• 제목/요약/키워드: Obstetric complication

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산과적 합병증과 유전적 위험도가 정신분열증 환자의 뇌구조에 미치는 영향 : 전산화단층촬영 소견에 의한 연구 (Effects of Obstetric Complications and Genetic Risk on Brain Structures in Schizophrenic Patients)

  • 정영기;김정훈
    • 생물정신의학
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    • 제3권2호
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    • pp.211-215
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    • 1996
  • The present study investigated the associations between CT measures and obstetric complications and family history of major mental illnesses. We had the hypothesis of diosthesis-stress model in the etiology of schizophrenia. We had the following findings. 1) Family history of major mental illnesses is inversely related to obstetric complications. 2) Prefrontal sulcal widening and family history of schizophrenia. are inversely related. 3) In female but not in male patients those with family history of schizophrenia tended to have less prefrontal sulcal widening and ventricular brain ratio. These results suggest that more genetic factors contribute to structural brain abnormalities in female than in male patients.

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산모에서 요부 경막외 차단후 발생한 편측 호너 증후군과 상지마비 -증례 보고- (Unilateral Horner's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient)

  • 장연;조은정;김정태;박수석;이재희
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.285-290
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    • 1997
  • Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

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Pregnancy and Neonatal Outcomes of Group B Streptococcus Infection in Preterm Births

  • Lee, Yae Heun;Lee, Yoo Jung;Jung, Sun Young;Kim, Suk Young;Son, Dong Woo;Seo, Il Hye
    • Perinatology
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    • 제29권4호
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    • pp.147-152
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    • 2018
  • Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.

유방수술 후 발생한 견관절 기능장애와 상지 저림에 대한 치험 2례 (Traditional Korean Medicine Management of Complications of Breast Surgery - A Case Report of Complications After Breast Surgery)

  • 권지명;김동철
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.176-186
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    • 2010
  • Purpose: To review the effectiveness affecting to the shoulder functionalities and upper numbness by Traditional Korean Medical treatment who are given a surgical operation for breast resection by breast tumor Method: To report the patients with dysfunction of shoulder joint and numbness in upper limb after breast surgery who improved by Traditional Korean Medical treatment and to study Traditional Korean Medicine(TKM) management of complications of breast surgery. Results: After about 2weeks treatment, patient's symptoms and signs were improved. TKM management was effective in recovery of shoulder function and upper limb numbness after breast surgery. Conclusion: We need to actively participate in management of complications of breast surgery as adjuvant therapy. And more study is needed for developing Traditional Korean Medical indication of complications of breast surgery.

지역별 분만서비스 접근도에 따른 산과적 합병증 비교 (Obstetric Complications by the Accessibility to Local Obstetric Service)

  • 최영현;나백주;이진용;황지혜;임남구;이성기
    • 농촌의학ㆍ지역보건
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    • 제38권1호
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    • pp.14-24
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    • 2013
  • 이 연구는 건강보험공단으로부터 획득한 2001년부터 2008년까지 전국 232개 시군구 지역의 분만 및 합병증 청구 자료를 바탕으로 산모가 자신의 거주 지역 내 외에서 출산하는 비율과 산과적 합병증과의 관련성을 밝히기 위한 생태학적 연구이다. 산모가 본인의 거주 지역 밖에서 출산하는 비율인 관외분만율은 정도에 따라 저도 관외분만율 지역, 중등도 관외분만율 지역, 고도 관외분만율 지역으로 범주화하였으며, 산과적 합병증은 '유산, 자궁외 임신 및 기태임신에 따른 합병증율', '유산율', '자간증율'을 구하였다. 관외분만율에 따른 산과적 합병증의 일원배치 분산분석에서 저도 및 중등도 관외분만율 지역보다 고도 관외분만율 지역이 '유산, 자궁외 임신 및 기태임신에 따른 합병증율'과 '자간증율'이 통계적으로 의미있게 증가하는 경향을 보였고(p<0.05), 산과적 합병증 각각을 종속변수로 한 다중선형회귀분석에서 '유산, 자궁외 임신 및 기태임신에 따른 합병증율'은 고도 관외분만율 지역(분만서비스 접근 취약지역)이 기타 지역보다 유의하게 높은 것으로 나타났으며(p<0.01), '자간증율'은 고도 관외분만율 지역에서 그리고 1인당 지방세납입액이 낮은 지역에서 더 높은 것으로 나타났다(p<0.01). 이 연구를 통해 분만서비스 접근 취약지역에 거주하는 산모에서 산과적 합병증이 높음을 나타냈고 따라서 이에 대한 적절한 대책이 세워져야 할 필요성을 시사하고 있다. 특히 응급 대응 및 산전관리의 충실성을 높이기 위한 체계적인 대안이 정책적으로 고려되어야 함을 보여주고 있다. 한편 이 연구는 시군구를 분석 단위로 한 생태학적 연구이므로 산전관리 수진 및 산과적 합병증 발생에 영향을 미치는 개인수준에서의 요인들까지 고려되지 못한 점은 이 연구의 한계점으로 가지고 있다. 따라서 추후 산전관리 및 산과적 합병증에 영향을 미치는 산모 개인수준에서의 요인들까지 고려한 후속연구가 필요하겠다.

