• Title/Summary/Keyword: Obstetric delivery

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Maternal Role Attainment of Primiparous During the Postpartum Period (산욕기 초산모의 어머니 역할획득에 관한 연구)

  • Lee, Eun-Sook
    • 모자간호학회지
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    • v.2 no.1
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    • pp.5-20
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    • 1992
  • This study was undertaken to identify the levels and affecting factors of the maternal role attainment(MRA) in the primipara during the postpartum period. The healthy ninety primiparous from the one university hospital and two local clinics in KwangJu city were selected and two Semantic Differential Scales (SD-Myself as Mothers, SD-My Baby) and the Pharis Self Confidence Scale were used in this study. Questionnaires were distributed at the 3rd days and the 4-6 weeks of the primiparous not showing any complication after normal delivery. The data collected were analysed statistically using t-test, Pearson's Product Moment Correlation Coefficient and ANOVA. The results obtained were summarized as follows; 1) On the 3rd day after the delivery, the scores of SD-myself as mother, SD-baby and Pharis Self Confidence were 70.6 points, 73.6 points and 78.6 points, respectively, showing the low level of MRA. 2) On the 4-6 weeks after delivery, the score of SD-myself as mother, SD-baby and Pharis Self Confidence were 72.8 points, 77.9 points, and 86.9 points, respectively, indicating the moderate level of MRA. 3) The mean scores of the SD scale and the Pharis Self Confidence during the postpartum periods were higher than those of the 3rd days, showing the SD-myself as mother (t=-2.09, P<.05), SD-baby(t=-4.12, P<.001), Pharis Self Confidence(t=-6.59, P<.001), respectively. 4) Positive correlations (r=.24$\sim$.69) were shown in the concepts related to the MRA and the cognitive-motor skill components and cognitive-affective skill components of the MRA became harmonious over time. 5) The relationships between the score of the MRA and the demographic and obstetric variables were as follows ; a) the score of the MRA in the twenties was higher than those of the thirties. b) the group with higher educational background showed higher MRA socres than the group with lower one. c) those who wanted pregnancy sustenance had higher MRA scores than those who did not. d) the group that did think of festus-feature represented higher MRA scores than those who did not. e) the group of mothers who have the daughters showed higher MRA scores than those who have boys. It can be concluded from the results that the MRA in the primiparous increased gradually, and that the cognitive-motor skills and cognitive-affective skills became harmonious over time. The level of the MRA was affected partly by the mothers general, obstetrical variables. Following suggestion were made oil the basis of the present study ; a) The longitudinal study on the MRA is needed. b) Multivariate analyses should be done for the identification of the factors influcening on the MRA. c) Education program for primiparous mother should be designed and developed to improve the MRA.

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Validity of Referral of High Risk Pregnancy in MCH Center (모자 보건 센터에서의 고위험 산모 의뢰 기준의 타당성)

  • Kim, Gui-Yeon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.146-152
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    • 1989
  • To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

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A Study of Nurses' Knowledges on Gestational Diabetes Mellitus (일부 간호사의 임신성 당뇨병에 대한 지식정도)

