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( Kwan Heup Song ),( Joo-hyuk Son ),( Tae-wook Kong ),( Jiheum Paek ),( Suk-joon Chang ),( Hee-sug Ryu ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: To evaluate risk factors for massive lymphatic ascites after laparoscopic retroperitoneal lymphadenectomy in gynecologic cancer and the feasibility of treatments using intranodal lymphangiography (INLAG) with glue embolization. 방법: A retrospective analysis of 234 patients with gynecologic cancer who received laparoscopic retroperitonal lymphadenectomy between April 2006 and November 2015 was done. In June 2014, INLAG with glue embolization was initiated to manage massive lymphatic ascites. All possible clinicopathologic factors related to massive lymphatic ascites were determined in the pre-INLAG group (n=163). Clinical courses between pre-INLAG group and post-INLAG group (n=71) were compared. 결과: In the pre-INLAG group (n=163), four patients (2.5%) developed massive lymphatic ascites postoperatively. Postoperative lymphatic ascites was associated with liver cirrhosis (three cirrhotic patients, p<0.001). In the post-INLAG group, one patient with massive lymphatic ascites had a congestive heart failure and first received INLAG with glue embolization. She had pelvic drain removed within 7 days after INLAG. The mean duration of pelvic drain and hospital stay decreased after the introduction of INLAG (13.2 days vs. 10.9 days, p=0.001; 15.2 days vs. 12.6 days, p=0.001). There was no evidence of recurrence after this procedure. 결론: Underlying medical conditions related to the reduced effective circulating volume, such as liver cirrhosis and heart failure, may be associated with massive lymphatic ascites after retroperitoneal lymphadenectomy. INLAG with glue embolization can be an alternative treatment options to treat leaking lymphatic channels in patients with massive lymphatic leakage.
Patient blood management to minimize transfusions during the postpartum period
Kwan Heup Song,Eun Saem Choi,Ho Yeon Kim,Ki Hoon Ahn,Hai Joong Kim 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.6
Patient blood management is an evidence-based concept that seeks to minimize blood loss by maintaining adequate hemoglobin levels and optimizing hemostasis during surgery. Since the coronavirus disease 2019 pandemic, patient blood management has gained significance due to fewer blood donations and reduced amounts of blood stored for transfusion. Recently, the prevalence of postpartum hemorrhage (PPH), as well as the frequency of PPH-associated transfusions, has steadily increased. Therefore, proper blood transfusion is required to minimize PPH-associated complications while saving the patient’s life. Several guidelines have attempted to apply this concept to minimize anemia during pregnancy and bleeding during delivery, prevent bleeding after delivery, and optimize recovery methods from anemia. This study systematically reviewed various guidelines to determine blood loss management in pregnant women.
Can common carotid artery ultrasonography help in screening high-risk pregnant women?
( Moon Hye Yeon ),( Park Hyeon Ji ),( Jeon Hye Jin ),( Kwan Heup Song ),( Ho Yeon Kim ),( Geum Joon Cho ),( Ki Hoon Ahn ),( Soon Cheol Hong ),( Min Jeong Oh ),( Hai Joong Kim ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-
Objective: Pregnancy at advanced maternal age has become more common in Korea. There are many studies between pregnancy induced complication such as pre-eclampsia, gestational diabetes mellitus (GDM) and advanced maternal age. Therefore, screening for high-risk pregnant women with pregnancy induced complications is important. Carotid intima-media thickness (CIMT) and peak systolic velocity (PSV) are well known indicators of atherosclerosis and cardiovascular disease. CIMT and PSV are affected by endothelial dysfunction and inflammation. This is similar to the mechanism that causes placental dysplasia and vascular disorders, leading to pregnancy induced complication. In this study, CIMT and PSV were compared between high-risk pregnant women and normal pregnant women. Methods: This study had been performed at Korea University Ansan Hospital between March 2019 and August 2022. All enrolled women measured CITM, PSV, and end-diastolic velocity by ultrasonography between 20 and 24 weeks of gestation. In addition, perinatal complications, clinical characteristics, delivery method, gestation age, birth weight of the fetus, neonatal intensive care unit administration, and Apgar score were compared among these pregnant women. Results: Maternal common carotid artery (CCA) IMT and PSV did not show a significant correlation with overt diabetes mellitus (DM) and GDM. However, pregnant women with pregnancy induced hypertensive disorder (PIH) showed decreased the PSV of CCA that compared to normal pregnant women. (p=value 0.043) In addition, CCA IMT showed a positive correlation with gestational age and birth weight. (p-value 0.02, 0.028 / r-value 0.277, 0.2262) Conclusion: In pregnant women with PIH, the PSV of CCA was decreased compared to normal pregnant women. This may help screening pregnant women who had high risk for PIH in the second trimester of pregnancy.