• Title/Summary/Keyword: Antenatal

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Evaluation and Management of Antenatal Hydronephrosis

  • Hong, Young Kwon;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.8-13
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    • 2015
  • Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

A Study on the Development of an Education Curriculum for Maternal-Child Health Center Managers (산후조리간호 관리자 교육과정 개발 연구)

  • Choi, Yang-Ja;Cho, Kap-Chul;An, Eun-Sook
    • Women's Health Nursing
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    • v.10 no.2
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    • pp.109-118
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    • 2004
  • Purpose: The purpose of this study was to develop a specialized education curriculum aimed at helping nurses prepare for running and managing a Maternal-Child Health Center (Postpartum Care Center). Method: This study was conducted by an academy and industry joint research group consisting of professors of Nursing, and nurses actually running a Postpartum Care Center. The group compiled job descriptions of nursing through document research, interviews and observation during site visits, surveys, and seminars. They then performed a feasibility study and developed the final curriculum. Result: The education curriculum is a 32-week(2semester) program compromised of a theory part (12 credits, 180 hours) covering maternal and infant care and business start-up and field practice (3 credits, 45 hours). Courses in the theory part include an antenatal care, overview and details of maternal care, starting a business and its management. Of these courses, the overview of a maternal care course was developed with web-based contents. Field practice is designed to give students opportunities to visit Postpartum Care Centers, observe the care provided, and get hands-on experience. Conclusion: The specialized education curriculum is a 32-week course comprised of 12 credits on theory of antenatal care, overview and details of maternal care, infant care, starting and operating a business and 3 credits of field practice.

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A Case of Pulmonary Sequestration with Pleural Effusion (산전 진찰에서 발견된 흉막액을 동반한 폐격리증 1례)

  • Ku, Hye Jin;Park, Ji Ae;Park, Su Eun;Kim, Young Dae
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.221-223
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    • 2005
  • Congenital pleural effusions are uncommon. The majority of cases are due to chylothorax, hydrops fetalis, and infection. Effusions of this nature are, for the most part, self-limited. We experienced a rare case of a congenital unilateral pleural effusion due to an extralobar sequestraion with pulmonary lymphangiectasia. Pleural effusion was found by antenatal ultrasonography and confirmed by CT scans and CT angiography of the chest in the neonatal period. The patient underwent an open thoracotomy where extralobar sequestraion located between the diaphragm and the left lower lobe was removed. His postoperative course was uncomplicated and there was complete resolution of the pleural effusion.

A Follow-up Survey of Mothers' Antenatal Breast-feeding Plans (임신시 모유 수유 계획의 실천에 대한 추적 관찰)

  • Kim, Hae Soon;Seo, Jeong Wan;Kim, Yong Joo;Lee, Kee Hyoung;Kim, Jae Young;Ko, Jae Sung;Bae, Sun Hwan;Park, Hye Sook
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.635-641
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    • 2003
  • Purpose : To investigate the success rate and factors that influence breast-feeding among women having antenatal breast-feeding plans. Methods : Questionnaires included items on success in breast-feeding, reasons for failure and perinatal factors. It was done by telephone calls to 152 randomly selected women having antenatal breast-feeding plans at 4 months after delivery. The questionnaires were analysed by bivariate ${\chi}^2$-analysis. Results : The breast-feeding rate for the first four months among women having antenatal breast-feeding plans was 37.5%. The major reason for breast-feeding failure was insufficient amount of breast milk(66.3%). The breast-feeding rate was 2.3(95% CI 1.15-4.62) times higher in women having antenatal breast-feeding plans for longer than 4 months(P<0.05), but maternal age, breast-feeding for previous baby, person advocating breast-feeding, and family size were not significant factors of success in breast-feeding. The breast-feeding rate of graduates of college was 0.43(95% CI 0.21-0.86) times lower than that of graduates of high school. The breast-feeding rate of employed mothers was 0.37(95% CI 0.17-0.83) times lower than that of housewives(P<0.05). Maternal disease, smoking, alcohol drinking, and understanding and knowledge about breast-feeding were not significant determinant factors of success in breast-feeding. Breast-feeding rate of infant born at local obstetric clinics was 3.97(95% CI 11-14.23) times higher than that of infant at general hospital(P<0.05). Conclusion : To increase the breast-feeding, medical personnel should educate mothers on problems during breast-feeding. Hospital polices that facilitate breast-feeding such as rooming-in must be promoted. For employed mothers, strategies for breast-feeding within companies must be encouraged.