  • Choi, Euy-Soon;Oh, Jeong-Ah;Park, Chai-Soon
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.419-431
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    • 2001
  • The purpose of this study was to provide the correct knowledge on GDM(Gestational Diabetes Mellitus) to nurses for effective care of pregnant women with GDM by investigating the knowledge of nurses about GDM. The subjects of this study were 557 nurses who work at six general hospitals in Seoul and Gyung-Gi province of Korea. The data were collected from November, 2000 to December, 2000, using a 30-item knowledge questionnaire about GDM consisted of eight areas developed by Choi et al. (2000): characteristics and diagnosis, influence on pregnancy, goal and method of management, diet therapy, exercise therapy, insulin therapy, hypoglycemia and hyperglycemia and postpartum care of GDM. The data were analyzed by SAS program for t-test, ANOVA and Scheffe test. The results were as follows: 1. The mean score of knowledge on GDM was 23.18. 2. There were significant differences according to age(p= 0.002), education background (p= 0.045). working period(p= 0.000), working unit(p= 0000), working experience of obstetric and gynecologic (OS & GY) units(p= 0.000), experience of pregnancy (p=0.003) and experience of delivery (p=0.014) in GDM knowledge. 3. The level of each area on GDM knowledge was as follows; 1) Area of characteristics and diagnosis of GDM The mean score of this area was 0.79. Nurses' knowledges were significantly different by age(p=0.003), marital status (p=0.018), working period(p=0.002) working unit(p=0.007), working experience of OB & GY units(p=0.005), experience of pregnancy(p=0.034) and experience of delivery(p=0.033). 2) Area of influence on pregnancy The mean score of this area was 0.93. Nurses' knowledges were significantly different by age(p=0.006), working unit (p=0.000) and working experience of OB & GY units(p= 0.000). 3) Area of goal and method of management The mean score of this area was 0.70. Nurses' knowledges were significantly different by age(p=0.004), region(p=0.006), education background(p=0.013), marital status(p=0.007), working period(p=0.000), working unit(p=0.011), working experience of OB & GY units(p=0.002), experience of pregnancy(p=0.025) and experience of delivery(p=0.043). 4) Area of diet therapy. The mean score of this area was 0.74. Nurses' knowledges were significantly different by age(p=0.002), region(p=0.011), marital status (p=0.001). working period (p=0.007). working unit(p=0.002), working experience of OB & GY units(p=0.001), experience of pregnancy(p=0.001), experience of delivery(p=0.011) and diabetes patients in family members(p=0.032). 5) Area of exercise therapy. The mean score of this area was 0.83. There were not significant differences in all general characteristics. 6) Area of insulin therapy The mean score of this area was 0.61. Nurses' knowledges were significant differences by age (p=0.024), marital status (p=0.048), working period(p=0.027), working unit(p=0.002), working experience of OB & GY units(p=0.000), experience of pregnancy (p=0.047) and experience of delivery(p=0.040). 7) Area of hypoglycemia and hyperglycemia. The mean score of this area was 0.83. Nurses' knowledges were significantly different by marital status (p=0.027), working period(p=0.001). experience of pregnancy(p=0.020) and experience of delivery(p=0.010). 8) Area of postpartum care The mean score of this area was 0.69. Nurses' knowledges were significantly different by working unit(p=0.000), working experience of OB & GY units (p=0.000) and working experience of medical unit(p=0.047). The results of this study are suggested that nurses might be taught systemically and individually about GDM so that they can become more proficient in detecting and preventing GDM, and therefore they will feel confident to teach GDM to women.

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Comparison of neonatal outcomes between the spontaneous and in vitro fertilization twin pregnancies (인공수정 및 자연수정으로 태어난 쌍생아간 임상 양상 비교)

  • Kim, Hee Moon;Lee, Jeong Won;Shin, Seon Hee;Kim, Sung Koo;Sung, Tae Jung
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.740-745
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    • 2007
  • Purpose : There is a dominant opinion that in vitro fertilization (IVF) leads to an increased incidence of twins, low birth weight (LBW) infants, prematurity and mortality. On the other hand, technical development of IVF and improvement of neonatal intensive care have increased the survival rate of neonates. The purpose of this study was to verify the tendency by comparing the clinical aspects of IVF and spontaneously conceived twins, and to establish methods to increase the survival rate of neonates after IVF. Methods : Retrospective reviews were performed on all twin infants who were admitted to the nursery and NICU at Kangnam Sacred Heart Hospital, Hallym University from January 1, 2000 to December 31, 2006. Medical records of IVF twins (study group, n=92) and spontaneously conceived twins (control group, n=265) were analyzed and compared. Neonatal outcomes and complications, as well as obstetric outcomes, were analyzed and compared. Results : Mean gestational age and birth weight of the study group ($34.6{\pm}3.5$ weeks, $2,203.9{\pm}617.2g$) were considerably lower than those of the control group ($36.3{\pm}2.4$ weeks, $2,367.0{\pm}517.9g$). The frequency of prematurity less than 37 weeks (68.5% vs 51.3%) and extremely LBW (15.2% vs 6.4%) were also significantly higher in the study group. Other neonatal outcomes were all insignificant. The obstetric characteristics, maternal age ($32.6{\pm}3.3$ years vs $30.3{\pm}3.9$ years) and the frequency of cesarean delivery(95.7% vs 79.9%) were significantly higher in the study group. Other obstetric outcomes were insignificant except for the frequency of incompetent internal os of cervix (36.2% vs 3.6%) and cerclage operation (38.3% vs 4.3%). Conclusion : Based on the above results, clinical outcomes of twin infants will be further improved by careful attention and thorough antenatal care of the IVF twins.

