• Title/Summary/Keyword: Obstetric outcomes

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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.

Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

Obstetric Outcomes in 68 Pregnant Patients with Recurrent Pregnancy Loss on Oreintal Treatment and Analysis of Factors Affecting the Success of Birth (한방치료 후 임신에 성공한 반복 임신손실 환자 68례의 산과적 결과 및 출산 성공 영향 인자의 분석)

  • Ie, Jae-Eun;Heo, Su-Jung;Cho, Hyun-Ju;Moon, Hyon-Ju
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.3
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    • pp.173-183
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    • 2010
  • Purpose: To estimate the effect of oriental treatment on recurrent pregnancy loss, a retrospective analysis was done. Methods: Sixty-eight pregnant women at the $\bigcirc\bigcirc$ oriental clinic, Korea, from January 2005 to May 2009 diagnosed as recurrent pregnancy loss were included in this study. The sixty-eight patients received oriental treatment such as acupuncture, moxibution, herbal acupuncture and herbal prescriptions, divided into two groups: Group A- live birth(N=58) and Group B- abortion(N=10). The maternal age, parity, menstrual history, gynecological history and period of treatment were compared. To find out factors affecting the success of birth, we performed binary logistic regression analysis(SPSS ver. 14.0 for windows). Results: The live birth rate was 85.3%. The maternal age, parity, menstrual history, gynecological history and period of treatment were not different between two groups. Logistic regression analysis showed that the significant factors predicting the occurrence of miscarriage were advanced maternal age(${\geq}35$)(P=0.005, Odds Ratio[OR]=3.809, 95% Confidence Interval[95%CI]: 1.514-9.585) and suffering from gynecological problems(P=0.044, OR=4.048, 95%CI: 1.037-15.801). Conclusions: The results suggest that oriental treatment has effectiveness on recurrent pregnancy loss. Further study will be needed.

Construction of the Nursing Diagnosis Ontology in Obstetric and Gynecologic Nursing Unit using Nursing Process and SNOMED CT (산부인과 간호단위의 간호과정과 SNOMED CT를 이용한 간호진단 온톨로지의 구축)

  • Park, Jeong-Eun;Chung, Kwi-Ae;Cho, Hune;Kim, Hwa Sun
    • Women's Health Nursing
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    • v.19 no.1
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    • pp.1-12
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    • 2013
  • Purpose: This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. Methods: The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. Results: One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. Conclusion: Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.

Comparison of neonatal outcomes between the spontaneous and in vitro fertilization twin pregnancies (인공수정 및 자연수정으로 태어난 쌍생아간 임상 양상 비교)

  • Kim, Hee Moon;Lee, Jeong Won;Shin, Seon Hee;Kim, Sung Koo;Sung, Tae Jung
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.740-745
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    • 2007
  • Purpose : There is a dominant opinion that in vitro fertilization (IVF) leads to an increased incidence of twins, low birth weight (LBW) infants, prematurity and mortality. On the other hand, technical development of IVF and improvement of neonatal intensive care have increased the survival rate of neonates. The purpose of this study was to verify the tendency by comparing the clinical aspects of IVF and spontaneously conceived twins, and to establish methods to increase the survival rate of neonates after IVF. Methods : Retrospective reviews were performed on all twin infants who were admitted to the nursery and NICU at Kangnam Sacred Heart Hospital, Hallym University from January 1, 2000 to December 31, 2006. Medical records of IVF twins (study group, n=92) and spontaneously conceived twins (control group, n=265) were analyzed and compared. Neonatal outcomes and complications, as well as obstetric outcomes, were analyzed and compared. Results : Mean gestational age and birth weight of the study group ($34.6{\pm}3.5$ weeks, $2,203.9{\pm}617.2g$) were considerably lower than those of the control group ($36.3{\pm}2.4$ weeks, $2,367.0{\pm}517.9g$). The frequency of prematurity less than 37 weeks (68.5% vs 51.3%) and extremely LBW (15.2% vs 6.4%) were also significantly higher in the study group. Other neonatal outcomes were all insignificant. The obstetric characteristics, maternal age ($32.6{\pm}3.3$ years vs $30.3{\pm}3.9$ years) and the frequency of cesarean delivery(95.7% vs 79.9%) were significantly higher in the study group. Other obstetric outcomes were insignificant except for the frequency of incompetent internal os of cervix (36.2% vs 3.6%) and cerclage operation (38.3% vs 4.3%). Conclusion : Based on the above results, clinical outcomes of twin infants will be further improved by careful attention and thorough antenatal care of the IVF twins.

Maternal and fetal outcomes of pregnancies in kidney donors: A 30-year comparative analysis of matched non-donors in a single center

  • Yoo, Kyung Don;Lee, Hajeong;Kim, Yaerim;Park, Sehoon;Park, Joong Shin;Hong, Joon Seok;Jeong, Chang Wook;Kim, Hyeon Hoe;Lee, Jung Pyo;Kim, Dong Ki;Oh, Kook-Hwan;Joo, Kwon Wook;Kim, Yon Su
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.356-365
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    • 2018
  • Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

Comparison of nutrient intake, life style variables, and pregnancy outcomes by the depression degree of pregnant women

