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Pancytopenia in pregnancy woman with upper respiratory infection
( Yoon Hyeon Hu ),( Tae Yeon Kim ),( Tae Gyu Ahn ),( Hyang Ah Lee ),( Sunghun Na ),( Jong Yun Hwang ),( Dong Hun Lee ),( Se Jin Lee ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-
Pancytopenia is reductions in all the three major cellular components of blood, and it is the simultaneous presence of anemia, leukopenia, and thrombocytopenia. It complicating pregnancy is rare. But during pregnancy it could be life-threatening for both mother and child. Pancytopenia, which occurs early in pregnancy, is particularly challenging in clinical settings because pregnancy management and outcomes are entirely dependent on underlying causes. The assessment of patients with pancytopenia requires a comprehensive approach and it can be difficult to determine the root cause when considering various causes, including drugs, autoimmune conditions, malignancies, infections, hemophagia, and inheritable conditions. While bone marrow failure syndromes and malignancies are important causes, certain non-malignant conditions such as infection and nutritional anemia are equally important causes. We present a 29-year primigravida woman with an uneventful medical history who was referred at 17weeks gestational age as a case of fever with pancytopenia. She had a cough and sore throat. And serum C-reactive protein and procalcitonin levels were elevated. She was admitted, investigated and diagnosed as a case of pancytopenia with peripheral blood smear showing normocytic normochromic anemia with aniso-poikilocytosis, leukopenia with lymphopenia (10%190/uL), and moderate thrombocytopenia. She was treated intravenous antibiotics and after the infection has been cured, the pancytopenia has improved spontaneously after 3 weeks later. We report a case who developed pancytopenia following upper respiratory infection in the rare case.
Anaphylactic shock following intravenous ranitidine in pregnancy woman
( Yoon Hyeon Hu ),( Tae Yeon Kim ),( Tae Gyu Ahn ),( Hyang Ah Lee ),( Jong Yun Hwang ),( Dong Hun Lee ),( Se Jin Lee ),( Sunghun Na ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-
Ranitidine is generally safe in pregnancy. Anaphylaxis is rarely observed with ranitidine. Anaphylaxis is triggering maternal hypotension leading to intrapartum hypoxic-ischemic encephalopathy in the infant. Furthermore, cesarean sections are performed at a high rate of anaphylactic pregnant woman. A 43-year-old primigravida was hospitalized for a cesarean section at 38+3 weeks of gestation. She didn’t have any underlying disease. She had histories of drug allergy for common cold medication. But she didn’t know exactly what drugs were causing allergies. Following admission, before the cesarean section, ranitidine was injected to her. At the beginning of the injection, the patient complained of dizziness, and within seconds she experienced shortness of breath and chest tightness. Several minutes later she experienced dyspnea, sweating, and severe cramping pain in the abdomen. Further, the fetal heart revealed bradycardia (70-80 beats per minute). She has received an emergency cesarean section under general anesthesia. A male infant weighing 3220 g was delivered with Apgar scores of 2 and 3 and 4 at 1, 5 and 10 minutes. The infant was transferred to the neonatal intensive care unit. After the surgery, the mother was received routine post-operation care and discharged home. We report a case who developed severe anaphylaxis following a single dose of intravenous ranitidine in the rare case.
( Yoon Hyeon Hu ),( Dong Hun Lee ),( Jong Yun Hwang ),( Sunghun Na ),( Tae Gyu Ahn ),( Yung-taek Ouh ),( Se Jin Lee ),( Chorong Kim ),( Darae Lee ),( Hyang Ah Lee ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
Objective: Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to sexual assault centers during the acute phase of sexual assault injury within 72 hours. Methods: From 2007 to December 2014, a total of 270 female patients who were 18 years of age or younger with a diagnosis of CSA were evaluated at Kangwon National University Hospital Sexual Assaults Center. We analyzed 158 cases which were complete with the time from occurrence to visit, characteristics of victims, victims behaviors, assailants, and types of abuses that occurred. We classified the victims into two groups: those who visited the center within 72 hours and those who did not. Results: Mean days from occurrence to visit were 1.05 days for victims who utilized medical services during the acute phase of sexual assault injury, and 34.43 days for victims who visited during the post-acute phase (delayed exposure). Victims with a physical sexual assault involving penetration showed a higher proportion of visit within 72 hours of the occurrence. In logistic regression, victims with single mother(OR=0.199), single father(OR=0.088), grand or stepparents or relatives(OR=0.147) were significantly less likely to visit during the acute phase in comparison to victims with both parents. Conclusion: The type of family and the presence of physical injuries are considered to be significant factors affecting CSA victims visiting medical institutions within three days.
