Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.
Journal of The Korean Society of Maternal and Child Health
/
v.21
no.3
/
pp.159-165
/
2017
The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.
In this study, HRV signals are analyzed to compare the autonomic nervous system activity of non-pregnant women and pregnant women. 99 disease-free pregnant women and 27 non-pregnant women from W Hospital participated in the study. The acquired HRV signals were used by the program to perform time domain analysis and frequency domain analysis. The measured values were statistically analyzed for differences between pregnancy periods through a one-way ANOVA. In the results, SDNN and RMSSD in time domain analysis had significantly higher results in early pregnancy and non-pregnant women compared to mid- and late pregnancy. In frequency domain analysis, LF and HF had significantly higher values for pregnancy and non-pregnancy compared to midand late-term, but there was no significant difference between VLF and LF/HF. his means that as pregnancy progresses, the ability to control autonomous nerves decreases in the middle and late stages of pregnancy and increases physical fatigue and mental fatigue. Therefore, the longer the pregnancy period, the more special care is needed to maintain mental and physical stability of pregnant women.
Objectives : A Pregnancy becomes a developmental challenge and a life-turning point for both the woman herself and her family. The purpose of this study was to identify the correlation amomg the family support, intention of pregnancy and the antenatal self-care of pregnant women. Method : The data were collected from 129 pregnant women by a questionnaire. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, using the SPSS program. Result : The findings of the study are as fellows : Statistically significant variables related to family support were age, religion, educational level, occupation, relationship with husband, relationship with mother. Statistically significant variables related to intention of pregnancy were religion, abortion history. Statistically significant variables related to antenatal self-care were age, religion, occupation, abortion history, relationship with mother, the term of marriage. There was a significant correlation between family support and intention of pregnancy, family support and antenatal self-care, intention of pregnancy and antenatal self-care. Conclusion : Therefore, it is proposed that family support is an appropriate nursing intervention to improve the antenatal self-care and intention of pregnancy in pregnant women.
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.
Purpose: The study was to explore the level of low back pain and characteristic factors influencing low back pain (LBP) and mental health during pregnancy. Methods: The subjects were a total of 383 healthy pregnant women in S City and K-Do. Data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation. Results: 82.5% of the pregnant women answered the existence of LBP and 19.7% of them had high LBP. The preferred method of controlling LBP was 'Just endure'(42.3%). There were significant differences in pregnancy level (p<.05) and discomfort condition related to pregnancy (p<.01) according to low back pain. There were significant differences in pain intensity according to mental health. The correlation between pain level and pregnancy weeks (p<.001) and BMI in previous pregnancy (p<.001) was significant. The correlation between mental health and age was significant (p<.001). Conclusion: The majority of the pregnant women experienced LBP during pregnancy. However, they were not offered the best method of controlling the pain. Thus, for preventing LBP during pregnancy, we recommend regular exercises and BMI control.
The purpose of this study was to examine the effects of physical activity on women's health. I conducted literature reviews for meta-analyses and randomized controlled trials with the target diseases including cardiovascular diseases, diabetes, cancers osteoporosis, and pregnancy outcomes. Women who were active had less total mortality and smaller incidence of hypertension, coronary heart diseases, and stroke. Exercise was better than drug therapies in preventing diabetes and effective in preventing colon and breast cancers. Exercise can reduce the risks of falling injury in elderly women. Walking during pregnancy was not harmful to the mothers and their infants, and desirable to prevent the complications of pregnancy or weight gain after pregnancy. Physical activity at work and leisure-time showed similar effects on women's health. Based on these results, moderate-intensity physical activity should be recommended to all women, Resistive, muscle strength, and balance-training exercise also can be recommended. Doctors' advices are effective to make women exercise, especially using handouts or motivational interviewing techniques. It is desirable to recommend to peform other health promotion measures together such as smoking cessation, weight control and diet control.
