Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.
Purpose : This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants. Methods : Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed. Results : The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor. Conclusion : In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.
Purpose: The purpose of this study is to verify the effects of the Qigong training program on the anxiety and labor pains of primipara. Method: The research subjects were a total of 60 primipara who consulted a doctor regularly concerning their antenatal care. Among them, 30 people were the experimental group, and the other 30 people were the control group, and were selected as homogeneous with the experimental group. The degree of anxiety and labor pains were measured by State-Trait Anxiety Inventory(STAI) and Graphic Rating Scale(GRS). SPSS WIN 11.0 was used for data analysis. Obstetric and general characteristics between experimental and control groups, and a homogeneity test of state and trait anxiety were done by both $X^2$ test and t-test. The hypothesis testing was analyzed by ANCOVA with a covariate of pretest value. Result: The first hypothesis, 'Primipara who join the Qigong training program have lower anxiety than those who do not join' was supported (F=28.8, p<.000). The second hypothesis, 'Primipara who join the Qigong training program have lower labor pain than those who do not join' was unsupported. Conclusion: It was verified that the Qigong training program was effective in alleviating anxiety; however it did not have any effect on relieving labor pain, so more in-depth research is needed later on.
Purpose: This study was to estimate salt preference and sodium intake of pregnant women, and identify the relationship between salt preference and sodium intake. Methods: Research design was a cross sectional correlational survey with 197 pregnant women who visited outpatient clinics for antenatal care. The sodium intake levels were estimated by the amounts of sodium intake using the 24-hour recall method and sodium concentration in spot urine. The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: Sodium intake using 24-hour recall method was $3,504{\pm}1,359mg$. Sodium intake levels had statistically significant differences depending on income. The average amount of sodium in spot urine was $2,882{\pm}878mg/day$. Sodium excretion levels had statistically significant differences depending on whether participants had preexisting hypertension in their family history and Body Mass Index (BMI) pre-conception. Salt preference was $62.61{\pm}20.96$ out of 180 points. Salt preference had significant differences depending on income, parity, gestational age, BMI pre-conception and showed negative correlation with sodium quantity in spot urine. Conclusion: Sodium intake in pregnant women recommended by World Health Organization recommended is 175%. Salt preference was not significantly different between sodium intake levels, however it was negatively correlated with sodium quantity in spot urine among pregnant women.
The present study was conducted to investigate physical characteristics, food habits of pregnant women with gestational diabetes mellites(GDM). The subjects were consecutive pregnant women, 21 GDM and 43 non-GDM controls who received antenatal care at the Obstetrics and Gynecology clinic. There were no significant difference in the mean age between the two groups(GDM:30.8years, non-GDM:30.5years). Significant differences were observed in several anthropometric characteristics such as height(GDM:159.7cm, non-GDM:162.3cm), prepregnancy weight(GDM:61.6kg, non-GDM:54.1kg), body mass index(GDM:23.9kg/$m^2$, non-GDM:20.5kg/$m^2$), and triceps skin fold thicknesses(GDM:30.9mm, non-GDM:24.7mm) between the two groups. The GDM group had an high incidence of(52.4%) family history of diabetes mellitus than those of control group(23.3%). In the GDM group, more irregularities of meals and more bed-time snacking were observed than those of control group. The intake amount of carbohydrates as well as the total energy were significantly higher in the GDM group when thery were compared with the control. These results suggest that the GDM women in Korea do exhibit clearly distinctive anthropometric and dietary characteristics. Nutritional management such as weight control before conception and throughout pregnancy, monitoring total energy and carbohydrate intakes, and implementing more rigorous meal scheduling might be beneficial for the prevention or reduction of the prevalence of the GDM or its complications. (Korean J nutrition 34(2):158~164, 2001)
In order to develop some indicies for the evaluation of village health worker's activities and to find out personal characteristics and other factors that affect the activities, an interview survey was conducted to thirty seven village health workers (VHW) in Sunwon, Naega and Bulun townships in Kangwha county, where the Community Health Project of Yonsei University, College of Medicine, has been implemented for the past ten years. In addition, daily activity records of the VHW's were also analyzed. The results are summarized below: First, meeting attendance rates, number of regular family visits, number of antenatal care visits and number of family planning visits were identified as the most meaningful criterion for the evaluation of the village health worker's activities. Second, personal factors that significantly affect the village health worker's activities were identified as age, educational background, living with in-laws, religion, presence of preschool child in the family, holding leader's position of village woman's association concurrently, and duration serving as a VHW. The more aged and the more educated VHWs were the more effective. Those VHWs who were living with in-laws, without preschool child in the family, holding the leader's position of the village woman's association, and the longer service duration were the more effective. Other factors that affect the VHW's activities were the number of households in the target village and the number of natural villages in the target villages. It showed that the smaller the size of number of households and natural villages, the higher the degrees of the effectiveness of the VHW.
