• 여성건강간호학회지
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• 제17권4호
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• pp.359-368
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• 2011

Purpose: To examine delivery type of mother who have had a previous cesarean and identify maternal factors related to type of delivery. Methods: The study sample included 60,504 mothers who had delivered through cesarean section. Related variables were categorized as sociodemographic factors (age, residence, health insurance type, income level) and clinical characteristics (14 maternal factor, 4 fetal factor and pre-term). For data analysis, $x^2$ and multivariate logistic regression were conducted. Results: Among the 60,504mothers, 3,075 were delivered through Vaginal Birth After C-Section (VBAC) and the VBAC rate was 5.1%. Underage 34, the VBAC rate increased according to age increases up to 3%. Mothers residing in urban areas had VBAC more frequently than mothers in rural area. Mothers in the high and middle income levels had a greater possibility of having VBAC than mothers in lower income levels. A greater likelihood of increase in repeated cesarean section were found in mothers with maternal and fetal factors. Conclusion: Evidence based nursing practice guidelines and education programs for previous cesarean section mothers and health policy are needed to increase VBAC.

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.72-78
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• 1991

척추 마취로 제왕절개술을 받은 건강한 30명의 산모를 대상으로 ephedrine sulfate의 정맥적 주군(15명)과 정맥내 주사군(15명)의 산모혈압과 심박, 오심, 구토, Apgar scores, 산모와 태아의 혈압가스압 등을 비교 관찰하였든바 다음과 같은 결론을 얻었다. 1) 척추마취후 적주군의 수축기 산모혈압은 의의있는 변화가 없었으나(p>0.1), 정주군에는 5, 7분 후 술전치에 비해 통계학적으로 의의있게 하강하였으며(p<0.005), 적주군과의 비교에서도 의의있는 변화를 나타내었다(p<0.001). 2) 적주군에서 정주근보다 오심, 구토의 발생 빈도가 낮았다(p<0.001). 3) 산모의 심박, Apgar scores, 산모와 태아의 혈액 가스압에는 양군간 유의한 차이는 없었다. 이상과 같이 제왕절개술을 위한 척추 마취시 ephedrine의 예방적 정맥내 적주가 안전하고 효과적일 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.249-260
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• 1986

1983년 5월부터 1986년 11월까지 영남대학교 의과대학 부속병원 산부인과에서 제절로 분만한 510예를 대상으로 임상적 관찰분석을 함으로써 다음과 같은 결론을 얻었다. 1. 제절발생빈도는 15.7%였으며 그중 일차제절은 10.9%, 반복제절은 4.7%였으며 제절수술이 점차 증가되는 경향이었다. 2. 연령분포는 26세에서 30세사이의 연령군에서 60.2%로 가장 높은 분포를 보였다. 3. 적응증은 기왕제절 30.2%, 아두골반불균형 26.9%, 이상태위 22.7%의 순이었으며, 일차초산 부제절은 아두골반균형이 일차경산부제절은 이상태위가 가장 많았다. 4. 제절시행 임신주수는 40주에 31.6%로 가장 많았다. 5. 신생아체중분포는 3,000~3,499gm군이 39.8%로 가장 많았으며 미숙아가 9.1%, 거대아는 5.6%였다. 6. 제절술식은 자궁협부횡절개술이 97.5%였다. 7. 제절술시 병행한 수술로는 난관결찰술, 난소낭종제거술, 자궁적출술, 충수제거술, 자궁근종제거술의 순이었다. 8. 마취방법으로 전신마취가 83.5%였다. 9. 모성이환율은 14.7%였으며 그 원인은 창상 감염, 요로감염, 불명열, 산후출혈의 순이었다. 10. 입원당시 빈혈의 정도별 모성이환율은 혈색소치가 10이하인 경우 18.4%의 모성이환율을 보였고, 낮을수록 모성이환율이 증가되었다. 11. 양수파막 24시간이상 경과군에서의 모성이환율이 44.4%였다. 12. 분만진통시간이 12시간이상군에서 24.6%의 모성이환율을 보였고, 진통시간이 길수록 되었다. 13. 자궁협부절개술에서 14.1%로서 가장 낮은 모성이환율을 보였다. 14. 응급수술시행군에서 선택적수술군보다 모성이환율이 2배정도 높았다. 15. 모성사망은 1예도 없었다.

• 대한한방부인과학회지
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• 제26권3호
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• pp.133-142
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• 2013

Objectives: To identify effects and safety of Korean traditional herbal medicine and auricular acupuncture for hyperemesis gravidarum patients. Methods: Korean traditional herbal medicine and auricular acupuncture were applied to 4 hyperemesis gravidarum patients, and we investigated changes of symptoms, continuance of pregnancy, and whether they delivered or not. Results: Hyperemesis gravidarum symptom was improved in 3 patients, and 1 patient showed complete recovery. Among them, 2 patients had children by natural childbirth, 1 patient had a repeat cesarean due to previous cesarean section, and 1 patient has been maintaining pregnancy well for 25weeks. Conclusions: It is confirmed that symptoms of hyperemesis gravidarum patients were improved by Korean traditional herbal medicine and auricular acupuncture, and these medical interventions are safe.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.