• Title/Summary/Keyword: Vaginal delivery

Search Result 151, Processing Time 0.02 seconds

Vaginal Microbiota Profiles of Native Korean Women and Associations with High-Risk Pregnancy

  • Chang, Dong-Ho;Shin, Jongoh;Rhee, Moon-Soo;Park, Kyung-Ryang;Cho, Byung-Kwan;Lee, Sung-Ki;Kim, Byoung-Chan
    • Journal of Microbiology and Biotechnology
    • /
    • v.30 no.2
    • /
    • pp.248-258
    • /
    • 2020
  • The vaginal microbiota may be important for pregnancy prognosis because vaginal dysbiosis during pregnancy appears to be related to preterm birth (PTB) or pregnancy loss. Previous reports have indicated that a Lactobacillus-poor microbial flora in the vagina and intrauterine infection by diverse anaerobes ascending from the vagina are associated with undesirable delivery outcomes. However, no research has involved the use of pyrosequencing analysis to examine vaginal microbiota profiles or their potential associations with high-risk pregnancy in Korean women. Vaginal swabs were collected from 500 Korean women for the identification of community state types (CSTs). Of these, 137 samples were further analyzed using a Roche/454 GS Junior pyrosequencer. Three distinct CSTs were identified based on the dominant vaginal microbes: CST I (Lactobacillus crispatus dominated), CST III (Lactobacillus iners dominated), and CST IV (with diverse species of anaerobes). Twelve of the 67 pregnant women had undesirable pregnancy outcomes (four miscarriages and eight PTBs). The dominant microbe in the vaginal microbiota of women who gave birth at full-term was L. crispatus. In contrast, L. iners was the dominant vaginal microbe in women who miscarried. Most (n = 6/8) vaginal microbiota profiles of women who experienced PTB could be classified as CST IV, with diverse bacteria, including anaerobic vaginal species. The present study provides valuable information regarding the characteristics of the vaginal microbiota of Korean women related to high-risk pregnancy. Investigation of the vaginal microbiotic structure in pregnant Korean women is necessary to enable better prediction of adverse pregnancy outcomes.

Analysis on prehospital care of emergency labor pain, vaginal bleeding and sexual assault patients by 119 emergency medical technicians (진통 분만, 질출혈과 성폭행 환자에 대한 119구급대원의 병원전 응급처치 분석)

  • Baek, Mi-Lye
    • The Korean Journal of Emergency Medical Services
    • /
    • v.17 no.2
    • /
    • pp.9-20
    • /
    • 2013
  • Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

Maternal Factors Affecting Delivery Mode of the Previous Cesarean Delivery Mothers (선행 제왕절개분만 산모의 제왕절개 후 질식분만과 반복 제왕절개분만 관련 요인)

  • Kim, Yun-Mi;Kim, Myung-Hee;Kim, Kyo-Hyun
    • Women's Health Nursing
    • /
    • v.17 no.4
    • /
    • pp.359-368
    • /
    • 2011
  • Purpose: To examine delivery type of mother who have had a previous cesarean and identify maternal factors related to type of delivery. Methods: The study sample included 60,504 mothers who had delivered through cesarean section. Related variables were categorized as sociodemographic factors (age, residence, health insurance type, income level) and clinical characteristics (14 maternal factor, 4 fetal factor and pre-term). For data analysis, $x^2$ and multivariate logistic regression were conducted. Results: Among the 60,504mothers, 3,075 were delivered through Vaginal Birth After C-Section (VBAC) and the VBAC rate was 5.1%. Underage 34, the VBAC rate increased according to age increases up to 3%. Mothers residing in urban areas had VBAC more frequently than mothers in rural area. Mothers in the high and middle income levels had a greater possibility of having VBAC than mothers in lower income levels. A greater likelihood of increase in repeated cesarean section were found in mothers with maternal and fetal factors. Conclusion: Evidence based nursing practice guidelines and education programs for previous cesarean section mothers and health policy are needed to increase VBAC.

