• Title/Summary/Keyword: High-risk Pregnancy

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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.

Effects of Antenatal Depression and Antenatal Characteristics of Pregnant Women on Birth Outcomes: A Prospective Cohort Study (산전우울과 임부의 산전특성이 출산 결과에 미치는 영향: 전향적 코호트 연구)

  • Kim, Hae-Won;Jung, Yeon-Yi
    • Journal of Korean Academy of Nursing
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    • v.42 no.4
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    • pp.477-485
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    • 2012
  • Purpose: This study was done to evaluate the effects of antenatal depression on birth outcomes. Methods: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. Results: Level of antenatal depression was associated with low birth weight ($x^2$=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. Conclusion: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy $BMI{\geq}23kg/M^2$ should be monitored and managed to ensure favorable birth outcomes.

Psychosocial Risk Factors of Postpartum Depression (산후우울증의 심리사회적 위험요인)

  • Park, Si-Sung;Han, Kwi-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.124-133
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    • 1999
  • Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.

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Analysis on the Occurrence Factors of High-Risk Diseases of Pregnant Women by the Degree of Obesity (산모의 비만정도에 따른 고위험 질환 발생요인 분석)

  • Kim, Su-Min;Ye, Soo-Young
    • Journal of the Institute of Convergence Signal Processing
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    • v.19 no.3
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    • pp.118-124
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    • 2018
  • Obecity in pregnancy causes many problems and increases risk of pregnancy complications at the time of childbirth. But there is a lack of comprehensive analysis of factors that are negatively affected during pregnancy. Therefore, this study is intended to analyze seven factors of high-risk maternal diseases by the degree of obesity using body mass index(BMI). We conducted a cross tabulation analysis and regression analysis to analisized relationship between variables : Gestational Hypertension(GH), Gestational Diabetes Mellitus(GDM), Thyroid Stimulation Hormone(TSH), Age, Blood Urea Nitrogen Test(BUN), Total-Cholesterol(T-C), and newborn's weight. As a result, the more the obesity level of mothers increases, the more the proportion of mothers with GH, GDM, TSH increases. And there was a positive relationship between the BMI of mothers and their age, T-C, and Newborn weight, and a negative relationship to the BUN.

High early pregnancy serum 25-hydroxy vitamin D level, within a sub-optimal range, is associated with gestational diabetes mellitus: a prospective cohort study

  • Yong, Heng Yaw;Shariff, Zalilah Mohd;Palaniveloo, Lalitha;Loh, Su Peng;Yusof, Barakatun Nisak Mohd;Rejali, Zulida;Bindels, Jacques;Tee, Yvonne Yee Siang;van der Beek, Eline M.
    • Nutrition Research and Practice
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    • v.16 no.1
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    • pp.120-131
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    • 2022
  • BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association. SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression. RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status. CONCLUSIONS: The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

Partial molar pregnancy and coexisting fetus with Turner syndrome: Case report and literature review

  • Park, Ji Eun;Park, Ji Kwon;Cho, In Ae;Baek, Jong Chul
    • Journal of Genetic Medicine
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    • v.15 no.1
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    • pp.43-47
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    • 2018
  • Partial hydatidiform mole and coexisting fetus is a rare entity with antecedent high risk of maternal and fetal complications, and risk of persistent trophoblastic disease in later life. Here, we report a case of twin pregnancy with live fetus identified as 45,X and normal placenta and another partial mole. Ultrasound scan at 10 weeks showed a hydrops fetus with a focal area of multicystic placenta. The patient underwent chorionic villus sampling and amniocentesis for chromosomal analysis, and the result was 45,X. Based on these finding, the patient then underwent induced abortion. Pathological examination (immunohistochemical staining) of the placenta confirmed the partial mole. This report suggests that careful prenatal ultrasonography and appropriate karyotyping in a molar pregnancy and coexisting fetus enable early diagnosis and may be beneficial for prognosis.

The risk of MTHFR variants, folate and vitamin B$_{12}$ deficiencies and hyperhomocysteinaemia during pregnancy associated with short gestational age and reduced birth weight (임산부에서의 Methylenetetrahydrofolate reductase (MTHFR) 유전자 변이, 엽산 및 비타민 B$_{12}$ 결핍과 고호모시스틴 혈증이 재태기간과 출산아의 체중에 미치는 영향)

  • 박혜숙;김영주;하은희;이화영;장남수;홍윤철;김우경
    • Environmental Mutagens and Carcinogens
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    • v.23 no.1
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    • pp.1-6
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    • 2003
  • The purpose of this study was to evaluate whether the MTHFR variants, folate and vitamin $B_{12}$ deficiencies increase the risk of hyperhomocysteinaemia and adverse pregnancy outcome such as short gestational age or reduced birth weight. Healthy pregnant women (n=136; 24-28 gestational weeks; 20-40 years old), who visited Ewha Womans University Hospital for prenatal care, participated in this study. At the time of delivery, trained nurses recorded the pregnancy outcome from medical chart. We determined maternal MTHFR polymorphisms (C to T subsitution at nucleotide 677) and measured serum homocyteine, vitamin $B_{12}$, and folate concentrations. We compared serum homocysteine level by MTHFR genotype, serum folate and serum vitamin B12 levels using ANOVA. To evaluate the association between serum homocysteine level and pregnancy outcome, we compared the gestational age and birth weight by serum homocysteine levels using multiple regression analysis, adjusting for other potential predictors. Mean level of serum homocysteine was highest among pregnant women of the MTHFR variants with low levels of serum folate and vitamin $B_{12}$. Regarding association with birth outcome, we found the relationship between homocysteine levels and increased gestational age (p=0.03) and reduced birth outcome (p>0.05). Our data demonstrates that serum level of folate and vitamin $B_{12}$ among pregnant women affects significantly serum homocysteine levels, and the genetic polymorphism of MTHFR modulates the relationship between them. However, we did not have conclusive evidence of association between high homocysteine level and adverse pregnancy outcome such as preterm or low birth weight.

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Successful delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a twin pregnancy

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.135-139
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    • 2018
  • There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

Stress and Coping Style of High-risk Pregnant Women's Spouses (고위험 임부 배우자의 스트레스와 대처양상)

  • Lee, Ju-Young;Choi, Euy-Soon
    • Women's Health Nursing
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    • v.16 no.3
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    • pp.234-244
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    • 2010
  • Purpose: This study determined the level of stress and type of coping style of spouses with high-risk pregnant women. Methods: Subjects were 102 spouses with high-risk pregnant women at 6 hospitals in Seoul and Gyeonggi province from January to August, 2009. The tools for this study were stress scale and coping scale. The data were analyzed by t-test, ANOVA, Scheffe's test and Pearson's correlation coefficient. Results: The average score of subjects stress was 2.18 and coping score was 2.46 point out of 4.00. The highest score of stress categories was 2.44 point in emotional problems and the lowest score was 1.72 in communication and support resources. The stress level was significant differences according to length of marriage, number of hospital visits, satisfaction with marriage relationship, hospitalization days and gestational age respectively. Spouses tended to use an active coping style (2.60) rather than a passive coping style (2.31). There were significant differences according to mother's age and gestational age in active coping and educational level in passive coping. Conclusion: Considering the level of stress coping style and characteristics of high-risk pregnant women's spouses, a nursing intervention should be provided to help them alleviate stress and to encourage active coping.

Validity of Referral of High Risk Pregnancy in MCH Center (모자 보건 센터에서의 고위험 산모 의뢰 기준의 타당성)

  • Kim, Gui-Yeon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.146-152
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    • 1989
  • To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

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