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Comparison of self-care and self-efficacy before and after childbirth in Pregnant women with Gestational Diabetes Mellitus (당뇨병을 가진 임부의 자가 간호와 자기효능감에 대한 출산 전후 비교)

  • Hong, Ji-Yeon;Lee, Mi-Joon;Kim, Seong-Shin;Lee, Ja-Yeon
    • Journal of Convergence for Information Technology
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    • v.11 no.10
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    • pp.293-301
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    • 2021
  • The aim of this study was to evaluate the difference of self-care and self-efficacy before and after childbirth in pregnant women with diabetes mellitus. Data were collected from 24 May 2018 to 23 May 2020 for 40 pregnant women over the 24th week of pregnancy. The collected data were analyzed by matched paired t-test using the SPSS 27.0 software program. 27 subjects (67.5%) were under the age of 35, and 13 subjects (32.5%) were over the age of 35. Self-care and self-effectiveness scores were lower in postpartum than in prenatal, which was statistically significant (p< .000). Therefore, it is necessary to develop a nursing intervention program to enhance self-care and self-efficacy after childbirth.

Decision-making process and satisfaction of pregnant women for delivery method (임산부의 분만방법 결정과정과 만족도)

  • Jun, Hae-Ri;Park, Jung-Han;Park, Soon-Woo;Huh, Chang-Kyu;Hwang, Soon-Gu
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.751-769
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    • 1998
  • This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.

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Effects of Administration of Oxytocin Antagonist on Implantation and Pregnancy Rates in Patients with Repeated Failure of IVF/ICSI Treatment (체외수정시술의 반복적인 실패 환자에서 옥시토신 길항제 주입이 착상 및 임신에 미치는 영향)

  • Ahn, Jun-Woo;Kim, Chung-Hoon;Kim, So-Ra;Jeon, Gyun-Ho;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.4
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    • pp.275-281
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    • 2009
  • Objective: This study was performed to evaluate the effect of oxytocin antagonist on the outcome of IVF/ICSI cycles in infertile patients with repeated failure of IVF/ICSI treatment. Method: Forty patients who had experienced two or more failures of IVF/ICSI treatment without low ovarian reserve, were recruited for this prospective randomized study. All patients received controlled ovarian stimulation (COS) using GnRH antagonist multidose protocol (MDP). For the intervention group, intravenous administration of atosiban (mixed vasopressin $V_{1A}$/oxytocin antagonist) started with a bolus dose 6.75 mg one hour before embryo transfer (ET) and continued at an infusion rate of 18 mg/hour. After ET, administered atosiban was reduced to 6 mg/hour and continued for 2 hours. The main efficacy endpoints were clinical pregnancy rate and implantation rate. Results: Patients' characteristics were comparable in the intervention and control groups. COS parameters and IVF results were also similar. The number of uterine contractions for 3 minutes measured just before ET was significantly lower in the intervention group than control group ($3.5{\pm}1.4$ vs $8.7{\pm}2.2$, p<0.001). While there was no statistically significant difference in the clinical pregnancy rate between control group and intervention group (20.0% and 40.0%, p=0.168), the implantation rate was significantly higher in the intervention group, with 16.9% (11/65) compared with 6.0% (4/67) in the control group (p=0.047). There were no differences in ectopic pregnancy rate and miscarriage rate between the two groups. Conclusion: This study demonstrates that administration of oxytocin antagonist during ET can improve the implantation rate probably by decreasing the frequency of uterine contractions in infertile patients undergoing IVF/ICSI treatment.