Estimation of Nursing costs for Hospitalized Patients Based on the KDRG Classification (5개 KDRG(한국형진단명기준환자군)에 대한 간호원가 산정)

  • Park, Jung-Ho;Song, Mi-Sook;Sung, Young-Hee;Ham, Myoung-Lim;Yun, Seon-Ok
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.3 no.2
    • /
    • pp.151-165
    • /
    • 1997
  • A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

  • PDF

Continuous Lumbar Epidural Analgesia for Labor and Vaginal Delivery in Epileptic Pregnant Women (간질이 있는 산모에서 간질의 예방 및 분만통 감소를 위한 경막외 진통의 경험 1예 -증례 보고-)

  • Choi, So-Yong;Rim, Sung-Jin;Lee, Jung-Tae
    • The Korean Journal of Pain
    • /
    • v.11 no.2
    • /
    • pp.332-334
    • /
    • 1998
  • A 25-year-old epileptic female patient scheduled for vaginal delivery, was referred to the pain clinic for the relief of labor pain. She had been taking anticonvulsant drugs, but suffered from seizure attacks three or four times a month. We had induced continuous lumbar epidural analgesia successfully and she subsequently gave birth to a healthy infant. So we report that continuous lumbar epidural analgesia should be considered as a safe method for reduction of labor pain and prevention of seizure attacks in epileptic pregnant women.

  • PDF

Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
    • /
    • v.22 no.4 s.28
    • /
    • pp.555-577
    • /
    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

  • PDF

The Influence of Cold Therapy on the Perineal Discomfort and the Healing State of the Postpartum Women (냉요법이 산모의 회음부 불편감 및 치유상태에 미치는 영향)

  • Shin, Hyun-Jeong
    • Women's Health Nursing
    • /
    • v.4 no.1
    • /
    • pp.67-83
    • /
    • 1998
  • A quasi-experiment, repeated measures design with non-equivalent control group was used to test the influence of cold therapy on the perineal discomfort and the healing state of the postpartum women undergoing vaginal delivery with episiotomy. Experiment was carried out from July 28, through October 2, 1996 with 40 postpartum women conveniently sampled from one university hospital located in Seoul. The 40 postpartum women undergoing vaginal delivery with episiotomy were as signed to experimental and control groups evenly(20 each). The instrument of measurement of perineal discomfort was 0-10 rating scale that was made by researcher and that of perineal healing state was Davidson's REEDA tool. The perineal discomfort and the healing state level were measured before and after each treatment. The treatment using ice glove that was given for the only experimental group was carried out at three points ; as soon as returning to the recovery room, 3 hours after returning to the recovery room and 6 hours after returning to the recovery room. The data was analysed by using t-test, chi-square test to determine the similarity between experimental and control groups. The hypotheses were tested using repeated measures ANOVA. The results of this study are summarized as follows; 1. The first hypothesis that the perineal discomfort level of the experimental group will be significantly lower than that of the control group(df(1,38), F=24.12, p=.0001) was supported. 2. The second hypothesis that the perineal healing state of the experimental group wil be better than that of the control group(df(1,38), F=0.48, p=.49) was not supported. Based on the results of this study, could therapy was turned out to have significant effect on the perineal discomfort of the postpartum women undergoing vaginal delivery with episiotomy.

  • PDF

Transmucosal Delivery of Luteinizing Hormone Releasing Hormone(LHRH): Evaluation of Membrane Permeability Enhancement of $[D-Ala^6]$ LHRH in Rabbit Mucosa and Ovulation Inducing Effect in Vaginal Administration of Rat by the Addition of Several Absorption Enhancers (황체호르몬 유리호르몬의 경점막 수송: 수종의 흡수촉진제를 사용한 $[D-Ala^6]$ LHRH의 점막투과촉진 및 흰쥐에 있어서의 배란유도효과 향상)

