• Title/Summary/Keyword: Emergency cesarean delivery

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Stress in pregnant women and the effect of cesarean delivery on anxiety and subjective anxiety statuses (임부의 스트레스 정도와 응급제왕절개분만시 상태불안과 주관적 불안에 관한 연구)

  • Shim, Chung-Sin;Chong, Ji-Yon;Bae, Sang-Yeol
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.77-90
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    • 2014
  • Purpose: This study was a descriptive survey research that aimed to investigate the stress level of pregnant women and subsequent effect of emergency cesarean delivery on anxiety and subjective anxiety statuses. Methods: The study samples were 233, including 109 emergency cesarean delivery and 124 normal vaginal deliveries between May 1, 2014, and August 26, 2014, in the Gwangju Metropolitan City. Results: None of the results showed any significant statistical difference in psychological stress between emergency cesarean delivery during mid-pregnancy and normal vaginal delivery (t = 1.784, p = .076). Emergency cesarean delivery has a significantly high level of anxiety (t = 10.849, p < .001) and subjective anxiety statuses (t = 13.294, p < .001) compared with normal vaginal delivery. Conclusion: A prenatal education program for stress and anxiety from emergency cesarean delivery needs to be developed for more effective stress management.

The Effect of Epidural Analgesia for Labor Pain on the Cesarean Section (경막외차단에 의한 무통분만이 응급제왕절개율에 미치는 영향)

  • Chung, Sung-Won;Park, Tae-Kyu;Kim, Ae-Ra;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.108-113
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    • 1999
  • Background: There is some concern that the administration of epidural analgesia for pain relief during labor increases the likelihood of cesarean delivery. But, several investigators showed a decrease in the rate of emergency cesarean delivery after epidural analgesia. The purpose of this study was to compare the emergency cesarean rate between the two groups with and without epidural analgesia. Methods: We reviewed retrospectively the medical records for 7846 parturients admitted our hospital between January 1, 1995 and December 31, 1996 and whose attending physician anticipated a normal labor and vaginal delivery. The number of parturients with epidural analgesia using 0.25% bupivacaine with fentanyl were 2839 and parturients without epidural analgesia were 5017. Results: An administration of epidural analgesia was not associated with the incidence of cesarean rate. 149 (5.25%) of 2839 parturients in epidural group and 371 (7.31%) of 5017 parturients in non-epidural group underwent emergency cesarean section. Conclusions: Our retrospective study has shown that an administration of epidural analgesia neither decrease nor increase in the rate of emergency cesarean delivery when compared with a non-epidural analgesia.

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Factors Determining Cesarean Section Frequency Rates of the OBGY Clinics in Metropolitan Area (수도권 소재 산부인과의원의 제왕절개율과 관련 요인분석)

  • Kim, Yun-Mi;Go, Su-Kyoung
    • Women's Health Nursing
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    • v.8 no.3
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    • pp.389-401
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    • 2002
  • This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.

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2020 Year of the nurse and the midwife: a call for strengthening midwifery in response to South Korea's ultra-low birth rate

  • Kim, Yun Mi
    • Women's Health Nursing
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    • v.26 no.4
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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.

Continuous Ilioinguinal-iliohypogastric Nerve Block for Groin Pain in a Breast-feeding Patient after Cesarean Delivery

  • Kim, Eun Soo;Kim, Hae Kyu;Baik, Ji Seok;Ji, Young Tae
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.193-196
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    • 2016
  • Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

A Literature Review about Labor theory and practice - Focused on Bulsusan(佛手散) - (임산(臨産) 의론(醫論)과 의방(醫方)에 대한 문헌고찰(文獻考察) - 불수산(佛手散)을 중심으로 -)

  • Lyu, Jeong-Ah;Jeong, Chang-Hyun
    • Journal of Korean Medical classics
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    • v.25 no.1
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    • pp.173-196
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    • 2012
  • Object : From the ancient times, the importance of childbirth has been well recognized by Korean Traditional Medicine. Numeral methods have been developed to ease the labor process and keep the mother and child healthy from conception to labor. Bulsusan(佛手散) is one of the main remedies to healthy labor in KTM, both widely known and applied as well. Method : This paper examines the labor theory and practice of KTM focused on Bulsusan which is composed of Angelica gigas Nakai(當歸) and Cnidium officinale MAKINO(川芎). Result : 1. From the ancient times until the Q$\bar{i}$ng period, much attention was placed to the handling of the placenta, as it was conceived as bearing much relation to the health of the mother and her fate, and thus included in the labor process. 2. There was a recognition of the 'birth pulse[離經脈]', an intense change in the pulse that presents itself prior to somatic signs of labor. 3. There were numerous prescriptions that were administered beforehand to ease the process. They are mostly constituted with medicinals that nurture Gi(氣) and stimulate its flow, which in turn makes the fetus firm and reduces the volume, easing the labor process. 4. The medical practice of labor-induction was called 'Choesaeng(催生)'. The prescriptions which functioned as such were mostly constituted with blood medicinals such as Angelica gigas Nakai and Cnidium officinale MAKINO, those which nurture both Gi(氣) and blood, and medicinals that physically lubricate the labor pathway such as honey, oil and Talcum(滑石). Conclusion : Bulsusan can be used in most problems concerning pregnancy and labor, and cases of emergency blood loss due to injury. The term 'bulsu(佛手)' infers to the medical ability of the great doctor who takes care of major blood-loss situations resulting from discharge of dead fetus, cesarean delivery, etc. The prescription name takes after this meaning, as it deals with similar conditions in its effect.

A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy

  • Ra, Moni;Kim, Myungkyu;Kim, Mincheol;Shim, Sangwoo;Hong, Seong Yeon
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.84-88
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    • 2018
  • A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.