• 제목/요약/키워드: Antenatal care

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구순열의 초음파 진단 (Prenatal Sonographic Diagnosis of Cleft Lip)

  • 서미현;김성민;오진실;명훈;이종호;최진영
    • 대한구순구개열학회지
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    • 제14권1_2호
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    • pp.29-36
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    • 2011
  • The frequency of fetal malformations accounts for around 3-5% and evaluation of the health of the fetus and screening for fetal malformations has become an important part of prenatal care. Improvements in prenatal diagnosis have allowed identification of malformation in fetuses during first and second trimesters of pregnancy. Prenatal ultrasonography has become routine part of antenatal examination. For development of imaging, the accuracy of diagnosis is getting higher and earlier diagnosis of congenital malformation, such as cleft lip and palate, can provide to parent counseling, and opportunity to prepare the further treatment. For the better understanding of congenital cleft lip diagnosis to the oral and maxillofacial surgeons, as healthcare providers, we reviewed around 19 english-written articles and summarized some knowledges of ultrasound findings in the prenatal cleft lip fetus.

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산후우울증 관련요인: 전향적 코호트 연구 (Predictors of Postpartum Depression: Prospective Cohort Study)

  • 윤지향;정인숙
    • 대한간호학회지
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    • 제43권2호
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    • pp.225-235
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    • 2013
  • Purpose: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. Methods: Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. Results: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (${\kappa}$=.55- .95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum. Conclusions: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

듀라터치 분만 교육이 분만 자신감, 분만지식, 부부관계만족도에 미치는 효과 (The effects of Doula Touch delivery education on self-confidence delivery, knowledge of childbirth, couple satisfaction)

  • 김금중
    • 한국산학기술학회논문지
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    • 제14권6호
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    • pp.2880-2888
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    • 2013
  • 본 연구는 듀라터치 분만교육이 분만자신감, 분만지식, 부부관계 만족도에 미치는 효과를 규명하고자 시도되었다. 대상자는 경기도 Y시에 소재한 보건소에서 2012년 10월부터 11월까지 주 1회 4번 듀라터치 분만교육을 받은 임산부 27명과 경기도 W시에 위치한 D병원에서 2012년 10월부터 2012년 11월 산전 진찰을 받은 대조군 28명을 대상으로 연구했는데, 그 결과는 다음과 같다. 듀라터치 교육을 받은 실험군이 대조군보다 분만자신감(t=-2.81, p=.007)과 분만지식정도(t=3.50, p=.001)에서 통계적으로 유의미하게 높았으나 듀라터치 교육을 받은 실험군과 대조군 간에는 부부관계 만족도는 유의미한 차이가 없는 것으로 나타났다(t=0.23, p=.818). 분만자신감과 부부관계 만족도에서 통계적으로 높은 상관관계를 나타냈다(r=314, p=.005).

Distribution and Determinants of Low Birth Weight in Developing Countries

  • Mahumud, Rashidul Alam;Sultana, Marufa;Sarker, Abdur Razzaque
    • Journal of Preventive Medicine and Public Health
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    • 제50권1호
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    • pp.18-28
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    • 2017
  • Objectives: Low birth weight (LBW) is a major public health concern, especially in developing countries, and is frequently related to child morbidity and mortality. This study aimed to identify key determinants that influence the prevalence of LBW in selected developing countries. Methods: Secondary data analysis was conducted using 10 recent Demography and Health Surveys from developing countries based on the availability of the required information for the years 2010 to 2013. Associations of demographic, socioeconomic, community-based, and individual factors of the mother with LBW in infants were evaluated using multivariate logistic regression analysis. Results: The overall prevalence of LBW in the study countries was 15.9% (range, 9.0 to 35.1%). The following factors were shown to have a significant association with the risk of having an LBW infant in developing countries: maternal age of 35 to 49 years (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.2 to 3.1; p<0.01), inadequate antenatal care (ANC) (aOR, 1.7; 95% CI, 1.1 to 2.8; p<0.01), illiteracy (aOR, 1.5; 95% CI, 1.1 to 2.7; p<0.001), delayed conception (aOR, 1.8; 95% CI, 1.4 to 2.5; p<0.001), low body mass index (aOR, 1.6; 95% CI, 1.2 to 2.1; p<0.001) and being in the poorest socioeconomic stratum (aOR, 1.4; 95% CI, 1.1 to 1.8; p<0.001). Conclusions: This study demonstrated that delayed conception, advanced maternal age, and inadequate ANC visits had independent effects on the prevalence of LBW. Strategies should be implemented based on these findings with the goal of developing policy options for improving the overall maternal health status in developing countries.

