• 제목/요약/키워드: Vaginal delivery

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의인성 쇄골하정맥 파열로 인한 응급 혈관내 스텐트 삽입 (Urgent Endovascular Stent Graft Placement for Iatrogenic Subclavian Artery Rupture)

  • 강병우;배준호;정진욱;조병주;박준기;나득영
    • Journal of Trauma and Injury
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    • 제28권2호
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    • pp.83-86
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    • 2015
  • Central venous cannulation is one of the most commonly performed procedures for critically ill patients in the emergency room. Serious complications like a rupture of subclavian artery may occur during this procedure. We report a case of successful stent graft deployment for iatrogenic ruptured subclavian artery after attempted right subclavian vein catheterization in a 31 year-old female patient with hypovolemic shock due to cervical os laceration during vaginal delivery.

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남편의 분만 지지와 분만참여 태도가 분만경험에 미치는 영향 (Influences of Husband's Childbirth Experiences related to Supports for their Wives during Childbirth and Attitudes toward Childbirth Presence)

  • 이유진;김선희
    • 부모자녀건강학회지
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    • 제18권2호
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    • pp.68-77
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    • 2015
  • Purpose: The purpose of this study was to identify the relations among supports during childbirth, attitudes toward childbirth presence, and the childbirth experiences in husbands. Methods: The participants in this study were 178 husbands whose wives were within 2 days after normal spontaneous vaginal delivery. Data were collected from September 1st to September 30th, 2013. Results: The significant factors affected on the childbirth experiences in husbands were attitudes toward childbirth presence (${\beta}=.61$), satisfaction for the nurse's cares during childbirth (${\beta}=.19$), psychological preparation for childbirth (${\beta}=.16$), baby weight (${\beta}=.09$), and prenatal education related to pregnancy (${\beta}=.09$). These variables explained 66% of the childbirth experiences in husbands. Conclusion: It would be necessary to develop nursing intervention programs that increasing positive attitudes toward childbirth presence, psychological preparation for childbirth, and prenatal education to increase positive childbirth experiences in husbands. Nurses should also provide husbands with satisfactory cares during childbirth.

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EPDS와 HRV 측정을 통한 산후초기우울과 심박변이도의 상관성 연구 (Relation Study of Edinburgh Postnatal Depression Scale and Heart Rate Variability in the Early Postpartum)

  • 이은희;김태희
    • 대한한방부인과학회지
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    • 제20권1호
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    • pp.186-198
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    • 2007
  • Purpose : Postnatal depression is a major public health problem. The aim of this study is to investigate the relation between Edinburgh postnatal depression scale and Heart rate variability in the Early Postpartum. Methods : The subjects were 33 women who admitted for postpartum treatment in Hospital of Woosuk University from 13th October to 8th December 2006. 33 women filled out an EPDS, general questionnaire and then they took the test of Heart rate variability at 3th day after normal spontaneous vaginal delivery. We studied the results to investigate the relation between EPDS and HRV. Results: 1. Mean age of risk group of depression is larger than non-risk group. 2. SDNN, RMSSD and SDSS of non-risk group of depression significantly increased compared with that of risk group. 3. Ln(TP), Ln(HF) of non-risk group of depression significantly increased compared with that of risk group. Conclusion : The results suggest that there were significant differences on HRV between risk group and non-risk group of early postpartum depression examined by EPDS.

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선천성 식도폐쇄 및 기관식도루 -1례 보고- (Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report-)

  • 이문금;장운하
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.489-493
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    • 1994
  • Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

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산욕부의 건강증진행위에 영향을 미치는 요인 (A Study on Factors Influencing the Health Promoting Behaviors in Postpartal Women)

  • 조루시아;최순희
    • 기본간호학회지
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    • 제5권2호
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    • pp.353-361
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    • 1998
  • The purpose of this study was to determine the predictors of health promoting behavior in postpartal $4{\sim}6$ week women. The sample consisted of 104 postpartal women who experienced a vaginal delivery at four obstetrical clinics located in Kwangju city. Data were collected for two months from June 1 to July 30, 1997. Analysis of the data was done by use of percentage, t-test, ANOVA, Pearson's Correlation Coeficients, and Stepwise Multiple Regression. The results of this study were summarized as follows : 1. The range of total HPLP score was from 93 to 182 and the mean score of that was 142.28. In comparison of mean scores defending on each item of six demensions, self-actualization demension tended to showed hightest score(3.33) and exercise & rest demension, the lowest score(2.47). 2. The HPLP score was not significantly different defending on the general characteristics. 3. The HPLP score showed a positive correlation with family-support(r=.51) and self-efficacy(r=.41), but a inverse correlation with perceived barriers(r=-.27). 4. By using stepwise multiple regression analysis it was determined that the main influencing factors on the HPLP score were family-support(26%) and self-efficacy (8%). These variables made it possible to explain 34% of variance in HPLP score.