Studies on the Efficiency of Piglet Production by Controlling the Farrowing Time I. Factors on the Normal Farrowing Time in Swine (돼지에 있어서 분만시각의 인위적 조절에 의한 자돈생산 효율에 관한 연구 I. 돼지에 있어서 자돈분만 시각에 미치는 요인에 관한 연구)

  • 정영채;김창근;윤종택;이종완;전광주;이석우;이학철;이관순;나광빈
    • Korean Journal of Animal Reproduction
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    • v.24 no.2
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    • pp.171-178
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    • 2000
  • To improve the pig farm management and efficiency of swine industry by inducing the farrowing to day-time from night, In the first experiment, reproduction records of purebred and crossbred pigs were collected and analyzed to estimate the $\varepsilon$ ffec 잉 of factors affecting day and night farrowing. The general linear model was used to estimate the least square means of the factors affecting various reproductive characteristics. And also, chi-square tests were used to examine the independence of the reproductive traits and environmental factors using the SAS (1992). The comparisons between pure and crossbred pigs for total number born, percentage of number born alive, gestation length, time length for farrowing were determined. The results indicated that the gestation length of crossbred (115.11 d) was slightly longer than that of purebred (114.89 d, p<0.05). For the seasonal effects on total number born, the largest was found in spring and no differences were found among summer, fall and winter. The average gestation length was 1 day longer in spring and winter than in summer and fall. The total number born and number born alive were smaller in first, second, and greater or equal to sixth parity than other parities. And also, the percentage of no. born alive was least in greater or equal to sixth parity. For the effect of mating methods, natural and artificial insemination, on total number born and number born alive, no differences between the two methods were found. However, the percentage of number born alive for natural mating was 98.06% and was higher than artificial insemination(93.75%). The time length for farrowing was I hour were found for the 6 hrs of farrowing time. In general situation of pig farms, day-time farrowing was 34.8% and night farrowing was 65.2%, indicating that night farrowing was almost double of the night farrowing.

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Increased Carboxyhemoglobin and Serum Iron Concentration as an Indicator of increased Red Cell Turnover in Preeclampsia (임신성 고혈압 환자에서 적혈구교체의 지표로서 일산화탄소 혈색소와 혈청 철의 임상적 의의)

  • Kim, Sang-Heon;Lee, Kwang-Hee;Kim, Mi-Sook;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.68-76
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    • 1993
  • Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis, and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia($86.5{\pm}6.1{\mu}g/dl$) than in the controls($53.2{\pm}5.3{\mu}g/dl$). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia(antepartum : $2.55{\pm}0.42{\mu}g/dl$, postpartum : $1.21{\pm}0.4{\mu}g/dl$) than the controls(antepartum : $0.61{\pm}0.2{\mu}g/dl$, postpartum $0.53{\pm}0.2{\mu}g/dl$) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but, there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similar in both groups.

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Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

The Improvement Plan on Unifying from Law and Regulations Related to Radiation (방사선관계법 개정 시 용어 적용에 관한 개선 방안)

  • Jeong, Dong-Kyong;Lee, Jong-Back;Park, Myeong-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.7-12
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    • 2006
  • Purpose: This is for the purpose to help the bill related to technologists be systematic and unitary by carefully analyzing a legislation, an enforcement ordinance, and enforcement regulations in the connection with the radiological worker and the radiation workers from the law and regulations related to technologists. Materials and Methods: Concerning technologists, a legislation, an enforcement ordinance, and enforcement regulations for a sort of medical technician, regarding the radiological worker, the rules of diagnosis radiation equipment safety management, and concerning the radiation workers, atomic energy law, an enforcement ordinance and enforcement regulations were gathered, compared with one another, and analyzed. Results: Among technologists, in the case of working in the department of diagnosis radiation, the title 'Radiological Worker' is used by the Medical Service Law, and in the case of working in the department of radiation tumors or the one of nucleus medicine, the title 'Radiation Workers' is used by the Atomic Energy Law. Conclusion: Besides the technical term that is used by characteristic tasks, unification of the terms that can be used in common is necessary for sure. And when a legislation, an enforcement ordinance, enforcement regulations, and notification, things like that in the radiation field are amended, certainly they should be done by mutual agreement through negotiation between the organization related to radiation and the governmental organization.

