• The Korean Journal of Pain
• /
• v.21 no.2
• /
• pp.159-163
• /
• 2008

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

• The Korean Journal of Pain
• /
• v.29 no.3
• /
• pp.193-196
• /
• 2016

Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.178-182
• /
• 1996

Background: To evaluate the effect of prophylactic transdermal scopolamine in reducing nausea associated with postoperative epidural morphine. Methods: 30 healthy patients scheduled for cesarean section were given local anesthetics epidurally for surgical anesthesia. After delivery of the baby, transdermal scopolamine patch($Kimite^{(R)}$ Myung Moon Pharm. Co., Seoul, Korea) was applied to the study group(n=15) and placebo patch to the control group(n=15). Postoperative analgesia was provided soley with epidural morphine. Nausea was treated with metoclopramide. Results: During 24 hours postoperatively, the mean nausea score was significantly lower in the study group than in the control group. But the nausea incidence was not significantly different between the two groups. The mean number of times antiemetic drugs which were administered to patients were lower in the study group than in the control group($1.5{\pm}0.5$ vs $3.3{\pm}1.3$, p<0.05). Conclusion: Transdermal scopolamine patch provides antiemetic effect simply, continuously and safely, preventing nausea which could occur during administration of epidural morphine after cesarean section.

• Journal of Yeungnam Medical Science
• /
• v.35 no.2
• /
• pp.187-191
• /
• 2018

Background: Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. Methods: We conducted this retrospective study using medical records. The study group included 80 full-term neonates diagnosed with RDS and hospitalized in the neonatal intensive care unit between January 2012 and December 2016, at Yeungnam University Hospital. We analyzed sex, gestational age, birth weight, delivery method, maternal age, number of pregnancy, history of abortion, and complication of pregnancy. The control group included 116 full-time neonates who were hospitalized with jaundice during the same period. Results: The incidence of full-term RDS was more common in males (odds ratio [OR], 3.288; 95% confidence interval [CI], 1.446-7.479), cesarean section (OR, 15.03; 95% CI, 6.381-35.423), multiparity (OR, 4.216; 95% CI, 1.568-11.335). The other factors rendered no significant results. Conclusion: The risk factors for RDS in full-tern neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants.

• The Journal of Korean Medicine
• /
• v.38 no.1
• /
• pp.112-124
• /
• 2017

Objectives: The purpose of this study is to investigate the various postpartum symptoms and the relevant factors. So it can provide fundamental data about postpartum health care. In conclusion, we can prevent and manage the postpartum disease by using this data. Methods: The subject of the present study was 94 women (63 women who completed vaginal delivery and 31 women who delivered by cesarean section) who completed labor between November 1, 2013 and January 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period, and Korean medical doctor examined the patients through the four examination methods. We classified the symptoms by maternal age, the frequency of maternal childbirth, the method of delivery, the delivery season, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Results: There were no remarkable corelation in the frequency of symptoms according to maternal age, the way of delivery, the delivery season, the change of weight before and after of delivery, gestational weeks at delivery, the manner of feeding and the body weight of infants except for the frequency of maternal childbirth. Conclusion: The symptoms of hemorrhoids, the feeling of coldness and chilliness increased with increasing the frequency of maternal childbirth. Other circumstances, there was no relationship with symptoms of postpartum.

• Women's Health Nursing
• /
• v.12 no.4
• /
• pp.355-362
• /
• 2006

Purpose: This study was to investigate the degree of postpartum depression and its predictors at six months postpartum. Methods: The subjects were 161 women six months after delivery who were registered with the public health center. The instruments included a survey of various characteristics, the Edinburgh Postnatal Depression Scale(EPDS), husband support, maternal self-esteem, and marital adjustment scale. The data was analyzed using the $x^2$-test, t-test, the Pearson correlation coefficients, and the logistic regression. Results: The point prevalence of postpartum depression at six months postpartum was 14.3%, corresponding to a score of 12 or higher on the EPDS. Postpartum depression was significantly associated with husband support, maternal self-esteem, and marital adjustment. Predictors of postpartum depression identified by the logistic regression analysis include marital adjustment (OR .29 [95% CI .13-.61]) and the delivery method(OR 3.57 [95% CI 1.25-10.23]). Conclusion: Strategies for improving postpartum depression, considerations of husband support and maternal self-esteem are important in research and practice. In addition, interventions for reducing Cesarean delivery and improving marital adjustment are needed.

