• Title/Summary/Keyword: 분만진통

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Analysis of the Use of Ambulance Services Among Pregnant, Childbearing, and Postpartum Women Using Data from the Korea Health Panel (한국의료패널을 이용한 구급 이송 서비스 이용 특성 분석: 임신, 출산, 산후기 여성을 중심으로)

  • Kang, Kyunghee
    • Fire Science and Engineering
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    • v.33 no.6
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    • pp.152-158
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    • 2019
  • This study examined the socio-economic and clinical characteristics associated with the use of ambulance services among pregnant, childbearing, and postpartum women based on data from the 2008-2016 Korea Health Panel. The analysis revealed that among the pregnant, childbearing, and postpartum women, the proportion using all ambulance services was 18.9% whereas 12.0% used private and 119 ambulances. Moreover, among those using ambulance services, delivery was the most common reason (38.7%) followed by complications of labor and delivery (20.0%) and pregnancy with abortive outcome (17.3%). There were statistically significant differences between the users and non-users of ambulance services in terms of the average annual household income, emergency arrival time, and delayed arrival at the emergency room. As childbirth becomes more complicated due to low fertility and elderly mothers, the expansion and improvement of ambulance services as a social safety net for pregnant, childbearing, and postpartum women will become increasingly important.

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
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    • v.11 no.2
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    • pp.332-334
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    • 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.

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Early-Onset Sepsis Due to Listeria Monocytogenes in a Extremely Low Birth Weight Infant (초극소 저출생 체중아에서 발생한 Listeria Monocytogenes에 의한 조발형 패혈증 1례)

  • Moon, Jin Hwa;Oh, Sung Hee;Moon, Soo Jee
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.245-249
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    • 2000
  • Listeria monocytogenes is one of the important causes of neonatal sepsis and listerial neonatal infection manifests in two forms : Early-onset sepsis syndrome, associated with spontaneous abortion, still birth, preterm labor, granulomatosis infantiseptica, respiratory distress, sepsis, hemodynamic compromise and late-onset listerosis mainly associated with meningitis. Cases of neonatal listerosis reported in Korea have been rare and all were full term newborns. We, herein, report a case of early-onset sepsis due to L. monocytogenes in a extremely low birth weight infant who were born in a critical condition and succumbed in the second day of life despite the intensive care.

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A Study on the Insurance Contribution and Health Care Utilization of the Regional Medical Insurance Scheme (1개 군지역 의료보험제도에서의 보험료 부담수준별 병.의원 의료이용에 관한 연구)

  • Lee, Sang-Il;Choi, Hyun-Rim;Ahn, Hyeong-Sik;Kim, Yong-Ik;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.578-590
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    • 1989
  • This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.

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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
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    • v.17 no.2
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    • pp.9-20
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    • 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.

Effects of Abdominal Breathing on Anxiety and Labor Time in Primipara Women (복식호흡이 초산부의 진통 중 불안과 분만소요시간에 미치는 효과)

  • An, Sung-Eun
    • Women's Health Nursing
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    • v.14 no.3
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    • pp.196-204
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    • 2008
  • Purpose: This study aimed to examine the effects abdominal breathing on anxiety and length of labor time in primipara women. Method: It was a quasi-experimental design with a non-equivalent comparison group, performed from October 11 to December 4, 2007. Thirty-six subjects who received pitocin and met the inclusion criteria were chosen by convenience sampling from the labor room of Y hospital located in Seoul. The intervention of abdominal breathing was 'four seconds of inhale, six seconds of exhale breathing method.' The abdominal breathing was carried out 30 times each when the uterine cervix was dilated $3{\sim}4cm$ and $5{\sim}6cm$. Psychological anxiety was measured by VAS-A before and after the cervix dilatation to $3{\sim}4cm$ and $5{\sim}6cm$. Result: Anxiety scores of the experimental was found lower than that of the control group at $3{\sim}4cm$(z=-3.05, p=.00) and $5{\sim}6cm$(z=-2.04, p=.04) of cervix dilatation. However, the abdominal breathing was not effective to the length of labor from the active phase thru full dilatation, though there was 56 minutes of difference between the two groups. Conclusion: Carrying out the abdominal breathing 30 times at two time points was effective in decreasing anxiety level during labor. Further study is suggested to examine the effects of abdominal breathing on labor time, fetal heart rate, and uterine contraction.

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Readmission of late preterm infants after discharge from nursery (신생아실에서 퇴원한 후기 조산아들의 재입원에 대한 고찰)

  • Kim, Myo-Jing
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.888-892
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    • 2009
  • Purpose : To evaluate the risk factors for hospital readmission during the neonatal period among late preterm infants who were discharged after nursery care. Methods : In this retrospective study, we reviewed medical records of 135 late preterm infants readmitted to the neonatal intensive care unit (NICU) during the neonatal period, after discharge from nursery of IL Sin Christian Hospital from January 2003 to December 2008. We compared the risk factors of the hospital readmission group with the control group. Results : The gestational age and birth weight of 135 study infants were $36^{+1}{\pm}0.5$ weeks and $2,718.4{\pm}296.9gm$, respectively. Identified risk factors of hospital readmission were breastfeeding (71.9% vs. 44.4%), short duration of nursery stay ($3.3{\pm}1.6$ days vs. $4.1{\pm}2.0$ days), firstborn (60.0% vs. 45.3%), and maternal pregnancy complication (31.9% vs. 18.8%). Jaundice accounted for the majority of hospital readmissions (83.7%), and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days, mostly at 5-6 postnatal days (40.7%). Identified risk factors of hospital readmission due to jaundice were spontaneous normal vaginal delivery (43.4% vs. 1.8%), younger maternal age ($29.8{\pm}3.4$ yrs vs. $32.1{\pm}4.2$ yrs), and lower maternal pregnancy complication (28.3% vs. 50%). Conclusion : Identified risk factors of hospital readmission were breastfeeding, short duration of nursery stay, firstborn, and maternal pregnancy complication. Jaundice accounted for the majority of hospital readmissions, and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days.

