Along with the low birth rate in Korea, the aging of mothers is progressing very rapidly. Recent studies have reported that the obstetric infrastructure is crumbling due to the accelerating closures of obstetric medical institutions resulting from the low birth rate and low reimbursement rates for obstetric procedures. The number of birth centers has also decreased, but women's interest in natural birth has actually increased, such that deliveries at birth centers now account for 11.8% of deliveries in obstetric clinics. In the Netherlands, Japan, and the United Kingdom, initiatives to promote natural birth through care provided by midwives increased the rate of natural births, decreased the number of cesarean sections, and lowered the rate of postpartum complications. In light of these examples, South Korea should also encourage natural delivery by midwives. A national support system for midwife applicants is necessary, and the requirements for institutions that train midwives should be revised. Independent birth centers should have emergency prescription privileges, and women should be given the choice to have a natural delivery by creating birth centers within hospitals.
Purpose: Sanhupung's pathological conditions is different from non-postpartum's disease. So it is important to analyze Sanhupung's construction, onset factors and Oriental theraphy. Methods: We studied 104 Sanhupung women visiting $\bigcirc\bigcirc$ hospital form January 2008 to December 2009. We analyzed the general characteristics, kinds of symptoms and Oriental theraphy's present condition. Also We compared patients' age, the number of live births and delivery month to the National Statistical Office's results. Results: 1. Patients over the age of 30, who have one child and who gave birth in September(14.42%) and in Summer(43.26%) occupied the highest percentage. But delivery method was not correlated with Sanhupung. 2. Musculo-skeletal symptoms(42.13%) were the most common symptoms. Wrist, waist, knees(59.59%) were the most common pain areas and the other pain symptoms (40.21%) appeared a significant portion of cases respectively. 3. In the 21~30days after delivery, the most patients visited. The number of patients admitted within 30 days after delivery or within 90 days was small comparing with Sanhupung onset. Patients treated within 10 days(47.12%) and treated only herb medicine(54.90%) were the most common. And the patients responded satisfacion or over were 88.46%. Conclusion: Patients' age, the number of born babies, delivery time were correlated with Sanhupung symptoms, but the method of delivery was not associated. And musculo-skeletal symptoms were the most common symptoms. Sanhupung patient's treatment period and methods were limited.
Objectives: The aim of this study was to assess the duration of lochia in women hospitalized at Korean medical postpartum care center and to identify factors that influence duration of lochia. Methods: On the obstetric variables of 315 cases, the duration of lochia was analyzed. In the postpartum care center, the obstetric variables were asked of 315 cases of women, and who examined a body composition. After discharge, women were surveyed for the duration of lochia by telephone. Results: The median duration of lochia was 30 days and the range was 18~53 days. Maternal age, parity and mode of delivery were associated with its duration. So, its duration was longer on women over the age of 35, multipara and women had a Cesarean section. Its duration was correlated with gestational age and BMI before pregnancy, but not neonatal gender, birth weight, maternal BMI change during pregnancy, maternal body weight gain, BMI before delivery. Conclusions: It was 30 days that the median duration of lochia of women who had been got Korean medical postpartum care management, and which was slightly different from previous studies. And it was influenced by maternal age, parity, mood of delivery, gestational age and BMI before pregnancy. In future more studies or surveys for the duration of lochia of women with no treatment, lochial pattern and so on should be done.
Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.
Purpose: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. Methods: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. Results: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. Conclusion: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.
Journal of Korean Academy of Fundamentals of Nursing
/
v.18
no.1
/
pp.54-62
/
2011
Purpose: The purpose of this study was to test the effects of aroma inhalation on subjective quality of sleep, state anxiety, and depression of mothers who underwent a Cesarean section delivery. Methods: This study was designed as a nonequivalent control group quasi-experimental study based upon data acquired through a pre-post test. The experimental group (n=33) was given general obstetric nursing care plus dry inhalation method using lavender essential oil, in which each mother put one drop on a tissue and breathe near it for 5 minutes before going to bed. Then they put 1~2 drops on their pillow for 6 nights. The control group (n=34) was only given general obstetric nursing care. Data were collected using a questionnaire for measures of subjective quality of sleep, state anxiety, and depression by self-report. ${\chi}^2$-test, Fisher's exact test, t-test, and ANCOVA with SPSS/Win12.0 were used to analyze the data. Results: There were significant differences in subjective quality of sleep (p<.001), state anxiety (p=.049) and depression (p=.029). Conclusion: The results suggest that aroma inhalation method can be an effective nursing intervention to improve quality of sleep and decrease anxiety and depression in postpartum mothers suffering from stress related to a Cesarean section delivery.