The purpose of this study is to present the reference values for cardiac size and cardiothoracic ratio change, normal range and diagnosis of cardiovascular disease in pregnancy and non pregnancy of normal Korean women using chest X-ray. The subjects of this study were 58 women, who were read as normal by chest radiologist, had chest radiography taken on both last month of pregnancy, pre-pregnancy and within 2 years following delivery. In this study, we defined the last month of pregnancy as pregnancy and before or post pregnancy as non-pregnancy. CS and CTR were measured by two radiological technologist who had clinical experience more ten years with Danzer's method. Statistical methods were paired t-test and one-way ANOVA. Significance level ${\alpha}$ was 0.05 and p-value 0.05 or less was statistically significant. For pregnancy, the mean of left and right cardiac size was $40.11{\pm}8.73mm$ and $89.51{\pm}11.9mm$, CS was $128.60{\pm}13.15mm$, CTR was $44.51{\pm}4.21%$. In non pregnancy, $36.50{\pm}8.18mm$ and $77.68{\pm}13.1mm$. CS and CTR were $114.18{\pm}14.28mm$ and $42.03{\pm}4.04%$. Both pregnancy and non pregnancy, the difference of the mean value in left and right cardiac size, CS and CTR were statistically significant (p<0.01). but comparing mean on age, height and weight, the difference of the mean value between groups was not (p>0.05). In the result of this study, the mean size of CS increased by 12.6% in pregnancy($128.60{\pm}13.15mm$) compared to the non pregnancy($114.18{\pm}14.28mm$), and increased by 9.8% in the right side of the heart and 15.2% in the left side. The mean size of CTR increased about 5.9% in pregnancy ($44.5{\pm}4.21%$) compared to non pregnancy($42.03{\pm}4.04%$).
Purpose: This descriptive phenomenological study aimed to explore the lived experience and meaning of pregnant women's adaptation. Methods: Ten pregnant women from an ongoing Pregnant Couples' Cohort Study agreed to participate in this study. The data were collected through telephone in-depth interviews regarding what they experienced and felt about pregnancy adaptation. The qualitative data were analyzed using Giorgi's method of descriptive phenomenology. Results: Five core situation components were extracted from the raw data, along with 12 themes and 33 focal meanings. The five core situations were 1) first recognizing the pregnancy, 2) pregnancy-related changes, (3) the upcoming birth, 4) the postpartum period, and 5) parenting. The 12 themes were as follows: "anxiety, pressure, and embarrassment due to pregnancy," "efforts to adapt to physical changes," "efforts to adapt to the psychological difficulties of pregnancy," "efforts to adapt to the financial burden and role changes caused by pregnancy," "connecting with the fetus," "adapting to a new marital relationship centering on the baby," "the frustration of childbirth," "fear of childbirth," "postpartum care, need help with lactation planning," "parenting beyond what I imagined," "dad's willingness to participate in parenting," and "career disconnect and consideration of workplace needs." Conclusion: We identified that pregnant women experience adaptation in physical, psychological, relational, and social aspects. The thematic clusters identified can be used to develop nursing interventions to promote women's adaptation to pregnancy.
Purpose: Uncertainty and restrictions on daily life have increased fear, stress, and depression during the coronavirus disease 2019 (COVID-19) pandemic. Depression is the most common mental health problem in pregnant women. The purpose of this study was to evaluate the levels of fear and stress related to COVID-19 experienced by pregnant women, as well as their levels of depression, and to examine the factors associated with depression during pregnancy. Methods: This was a cross-sectional, correlational study conducted among 153 pregnant women who visited a maternity hospital in Busan, South Korea. A self-reported questionnaire was used for data collection from December 18, 2021 to March 8, 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression. Results: Pregnant women experienced a moderate level of fear related to COVID-19, with an average score of 21.55±4.90. The average score for depression during pregnancy was 14.86±11.10, with 50.3% of the participants experiencing depression (≥13). The factors associated with depression during pregnancy were fear of COVID-19, contact with a confirmed case of COVID-19, being in the third trimester of pregnancy, high stress levels due to difficulties experienced from social distancing measures, and unintended pregnancy. These five statistically significant factors explained 35.0% of variance in depression during pregnancy. Conclusion: Considering the prevalence of depression in pregnant women during the COVID-19 pandemic, it is necessary to develop interventions to reduce anxiety by providing correct information and alleviating the stress of social distancing.
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