• 대한간호학회지
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• 제22권4호
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• pp.444-453
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• 1992

Recent research reported that postpartum mothers showed different responses according to the type of delivery, and though most mothers preferred vaginal delivery to cesarean section, the numbers of negative comments about the delivery experience were higher in a vaginal delivery group than in a cesarean section group. This study set out to understand the meaning of vaginal delivery as perceived by mother who delivered their babies vaginally and how the mothers felt about their delivery experience. The subjects of this study were 17 primiparous mothers right after vaginal delivery in one university affiliated hospital. Date were collected from March to April, 1992 through interviews lasting 20∼30 minutes using open ended questions about the delivery experience. The data were analyzed by Giorgi's phenomenological analysis method and categorized according to similarity of countent. The meaning of the vaginal delivery was grouped in to four categories and the reason for vaginal in to three. One category of the meaning of vaginal delivery was pain, consisting of the subcategories too painful, want to be rid of the pain, unbearable pain and bearable pain. Another cutegory was a sense of accomplishment containing the subgroups wonderful, good and being finished, The third category was the feeling of becoming a mother The fourth category was that of not having any sense yet of the experience. The reasons for preference for vaginal delivery to a cesarean section were categorized in to the instinctive thinking that vaginal delivery was the natural method, a shortened period of recovery and a lower incidence of complications and a stronger feeling of maternal identity.

• 여성건강간호학회지
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• 제15권4호
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• pp.353-361
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• 2009

Purpose: This study aimed to provide fundamental information about childbirth and antenatal care for pregnancy women and to find differences in mother's antenatal care and delivery service satisfaction between vaginal delivery and cesarean section. Methods: This study was conducted in 4 residential areas and a study sample of 184 postpartum mothers who agreed to collect data. Data was collected from September 1 to October 20 2007 and a structured questionnaire were recruited by the survey. The data was analyzed by t-test and chi-squire test using SPSS/WIN 12.0. Results: There was a significant difference in delivery place between vaginal delivery and cesarean delivery. Only 10.7% of vaginal delivery group delivered in general hospitals, however 24.5% of the cesarean section group delivered in general hospitals. Early antenatal care also showed statistical difference in mode of delivery. 43.5% of vaginal delivery mothers visited hospitals for the detection of pregnancy but 28.3% of cesarean section mothers did that. Vaginal delivery mothers more satisfied with her own delivery method and suggested a vaginal delivery to others. Conclusion: These results suggest that cesarean section mother's sensitivity of early antenatal care was less than vaginal delivery mother. Satisfaction related to delivery care services were higher in the vaginal delivery group.

• 한국응급구조학회지
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• 제18권3호
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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.

• 동의신경정신과학회지
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• 제17권1호
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• pp.121-127
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• 2006

Objective : As this is a quasi-experimental study by the post-test design for a nonequivalent control group, it was attempted to verify the effect of massage using aroma oil on whether or not the normal vaginal delivery of primiparous mothers. Methods : As for the experimental treatment, it applied the aroma oil massage to the experiment group when the cervical dilatation was $4{\sim}5cm$, and as for the data analysis, it conducted the significance test using the program of SPSS 12K for Windows, with Chi-square test $(X^2)$ and t-test. Results : The experiment group that carried out the aroma massage therapy, was high in the cases of normal vaginal delivery(P<0.05), compared to the control group that did not carry out the aroma massage therapy. Conclusion : The experiment group, which received the aroma massage therapy, had significant difference in the cases of normal vaginal delivery, compared to the control group that did not receive the aroma therapy, thus the aroma massage therapy is thought to be a nursing-intervention plan, which can be usefully applied as to the primiparous mothers aiming at normal vaginal delivery.