Purpose: This study were to investigate BMD of middle-aged women and to examine the relationships between BMD and Physical, Obstetric characteristics Method: The data was collected from 119 healthy women who were 40-60 years old. they were examined for BMD at 4 regions(forearm, lumbar, femur, whole body), %fat by DEXA and investigated physical, obstetric characteristics using scale, questionnaire from January to March, 2001. Result: 1) According to bone diagnostic results by WHO classification, 95.8% of forearm and whole body BMD were normal but 21.8-48.7% of lumbar and femur BMD(neck, trochanter, ward's triangle) were diagnosed osteoporosis or osteopnea. 2) The bones were significantly positive correlations of each other (r=.19-.69, p=.04-.00) and there were significant correlations between BMD and physical, obstetric characteristics such as age (r=-.22, p=.02), weight(r=.36~.48, p=.00), height(r=.22, p=.02), %fat(r=.19, p=.04) and age of first delivery(r=-.28, p=.00). Conclusion: Based on this study, healthy middle-aged women were also exposed to risk of osteoporosis related to aging, change of physical conditions or hormonal release. Further research to develop nursing interventions for the purpose of preventing osteoporosis by modifying risk factors is suggested.
Purpose: The aim of this study was to investigate the relation between peripheral blood leukocyte differential - Granulocyte rate, Lymphocyte rate and its calculated Granulocyte/Lymphocyte ratio - and the obstetric variables. Methods: From 270 cases of women who were in the postpartum care center attached to Won-Kwang Korean Medical Hospital, 36 cases met exclusion criteria. On the obstetric variables of 234 cases, peripheral blood leukocyte differential - Granulocyte rate, Lymphocyte rate and its calculated Granulocyte/Lymphocyte ratio - was analyzed. In the postpartum care center, the obstetric variables were asked of 234 cases of women, and who measured leukocyte differential. Results: Mean granulocyte rate and lymphocyte rate of peripheral blood leukocyte differential showed statistically significant difference from those in healthy people and was high. There was statistically significant difference in granulocyte/lymphocyte ratio according to mood of delivery, parity and period passed from childbirth. But whether postpartum women with anemia or not, maternal age and gender of neonate were not associated with granulocyte/lymphocyte ratio, and which was not significantly correlated with gestational age and neonatal birth weight. Conclusions: These findings suggest that activation of the sympathetic nervous system in postpartum women is higher than in healthy people. And granulocyte/lymphocyte ratio was influenced by mood of delivery, parity and period passed from childbirth. In future, more studies or surveys, with less bias, for the relation between peripheral blood leukocyte differential and the obstetric variables are required.
Choi, Young Hyun;Na, Baeg Ju;Lee, Jin Yong;Hwang, Ji Hye;Lim, Nam Gu;Lee, Seong Ki
Journal of agricultural medicine and community health
/
v.38
no.1
/
pp.14-24
/
2013
Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).
This study was to investigate the factors affecting the obstetric outcomes of married immigrant women and to compare the results with the Korean women's and to provide basic data for establishing effective nursing interventions for the married immigrant women. The subjects were 302 married immigrant women and Korean women who were delivered in the university hospital from 2011 to 2015. Data were analyzed using frequency, mean, standard deviation and logistic regression using SPSS WIN 24.0 program. Factors affecting obstetric outcome were premature rupture of membranes, gestational hypertension, amniotic fluid abnormalities, and medical illness in both married immigrant women and Korean women. In addition, age, spouse's age, occupation, hemoglobin level, and placental abnormality were found to have an effect on obstetrical outcome in married immigrant women. Therefore, in order to improve the obstetric outcome of married immigrant women, a prenatal care program considering these influencing factors will be needed.
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