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치명적 산후출혈에서 N-Butyl Cyanoacrylate를 이용한 하장간막동맥 색전술: 두 개의 증례 보고와 문헌 고찰 (Inferior Mesenteric Artery Embolization with N-Butyl Cyanoacrylate for Life-Threatening Postpartum Hemorrhage: A Report of Two Cases and Literature Review)

  • 유해원;최민정;김봉만
    • 대한영상의학회지
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    • 제82권3호
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    • pp.693-699
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    • 2021
  • 하장간막동맥은 산후출혈의 매우 드문 출혈 혈관이다. 저자들은 질분만 후 하장간막동맥에서 출혈이 있었던 일차성 산후출혈 두 개의 증례를 보고한다. 두 환자 모두 저혈량성 쇼크의 징후를 보이고 있었고, 파종성혈관내응고가 의심되는 상태였다. 산후출혈의 흔한 출혈 혈관인 자궁동맥을 색전한 후에도 출혈은 지속되었다. 하장간막동맥 혈관조영술에서 상직장동맥으로부터 조영제의 혈관외누출이 확인되어 N-butyl cyanoacrylate를 이용한 선택적 색전술을 시행하였다. 이 증례를 통해 산도 손상에 의한 산후출혈이 조절되지 않고 지속될 때 하장간막동맥이 출혈 동맥일 수 있다는 점을 강조하고자 한다.

합곡(合谷 LI-4)지압이 초산부의 분만 통증정도와 소요 시간에 미치는 효과 (Effects On Labor Pain and Duration of Delivery Time for Primipara Women treated by Hob-Gog(Li-4) Pressure)

  • 김영란;이선혜;강진선;정금옥;주영아
    • 여성건강간호학회지
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    • 제7권3호
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    • pp.331-347
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    • 2001
  • The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.

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한방병원 산후조리센터에서 전원된 신생아에 대한 연구 (Transferred newborn from oriental hospital postpartum care center; symptoms and high risk factor)

  • 장규태;김장현;오주영
    • 대한한방소아과학회지
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    • 제17권2호
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    • pp.37-53
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    • 2003
  • Objective : To find risk factor and symptoms for transferred newborn from postpartum care center Method : We performed a follow-up study using medical record. Subjects comprised 188 neonates(include 4 twins) and 184 women in childbed who were hospitalized in oriental postpartum care center from January, 1, 2002 to December, 31, 2002. Result: Transferred newborn was total 24, N.V.D. 17, C.S. 7, male and female were 12 separately. The symptom of transfer was fever(16), diarrhea(4), jaundice(3), convulsion(1) Transferred number and rate was male 12(10.7%), female 12(15.8%). In delivery method, total normal vaginal delivery(N.V.D.) was 136 and transferred 17(12.5%), total cesarean section(C.S.) was 52 and transferred 7(13.5%). Transferred rank was N.V.D. female(17.9%). C.S. male(15.6%), C.S. female(10%), N.V.D.(8.6%). Of the 188 neonates. immature infants were 2 and transferred 1(50%), term infants were 184, transferred 23(12.5%), post-term infants were 2 and transferred none(0%). In age of women in childbed, transferred ratio was 15.4%(over 35), 15.2%(25-29), 10.5%(30-34). In fever,. C.S. infants were more transferred than N.V.D. and male infant had a tendency to transfer in later period of hospitalization and female in early period. It seems that transfer was related to abortion. In diarrhea, all was N.V.D. and their diagnosis was rotavirus. The average age of women in childbed was yonger(28.5). In jaundice, all was 1st, and average birth weight was lighter(3153g). The average age of women in childbed was older(30). In convulsion, birth weight was lighter(3153g), and age of women in childbed was older(30). Conclusion : There's any relation with sex and delivery method, birth weight and mother's age in transfer. But we cannot find any statistically significance. Further prospective studies are needed to find risk factors in transfer.

