• 여성건강간호학회지
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• 제26권4호
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• pp.255-259
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• 2020

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.

• 대한한방부인과학회지
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• 제23권3호
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• pp.192-204
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• 2010

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.

• 대한한방부인과학회지
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• 제26권3호
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• pp.59-72
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• 2013

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.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.338-346
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• 2018

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.

• 여성건강간호학회지
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• 제17권4호
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• pp.407-414
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• 2011

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.

• 기본간호학회지
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• 제18권1호
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• pp.54-62
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• 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.

• 성인간호학회지
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• 제14권4호
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• pp.532-542
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• 2002

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.

• 대한한방부인과학회지
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• 제26권4호
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• pp.82-93
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• 2013

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.

• 농촌의학ㆍ지역보건
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• 제38권1호
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• pp.14-24
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• 2013

이 연구는 건강보험공단으로부터 획득한 2001년부터 2008년까지 전국 232개 시군구 지역의 분만 및 합병증 청구 자료를 바탕으로 산모가 자신의 거주 지역 내 외에서 출산하는 비율과 산과적 합병증과의 관련성을 밝히기 위한 생태학적 연구이다. 산모가 본인의 거주 지역 밖에서 출산하는 비율인 관외분만율은 정도에 따라 저도 관외분만율 지역, 중등도 관외분만율 지역, 고도 관외분만율 지역으로 범주화하였으며, 산과적 합병증은 '유산, 자궁외 임신 및 기태임신에 따른 합병증율', '유산율', '자간증율'을 구하였다. 관외분만율에 따른 산과적 합병증의 일원배치 분산분석에서 저도 및 중등도 관외분만율 지역보다 고도 관외분만율 지역이 '유산, 자궁외 임신 및 기태임신에 따른 합병증율'과 '자간증율'이 통계적으로 의미있게 증가하는 경향을 보였고(p<0.05), 산과적 합병증 각각을 종속변수로 한 다중선형회귀분석에서 '유산, 자궁외 임신 및 기태임신에 따른 합병증율'은 고도 관외분만율 지역(분만서비스 접근 취약지역)이 기타 지역보다 유의하게 높은 것으로 나타났으며(p<0.01), '자간증율'은 고도 관외분만율 지역에서 그리고 1인당 지방세납입액이 낮은 지역에서 더 높은 것으로 나타났다(p<0.01). 이 연구를 통해 분만서비스 접근 취약지역에 거주하는 산모에서 산과적 합병증이 높음을 나타냈고 따라서 이에 대한 적절한 대책이 세워져야 할 필요성을 시사하고 있다. 특히 응급 대응 및 산전관리의 충실성을 높이기 위한 체계적인 대안이 정책적으로 고려되어야 함을 보여주고 있다. 한편 이 연구는 시군구를 분석 단위로 한 생태학적 연구이므로 산전관리 수진 및 산과적 합병증 발생에 영향을 미치는 개인수준에서의 요인들까지 고려되지 못한 점은 이 연구의 한계점으로 가지고 있다. 따라서 추후 산전관리 및 산과적 합병증에 영향을 미치는 산모 개인수준에서의 요인들까지 고려한 후속연구가 필요하겠다.

• 한국융합학회논문지
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• 제9권3호
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• pp.279-287
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• 2018

본 연구는 결혼이주여성의 산과적 결과에 미치는 요인을 파악하고 이를 한국여성의 결과와 비교하여 결혼이주여성의 출산건강에 효과적인 간호중재 수립을 위한 기초자료를 제공하고자 수행된 조사연구이다. 연구대상자는 2011년부터 2015년까지 일 대학병원 분만실에서 분만한 결혼이주여성과 한국여성 총 302명으로 하였으며 후향적으로 의무기록을 조사하였다. 자료분석은 SPSS WIN 24.0 프로그램을 이용하여 빈도, 평균과 표준편차, 로지스틱 회귀분석을 실시하였다. 산과적 결과에 영향을 미치는 요인은 결혼이주여성과 한국여성 모두 조기양막파열, 임신성고혈압, 양수이상, 내과적 질환으로 나타났으며, 결혼이주여성의 경우에는 연령, 배우자의 연령, 직업, 헤모글로빈 수치, 태반이상 등이 추가적으로 영향을 미치는 것으로 나타났다. 따라서 결혼이주여성의 산과적 결과를 향상시키기 위해서는 이들 영향 요인들을 고려한 산전관리프로그램이 필요하다.