The Preventive Effect of Antenatal Administration of Ambroxol on the Neonatal Respiratory Distress Syndrome (산전에 투여한 Ambroxol의 신생아 호흡 곤란 증후군 예방 효과)

  • Lee, Eun-Sil;Kim, Kyung-Ah;Shin, Son-Moon;Koh, Min-Whan;Lee, Tae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.52-59
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    • 1999
  • This study was conducted to evaluate the effect of the antenatal ambroxol administration to mothers who were in danger of imminent preterm delivery in preventing the neonatal respiratory distress syndrome(RDS). Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, 21 in ambroxol-treated group and 21 in control group. Six cases of the respiratory distress syndrome were developed from 21 ambroxol-treated infants, but 13 cases of RDS, from 21 control infants. This result indicated a significant reduction of the occurrence of RDS by antenatal administration o[ ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between the two groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, the administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndrome without significant adverse effects.

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A Study on the Status of Maternal and Child Health (MCH) and Family Planing (FP) in a Rural Area (Yeoju), 1984 (일부 농촌지역의 모자보건 및 가족계획실태에 관한 연구)

  • Kim, Yang-Soo;Yum, Yong-Tae;Song, Dong-Bin;Kim, Soon-Duck
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.54-62
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    • 1987
  • This study was performed as a part of survey for the operation and interim evaluation of the on-going pilot project of community health in Jeomdong-Myon, Yeoju-Gun, Kyunggi-Province since 1982. Seven Villages (Ri) were selected purposively for the survey from a total of 26 villages in Jeomdong-Myon, target area, under the consideration of the socio-economic background and the distribution of health resources. The target population was the women in age group of 15-44 years in that area and a total of 156 women were interviewed. This study was done by the interview survey using questionnaire which was composed with questions about MCH and FP. The results were as follows; 1) ln the status of maternal health, (1) the proportion of receiving antenatal care was relatively high (67.1%) in this area, but the starting time of antenatal care was delayed to 7 months or more of gestational period in 22 percent. Therefore some intervention would be necessary for advancing the time of antenatal care. (2) The proportion of home delivery was decreased according to the rank of birth-order. And more than 50 percent of delivery attendants were mothers-in-law or neighbors. The fact indicates that the health education for non-professional delivery attendents would be necessary for improving home delivery and the content of education would be preferable to focussing to the method of hygienic delivery attending. (3) The comprehensive health service and education would be recommended for the postnatal care, because of the extremely low rate of postnatal care in this area. 2) In the status of child health, (1) the pro-portion of breast feeding was 90.2 percent, and the weaning started after 12 months of birth in 12.7 percent. This indicates the necessity of education about the weaning program. (2) The proportion of completed basic vaccination was 39.6% and the main reason of missing vaccination was poor accessibility in terms of time. For that, the supply of vaccine to primary health care units (health subcenters) should be continuous, not infrequent nor occassional. 3) The proportion of respondants who were using contraceptive methods currently was 79.8 percent and in 44.7 percent they accepted the permanent contraceptive methods. Those results are distinct in this area. But it seems a serious health problem that 53.2 percent of respondants were experienced the induced abortion for birth control.

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The Prenatal and Postnatal Incidence of Congenital Anomalies of the Kidneys and Urinary Tract (CAKUT) Detected by Ultrasound

