• Title/Summary/Keyword: Birth Outcomes

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Protocol for management of pregnant patients requiring emergency minor oral surgical procedures: a prospective study in 52 patients

  • Ajinath Nanasaheb Jadhav;Shushma G;Uzma Hamidullah Siddiqui;Minal Sharma;Yaseer Irfan Shaikh;Pooja Raosaheb Tarte
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.1
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    • pp.21-29
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    • 2023
  • Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

Update of minimally invasive surfactant therapy

  • Shim, Gyu-Hong
    • Clinical and Experimental Pediatrics
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    • v.60 no.9
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    • pp.273-281
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    • 2017
  • To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

The Relationship between the Infant Birth Weight and the Body Weight Gain during Pregnancy of Women in the Taegu Area (임신부 체중증가와 신생아 체중과의 관계)

  • 정효지;김은정;최봉순;최경호;신정자;윤성도
    • Journal of the East Asian Society of Dietary Life
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    • v.10 no.6
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    • pp.522-529
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    • 2000
  • This study was carried out to find the factors which are related to the weight gain during pregnancy of women and infant birth weight. The information of the general characteristics and pregnancy outcomes of the 506 women who had a delivery during Jan to Dec, 1997 in a hospital at Taegu area were collected from the medical records. The results are as follows. The mean age of the subjects was 29 years old and the average prepregnancy weight was 52.75kg. They gained 13.51kg of weight during the pregnancy. The weight gain during pregnancy was higher in prepregnancy BMI<20kg/m$^2$, the infant weight was heavier in groups that had over 14kg of weight gain during the pregnancy than other groups. The prepregnancy BMI was negatively correlated to weight gain during pregnancy(r=0.2825), and positively correlated to number of pregnancy(r=0.2146), number of living delivery(r=0.1409), and infant weight(r=0.1250). The baby weight was Positively correlated to weight gain during pregnancy(r=0.1392) and Apgar score(r=0.1627). The results showed that the prepregnancy BMI and weight gain during pregnancy may be the influential factors on the infant weight, thus we need to develop the specific nutritional management program according to the status of prepregnancy weight.

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Angiotensin receptor blocker induced fetopathy: two case reports and literature review

  • Jinwoon Joung;Heeyeon Cho
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.121-126
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    • 2023
  • The administration of angiotensin type 2 receptor blockers (ARBs) during pregnancy is known to cause ARB fetopathy, including renal insufficiency. We aimed to analyze the outcomes of two patients who survived ARB fetopathy and perform an accompanying literature review. Case 1 was exposed antenatally from a gestational age of 30 weeks to valsartan because of maternal pregnancy-induced hypertension. The patient presented with oliguria immediately after birth, and renal replacement therapy was administered for 24 days. Seven years after birth, renal function was indicative of stage 2 chronic kidney disease (CKD) with impaired urinary concentration. Case 2 had a maternal history of hypertension and transient ischemic attack and was treated with olmesartan until 30 weeks of pregnancy. Renal replacement therapy was performed for 4 days since birth. After 8 years, the patient is with CKD stage 2, with intact tubular function. Recent reports suggest that ARB fetopathy might manifest as renal tubular dysgenesis and nephrogenic diabetes insipidus, in contrast to mild alterations of glomerular filtration. Tubular dysfunction may induce CKD progression and growth retardation. Patients with ARB fetopathy should be monitored until adulthood. The ARB exposure period might be a critical factor in determining the severity and manifestations of fetopathy.

Nutritional strategy of early amino acid administration in very low birth weight infants

  • Lee, Byong Sop
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.77-83
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    • 2015
  • Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental outcomes. Although the minimum starting amino acid (AA) dose to prevent negative nitrogen balance is well established, the upper limit and the rate of increase of early AA doses are controversial. Most randomized controlled trials show that early and high-dose (target, 3.5 to 4.9 g/kg/day) AA regimens, with or without high nonprotein calories, do not improve long-term growth and neurodevelopment. High-dose AA supplementation may lead to early metabolic disturbances and excessive or disproportionate plasma AA levels, particularly in infants of very low gestational age. Further large studies are needed to clarify the optimal strategy for early administration of parenteral AA doses in VLBW infants.

The Roles of the National Health Insurance Service in the Public Health Security (건강보장과 국민건강보험공단의 역할)

  • Kim, Yong-Ik
    • Health Policy and Management
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    • v.28 no.3
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    • pp.210-216
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    • 2018
  • National Health Insurance Service (NHIS) has put a great effort on extending life expectancy, for last 40 years. The system has also made remarkable outcomes in achieving universal health coverage. However, it is facing challenges of low health insurance benefits and sustainability risk due to low birth rate and aging society at the same time. To overcome the difficulties and build a lifelong health security system for the nation, it is required for NHIS to make multilateral changes in its roles. Based on the quantitative growth achieved so far, NHIS needs to strive for the growth in quality by not only increasing coverage and reforming contribution imposition system, but also reorganizing the relevant systems such as lifelong health management support, rational adjustment to the medical fee, and benefit costs monitoring. In addition, it's important for NHIS to restructure the organizational culture by having specialty and communicating with people for high quality of administration and health insurance sustainability.

Effects of Birth Control Empowerment Program for Married Immigrant Vietnamese Women in South Korea

  • Kim, Jihyun;Kim, Nam Cho
    • Women's Health Nursing
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    • v.23 no.1
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    • pp.1-10
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    • 2017
  • Purpose: Aims of the researchers were to develop an birth control empowerment program (BCEP) designed to help married immigrant women in Korea to plan their pregnancies. Methods: This study was as a randomized controlled trial to verify the effects of the BCEP. The BCEP was developed based on Falk-Rafael (2001)'s Empowerment caring model. The program was offered once a week, for 90 minutes per session, for a total of 10 weeks. The BCEP incorporated group instruction, group discussion, and counseling. The eligible participants were randomly assigned to either experimental group (n=23) or control group (n=23). Results: Participants in the intervention group had significantly better outcomes in contraceptive knowledge (p<.001), contraceptive self-efficacy (p=.014), perceived contraceptive control (p<.001), sex-related spousal communication (p<.001), and sexual autonomy (p=.009). Conclusion: The BCEP was effective intervention method, which can promote family planning practices among married immigrant women.

Preimplantation genetic testing for aneuploidy: The management of mosaic embryos

  • Yu, Eun Jeong;Kim, Min Jee;Park, Eun A;Kang, Inn Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.3
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    • pp.159-167
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    • 2022
  • As the resolution and accuracy of diagnostic techniques for preimplantation genetic testing for aneuploidy (PGT-A) are improving, more mosaic embryos are being identified. Several studies have provided evidence that mosaic embryos have reproductive potential for implantation and healthy live birth. Notably, mosaic embryos with less than 50% aneuploidy have yielded a live birth rate similar to euploid embryos. This concept has led to a major shift in current PGT-A practice, but further evidence and theoretically relevant data are required. Proper guidelines for selecting mosaic embryos suitable for transfer will reduce the number of discarded embryos and increase the chances of successful embryo transfer. We present an updated review of clinical outcomes and practice recommendations for the transfer of mosaic embryos using PGT-A.

Changes of neurodevelopmental outcomes and risk factors of very low birth weight infants below 1,500 g, in the last 10 years (최근 10년간 1,500 g이하 극소 저출생 체중아의 신경학적 위험 요인 및 예후 변화에 관하여)

  • Lee, Se Kyu;Lee, Ji Hyun;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1050-1055
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    • 2006
  • Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.