• Title/Summary/Keyword: 산모

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Development of Time Varying Kalman Smoother for Extracting Fetal ECG using Independent Component Analysis : Preliminary Study (독립요소분석을 이용한 태아심전도 추출을 위한 시변 칼만 평활기의 개발 : 예비연구)

  • Lee, Chung Keun;Kim, Bong Soo;Kwon, Ja Young;Choi, Young Deuk;Song, Kwang Soup;Nam, Ki Chang
    • Journal of the Institute of Electronics and Information Engineers
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    • v.49 no.10
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    • pp.202-208
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    • 2012
  • Fetal heart rate monitoring is important information to assess fetal well-being. Non-invasive fetal ECG (electrocardiography) can be derived from maternal abdominal signal. And various promising signal processing methods have been introduced to extract fetal ECG from mother's composite abdominal signal. However, non-invasive fetal ECG monitoring still has not been widely used in clinical practice due to insufficient reliable measurement and difficulty of signal processing. In application of signal processing method to extract fetal ECG, it might be lower signal to noise ratio due to time varying white Gaussian noise. In this paper, time varying Kalman smoother is proposed to remove white noise in fetal ECG and its feasibility is confirmed. Wiener process was set as Kalman system model and covariance matrix was modified according to white Gaussian noise level. Modified error covariance matrix changed Kalman gain and degree of smoothness. Optimal covariance matrix according to various amplitude in Gaussian white noise was extracted by 5 channel fetal ECG model, and feasibility of proposed method could be confirmed.

Disorders in Hemostasis

  • Sung, Tae-Jung
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.14-22
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    • 2011
  • Neonatal bleeding is a common problem encountered in nursery rooms or neonatal intensive care units, especially among premature infants. Furthermore, owing to recent remarkable improvement of neonatology, survival rates of preterm neonates have increased; hence, neonatal bleeding cannot be emphasized enough. Since the total blood volume of neonates is small, bleeding can be one of the causes of morbidities and mortalities. Therefore, rapid diagnosis and immediate therapy is urgently needed. The patient's medical history including a familial history of a bleeding disorder or of a previously affected infant who suffered from bleeding along with maternal and neonatal drugs can provide important diagnostic clues. Presence of bleeding with or without petechiae and ecchymoses in a healthy term or late preterm infant with thrombocytopenia but normal prothrombin time and activated partial thromboplastin time strongly suggests a congenital bleeding disorder. For a sick infant who is bleeding from multiple sites, an acquired disorder such as disseminated intravascular coagulation is suspected. Intracranial hemorrhage in term or late preterm infants without a history of birth trauma is highly suggestive of coagulation disorders. The purpose of this review is to summarize recent advances in diagnostic methods is as well as basic concepts of neonatal hemostatic disorders. First, an outline of background information will be presented followed by a discussion of primary and secondary hemostatic disorders as well as inherited and acquired disorders.

Two Cases of Dry Lung Syndrome (Dry lung syndrome 2예)

  • Song, In-Gu;Kim, Su-Yeong;Lee, Ju-Young;Lee, Eun-Hee;Sohn, Jin-A;Choi, Eun-Jin;Kim, Eun-Sun;Lee, Hyun-Ju;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.158-162
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    • 2011
  • Preterm infants with oligohydramnios after preterm premature rupture of membranes can present with severe respiratory distress immediately after birth, and the most common cause is pulmonary hypoplasia. Unlike infants with pulmonary hypoplasia, some cases have shown dramatic improvement with aggressive ventilatory support during the initial 1-2 days of distress: those patients have been defined as having dry lung syndrome. It is assumed that oligohydramnios leads to functional pulmonary hypoplasia by compression of the fetal lungs: some of the improvement in dry lung syndrome may thus have resulted from inflation of compressed lung tissue and increase of lung compliance. We report two incidences of dry lung syndrome that were treated successfully with high inflation pressure and inhaled nitric oxide (NO): these are the first dry lung syndrome cases to be reported in Korean infants.

Evaluation of Gestational Diabetes Mellitus Risk Factors Using Abdominal Subcutaneous Fat Thickness for Early Pregnancy in the US Imaging (초음파영상에서의 임신초기 복부피하지방두께를 이용한 임신성당뇨 위험인자 평가)

  • Kim, Changsoo;Yang, Sung-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.35-40
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    • 2017
  • The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and earely pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM.

