• Journal of Yeungnam Medical Science
• /
• v.35 no.1
• /
• pp.135-139
• /
• 2018

There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.2
• /
• pp.247-251
• /
• 2005

Intussusception in a preterm neonate is a very rare disorder. We experienced a case of intrauterine intussusception presented with symptoms of the small bowel obstruction in a preterm infant whose gestational age was $28^{+2}$ weeks. Urgent ultrasonography of abdomen revealed no definite intussuscepted segment. At emergent surgery performed on the 11th days of life under the diagnosis of distal small bowel obstruction, an ileo-ileal intussusception with distal ileal atresia without perforation was found.

• Clinical and Experimental Pediatrics
• /
• v.57 no.10
• /
• pp.425-433
• /
• 2014

Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

• Women's Health Nursing
• /
• v.6 no.4
• /
• pp.493-505
• /
• 2000

The purpose of this study was to contribute to maternal nursing in the early postpartum stage and neonate nursing. Data were collected through self-report questionaires which were constructed to include perception of the newborn scale, parental role stress scale and anxiety scale. The subjects consisted of 81 mothers of preterm babies at seven hospitals in Seoul and Kyoungki-Do, from July 15 to September 30, 2000. Data were analysed by SPSS/PC using frequency, percentage, mean, standard deviation, ANOVA, t-test and Pearson correlation coefficient. The results were summarized as follows ; 1. The mean of perception of the newborn in the early postpartum stage was 1.35. The mean of parental role stress was 10.78. The mean of anxiety of mother was 39.74. 2. There were significant positive correlation between parental role stress and anxiety of mothers. 3. There were not significant influencing general characteristics to perception of the newborn and parental role stress. General characteristics related to the level of anxiety were economic status, expectation of pregnancy, birthing order, newborn weight. The above findings indicated that the level of parental role stress and anxiety of preterm birth mothers were correlated. Therefore nursing intervention for reducing parental role stress and anxiety should be provided for preterm birth mothers.

• Neonatal Medicine
• /
• v.16 no.1
• /
• pp.94-98
• /
• 2009

Listeria monocytogenes (L. monocytogenes) is a foodborne anaerobic gram-positive rod and the third most common pathogen for neonatal meningitis. Although the mortality and morbidity of L. monocytogenes infections are high, thus causing serious problems in Western populations, neonatal listeriosis is relatively rare in Eastern countries, including Korea. Possible routes for intrauterine infection or vertical transmission of L. monocytogenes include infected placentas and the reproductive tract. Intrauterine infections may cause chorioamnionitis, preterm labor, spontaneous abortion, stillbirth, or neonatal infection. A high index of suspicion and early empirical antibiotic treatment are critical to achieve a favorable prognosis for neonatal listeriosis. We managed a case of L. monocytogenes sepsis and pneumonia in a premature neonate born at 26 weeks of gestational age from an asymptomatic mother with culture-proven placental infection. The neonate was successively treated with ampicillin and gentamicin.

• Neonatal Medicine
• /
• v.28 no.2
• /
• pp.83-88
• /
• 2021

Treatment guidelines for postnatal cytomegalovirus (pCMV) infection in preterm have not been established yet. Neutropenia, thrombocytopenia, hepatitis, colitis, and sepsis-like disease are among the clinical manifestations, which range from moderate to serious. We present a case of autopsy diagnosed as pCMV infection in a premature infant delivered at gestational age of 24 weeks and 5 days. On the 7th and 14th days of birth, urinary CMV polymerase chain reaction samples were negative, ruling out congenital CMV infection. However, autopsy examination revealed that the patient had disseminated pCMV infection. CMV inclusion bodies were found in the majority of tissues, including the lung, liver, pancreas, breast, kidney, and adrenal gland, but not the placenta. The thymus exhibited significant cortical atrophy and T-cell immunodeficiency, possibly induced by dexamethasone treatment for bronchopulmonary dysplasia or by pCMV infection itself. If dexamethasone treatment is extended or high doses are considered, it may be beneficial to test the CMV infection status to prevent aggravation of infection. This case demonstrates that, despite the low prevalence, pCMV infection should be considered a differential diagnosis in preterm if other conditions or etiology cannot justify clinical deterioration.

• Clinical and Experimental Pediatrics
• /
• v.45 no.3
• /
• pp.325-330
• /
• 2002

Purpose : We intended to find out how the red cell transfusion would change the white cell count in preterm neonates under treatment in the intensive care unit. We also speculated whether the magnitude of such a change could indicate a potential neonatal infection. Methods : Total white blood cell count, total neutrophil count, and band count were compared and analyzed retrospectively on 33 preterm neonates who received red cell transfusions in our hospital's intensive care unit over a period of two years and a month. Results : We found a mean change of $1.33{\times}10^3/mm^3$ and $0.55{\times}10^3/mm^3$ in total white blood cell count and total neutrophil count in the first eight hours following the red cell transfusion. No significant change was observed in band count between pre and post-red cell transfusion. Conclusion : A mild increase in the white blood cell count caused by an increase in neutrophil count was observed temporarily following the red cell transfusion. But the white blood cell count returned to the pre-transfusion level in about 24 hours, indicating that such a low level of increase cannot be interpreted as an infection of a preterm neonate.

• Journal of Yeungnam Medical Science
• /
• v.14 no.1
• /
• pp.77-84
• /
• 1997

We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index, resistive index. Intracranial velocities and pulsatility indexes were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a useful noninvasive means of monitoring cerebrohemodynamics in normal preterm neonates and flow change of sick babies.

• Korean Parent-Child Health Journal
• /
• v.12 no.2
• /
• pp.160-176
• /
• 2009

Purpose: The purpose of this study was to identify patterns and trends of studies, analyze the research, and improve direction of nursing research related to the neonatal pain relief intervention in Korea. Method: The studies were selected from dissertation, nursing journals and others in Korea. Result: Until 1995, there were no studies related to the neonatal pain relief intervention. The most studies have been increased rapidly after 2005. Pure of true experimental design of research design was used 5, Quasi experimental design was 7, preexperimental design was 7. Participants were preterm baby was 8, full-term baby was 9, and preterm and full-term baby was 2. Utilization of instruments as follows: NIPS, PIPP, ABSS, NFCS, pulse oximeter, EKG monitoring, and stethoscope. Contents of the research studies were classified 4 different types, such as studies of about the effect of auditory stimulation, taste stimulation, tactile stimulation, and topical anesthetic cream. The results of 25 studies were effective for the neonatal pain relief, but the results of 5 studies weren't. Conclusion: In the future studies need to develop the various instrument which is assessment of neonatal pain. It is important to the integrated by meta analysis. Additionally, we should develop protocol nursing intervention for the effective pain release.

• Tuberculosis and Respiratory Diseases
• /
• v.78 no.4
• /
• pp.450-454
• /
• 2015

Although tuberculosis is highly prevalent worldwide, congenital tuberculosis is one of the least common manifestations of the disease. The diagnosis is usually difficult because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy and delivery. We present the case of a preterm neonate with congenital tuberculosis, born to a previously healthy mother who had developed severe disseminated tuberculosis during her pregnancy. Once the diagnosis was confirmed in the mother, the congenital infection was confirmed by isolation of Mycobacterium tuberculosis in gastric aspirates, and positive polymerase chain reaction in a cerebrospinal fluid examination. Treatment for tuberculosis with a four-drug regimen resulted in an adequate clinical response in both the mother and infant.