• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.135-139
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• 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
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• 제8권2호
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• pp.247-251
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• 2005

미숙아에서 드물기는 하나 심한 복부 팽만과 담즙이 섞인 구토, 혈변 등의 증상이 비교적 일찍 초래되는 경우 장중첩증을 감별 진단으로 고려하여야 한다. 저자들은 극소 저출생 체중 미숙아에서 괴사성 장염과 유사한 증상을 보였으나 생후 11일경에 수술로 진단된 회장 폐쇄를 동반한 태생기 회장-회장형 장중첩증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제57권10호
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• pp.425-433
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• 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.

• 여성건강간호학회지
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• 제6권4호
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• pp.493-505
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• 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
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• 제16권1호
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• pp.94-98
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• 2009

저자들은 태반에서 L. monocytogenes 균이 동정된 무증상 산모에서 출생한 $26^{+4}$주, 930g 초극소 저체중 출생아에서 리스테리아 조기 패혈증 및 폐렴이 발생하여 항생제 치료 후 호전된 1례를 경험하여 이를 문헌 고찰과 함께 보고하는 바이다.

• Neonatal Medicine
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• 제28권2호
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• pp.83-88
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• 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
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• 제45권3호
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• pp.325-330
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• 2002

목 적 : 신생아 집중치료실에서 치료 중인 미숙아에서 적혈구 수혈 후의 백혈구수의 변화를 조사해 보고자 하였다. 그리고 그 정도가 신생아 감염을 의미할 만한 정도인지 알아보고자 하였다. 방 법 : 2년 1개월간 본원 신생아 집중 치료실에서 농축 적혈구를 수혈 받은 환아 33명(총 수혈횟수 48회)을 대상으로 수혈 전후의 백혈구수, 호중구수, 대호중구수를 후향적으로 비교, 분석하였다. 결 과 : 적혈구 수혈 후 최초 8시간(제 1기)에 백혈구와 호중구가 각각 평균값이 $1.33{\times}10^3/mm^3$(P=0.03), $0.55{\times}10^3/mm^3$(P=0.05 )증가하였으나, 수혈 후 17-24시간(제 3기)에는 수혈 전과 큰 차이가 없었다. 대호중구수는 모든 대상 환아에서 수혈 전후에 큰 변화가 없었다. 결 론 : 적혈구 수혈 후 일시적으로 호중구 상승에 의한 백혈구 상승이 나타나지만, 24시간경에는 수혈전 수치에 가까워지고, 초기의 그 상승 정도가 크지 않아 신생아 감염으로 혼동되지는 않을 것 같다.

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.77-84
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• 1997

55명의 미숙아를 대상으로 이중 도플러 초음파 검사를 실시하여 대천문을 통한 전 뇌동맥의 혈류속도 및 혈류형태를 조사하였다. 미숙아에서 뇌 혈류속도 및 pulsatility index는 재태기간, 출생 체중, 및 미숙아의 나이 등의 증가에 따라 비례하여 증가하였으나 resistive index는 감소하였다. 뇌실 출혈이 있는 환아 군에서는 특징적인 resistive index의 증가가 보였지만 혈류속도 및 plusatility index는 불규칙하였다. 정상 미숙아의 뇌혈류 관찰 및 환아 군에서의 뇌혈류 검사에서 이중 도플러 초음파 검사는 비침습적이고 재현성도 뛰어나 선별검사로 유용한 방법이라고 생각한다.

• 부모자녀건강학회지
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• 제12권2호
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• pp.160-176
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• 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
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• 제78권4호
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• pp.450-454
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• 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.