쌍태임신에 관한 임상적 고찰;I. 주산기 사망 (Clinical Study in Twin-Pregnancy;I. Perinatal Mortality)

  • 박찬규;곽현모
    • Clinical and Experimental Reproductive Medicine
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    • 제8권1호
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    • pp.23-34
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    • 1981
  • In order to study twin pregnancies, a retrospective survey was carried out in Yonsei University, Severance Hospital. Twin deliveries during 1967-1976 numbered altogether 264, and their relative frequency was 1.30%. Clinical palpation in addition to auscultation and roentgenologic technique had been used in the twin diagnosis. The diagnosis was made prior to delivery in 93.18% of the cases. The deliveries took place in the 37.26th (S.D. 3.95) gestational weeks on an average. The mean weights of the infants were-A (first baby) 2416.03g. (S.D. 802.61), and B (second baby) 2299.81g. (S.D. 190.31). The most common manner of twin delivery was spontaneous vaginal delivery. Cesarean section was done in 14.39%, of which the most common indication was hypotonic uterine dysfunction (34.21 %). Low one minute Apgar scores occured more often in B twins than among A twins. Breech delivery gave low one minute Apgar scores more often than did spontaneous vertex delivery in both twins. Full term twins and infants weighing more than 2500g. had fewer low one minute Apgar scores than the preterm infants and those with low birth weight. Perinatal mortality (PNM) in the total series was 14.77% (A 12.50% and B17.05%). The most common cause of perinatal mortality was prematurity in 44.87%. The worst outcome was recorded for the age groups 15-19 and ${\geqq}$40, in which perinatal mortality were 50.00%, respectively. The perinatal mortality of both A and B infants was lowest in the group diagnosed early during antenatal care before delivery. On the basis of our findings, we wish to emphasize particularly the importance of the early diagnosis of twins.

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선천성 자궁기형 환자의 생식력에 관한 고찰 (Reproductive Performance of Women with Uterine Anomalies)

  • 김학순;김정구;문신용;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제13권2호
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    • pp.137-144
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    • 1986
  • A reveiw of 85 patients with uterine anomalies was made in respect to the incidence, chief complaints, the reason of infertility, fetal wastage rate, pregnancy complications, fetal presentations and obstetric outcome after metroplasty from 1980 to 1985. The results were summarized as follows: 1. Incidence of uterine anomaly was 0.18% among all outpatients (85/48,240). 2. Of the 85 patients, there were 36 with bicornuate deformities (42.3%), 21 septate (24.7%), 18 uterus didelphys (21.2%), 8 arcuate (9.4%) and 2 patients with unicornuate anomalies (2.4%). 3. Uterine anomalies were diagnosed by hysterosalpingogram (54.1%), pelvic examination (14.2%) and other operative procedures. 4. Chief complaints were primary infertility (41.2%), secondary infertility (15.3%), repeated pregnancy loss (12.9%), antenatal care (11.8%) and menstural disturbance (10.6%), etc. 5. Twenty-nine patients with uterine anomalies had primary infertility. The cause of infertility was proved nonuterine in 26 cases and remained unknown in 3 cases. 6. The obstetric outcome of 104 pregnancies was spontaneous abortion in 51.0%, premature delivery in 11.50/0 and fetal loss in 57.7%. 7. Complications of 41 present pregnancies were threatened abortion (22%), premature rupture of membrane (12%) and premature labor (10%), etc. The frequency of abnormal presentation was 35.3% and 64.7% of deliveries was made by Cesarian section. 8. Metroplasty was performed in 13 patients who didn't have a baby because of repeated miscarriage and unknown cause of infertility. Subsequently 8 patients had 9 successful pregnancies: 6 patients had 7 healthy babies and 2 patients are now in pregnancy without any complications.