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Effects of Transcutaneous Electrical Stimulation on Physiological Symptoms and Psychological Satisfaction in Women With Stress Urinary Incontinence: A Preliminary Study

  • Kim, Ji-hyun;Kwon, Oh-yun;Jeon, Hye-seon;Hwang, Ui-jae;Gwak, Kyeong-tae;Yoon, Hyeo-bin;Park, Eun-young
    • 한국전문물리치료학회지
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    • 제26권3호
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    • pp.67-75
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    • 2019
  • Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

모성 간호 실습 후 분만과정에 대한 간호학생의 심리적 반응 고찰 -모성 간호 실습, 실습에 대한 간호학생의 심리적 반응- (A Review of Responses of Nursing Students Following Clinical Maternity Nursing Practice)

  • 조정호
    • 모자간호학회지
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    • 제4권1호
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    • pp.41-51
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    • 1994
  • The purposes of this study were to identify responses of nursing students following clinical maternity nursing practice, to develop data of further effective clinical maternity nursing practice, to understand nursing students perceive the natural maturation process toward pregnancy delivery and puerperal process, to help the nursing students achieve personality growth and development through clinical maternity nursing practice. The subjects were 35 senior nursing students from the Department of Nursing Science of Chung-Ang University. The data were collected from the 1st semester (Feb.22$\sim$June 9) to the 2nd semester(Aug.23$\sim$Nov.10), 1993 through self-reporting using an open ended questionnaire about perception and feelings regarding the normal delivery process. The data analysis used descriptive method. Results of the study were as follows : 1. Following clinical practice in maternity nursing, the responses of the nursing students were collected included both positive and negative aspects. The positive responses were classified in to four categories and each category included subgroups. One group, labelled as $\ulcorner$The birth of noble life$\lrcorner$ had a subgroup, (I felt the mystery and wonder of life), another group, $\ulcorner$After delivery, comfort and satisfaction$\lrcorner$ with the subgroup (I can bear to see the comfort and relief beyond pain) (C/S is better than vaginal delivery) (Very easy), the 3rd group, $\ulcorner$ I realized family friendship and support$\lrcorner$ with subgroup (Honorable, Magnificient) (I thank my parents ) (It's good to looking at my husband's support), and the 4th group, $\ulcorner$The birth of a healthy baby$\lrcorner$, with its subgroup, (baby looks pretty and healthy). 2. The negative responses were classified in eight categories and each category included subgroups. One group labelled as $\ulcorner$Fear$\lrcorner$, had subgroups of (Terrible, Horrible) (Shock) (Dread), another group, $\ulcorner$Tension$\lrcorner$, and its subgroup, (I became tense about stories heard before clinical practice), the 3rd group, $\ulcorner$surprise$\lrcorner$ and its subgroup (I was surprised at the delivery process), the 4th group, $\ulcorner$Power lessness$\lrcorner$ and its subgroup, (I watched the labor pain impatiently), the 5th group $\ulcorner$Apathy$\lrcorner$ ; and its subgroup, (I didn't feel the empathy for the labor pain of the pregnant women), the 6th group, $\ulcorner$Disgust$\lrcorner$ and its subgroup, (Disgust, Embarrassed), the 7th group, $\ulcorner$Inevitable destiny$\lrcorner$ and its subgroups (necessity of self-sacrifice and difficulty) (I accepted it as a women's destiny) (I can't do it), the last group, $\ulcorner$There seems to be trouble$\lrcorner$ and its subgroup, (It seems to have been a little too hard for mother and baby). Suggestions for further studies are as follows : 1. Nursing students should receive intensive education about $\ulcorner$The birth of noble life$\lrcorner$ $\ulcorner$After delivery, comfort and satisfaction$\lrcorner$ $\ulcorner$I realized family friendship and support$\lrcorner$ $\ulcorner$The birth of a healthy baby$\lrcorner$, so that a more positive attitude can be developed before clinical maternity nursing. 2. Nursing students should be given an orientation which is reality based and related clinical maternity nursing (using for A.V. Materials), so that they will not feel they tension, of the negative categories. 3. Nursing students should be received articles on Pain Relief Method, so that they will be prepared activie and positive in the clinical practice, and therefore they will not feel the powerlessness, of the negative categories. 4. F/U for responses of nursing students should be checked following clinical maternity nursing to evaluate the effects of the instruction.

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