  • Choi, Hyun Ah;Lee, Dong Jun;Shin, Son Moon;Lee, Yeon Kyung;Ko, Sun Young;Park, Sung Won
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.29-32
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    • 2016
  • Purpose: Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common anomalies identified in newborns. This study aims to demonstrate the prevalence of CAKUT including hydronephrosis diagnosed by antenatal and postnatal ultrasound over a five-year period. Methods: The records of births between May $1^{st}$, 2009 and April $30^{th}$, 2014 at our hospital were collected. The number of infants who underwent renal ultrasound after birth for the detection of CAKUT was counted. The incidence of each type of CAKUT such as hydronephrosis, size abnormality, horseshoe kidney, and Multicystic dysplastic kidney (MCDK) was retrospectively evaluated for antenatal screening and postnatal follow-up examination. Results: During the study period, 33,276 infants were born and 521 neonates underwent postnatal renal ultrasound. 183 cases of CAKUT were detected prenatally and 140 postnatally using ultrasonographic examinations at the following time: (i) 3-7 days postnatally in 123 newborns (87.9%), (ii) during 1-3 months in 11 newborns (7.9%), and (iii) later than 3 months in 6 newborns (4.3%). Among diagnosed CAKUT, hydronephrosis was the most common anomaly with 113 newborns diagnosed prenatally and 46 postnatally. Duplex kidney was the second most common anomaly followed by horseshoe kidney, simple cysts in the kidney and so on. Conclusion: The detection of CAKUT is an important part of the prenatal ultrasound. This study analyzed the prevalence of CAKUT detected on prenatal screening and compared the results to those detected postnatally. Prenatal ultrasound screening fulfills the needs of postnatal examinations and therefore, both antenatal and postnatal sonographic investigations are of vital importance for diagnosis of renal and urinary tract anomalies.

Clinical Implication of Surgically treated Abdominoperineal Soild Tumor in the Newborn : A Single-Center Experience

  • Cho, Yong-Hoon;Kim, Soo-Hong;Kim, Hae-Young;Han, Young-Mi;Lee, Na-Rae;Bae, Mi-Hye;Park, Kyung-Hee;Byun, Shin-Yun
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.23-28
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    • 2018
  • Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

The Effects of Sophrologic Prenatal Education Program in Community Health Centers (일개 보건소의 소프롤로지 식 분만교육의 효과)

  • Kim, Jung-Soon;Kim, Yoon-Hee;Kim, Young-Seon;Kim, Bock-Ja;Lee, Jung-Hee;Kim, Myoung-Soo
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.598-607
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    • 2003
  • Purpose: The purpose of this study was to identify the effects of the Sophrologic Prenatal Education Program. Method: The subjects of this study were 16 antepartum women who had been registered at community health centers at S-gu in Pusan. Data were collected from women who visited for antenatal care during the period from the 7th of May to 28th of June in 2003. Participants were evaluated before and on completion of the 8 weeks' educational program using 3 instruments: Breast-feeding knowlege, Maternal-fetal attachment and Antenatal stress. The Wilcoxon Signed-Ranks Test was conducted for data analysis using SPSS/WIN 10.0. Results: Statistically significant difference was found between the pretest and posttest in the mean score of the Breast-feeding knowledge. The mean scores of the experiment group and the control group were $31.44{\pm}5.51\;and\;37.06{\pm}4.27$ respectively (p=.001). No statistically significant difference was found between the pretest and posttest in the mean score of the Maternal-fetal attachment (p=.315, p=.578). Conclusions: Community health care providers must consider the emotional needs of Korean people and make efforts to adapt the Sophrologie Prenatal Education Program for a larger number of antepartum women in community.

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A case of Bartter syndrome type I with atypical presentations

  • Lee, Eun-Hye;Heo, Ju-Sun;Lee, Hyun-Kyung;Han, Kyung-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.809-813
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    • 2010
  • Bartter syndrome (BS) is an autosomal recessively inherited rare renal tubular disorder characterized by hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism with normal to low blood pressure due to a renal loss of sodium. Genetically, BS is classified into 5 subtypes according to the underlying genetic defects, and BS is clinically categorized into antenatal BS and classical BS according to onset age. BS type I is caused by loss-of-function mutations in the $SLC12A1$ gene and usually manifests as antenatal BS. This report concerns a male patient with compound heterozygous missense mutations on $SLC12A1$ (p.C436Y and p.L560P) and atypical clinical and laboratory features. The patient had low urinary sodium and chloride levels without definite metabolic alkalosis until the age of 32 months, which led to confusion between BS and nephrogenic diabetes insipidus (NDI). In addition, the clinical onset of the patient was far beyond the neonatal period. Genetic study eventually led to the diagnosis of BS type I. The low urinary sodium and chloride concentrations may be caused by secondary NDI, and the later onset may suggest the existence of a genotype-phenotype correlation. In summary, BS type I may have phenotype variability including low urine sodium and chloride levels and later onset. A definitive diagnosis can be confirmed by genetic testing.