A Case-Control Study on the Predictors of Neonatal Near-Miss: Implications for Public Health Policy and Practice

  • Johnson, Avita Rose;Sunny, Sobin;Nikitha, Ramola;Thimmaiah, Sulekha;Rao, Suman P.N.
    • Neonatal Medicine
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    • 제28권3호
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    • pp.124-132
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    • 2021
  • Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

조산원 분만을 선택한 여성의 특성, 선택동기 및 출산경험 조사 (Characteristics, Motivation of Choice and Childbirth Experience of Women Who Selected Delivery at Midwifery Clinic)

  • 이선희;이미옥
    • 부모자녀건강학회지
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    • 제16권1호
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    • pp.1-10
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    • 2013
  • Purpose: This study is descriptive research to identify characteristics and childbirth experience of women who selected delivery with midwives. Methods: The research methods included structured questionnaires, open questions and charts and data were collected from March 2009 to May 2010 at one midwifery clinic. The 108 data of primipara and multipara were analyzed using descriptive statistics and grouping in same meaning. Results: The general characteristics of participants were age of 31~35, housewife, college or university graduate, religion 'yes', and economic state 'middle'. The obstetric characteristics of participants were abortion rate of 23.1%, none complication to pregnancy and delivery of 97.2%, and none postpartum complication. This study was analyzed using positive experiences of 3 categories, that is 'comfortable and natural childbirth', 'satisfaction and trust to personal care of midwives', and 'experience of baby-and-family-centered childbirth' and negative experiences of 3 categories, that is 'improvement of healthcare environment', 'insufficient facilities and nursing care', and'burden of cost'. Conclusion: This study is significant, since it investigates in the absence of domestic research on the characteristics of women who delivered at midwifery clinic. Thus, this study provided basic data on the characteristics of women who delivered at midwifery clinic.

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자폐스펙트럼장애와 지적 장애의 산과적 합병증 및 임상적 특성의 차이 (Differences of Obstetric Complications and Clinical Characteristics between Autism Spectrum Disorder and Intellectual Disability)