• Journal of Digital Convergence
• /
• v.11 no.5
• /
• pp.347-354
• /
• 2013

In contrast to the increase in demand for high quality healthcare, there is limited medical human resources such as doctors and nurses so an excessive amount of workload is being forced to them. Therefore, a patient monitoring system using USN(Ubiquitous Sensor Network) is becoming a solution. This paper proposes a patient monitoring system applying USN in maternity hospital to reduce the workload of nurses. According to the efficiency evaluation test based on the model of two university hospitals(S, K University Hospital) and their doctor's diagnosis, the results showed that under the circumstances that one nurse is in charge of 12 patients(6 normal delivery patients and 6 cesarean delivery patients), a total of 1,260 minutes of workload was saved during hospitalization period(5 days). Also, we compared the workload of nurses with or without our proposed system, and the figures showed that in case of normal delivery patients, the workload of nurses decreased by 50 minutes per patient, whereas in case of cesarean delivery patients, the workload of nurses decreased by 130 minutes per patient.

• Clinical and Experimental Reproductive Medicine
• /
• v.27 no.4
• /
• pp.353-357
• /
• 2000

Objective: Extrauterine formation of decidua of stromal cells has been well described, particularly in the cervix and ovary. The apparent hormonal mechanisn of this phenomenon suggestes a relationship to endometriosis. Whether formation of ectopic decidua represents a marked progestational response of endometriosis or an independent peritoneal-stromal reaction to pregnancy is unclear. This study was designed to determine the prevalence of deciduosis in the patients whose fertility were proven. Design: Prospective study of patients who had undergone cesarean delivery without history of endometriosis. Materials and Methods: The study was performed in 179 full tenn pregnant women. During the cesarean section, the pelvic organs were thoroughly investigated and the biopsies were collected at the lesions suspicious endometriosis. And then microscopic examination of removed tissues were done. Results: Of the 179 patients who underwent cesarean delivery, 48 women (26.8%) had the lesions suspicious endometriosis such as adhesion, pigmented spots. The ovary was the most frequently ocurred site (79.2%). Microscopically, decidual cells were observed in 34 cases (70.8%) of 48 biopsed patients. Conclusion: Endometriosis has been known to be associated with subfertility. Our observations found the prevalence of deciduosis was 19.0% (34/179) in tenn pregnant women whose fertilites were proven. We suggests that the deciduosis maya manifestation of endometriosis during pregnancy. However, further follow up study should be done to confirm this clinicopathologic process.

• 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.

• Women's Health Nursing
• /
• v.5 no.2
• /
• pp.191-203
• /
• 1999

A clinical study was made on 365 low birth weight infant and 406 normal birth weight infant who had been born at Kangnam St. mary's Hospital during past 3 years from Jan. 1, 1995 to Dec. 31, 1997. the data of this study were gathered through reviewing of medical records. 1. Comparison of general characteristic with of obstetric characteristic 1) Old maternal age, previous abortion and previous LBWI delivery in the group of low birth weight infant(LBWI) mother were more prevalent than those in the group of normal birth weight infant(NBWI)mother 2) Cesarean section, abnormal presentation and multiple pregnancy in the group of LBWI mother were prevalent than those in the group of NBWI mother. 3) regular antenartal care and visiting rate of tertiary hospital in the group of LBWI mother were more prevalent than those in the group of NBWI mother. 2. Frequency of low birth weight infant 1) Anmual average frequency of LBWI was 6.5% and monthly frequency was the highest in January and december. 2) The frequency of LBWI was the highest in 37-40wks of gestational age and was the highest in 2251-2500 gm of birth weight. 3) The frequency of congenital anomaly in the group of LBWI was more prevalent than that of NBWI. 3. Mortality rate of LBWI The mortality rate of LBWI was 9.2%. The highest mortality rate was noted before 27wks of gestational age, less than 1000gm of birth weight and within 12hrs of delivery. 4. The most common complication of pregnant women was pre-term labor, the most complication relating to placenta was premature rupture of membrane(PROM) and the most fetal complication was fetal distress in delivered LBWI. 5. Significant relating factors of low birth weight infant delivery were associated with maternal age, previous delivery, previous low birth weight delivery, pre-eclampsia, anemia, oligohydramnios, PROM, placenta previa, abruptio placenta, fetal sex, fetal distress and congenital anomaly.