• PNF and Movement
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• 제15권3호
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• pp.373-380
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• 2017

Purpose: The purpose of this study was to investigate of the effects of the mode of delivery on pelvic floor muscle function by examining bladder base movement and urinary incontinence. Methods: This study was conducted on 100 females who had delivered in the previous 3-8 months. There were 2 groups: 56 vaginal deliveries and 44 cesarean section deliveries. Prior to the study, a survey was conducted on the subjects' general status, delivery mode, urinary incontinence, and physical activity. The groups could not be blinded due to scar tissue from the operations. The function of the pelvic floor muscle was observed with the bladder base movement using transabdominal ultrasound during pelvic floor contraction. To objectify and measure the subjective symptoms of subjects suffering from urinary incontinence, an incontinence quality of life (I-QoL) test was administered. Statistical analysis of the data was performed using SPSS version 20.0. An independent t-test was used to assess the statistical significance of pelvic floor muscle function between the 2 groups after delivery. Results: The movement of the bladder base in the pelvic floor muscle function was decreased in the vaginal delivery group, but the difference was not significant. Urinary incontinence was significantly increased in the vaginal delivery group. Conclusion: The function of the pelvic floor muscles was better in the cesarean section group and the incidence of urinary incontinence was relatively low in this group. Therefore, vaginal delivery requires more efforts to restore the function of the pelvic floor muscles than cesarean delivery.

• 대한한의학회지
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• 제22권4호
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• pp.121-130
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• 2001

Objectives : As participation of women in public affairs increases, they are more concerned about postpartum management. However, objectivity of its effect tends to be insufficient. This study was done to investigate the clinical applications of postpartum management in Oriental Medicine. Subjects and methods : This clinical study was done on 74 patients who were treated by postpartum management in the Oriental Medical Hospital of Woosuk University from November 1999 to August 2000. We analyzed the changes of hematology and blood chemistry. Then, we examined the differences between two groups : one group had undergone vaginal duct delivery and the other cesarean section in mode of delivery. Results : I) The ratio of vaginal duct delivery to cesarean section was 39:35. Two major age groups were 25-29 and 30-34, respectively 43% and 35%. 2) According to the hematology, hemoglobin, hematocrit, REC and platelet count significantly increased, while WBC and ESR level significantly decreased. 3) To the hematology by mode of delivery, WBC level decreased in both groups. WBC level of the vaginal duct delivery group was significantly lower than that of cesarean section. RBC level increased in both groups, the cesarean section group were statistically significant. Hemoglobin, hematocrit and platelet count increased but they were not significant in either group. 4) To the blood chemistry, Triglyceride (TG), protein, albumin and sodium levels were significantly increased but cholesterol, ALT, BUN, creatinine, potassium and chloride levels were not statistically significant. 5) According to the blood chemistry by mode of delivery, TG level of the vaginal duct delivery group was significantly reduced but the others were not significant. Conclusious : The effective results were shown that postpartum management by Oriental Medicine assisted postpartum health care as well as postpartum anemia.

• 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.

• Archives of Pharmacal Research
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• 제18권5호
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• pp.325-331
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• 1995

The objective of this study was to find a rational dosage form for vaginal mucosal delivery of LHRH. Vaginal absorption of LHRH was estimated by measuring its ovulation inducting effect in rat and in vitro vaginal membrane permeation study in rabbit. THe effects of different hydrogel bases, such as Polycarbophil and Pemulen compared with solutions on vaginal membrane permeation of LHRH were investigated. Sodium laurate, disodium ethylenediamine brane permeaiton of LHRH were investigated. Sodium ethylenediamine tetraacetate (EDTA) and sodium tauro-24, 25-dihydrofusidate (STDHF), which are effective peptidase inhibitors were chosen as additives to a LHRH hydrogel delivery system and LHRH solutions. A Polycarbophil compared with a solution formulation 3.4 times increase in LHRH vaginal membrane permeability compared with a solution formulation. Vaginal membrane permeability from the Polycarbophil was greater than that from Pemulen hydrogels. This may be due to the larger bioadhesive values. LHRH solution with EDTA(2%), STDHF(1%) and sodlaurate(0.5%) showed 4.1 times, 4.8 times and 6.0 times of ovulation inducing activity compared with control. These results suggest that enzyme inhibition effect of EDTA, STDHF and sod, laurate may be result in substantial enhancement of vaginal absorption. By administraiton of Polycarbophil hydrogels containing LHRH the ovulation inducing activity was 3.3 times greater than the solutions. This result indicates the bioadhesive hydrogels as well as peptidase in hibition significantly improved absorption of LHRH. By coadministration with these inhibitors the ovulation inducing activity of Polycarbophi hydrogel containing LHRH was comparable with subcutaneous administration in ovulation inducing activity.