  • Bae, Hyun-Sook;Kim, Sun-Young;Ahn, Hong-Seok;Cho, Yeon-Kyung
    • Nutrition Research and Practice
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    • v.4 no.4
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    • pp.323-331
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    • 2010
  • The aim of this study was to analyse effects that the degree of depression have on the life style variables, nutrient intake, iron indices and pregnancy outcome. Subjects were 114 pregnant women who were receiving prenatal care at a hospital in Seoul. We collected data for general characteristics and lifestyle variables from general survey instrument and for depression score from the questionnaire on depression. Dietary intakes of subjects were estimated by 24 hour dietary recall method. Also we analysed iron indices and pregnancy outcomes. We classified subjects by 10 point, which was the average depression score, into two groups [Low depression score group (LS) : High depression score group (HS)]. As to the intakes of total calcium, plant-calcium, plant-iron, potassium, total folate and dietary folate, LS group was far higher than HS group (P < 0.05, P < 0.05, P < 0.01, P < 0.001, P < 0.05, and P < 0.01, respectively). As to pre-pregnancy alcohol drinking, LS group had 41.9% in non-drinker, which was far higher than 28% in HS group in non-drinker (P < 0.05). As for drinking coffee during pre-pregnancy, pregnant women who don’ drink coffee in LS group took 43.6%, which was higher than 38% in HS group (P < 0.01). Regarding delivery type, the cesarean section in LS group (18%) was significantly lower than that in HS group (45%) (P < 0.01). Bivariate analysis showed that birth weight was significantly associated with the gestational age (P < 0.01). The pregnant women with higher depression score tended to have undesirable life habit, which might affect negative pregnancy outcomes. A better understanding of how depression and intake of nutrients work together to modulate behavior will be benefit nutritional research.

Outcome of Twin Pregnancies after Selective Fetal Reduction (선택적 유산술에 의한 쌍태임신의 예후에 관한 연구)

  • Seo, Seong-Seog;Jo, Mi-Yeong;Kim, Mi-Ran;Hwang, Kyung-Joo;Kim, Young-Ah;Ryu, Hee-Sug
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.85-93
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    • 2003
  • Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

Simulation Nursing Education Research Topics Trends Using Text Network Analysis (텍스트네트워크분석을 적용하여 탐색한 국내 시뮬레이션간호교육 연구주제 동향)

  • Park, Chan Sook
    • Journal of East-West Nursing Research
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    • v.26 no.2
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    • pp.118-129
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    • 2020
  • Purpose: The purpose of this study was to analyze the topic trend of domestic simulation nursing education research using text network analysis(TNA). Methods: This study was conducted in four steps. TNA was performed using the NetMiner (version 4.4.1) program. Firstly, 245 articles from 4 databases (RISS, KCI, KISS, DBpia) published from 2008 to 2018, were collected. Secondly, keyword-forms were unified and representative words were selected. Thirdly, co-occurrence matrices of keywords with a frequency of 2 or higher were generated. Finally, social network-related measures-indices of degree centrality and betweenness centrality-were obtained. The topic trend over time was visualized as a sociogram and presented. Results: 178 author keywords were extracted. Keywords with high degree centrality were "Nursing student", "Clinical competency", "Knowledge", "Critical thinking", "Communication", and "Problem-solving ability." Keywords with high betweenness centrality were "CPR", "Knowledge", "Attitude", "Self-efficacy", "Performance ability", and "Nurse." Over time, the topic trends on simulation nursing education have diversified. For example, topics such as "Neonatal nursing", "Obstetric nursing", "Pediatric nursing", "Blood transfusion", "Community visit nursing", and "Core basic nursing skill" appeared. The core-topics that emerged only recently (2017-2018) were "High-fidelity", "Heart arrest", "Clinical judgment", "Reflection", "Core basic nursing skill." Conclusion: Although simulation nursing education research has been increasing, it is necessary to continue studies on integrated simulation learning designs based on various nursing settings. Additionally, in simulation nursing education, research is required not only on learner-centered educational outcomes, but also factors that influence educational outcomes from the perspective of the instructors.

A Retrospective Analysis on Pregnant Patients Visiting Korean Gynecology Clinic of Korean Medicine Hospital (임신 중 일개 한방병원 한방부인과에 내원한 환자에 대한 후향적 분석)

  • Cho, Si-Yoon;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.4
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    • pp.111-130
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    • 2021
  • Objectives: The purpose of this study was to identify the current status of Korean medicine clinical practice for pregnant patients. Methods: The study is conducted by searching medical records of 209 pregnant patients using Korean Standard Classification of Diseases related pregnancy at the Korean Gynecology Clinic of traditional Korean medicine hospital from March 1, 2016 to February 28, 2021. We retrospectively investigated characteristics, symptoms, pregnancy outcomes of the patients and treatments for the patients. Results: The most frequent symptoms of pregnant patients were musculoskeletal symptoms (60.63%) followed by neuropsychiatric symptoms (14.55%) and genital symptoms (10.82%). The most common contributory factor of the symptoms was the motor vehicle accident (74.64%). Acupuncture (94.94%) and moxibustion (90.91%) were performed to most pregnant patients. Cupping (86.60%), herbal medicine (52.63%), Chuna therapy (30.62%), and pharmacopuncture (21.05%) were performed to the patients. Normal pregnancy maintenance and delivery were reported by 147 patients (91.30%). Premature birth was reported by 11 patients (6.83%), and miscarriage was reported by 3 patients (1.86%). Conclusions: Most patients were the patients with musculoskeletal symptoms injured by motor vehicle accidents. Various Korean medicine treatments were performed during pregnancy with safety outcomes. This study could be used as basic data to provide instructions for the development of traditional Korean medicine in the obstetric clinical fields.