"Saengsanbibang" is Obsterics technical books published in 1915. After the publishing of first edition, it was published 15 times so I supposed that this book was very popular in that times. And this book is also valuable because Obsterics books written in Korea are uncommon. But there had not been enough detailed study on this book, so I tried to study on the formation of this book. For that, I compared the formation between this book and 4 kinds of typical Obsterics technical books in Qing dynasty, "Taesansimbub", "Taesanbiseo", "Daesaengyoji", and "Dalsaengpyeon". As the result, "Saengsanbibang" refered to "Dalsaengpyeon" for the contents that the reason and prevention of distocia, the basic principle for antenatal care, and the formulae to tonify blood. The contents that the taking methods of Saenhwatang (生化湯) accroding to the diseases, are mainly affected by "Taesanbiseo". Some contents which had been refered in "Taesansimbub", "Daesaengyoji" weren't refered to "Saengsanbibang". So "Saengsanbibang" is valuable because this book easily summarized the medical knowledge for spreading it to ordinary people. I look forward to more specific study for "Saengsanbibang".
Purpose: To determine whether maternal attitude toward sex during pregnancy and health-related quality of life could influence sexual function of pregnant women. Methods: In this study, 138 second and third trimester pregnant women completed self-report questionnaires during their visits to women's hospitals or community health centers to assess their general characteristics, attitude toward sex during pregnancy (PIES-M), health-related quality of life (EQ-5D), and sexual function (FSFI-6K). Multiple regression analysis was performed to test the research model with SPSS version 23. Results: Pregnant women who had discontinued their sexual life after recognizing their pregnancy accounted for 27.5% of women questioned. The average sexual function score of pregnant women was higher in the second trimester than the third trimester. Attitude toward sex during pregnancy (${\beta}=-.38$, p<.001), maintaining sexual life (${\beta}=.20$, p=.028), health-related quality of life (${\beta}=.18$, p=.030), and adverse symptoms during sex (${\beta}=.18$, p=.042) were determinants of sexual function during pregnancy. Conclusion: Nurses in antenatal care units need to help pregnant women maintain a positive attitude toward sexual activity during pregnancy and manage their health-related quality of life to maintain their sexual life during pregnancy.
This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.
A Pregnancy is the women's normal physiological and developmental process, in which many psychological changes including sexual problems always occur. But there have been few guidelines on sexual life during pregnancy. So this study was performed to evaluate the sexual life of pregnant women, and to analyze the factors affecting satisfaction of sexual life during pregnancy. Questionnaires were given to pregnant women who visited two general hospitals for antenatal care as well as to attendants at a prenatal Lamaze class. The results were as followings : 1) The average age of the 194 pregnant women was 28.5 years ; 98.4% of them had educated more than 12 years. ; the average monthly income was about 15,000,000 won ; primigravida women were 81.4% of the total cases. 2) As the pregnancy progressed, the frequency of the sexual intercourses was decreased in 48.5% because of the anxiety on the fetal damages. The was no significant differences between frequency of sexual intercourses and the degrees of physical discomfort and spouse intimacy. Man superior position was taken in 88.1% ; the incidence of orgasms before and during pregnancy were 71.1% and 41.1%, respectively ; the incidence of painful sexual intercourse in primigravida women was decreased by pregnancy in 4.6%, and in the case of multigravida women it was increased in 2.1%. 3) The average point of sexual knowledge was 11.5 in total points of 20 ; that of sexual attitude was 29.1 in total points of 40 ; that of sexual satisfaction was 28.5 in perfects points of 40. 4) The factors which significantly related to the satisfaction of sexual life were spouse intimacy, sexual attitude, change of sexual body position during pregnancy, and the orgasms before and during pregnancy. Considering above results, nursing care and nursing intervention including sexual education and counselling programs are needed during pregnancy as well as before pregnancy.
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