• 여성건강간호학회지
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• 제8권3호
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• pp.389-401
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• 2002

This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.

• The Korean Journal of Pain
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• 제26권3호
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• pp.270-276
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• 2013

Background: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. Methods: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-${\mu}g$ fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. Results: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. Conclusions: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.

• International Journal of Computer Science & Network Security
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• 제23권5호
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• pp.47-52
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• 2023

In this paper a new fuzzy prediction is designed and developed to predict the type of delivery based on 7 factors. The developed system is highly needed to give a recommendation to the family excepting baby and at the same time provide an advisory system to the physician. The system has been developed using MATLAB and has been tested and verified using real data. The system shows high accuracy 95%. The results has been also checked one by one by a physician. The system shows perfect matching with the decision of the physician.

• The Korean Journal of Pain
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• 제27권1호
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• pp.90-91
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• 2014

• Clinical and Experimental Reproductive Medicine
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• 제43권1호
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• pp.51-53
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• 2016

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

• Advances in pediatric surgery
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• 제19권2호
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• pp.81-89
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• 2013

The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

• 대한추나의학회지
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• 제5권1호
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• pp.11-17
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• 2004

Objective : Women can be affected physically and psychologically by pregnancy and delivery. Because the relaxation of pelvic ligaments has a chance to cause pelvic deviation, we investigated the radiological peivic deviation according to delivery types and experiences. Method : 71 patients were evaluated by X-ray findings. Every patients divided into two group according to delivery types and experiences. After measured innominate measurement. off centering measurement, sacral ala measurement and ilium shadow measurement, X-ray findings in each group were analyzed statistically. Results and Conclusions : It was concluded that the ilium was more deviated into outer side in normal delivery group than caesarean operation group, and more deviated into inner or outer side in multipara group than primipara group.

• 보건교육건강증진학회지
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• 제17권1호
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• pp.61-79
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• 2000

This study to study and analyze the current state of infancy breast-feeding ＆ practice and related factors and to provide basic data for the effective practice of breast-feeding and breast-feeding percentage improvement. For the object, 474 mothers of the infants who were born between Jan. 1, 1998 and Dec. 31, 1998 were selected, and the survey period ＆ method were from Oct. 15, 1999 through Nov. 14, 1999 (1 month period) and telephone interview, respectively. To examine by month breast-feeding type, the average breast-feeding percentage in 1 month after a child's birth was 42.4%, but after 6 month it decreased to 23.0%. To see breast-feeding percentage by academic background, the breast-feeding of elementary school graduated mothers was 33.3%, which was highest, and it decreased as the academic background of mothers went better (p〈0.01). By employment state, the percentage for the mothers who were not employed was higher (24.6%) than that of those who were employed at the time, which was 8.0% (p〈0.001). There was no meaningful difference found in breast-feeding percentage by infant mothers age, delivery place, infant sex, child order in family, weight at the time of birth. To examine breast-feeding percentage by delivery method, natural delivery was 27.0% which was higher than 13.1% of Caesarean section (p〈0.01), and by breast-feeding experience before leaving the hospital, 35.6% of those who have breast-fed were breast-feeding while it was 16.4% for those who never did it while in the hospital (p〈0.001). After conducting logistics multi return analysis having breast-feeding percentage as a variable at the time of 6 months after babys birth, I found that infant mothers employment state, delivery method, and breast-feeding experience before leaving the hospital become meaningful variables. As unemployed mothers (p〈0.05), as chose natural delivery (p〈0.05), as experienced breast-feeding before leaving the hospital (p〈0.001), there was more tendency to do breast-feeding. Summing the above results, I would like to suggest the following to raise breast-feeding percentage. Firstly, systematic education about the importance and advantages of breast-feeding and correct breast-feeding method should be practised for women. Secondly, vacation before and after childbirth for working women should be practised and the support of systems for working womens breast-feeding such as installation of nursery in work place are needed. Thirdly, continuous publicity and education for natural delivery inducement is necessary, and for the ones who chose Caesarean section, recommendation of breast-feeding is also needed. Fourth, for breast-feeding within fastest time after delivery, rooming-in required and legal and systematic support is also needed. Lastly, in the governmental level, publicity for breast-feeding and breast-feeding recommending programs that promotes 10 rules for successful breast-feeding bringing-up, provided by UNISEF and WHO, are to be provided.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2211-2215
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• 2016

The purpose of this study was to evaluate the prevalence and predictors of post-Loop Electrosurgical Excision Procedure (LEEP) complications in Srinagarind Hospital, Khon Kaen, Thailand. Retrospective chart review was performed for 200 patients undergoing LEEP during January 2012 to February 2013. Their mean age was 45 years-old. Fifty-three (26.5%) were menopausal. The three most common preceding abnormal cervical cytology were high-grade squamous intraepithelial lesion (HSIL; 50%), atypical squamous cell cannot exclude HSIL (ASC-H; 10.5%), and low-grade squamous intraepithelial lesion (LSIL; 10%). The overall complications prevalence rate was 16.5% (95%CI, 11.4-21.6). Complications included bleeding (11%; 95%CI, 6.66-15.3), offensive discharge (4%; 95%CI, 1.28-6.72), and pelvic inflammatory disease (1.5%; 95%CI, 0.18-3.18). Only mode of delivery was an independent predictor of post-LEEP complications. Women with previous caesarean sections carried an increased risk of complications by 3.9 times (95%CI, 1.21-12.56) compared with vaginal delivery. In conclusion, LEEP is generally safe with an acceptable complication rate. Previous caesarean section was the only independent predictor for post-LEEP complications. However, this predictor still needs prudent evaluation as no clear cause-effect relationship was identified.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.216-221
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• 2017

Purpose: To analyze presence of Helicobacter pylori infection and environmental risk factors among children with and without allergy. Methods: Parents of children at primary health care centres/kindergartens and allergologist consultation were asked to answer a questionnaire and to bring a faecal sample. H. pylori infection was detected by monoclonal stool antigen test. Prevalence of H. pylori infection and risk factors were compared between individuals with and without allergy using ${\chi}^2$ test, ANOVA test and logistic regression. Results: Among 220 children (mean age, 4.7 years; ${\pm}standard$ deviation 2.3 years) H. pylori positivity was non-significantly lower among patients with allergy (n=122) compared to individuals without allergy (n=98): 13.9% (17/122) vs. 22.4% (22/98); p=0.106. In logistic regression analysis presence of allergy was significantly associated with family history of allergy (odds ratio [OR], 8.038; 95% confidence interval [CI], 4.067-15.886; p<0.0001), delivery by Caesarean section (OR, 2.980; 95% CI, 1.300-6.831; p=0.009), exclusive breast feeding for five months (OR, 2.601; 95% CI, 1.316-5.142; p=0.006), antibacterial treatment during the previous year (OR, 2.381; 95% CI, 1.186-4.782; p=0.015). Conclusion: Prevalence of H. pylori infection did not differ significantly between children with and without allergy. Significant association of allergy with delivery by Caesarean section and antibacterial therapy possibly suggests the role of gastrointestinal flora in the development of allergy, while association with family history of allergy indicates the importance of genetic factors in the arise of allergy.