorrhea and the pulsation index and resistance index of the uterine artery. Based on these results, it can be seen that the doppler indicies of uterine artery have the potential to be used as an evaluation scale for Korean traditional medicine for primary dysmenorrhea.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.1
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• pp.51-53
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• 2016

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.3
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• pp.215-223
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• 2001

Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.1
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• pp.30-35
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• 2019

Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply. Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and $anti-M\ddot{u}llerian$ hormone (AMH) levels. Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p> 0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p> 0.05 for all). Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.3
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• pp.165-172
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• 2005

The aim of this study was to determine the roles of ET-1 and NO on uterine blood flow in pregnancy. Uterine arteries were isolated from 17 nonpregnant and 12 pregnant women. Nonpregnant group included patients with median age of $48.6{\pm}2.3$ years who underwent hysterectomy, because of myoma. Pregnant group included patients with median age of $31.3{\pm}1.4$ years undergoing cesarean delivery. ET-1 and ET-2 induced concentration-dependent contraction in isolated nonpregnant and pregnant uterine arteries. The contractile response and maximal contraction were increased in pregnant uterine arteries. In nonpregnant uterine arteries, there was no contraction in response to ET-3, whereas pregnancy induced concentration-dependent contraction by ET-3. Tissue nitrite/nitrate level and immunohistochemical staining of eNOS and iNOS were increased in pregnant uterine arteries, compared with nonpregnant uterine arteries. In addition, the expressions of eNOS and iNOS mRNA were significantly increased in pregnancy. Moreover, contractions by ET isopeptides, including ET-1, were enhanced, and immunohistochemical staining of ET-1 and ET-1 mRNA expression was increased in pregnant uterine arteries. These results suggest that NO production by increased NOS activity, especially eNOS activity, is related to placental and uterine blood flow. Furthermore, ET-1 appears to play a pathophysiological role in pregnant complications such as hypertension.

• Women's Health Nursing
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• v.12 no.4
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• pp.316-325
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• 2006

Purpose: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. Method: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. Result: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. Conclusion: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost.effectiveness, and the patients' and staffs' satisfaction.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.4
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• pp.163-168
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• 2015

Objective: To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods: In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results: Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (${\geq}2$) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion: Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids.

• Clinical and Experimental Reproductive Medicine
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• v.41 no.4
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• pp.174-177
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• 2014

Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.