Guideliness of the Parameters Using Integrated Test in Down Syndrome Risk Prediction (다운증후군위험도 예측에서 통합선별검사를 이용한 파라미터의 유의성)

  • Lee, Jin-Won;Go, Sung-Jin;Kang, Se-Sik;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.549-555
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    • 2016
  • This study was an evaluation of the significance of each parameter through aimed at pregnant women subjected to screening test(integrated test) in predicting risk of Down syndrome. We retrospectively analysed the correlation of risk of Down's syndrome with Nuchal Translucency(NT) images measured by ultrasound, Pregnancy Associated Plasma Protein A(PAPP-A), alpha-fetoprotein(AFP), unconjugated estriol(uE3), human chorionic gonadotrophin(hCG) and Inhibin A by maternal serum. As a result, a significant correlation with NT, uE3, hCG, Inhibin A is revealed with Down's syndrome risk(P<.001). In ROC analysis, AUC of Inhibin A is analysed as the biggest predictor of Down's syndrome(0.859). And the criterion for cut-off was inhibin A 1.4 MoM(sensitivity 81.8%, specificity 75.9%). In conclusion, Inhibin A was the most useful in parameters to predict Down's syndrome in the integrated test. If we make up for the weakness based on the cut-off value of parameters they will be able to be used as an independent indicator in the risk of Down's syndrome screening.

Evaluation of the Fetal Dose during Prophylactic Placement of Internal Iliac Artery Balloon Occlusion Catheters in Placenta Accreta (유착태반환자의 예방적 내장골동맥 풍선카테터 설치술 시행 시 태아선량 평가)

  • Kim, Dong-Sik;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.313-321
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    • 2016
  • Placenta accrete patients whose mother mortality rates are rather high due to massive bleeding during childbirth need to have Prophylactic placement of Internal Iliac Artery Balloon Occlusion Catheters procedure to reduce amount of blood loss and inoperative transfusion. Nevertheless, studies for mothers inevitably exposed to dose during PIIABOCs procedure have not been published many yet. Therefore, this study is to investigate exact information on radiation dose exposed to fetus during PIIABOCs procedure. Average effective dose of fetus per organ is 2.38~8.83 mGy, measured highest at beam center and followed by eyeball, stomach and bladder. The result showed that the longer fluoroscopy time is used, the closer beam center is and the thicker abdominal thickness is, the more effective dose on fetus is increasing. When using the collimator and protection shown to decrease the effective dose and when using higher the patient table shown to decrease the effective dose. It has been reported that the threshold of deterministic effect is about 100mGy. Deterministic effect was regarded as a factor that would influence on fetus exposed by medical radiation than stochastic effect. Consequently, it concluded that dose exposed on fetus in PIIABOCs procedure was approximately 10% of threshold of deterministic effect with effective dose of 0.49~18.27 mGy.

Effects of Oketani Breast Massage on Breast Discomfort, Breast Milk Amount, and Breast Milk Total Protein (오케타니 유방마사지가 유방불편감, 모유량 및 모유 Total Protein에 미치는 효과)

  • Kim, Su-Mi;Jeon, Soon-Ie;Song, Seon-mi
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.493-503
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    • 2018
  • The purpose of this study was to measure the effects of Oketani breast massage on breast discomfort, The amount of the breast milk, and the total protein of the breast milk in early postpartum mothers. The design was a non-equivalent control group Quasi-experiment. In the nursing intervention, The Oketani breast massage was given to the experimental group twice after giving birth, and Self Mamma Care (SMC) training was given to the control group. The collected data were analyzed by $x^2-test$ and t-test. The results of the study showed that the Oketani breast massage was more effective than the SMC-treated control group because of decreasing breast discomfort and increasing the amount of breast milk and total milk protein. Therefore, the Oketani breast massage will help early postpartum mothers more easily breastfeed. For the implication for practice, this study suggests that Oketani breast massage can be used as the effective nursing intervention that facilitates breastfeeding of early postpartum mothers in clinical practice.

A Comparative Study on the Level of Postpartum Women's Fatigue between Rooming-in and Non Rooming-in Groups (모자동실군과 모자별실군 질식분만 산모의 피로도 비교)

