계류유산 환자의 자연배출을 돕는 芎歸湯加減 치험 1례
A Case Study of Gunggi-tang that induces Natural Expulsion in Missed Abortion
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (23)
- The Society of Korean OB & GY., "Korean Gynecology Vol. Ⅱ", pp.418~443 (2012), Euisung-dang
- Gemzell-Danielsson K, "Misoprostol to treat missed abortion in the first trimester", Int J Gynecol Obstet, 99(Suppl 2), pp.182~185 (2007)
- 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, 123(3), pp.676~692 (2014)
- AlSaad D, "Misoprostol for miscarriage management in a woman with previous five cesarean deliveries : a case report and literature review", Ther Clin Risk Manag, 13, pp.625~627 (2017)
- Hooker A, "Long-term complications and reproductive outcome after the management of retained products of conception : a systematic review", Fert Steril, 105(1), pp.156~164 (2016)
- Ben-Ami I, "Infertility following retained products of conception : is it the surgical procedure or the presence of trophoblastic tissue?", Eur J Obstet Gynecol Reprod Biol, 182, pp.132~135 (2014)
- Marwah S, "A comparative study to evaluate the efficacy of vaginal vs oral prostaglandin E1 analogue(misoprostol)in management of first trimester missed abortion", J Clinical and Diagnostic Research, 10(5), pp.14~18 (2016)
- Waard M, "Management of miscarriage a randomized controlled trial of expectant management versus surgical evacuation", Hum Reprod, 17(9), pp.2445~2450 (2002)
- Nadarajah R, "A radomised controlled trial of expectant management versus surgical evacuation of early pregnancy loss", Eur J Obstet Gynecol Reprod Biol, 178, pp.35~41 (2014)
- Wu H, "Misoprostol for medical treatment of missed abortion : a systematic review and network meta-analysis", Sci Rep, 7(1), pp.1664~1672 (2017)
- Trinder J, "Management of miscarriage : expectant, medical, or surgical? Results of randomised controlled trial(miscarriage treatment(MIST)trial)", BMJ, 332, pp.1235~1240 (2006)
- Leladier C, "Mifepristone(RU 486)induces embryo expulsion in first trimester non-developing pregnancies : a prospective randomised trial", Hum Reprod, 8(3), pp.492~495 (1993)
- 조대연, "方藥合編 中 婦人科에 관련된 方劑의 활용에 대한 고찰", 동의생리병리학회지, 18(6), pp.1543~1547 (2004), 한의병리학회
- Huh J, "Dong-Eui-Bo-Kham", pp.1190~1255 (2005), Bubinbooks
- 송영훈, "한방치료로 호전된 산후풍 환자의 치험 2례", 한의학연구소 논문집, 20(1), pp.111~117 (2011), 한의학연구소
- Dong-Eui Medicine Research Center, "BangYakHapPyun(方藥合編) Vol. 4", pp.717~ (2006), Dansam
- 최웅식, "평위산의 방론에 대한 고찰", 대한한의학 방제학회지, 23(2), pp.225~233 (2015), 대한한의학방제학회[DOI]
- Choi M., "Dong’s acupuncture", pp.50~ (2003), Ilung Inc
- 이아영, "보허탕가감 투여가 산후 생쥐의 유즙분비량 및 유즙분비 관련 인자에 미치는 영향", 대한한방부인과학회지, 29(1), pp.35~52 (2016), 대한한방부인과학회[DOI]
- Hwang D., "Sinjeung Bangyakhappyeon", pp.179~ (2002), Yeonglimsa
- The Society of Acupuncture & Moxibustion Nationwide College of Oriental Medicine, "Acupuncture & Moxibustion Medicine Vol 1", pp.323~ (1994), Jipmundang
- 권지명, "자궁내막이 얇은 불임 환자 자연임신 1례", 대한한방부인과학회지, 28(1), pp.138~146 (2015), 대한한방부인과학회
- Rafi J, "Expectant Management of Miscarriage in View of NICE Guideline 154", Journal of Pregnancy, 2014, pp.824527~ (2014)