Anxiety, Depression and Quality of Life of Married Women with Urinary Incontinence Living in the Community (지역사회 거주 기혼 여성의 요실금 중증도에 따른 불안, 우울 및 삶의 질)

  • Song, Young-Shin;Hong, Sung-Kyung;Song, Ju-Eun;Cho, Hye-Kyung;Son, Youn-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.4
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    • pp.483-492
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    • 2007
  • Purpose: The purpose of this study was to compare anxiety, depression and quality of life according to the severity of urinary incontinence in married women. Method: The participants were 168 married women aged 30-65 years who experienced urinary incontinence. The data were collected from May to July, 2006 using a structured questionnaire. Frequencies, percent, means and standard deviation, t-test, ANOVA, $X^2-test$ and Scheffe test with SPSS win 14.0 program were used to analyze the data. Results: The distribution of urinary incontinence severity was mild 87.5%, or moderate 12.5%. Significant differences in the severity of urinary incontinence were found for the general characteristics of age, education level, having a job and having a spouse and for the obstetric characteristics of type of delivery, and menopause. Differences in the score for anxiety(t=-2.41, p=0.001) and quality of life(t=5.50, p<0.001) according to the severity of urinary incontinence were statistically significant. Conclusion: Women with moderate to severe urinary incontinence should be screened for psychosocial factors. Severity of urinary incontinence in married women negatively affects their quality of life. Further research is needed to determine factors predicting the quality of life for incontinent women.

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Impact of Uncertainty on the Anxiety of Hospitalized Pregnant Women Diagnosed with Preterm Labor: Focusing on Mediating Effect of Uncertainty Appraisal and Coping Style (입원한 조기진통 임부의 불확실성이 불안에 미치는 영향: 불확실성 평가와 대처양상의 매개효과를 중심으로)

  • Kim, Eun Mi;Hong, Sehoon
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.485-496
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    • 2018
  • Purpose: This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor. Methods: The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation. Results: The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (${\beta}=.64$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p<.001). Uncertainty opportunity appraisal (${\beta}=-.45$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p<.001). Emotion-focused coping (${\beta}=-.23$, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044). Conclusion: Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.

Comparison of nutrient intake, life style variables, and pregnancy outcomes by the depression degree of pregnant women

  • Bae, Hyun-Sook;Kim, Sun-Young;Ahn, Hong-Seok;Cho, Yeon-Kyung
    • Nutrition Research and Practice
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    • v.4 no.4
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    • pp.323-331
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    • 2010
  • The aim of this study was to analyse effects that the degree of depression have on the life style variables, nutrient intake, iron indices and pregnancy outcome. Subjects were 114 pregnant women who were receiving prenatal care at a hospital in Seoul. We collected data for general characteristics and lifestyle variables from general survey instrument and for depression score from the questionnaire on depression. Dietary intakes of subjects were estimated by 24 hour dietary recall method. Also we analysed iron indices and pregnancy outcomes. We classified subjects by 10 point, which was the average depression score, into two groups [Low depression score group (LS) : High depression score group (HS)]. As to the intakes of total calcium, plant-calcium, plant-iron, potassium, total folate and dietary folate, LS group was far higher than HS group (P < 0.05, P < 0.05, P < 0.01, P < 0.001, P < 0.05, and P < 0.01, respectively). As to pre-pregnancy alcohol drinking, LS group had 41.9% in non-drinker, which was far higher than 28% in HS group in non-drinker (P < 0.05). As for drinking coffee during pre-pregnancy, pregnant women who don’ drink coffee in LS group took 43.6%, which was higher than 38% in HS group (P < 0.01). Regarding delivery type, the cesarean section in LS group (18%) was significantly lower than that in HS group (45%) (P < 0.01). Bivariate analysis showed that birth weight was significantly associated with the gestational age (P < 0.01). The pregnant women with higher depression score tended to have undesirable life habit, which might affect negative pregnancy outcomes. A better understanding of how depression and intake of nutrients work together to modulate behavior will be benefit nutritional research.

Does Cervical Screening in Young Women Aged 20-25 Years Lead to Unnecessary and Harmful Interventions?

  • Al-Kalbani, Moza;Price, John;Thompson, Gwen;Ahmad, Sarfraz;Nagar, Hans
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6557-6559
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    • 2015
  • Background: Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population. Materials and Methods: A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study. Results: During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and-thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases. Conclusions: Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).

Breast Feeding Rates and Factors Influencing Breast Feeding Practice in Late Preterm Infants: Comparison with Preterm Born at Less than 34 Weeks of Gestational Age (후기 미숙아의 모유수유 실천 정도와 모유수유 실천 예측 요인: 재태기간 34주 미만 미숙아와의 비교 분석)

  • Jang, Gun-Ja;Lee, Sang-Lak;Kim, Hyeon-Mi
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.181-189
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    • 2012
  • Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

A Case of Paraplegia Associated with Epidural Anesthesia -A case report- (산모에서 발생한 경막외 블록 후 하지 마비 -증례보고-)

  • Kim, Hyun Hea;Kim, Doo Hwan;Kim, Sung Hoon;Leem, Jeong Gill;Lee, Cheong;Shin, Jin Woo
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.159-163
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    • 2008
  • Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.