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Seropositivity of Toxoplasmosis in Pregnant Women by ELISA at Minia University Hospital, Egypt

  • Kamal, Amany M.;Ahmed, Azza K.;Abdellatif, Manal Z.M.;Tawfik, Mohamed;Hassan, Ebtesam E.
    • Parasites, Hosts and Diseases
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    • 제53권5호
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    • pp.605-610
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    • 2015
  • Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.

A Case of Successful Treatment of Congenital Syphilis in an Extremely Preterm Baby With Severe Respiratory Distress

  • Yoon Kyung Cho;Yeon Kyung Lee;Sun Young Ko
    • Pediatric Infection and Vaccine
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    • 제29권3호
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    • pp.161-165
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    • 2022
  • We report a case of successful treatment of congenital syphilis in an extremely preterm baby. A 1,395 g female infant was born by emergency Caesarean section due to preterm labor and breech presentation at gestational age at 29 weeks and 3 days with an Apgar score of 2 and 4 at 1 minute and 5 minutes, respectively. The mother of the newborn, an illegal immigrant who did not receive any antenatal care, was diagnosed as active syphilis infection by reactive rapid plasma regain (RPR) (titer 1:128) just before the delivery. Upon birth, the newborn presented with various clinical manifestations, including severe respiratory distress syndrome, persistent pulmonary hypertension of the newborn, disseminated intravascular coagulopathy, desquamation and scaling of the whole body, and osteolytic changes of long bone ends. Results of laboratory tests showed signs of early congenital syphilis, including positive syphilis reagin test (12.7 R.U.), reactive with RPR titer of 1:64, and positive for immunoglobulin (Ig) M and IgG fluorescent treponemal antibody absorption test. However, after completion of penicillin G treatment for two weeks, laboratory results dramatically improved, showing a negative syphilis reagin test (0.5 R.U.) and non-reactive in RPR. In conclusion, the incidence of congenital syphilis is prone to be resurgent in South Korea, neonatologists should be fully aware of the clinical features of congenital syphilis because early diagnosis and prompt treatment are essential in order to reduce the social and economic burden due to congenital syphilis.

신생아간호 운영체계에 대한 산모의 인식과 이용에 따른 차이 (Comparisons of Maternal Perceptions between Rooming-in and Non Rooming-in Postpartum Women)

  • 김윤미;박광옥;장혜령;정은자;김지수;김은영
    • 임상간호연구
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    • 제15권2호
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    • pp.77-89
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    • 2009
  • Purpose: The purpose of this study was to compare maternal perceptions between two groups of postpartum women, women who chose to have their babies room-in and women who did not (non rooming-in group). Methods: Data collection was conducted in 37 hospitals from August 10 to September 20, 2008. The participants were 209 mothers opting for rooming-in and 128 mothers for non rooming-in. The women completed a questionnaire which included the Edinburgh postpartum depression scale, maternal attachment inventory, and postpartum self-evaluation questionnaire. Results: There were significant differences in education level, income and antenatal education between the rooming-in and non rooming-in groups. The rooming-in group also showed higher levels of satisfaction with medical services. More important, the rate of breast feeding for the rooming-in group was higher than for the non rooming-in group. There was no difference between the two groups for postpartum depression, maternal attachment and mothers' confidence with infant care tasks. Conclusion: These findings suggest that rooming-in system has more advantages compared to non rooming-in and that it can help to promote breast feeding. The authors recommend that the rooming-in system be expanded nationwide. The results of this research can be used to assist the development of future rooming-in system expansion strategy.

농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구 (A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program)

  • 허달영;이명숙;염용태;김순덕
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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