  • Han, Kun;Jeong, Nam-Joo;Park, Jeong-Sook;Park, Hee-Beom;Chung, Youn-Bok;Moon, Dong-Cheul
    • YAKHAK HOEJI
    • /
    • v.38 no.4
    • /
    • pp.440-450
    • /
    • 1994
  • Due to the limited bioavailability of $[D-Ala^6]$LHRH from nonparenteral transmucosal sites of administration, enhancement of mucosal permeability by coadministration of several protease inhibitors and/or penetration enhancers were studied in rabbit mucosa. As a reliable bioassay method for $[D-Ala^6]$LHRH, ovulation-inducing effect were measured after vaginal administration in the rat. The permeation of $[D-Ala^6]$LHRH through the mucosal membrane of rabbit mounted on George-Grass diffusion cells were examined in the presence of polyoxyethylene 9-lauryl ether (POE), ${\beta}$-cyclodextrin$({\beta}-CyD)$ or ethylene diamine tetra acetate disodium salt(EDTA). The vaginal membrane showed higher permeability of $[D-Ala^6]$LHRH than the rectal and nasal membrane. POE and ${\beta}-CyD$ showed a small promoting effect on the membrane permeation of $[D-Ala^6]$LHRH, but EDTA showed significant enhancement. Ovaluation was enhanced by the coadministration of sodium laurate(0.5%), a protease inhibitor but was not enhanced by EDTA, a penetration enhancer. On the other hands, coadministration of sodium tauro 24,25 dihydrofusidate(1%) and EDTA(2%) enhanced the ovulation inducing-effect 2.8 times. These results suggest that the vaginal administration of $[D-Ala^6]$LHRH with STDHF or sodium laurate as a protease inhibitor, and EDTA as a penetration enhancer, may become an elective method for transmucosal delivery of $[D-Ala^6]$ LHRH.

  • PDF

The Analgesic Efficacy and Side Effects of Subarachnoid Sufentanil-Bupivacaine on Parturients in Advanced Labor (지주막하강 수펜타닐과 뷰피바케인의 혼합 투여가 분만 제 1 기 산모의 진통 효과에 미치는 영향)

  • Han, Tae-Hyung;Cho, Yong-Sang
    • The Korean Journal of Pain
    • /
    • v.10 no.1
    • /
    • pp.21-27
    • /
    • 1997
  • Background : Previous studies have proven beneficial in labor analgesia to use subarachnoid sufentanil(alone or with adjuvant) on parturients in early first stage of labor. We designed this prospective study to evaluate analgesic efficacy and side effects of subarachnoid sufentanil plus bupivacaine in women with cervical dilatation of 7 cm greater. Methods : This was an open-label, nonrandomized trial of 32 parturients in late first stage labor who requested labor analgesia. After signing the consent form each patient received subarachnoid sufentanil (10 ${\mu}g$) and bupivacaine (2.5 mg). Patients were asked to rate their verbal pain score (0-10 scale) before regional anesthesia and 5 minutes after subarachnoid injection, and every 20 minutes thereafter until delivery or request for additional analgesia. Blood pressure, pruritus, Bromage motor block score, mode of delivery and need for supplemental analgesics were recorded. Results : Thirty women were included in the study. Mean pain scores (mean${\pm}$SD) were $8.7{\pm}1.0$ pre-spinal, $0.7{\pm}1.5$ 5 minutes post-injection, and remained less than 5 for 130 minutes after spinal injection. Of 30 patients, 24 had unassisted vaginal delivery, 4 instrumental vaginal delivery (vacuum), and 2 cesarean delivery. Of 28 patients who delivered vaginally, 19 did not require supplemental analgesics and had a delivery pain score of 5 or lower. Blood pressure decreased in three patients after spinal analgesia (p<0.05), which necessitated treatment. The Bromage motor block score was 0 in 26 patients and 1 in 4 patients. Pruritus was noted in 22 patients. Conclusion : Subarachnoid sufentanil-bupivacaine provides rapid analgesia for an effective duration of approximately 130 minutes in parturients in late first stage of labor.

  • PDF

Defects in Ketone Body Metabolism and Pregnancy

  • Fukao, Toshiyuki
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.18 no.3
    • /
    • pp.69-77
    • /
    • 2018
  • Pregnancy and delivery pose a high risk of developing metabolic decompensation in women with defects of ketone body metabolism. In this review, the available reported cases in pregnancy are summarized. It is very important to properly manage women with defects of ketone body metabolism during pregnancy, especially nausea and vomiting in the first trimester of pregnancy, and during labor and delivery. Pregnant women with deficiencies of HMG-CoA lyase or succinyl-CoA:3-ketoacid CoA transferase (SCOT) often experience metabolic decompensations with nausea and vomiting of pregnancy, often requiring hospitalization. For successful delivery and to reduce stresses, vaginal delivery with epidural anesthesia or elective cesarean delivery with epidural or spinal anesthesia are recommended for women with HMG-CoA lyase and SCOT deficiency. In beta-ketothiolase deficiency, four pregnancies in three patients had favorable outcomes without severe metabolic problems.

  • PDF