  • 이슬비;김지용;정희정;김성우;임우영;송정은
    • 정신신체의학
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    • 제24권2호
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    • pp.165-173
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    • 2016
  • 연구목적 자폐스펙트럼장애에 대한 인식이 높아지면서 진단을 위해 병원에 방문하는 영유아가 늘고 있고 조기 진단을 통한 조기 개입의 중요성이 부각되고 있다. 그러나, 자폐스펙트럼장애 환자가 처음 병원을 방문하게 되는 주 문제가 대부분 발달 지연이기 때문에 지적 장애와의 진단적 구별이 어렵다. 본 연구는 1) 자폐스펙트럼장애와 지적 장애 아동의 인구학적, 임상적 특성 및 산과적 합병증을 비교하고, 2) 초진 시 지적 장애로 진단을 받은 아동 중 재 방문 시 진단이 바뀐 아동과 진단이 유지된 아동의 특징을 비교하고자 한다. 방 법 2001년 5월부터 2014년 12월까지 국민건강보험 일산병원 발달지연클리닉에 내원한 아동 중 자폐스펙트럼 장애나 지적 장애로 진단된 816명의 아동을 대상으로 하였다. 부모 면담을 통해 인구학적, 산과적 합병증에 대해 조사하였다. 인지 평가를 위해 한국 베일리 영유아 발달검사와 한국 웩슬러 유아 지능검사를 시행했고 언어평가를 위해 영유아 언어 발달검사와 취학전 아동 수용언어 표현언어 발달척도I를 시행하였다. 1차 방문에서 자폐스펙트럼장애와 지적 장애로 진단된 아동의 특성을 비교하였고, 1차 방문 시 지적 장애로 진단된 아동 중 2차 방문 시 진단이 자폐스펙트럼장애로 바뀐 아동과 지적 장애로 유지된 아동의 특성을 분석 하였다. 결 과 1차 방문 시 자폐스펙트럼장애와 지적 장애로 진단 받은 아동을 비교한 결과 자폐스펙트럼장애에서 남아의 비율이 높고 산과적 합병증은 적었다. 또한, 자폐스펙트럼장애 아동이 지적 장애 아동에 비해 언어 평가상 전체 수행이 저조 하였고 특히 수용언어발달지수가 더욱 저조하였다. 1차 방문 시 지적 장애로 진단 받은 아동 중 2차 방문 시 진단이 자폐스펙트럼 장애로 바뀐 아동은 모두 남아였고, 지적 장애로 진단이 유지된 아동에 비해 발달 지연의 가족력(family history)이 많았다. 언어 평가 결과에서는 자폐스펙트럼 장애로 진단이 바뀐 아동에서 1차 내원 때 시행한 언어평가에서 수용언어지수가 더 낮은 점수를 보였다. 결 론 이러한 결과를 통해 성별, 언어평가 결과, 산과적 합병증 여부가 자폐스펙트럼장애의 조기 진단에 도움을 줄 수 있음을 알 수 있다.

저출생 체중아 분마에 대한 임상적 고찰 (Clinical Observation on Delivery of Low Birth Weight Unfant)

  • 송선호;최의순
    • 여성건강간호학회지
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    • 제5권2호
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    • pp.191-203
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    • 1999
  • A clinical study was made on 365 low birth weight infant and 406 normal birth weight infant who had been born at Kangnam St. mary's Hospital during past 3 years from Jan. 1, 1995 to Dec. 31, 1997. the data of this study were gathered through reviewing of medical records. 1. Comparison of general characteristic with of obstetric characteristic 1) Old maternal age, previous abortion and previous LBWI delivery in the group of low birth weight infant(LBWI) mother were more prevalent than those in the group of normal birth weight infant(NBWI)mother 2) Cesarean section, abnormal presentation and multiple pregnancy in the group of LBWI mother were prevalent than those in the group of NBWI mother. 3) regular antenartal care and visiting rate of tertiary hospital in the group of LBWI mother were more prevalent than those in the group of NBWI mother. 2. Frequency of low birth weight infant 1) Anmual average frequency of LBWI was 6.5% and monthly frequency was the highest in January and december. 2) The frequency of LBWI was the highest in 37-40wks of gestational age and was the highest in 2251-2500 gm of birth weight. 3) The frequency of congenital anomaly in the group of LBWI was more prevalent than that of NBWI. 3. Mortality rate of LBWI The mortality rate of LBWI was 9.2%. The highest mortality rate was noted before 27wks of gestational age, less than 1000gm of birth weight and within 12hrs of delivery. 4. The most common complication of pregnant women was pre-term labor, the most complication relating to placenta was premature rupture of membrane(PROM) and the most fetal complication was fetal distress in delivered LBWI. 5. Significant relating factors of low birth weight infant delivery were associated with maternal age, previous delivery, previous low birth weight delivery, pre-eclampsia, anemia, oligohydramnios, PROM, placenta previa, abruptio placenta, fetal sex, fetal distress and congenital anomaly.

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