  • Song, Ju-Eun
    • Women's Health Nursing
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    • v.7 no.3
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    • pp.241-255
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    • 2001
  • This is a cross-sectional descriptive study which compares the level of postpartum women's physical, phychological, neurosensory fatigue between rooming-in and non rooming-in groups. The data were collected by using self-report questionnaire from April 1 to May 31, 2001. Subjects were 68 mothers who opted the rooming-in choice and 98 mothers who did not choose the rooming-in at one hospital in Seoul, Korea. They all had NSVD. The research questionnaire consisted of 36 items on general chracteristics and 30 items on postpartum fatigue developed by Pugh (1993). The data were analyzed by using the SPSS 10.0 window program. The results of this study were as follow: 1. There was significant statistical difference in general characteristics between rooming-in and non rooming-in groups in prenatal class attendance ($x^2$=3.935, p=0.047), maternal fetal attachment score (t=2.130, p=0.035), husband attendance during the labor and delivery ($x^2$=9.147, p=0.002), breast feeding ($x^2$=12.503, p=0.000), and self feeding time including bottle feeding (t=4.588, p=0.000). 2. There was no significant statistical difference in the level of total fatigue score between two groups (t=0.282, p=0.780). 3. The physical and neurosensory fatigue scores were slightly higher in rooming-in group ($21.63{\pm}4.92$, $18.53{\pm}4.60$) than those ($20.71{\pm}5.78$, $18.23{\pm}5.39$) of non rooming-in group. And the phychological fatigue score was slightly higher in non rooming-in group ($17.67{\pm}4.95$) than that ($17.04{\pm}4.63$) of rooming-in group. However, there was no significant statistical difference in the level of three sub-dimension fatigue between two groups (t=1.068, p=0.287; t=-0.827, p=0.410; t=0.368, p=0.714). 4. Even after controlling characteristics showed significant differences between two groups, there was no significant statistical difference in the level of fatigue between two groups (F=0.135, p=0.714). According to this study, there was no significant statistical difference in the level of postpartum fatigue whether they were rooming-in or not. Based on this result, the common notion of rooming-in mothers will be more fatigue than non rooming-in mothers is proved to be false. However, it is necessary to develop appropriate nursing interventions to meet the need of mothers who decide to rooming-in.

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Integrative Review of Domestic Research Papers on Breast-Feeding Intervention (모유수유 중재에 관한 국내 연구논문의 통합적 고찰)

  • Choi, Eun-Young;Park, Bock-Soon;Park, Sun-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.441-452
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    • 2016
  • The purpose of this study was to examine the characteristics of domestic research into breast-feeding intervention education geared toward mothers and the content of the intervention based on the existing literature in an effort to provide information on how to offer the best intervention. Domestic studies reported between January 1993 and December 2014 were analyzed using four different databases. Fifteen studies were selected from 76 studies included in the databases after performing the searches. How long breast-feeding intervention remains effective should be studied to secure scientific rationales, which is one of the proper nursing interventions to boost breast feeding. As a result of analyzing the papers according to Whittmore and Knaf's integrative review method, the individual educational intervention was offered in two papers, and the individual education and group education were both provided in four. In nine papers, individual education, group education, phone counseling and education by home visits were all offered. Follow-up studies should be conducted by adopting a systematic research design to find more scientific evidence for appropriate nursing interventions to boost breast-feeding. These results will be useful for the development of educational programs for breast-feeding if more accurate information on breast-feeding education for mothers can be obtained.

Estimation of Indicator PCBs Exposure in Infants via Breast-Feeding Period (수유기간에 따른 모유 중 Indicator PCBs 분석을 통한 영유아의 인체노출평가)

  • We, Sung-Ug;Yoon, Cho-Hee;Min, Byung-Yun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.1
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    • pp.7-15
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    • 2012
  • The levels of indicator PCBs were determined in 132 human milk samples (Colostrum, 30th days after delivery, 60th days after delivery) collected in 2006 according to World Health Organization's (WHO) protocol. In addition, concentrations of indicator polychlorinated biphenyls (PCBs) were measured by the isotope dilution method with high resolution gas chromatograph/high resolution mass detector (HRGC/HRMS), which gave accurate and precise data for estimations of international trend and comparisons. Average daily intakes (ADIs) of all analytes were calculated. The median level of total indicator PCBs was 14 ng/g lipid, which is significantly lower than the level found in individuals from other countries. PCB congeners 138, 153 and 180 accounted for about 65% of the sum of the indicator congeners analyzed. The concentration of the most abundant PCB 153 is positively correlated with the concentration of the sum indicator PCBs (p<0.001). In this study, concentrations of total indicator PCBs significantly decreased with increasing number of children for a mother, indicating that parity and breast-feeding period an important role in the accumulation and elimination of these compounds in lactating women. The ADI for the median of total indicator PCBs for an infant was evaluated at $0.077{\mu}g/kg{\cdot}bw/day$ from birth to 6 months of age. The present study shows that concentrations of PCB 118 primipara breast milk have decreased 25~35 since 1998, and that this trend is continuing.