( Yoon Hyeon Hu ),( Yung-taek Ouh ),( Chorong Kim ),( Se Jin Lee ),( Tae Gyu Ahn ),( Hyang Ah Lee ) 대한폐경학회 2021 대한폐경학회지 Vol.27 No.2
Spontaneous rupture of an ovarian artery aneurysm is an extremely rare, life-threatening disease and has been reported to be most highly associated with pregnancy. The current study presents a case of intraperitoneal and retroperitoneal hematoma caused by spontaneous rupture of a right ovarian artery aneurysm in a 56-year-old woman. A 56-year-old woman visited the emergency room with right lower quadrant abdominal pain. Contrast-enhanced computed tomography showed a large retroperitoneal and intraperitoneal hematoma and active extravasation of contrast medium in the right retroperitoneum. Consequently, transcatheter arterial embolization was successfully performed. Spontaneous rupture of an ovarian artery aneurysm should be suspected in multiparous women with abdominal or flank pain even if it is unrelated to pregnancy. Suspicion of this entity is needed for earlier diagnosis and management.
High Grade Squamous Intraepithelial Lesion with Endocervical Myoma
( Chorong Kim ),( Yoon Hyeon Hu ),( Darae Lee ),( Tae Gyu Ahn ),( Hyang Ah Lee ),( Jong Yun Hwang ),( Dong Hun Lee ),( Se Jin Lee ),( Sunghun Na ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
High grade squamous intraepithelial lesion (HSIL) is a squamous cell abnormality. They are usually caused by chronic infection with certain types of human papillomavirus (HPV) and are found when a Pap test or biopsy are done. A 48-year-old woman visited emergency room because of lower abdominal pain. She had also vaginal bleeding since two weeks ago. In the test, urine hCG was negative. Ultrasonographic findings showed that about 7cm heteroechogenic round mass was in the endocervical canal. Computed Tomography (CT) showed About 7.7cm round mass of subtle enhancement in endocervical canal or left lateral wall of endocervical canal and hemorrhage in posterior to this lesion. Therefore, uterine myoma (submucosal or pedunculated) or infarcted polyp with hydrometra was suspected, and the next day hysterectomy was planned. She had hysterectomy with bilateral salpingectomy. When I grossly looked at the sample, myoma was suspected. But several days later, a biopsy result came out, and the results were HSIL, and leiomyoma. She was received routine post-operation care and discharged home. HSIL is usually found in the PAP smear and may be overlooked if the myoma is present. But they may be together. We report a case that HSIL lesion was found in cervix in a patient who was suspected of myoma.
Corpus luteal cyst Rupture with Tubal Abortion
( Darae Lee ),( Yoon Hyeon Hu ),( Chorong Kim ),( Tae Gyu Ahn ),( Hyang Ah Lee ),( Sunghun Na ),( Jong Yun Hwang ),( Dong Hun Lee ),( Se Jin Lee ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-
Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. And ectopic pregnancy has also hemoperitoneum. Tubal abortion, which is a rare type of ectopic pregnancy, is characterized by the extrusion of an ectopic product of conception implanted in the fallopian tube through the abdominal ostium into the peritoneal cavity. A 39-year-old woman visited emergency room because of abnormal bleeding and lower abdominal pain since 3 days ago. She was an infertile patient. She had In vitro fertilization and embryo transfer a month ago, but she failed pregnancy and continued to had vaginal bleeding. In urine test, human chorionic gonadotropin (hCG) was positive. Ultrasonographic findings showed that the absence of an intrauterine gestational sac, with bilateral ovarian anechoic cyst and small echogenic free fluid in posterior Cul-de-Sac(PCDS). According to the blood test, beta-hCG was 3,679 mIU/mL and hemoglobin was 8.4 g/dL. The vital sign was stable. She was hospitalized and monitored, and the next morning on a blood test, beta-hCG dropped to 2,905mIU/mL and hemoglobin 7.3 g/dL. Ultrasound findings, fluid collection was increased, and emergency surgery was determined. In the surgical findings, hematoma of the right fallopian tube was observed, cyst rupture was found in the right ovary, and ovarian cyst was also observed in the left ovary. She had right salpingectomy, bilateral ovarian cystectomy, and dilatation and curettage with biopsy. Pathologic results were hematoma in tubal lumen, hemorrhagic corpus luteal cyst. In uterine endometrium, there are proliferative glands with predecidualized stroma. After surgery, she was received routine post-operation care and discharged home. We report a rare hemoperitoneum case in which both hemorrhagic corpus luteal cyst and tubal abortion developed simultaneously.