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Effect of the Level of Concentrates and Pasture Grazing on Growth, Feed Efficiency and Reproductive Performance in Autumn Born Hanwoo Heifers (농후사료 급여수준 및 방목이 추계분만 한우 암송아지의 성장발육, 사료이용성 및 번식능력에 미치는 효과)

  • Kang, S.W.;Im, S.K.;Jeong, J.W.;Jang , S.S.;Jeon, K.J.
    • Journal of Animal Science and Technology
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    • v.45 no.6
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    • pp.975-986
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    • 2003
  • Present study was conducted to investigate the effect of the level of concentrates and pasture grazing in 36 autumn born Hanwoo heifers(initial body weight, 119.7${\pm}$25.6kg) for 426d including 195d for a pasture stage. The animals were fed commercial concentrates at a rate of 0.5%(T1), 1.0%(T2), 1.5%(T3) and 2.0%(T4) of body weight, respectively, for pre- and post-pasture. 1. Mean daily gains by treatments were 0.348, 0.403, 0.450 and 0.501kg for T1, T2, T3 and T4, respectively, indicating that increases in concentrates intake was associated with the daily gain of grazing Hanwoo heifers. However, the mean daily gain was the highest for T2 during the pasture stage. 2. TDN intakes per 1kg gain were, on average, 8.61kg for the entire experimental period and 9.22kg for the pasture stage, respectively. In addition, the rate of roughage to concentrate during the entire experimental period was 49.6 to 68.2%(mean 58.5%). 3. Age reached 225 and 250kg of body weight was, on an average, 15.1mo. and 17.6mo., respectively, indicating that increasing the level of concentrates feeding(by 0.5% of body weight) reduced the first pregnancy by 0.9 mo. Ages and body weight for first service were 19.5mo. and 272.2 kg, respectively. Mean pregnant rate of total heads was approximately 52.8%, but appeared to 66.6% for T3 and T4. Therefore, it may be concluded that the optimum level of concentrates for autumn born Hanwoo heifers is 1.8% of body weight for indoor feeding on rice straw-based diet and 1.5% of body weight for a pasture stage, respectively.

Clinical Efficacy of Clomiphene Citrate and Letrozole Combined with Gonadotropins for Superovulation in Patients with Clomiphene-Induced Thin Endometrium (클로미펜에 얇은 자궁내막을 보이는 환자에서 성선자극호르몬 병합 과배란유도시 클로미펜과 레트로졸의 임상적 효용성)

  • Lee, Eun-Joo;Park, Hyun-Jong;Yang, Hyo-In;Lee, Kyung-Eun;Seo, Seok-Kyo;Kim, Hye-Yeon;Cho, Si-Hyun;Choi, Young-Sik;Lee, Byung-Seok;Park, Ki-Hyun;Cho, Dong-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.111-119
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    • 2009
  • Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

Effects of Herb Mixture to Postpartum Body Control and Arthralgia (한방 복합제가 산모의 체중조절 및 관절통에 미치는 영향)

  • 김상만;정화영;임재연;확보식;권석형
    • The Korean Journal of Food And Nutrition
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    • v.15 no.3
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    • pp.267-271
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    • 2002
  • We have studies in 38 subjects (19 control and 19 experiment) for development of functional food for postpartum body control. Mean age of control and experimental subjects were each other 30.4 and 29.0 years old, and mean body mass index were 20.2 and 21.4. Total weight gain during pregnancy of control and experimental subjects were 14.0kg and 19.8kg. We measured change of weight and liver activity after parturition for 3 months. It shows that weight not reduced until 30 days in postpartum but significantly decreased during 30 days to 90 days. The mean weight of control and experimental subjects were decreased 3.15kg and 6.46kg at 60 days(p<0.05), 4.47kg and 7.44kg at 90 days(p<0.05). In this study, hemoglobin, GOT and CPT level were not changes before and after of experiment, respectively.