• Journal of Preventive Medicine and Public Health
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• 제18권1호
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• pp.41-50
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• 1985

To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.751-769
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• 1998

본 연구는 임산부들의 분만전 분만방법에 대한 태도, 자신의 분만방법에 대한 이해 및 개입 정도, 분만후 분만방법에 대한 만족도 등을 평가하기 위하여 대구시내 1개 대학병원과 1개 산부인과 전문병원에서 산전진찰을 목적으로 내원한 임신 36주 이상의 임부 693명을 대상으로 분만전, 분만직후, 분만 1개월 후 3차례에 걸쳐 설문조사를 시행하였다. 임신기간 중 분만방법에 대한 교육이나 상담을 받은 임부는 24.0%였으며, 교육이나 상담을 받은 임부의 비율은 이전에 제왕절개분만을 한 임부에서 유의하게 높았다(p<0.05). 초산부, 자연분만을 했던 경산부, 제왕절개분만을 했던 경산부 모두 자연분만이 엄마나 아기의 건강에 더 좋다고 대답하였으나, 제왕절개분만을 했던 임부들 중 9.2%는 제왕절개분만이 아기의 건강에 더 좋다고 생각하였다. 분만전 선호하는 분만방법은 초산부와 자연분만을 했던 경산부는 90% 이상이 자연분만을 원했으나, 제왕절개분만을 했던 경산부는 85.6%가 제왕절개분만을 선호하였다. 분만전 자연분만을 선호하였던 임부들이 제왕절개 분만을 결정하게 된 이유는 의사의 권유가 81.9%, 남편의 권유가 0.8%, 충분히 상담후 결정한 경우가 4.7%, 산모가 원하여 12.6%였으며, 자연분만을 결정하게 된 이유는 대부분이 제왕절개분만을 할 특별한 사유가 없었거나(67.2%) 산모가 원한 것(30.6%)으로 나타났다. 제왕절개분만을 원했던 임부들의 제왕절개분만을 결정하게 된 이유는 의사의 권유가 76.2%, 산모가 원한 경우 20.0%, 남편의 권유가 1.3%, 의사와 충분히 상담후 결정한 경우는 2.5%였다. 의사의 권유로 제왕절개분만한 산모가 수술 이유에 대해 충분히 설명을 들은 경우는 55.1%였다. 제왕절개분만을 한 산모들의 수술 이유에 대한 의무기록과 산모 대답간의 일치율은 75.9%였으며, 반복 제왕절개분만일 경우와 산모가 원한 경우에 5% point 이상 응답을 차이가 났다. 초산부와 자연분만을 했던 경산부의 산전에 선호한 분만방법은 실제 분만방법과 유의한 관련성을 보였고(p<0.05), 제왕절개분만을 했던 경산부들은 선호도에 관계없이 100% 제왕절개분만을 하였다. 분만후 분만 방법별 자신의 분만방법에 만족하는 비율은 자연분만한 산모는 분만직후 84.9%, 분만 1개월 후 85.1%였으나 제왕절개분만을 한 산모는 분만직후 44.7%, 분만 1개월 후 42.0%로 나타냈다(p<0.05). 분만후 분만방법에 대한 선호도는 분만직후, 분만 1개월 후 모두 분만방법과 유의한 관계를 보였고, 각 시기별 분만방법에 대한 만족도와는 자연분만을 한 산모들은 자신의 분만방법에 만족할수록 자연분만을 선호하였지만, 제왕절개분만을 한 산모들은 만족 정도와 관계없이 제왕절개분만에 대한 선호도가 높았다. 이러한 결과는 그동안의 의사 중심의 전문적인 기술위주의 산전관리와 분만관리에서 기본적인 예방 및 건강증진 위주의 임부와 태아 중심 관리로의 방향 전환이 필요하며, 임부의 임신과 분만에 관한 적극적인 교육 및 상담이 필요하며, 분만방법 결정과정에 임부가 적극적으로 참여함으로써 제왕절개 분만율을 낮추고 제왕절개술후의 자연분만을 유도할 수 있을 뿐만 아니라 분만후 분만방법에 대한 만족도도 향상시킬 수 있음을 시사한다.