A case of Tocolytics Induced Pulmonary Edema (Tocolytics에 의해 유발된 폐부종 1예)

  • Lee, Dae Jun;Kim, Chang In;Jee, Young Goo;Lee, Kye Young;Kim, Keun Yeol;Choi, Young Hi;Seo, Pil Weon
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.183-190
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    • 1997
  • Tocolytics are agents widely used in the treatment of premature labor to inhibit uterine contractions. Ritodrine is most commonly used tocolytic agent and acts by increasing intracellular cyclic adenosine monophosphate, which decreases the activity of myosin light-chain kinase, the rate-limiting enzyme in the signal network leading to contraction. Physiologic effects associated with the use of ritodrine are due to their effect on bera-l as well as beta-2 receptors. Some of maternal complications of therapy are rachycardia, hyperglycemia, hypokalemia, lactic acidosis, myocardial ischemia, and pulmonary edema. Tocolytics induced pulmonary edema is a serious complication that can lead to marternal death, although infrequent, The incidence varies from 0.5% to 5% of those receiving these agents. Predisposing factors include the concommitant use of corticosteroid, twin gestation, fluid overload (particularly with saline), and anemia. Several mechanisms have been postulated, but the pathogenesis is uncertain. It is suggested that both types of mechanism, hydrostatic and permeability induced, might be involved. The association of tocolytic therapy with pulmonary edema appears to be unique to the pregnant state, because this complication has never been reported in asthmatic patients exposed to high dosages. We report a case of tocolytic induced pulmonary edema developed in 24 hours after delivery.

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Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia?: Retrospective observational study (경막외 진통은 비경막외 진통에 비해 초산부의 분만을 지연시키는가?: 후향성 관찰 연구)

  • Jang, So Young;Lee, Ae Ryoung;Yun, So-hui;Choi, Yun Suk;Park, Jong Cook;Cho, Woo Jin
    • Journal of Medicine and Life Science
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    • v.15 no.2
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    • pp.95-100
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    • 2018
  • We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. This retrospective, observational study based on the review of the medical records from February 2014 to July 2017. Epidural analgesia was initiated with a 10 mL epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. Non-epidural analgesia was initiated with pethidine 12.5 mg bolus, followed by additional boluses as needed. The primary outcome was the duration of the labor. 149 healthy nulliparous women at term pregnancies with no evidence of fetal distress were enrolled in this study. 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. Using a Kaplan-Meier survival analysis, there was no significant difference in the overall duration of the labor(P=0.233). The duration of the first stage of labor was $187.6{\pm}167.3min$ in Group NE, $248.6{\pm}168.7min$ in Group E (Mean${\pm}$SD, P=0.032). The duration of the second stage of labor was $67.1{\pm}57.8min$ in Group NE, $64.1{\pm}47.5min$ in Group E (Mean${\pm}$SD, P=0.693). Epidural analgesia delayed the first stage of labor in this study. But there were no significant differences between the two groups in the duration of the second stage and the total duration of labor.

Analysis of Experimental Researches in Korea on the Effects of Aromatherapy to Relieve Pain (아로마테라피의 통증 감소 효과에 관한 국내 실험논문 분석)

  • Park, Jeong-Sook;Park, Jeong-Eon;Yang, Jang-Soon;Kwak, Hye-Weon;Han, Jung-An
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.8-19
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    • 2011
  • Purpose: This study identifies research trends and provides fundamental data related to curative power of aromatherapy to relieve pain in Korea. Methods: The study analyzed 44 experimental studies on humans that were published in Korea before the end of December, 2009. The key words used for searching were: aroma, aromatherapy, hyang-yobeob, hyanggi-yobeob, hyanggichilyo, aromatherapy and pain, headache, scapulodynia, omodynia, feeling uncomfortable in the perineal region, sense of pain, labor pains, arm pain, menstrual pain, aches, and dysmenorrheal. Those words were found on websites, including those for Korea Education & Research Information Service, the National Assembly Library, KISS, KoreaMed, and NDSL. Collected data were analyzed using descriptive statistics. Results: The results showed that most of essential oils to relieve pain is composed of three to four kinds of oils, including Lavender, Roman chamomile, Rosemary, and Clarysage. Aromatherapy is applied usually by means of massage (50%), inhalation (13.6%), or a combination of the above two (13.6%). Measuring instruments as a dependent variable include VAS, questionnaire, GRS, blood pressure, pulse, and Algometer. Aromatherapy plays an important role in soothing headaches and arthralgia. However, when it comes to labor and menstrual pain, it doesn't seem to be effective. Conclusion: The study found that different kinds of oil, frequencies, and periods of time are used for the same symptoms. Further research should employ standardized oil blending, application, duration, and measuring instruments, and more systematically analyze the effects of aromatherapy to establish the effects on relieving pain.