• 제목/요약/키워드: Pregnancy and delivery

검색결과 472건 처리시간 0.032초

일지역 임신부의 스트레스 요인 및 상황과 간호중재에 대한 기초연구 (A Pilot study of stressor and stress situation and Nursing Intervention of Pregnant Women)

  • 안황란
    • 대한간호학회지
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    • 제13권3호
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    • pp.75-85
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    • 1983
  • This study was done to research the relationship between general characteristics and stressor, stress situation, Nursing Intervention of pregnant woman. The subjects for this study were 70 pregnant woman from 3 clinics of Obstetrics and Gynecology located in J city. The data was collected through questionaires which was developed by Norman J. Chestnut. The content of the questionaire consist of following 3 categories; (1) stressor (2) stress situation (3) Mental and Physical support of husband. Analysis of data was done by use percentage, x²-test. (through EDPS) The findings of this study are as follows; 1, Stressors of pregnant woman are stresses associated with fetus, socioeconomic problem, herself, delivery, abortion and prematureity, husband, change of appearances, management of home, a woman's parents-in-law. Stress situations of pregnant woman are when she is doing on the heavy management of home, limit of life, socioeconomic discomfort, taking medicine, difficult relationship with a woman's parents-in-law, being sign of abortion and prematurity, her physical discomfort, family desire of delivery of son baby. 2. Husband's mental support that pregnant woman desired are careful husband's role, More love and interest about pregnant, cooperation of child reaing, maintenance of healthy life, understaning of diffical pregnancy, early return home, giving up drinking, positive feeling about changed appearance, unconcern about sex of fetus. And husband's mental supports that pregnant woman desired are cooperating of homework and childrearing, limit of intercouse, release behavior of pregnant woman's physical discern-fort, a walk, behavior with pregnancy together, socioeconomic stability. 3. Stressor of pregnant woman was significant with education, number of son, economic status, personality of husband, dowelling. (P<.05) And stress situation of pregnant woman was significant with personality of husband, dwelling, husband's desired sex .of baby. (P<.05) 4. Husband's mental and physical supports that pregnant woman desired was significant with number of daughter. (P<.05).

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플립드 러닝을 적용한 '임신, 분만 및 산욕간호' 수업경험: 혼합연구 (Class Experience of the Students on 『Pregnancy, Delivery and Puerperium』 Nursing Course through Flipped Learning: Mixed Method Research)

  • 이병주;황선영
    • 여성건강간호학회지
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    • 제22권4호
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    • pp.221-232
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    • 2016
  • Purpose: The purpose of this study was to examine the applicability of a flipped learning course in Women's Health Nursing for nursing students. Methods: A total of 200 senior nursing students participated in flipped learning class of pregnancy, delivery and postpartum area, which included team-based learning and self-reflection for 8 weeks. One group pre-post test design was adopted and the changes in learning motivation and satisfaction were examined. In addition, reflective journals of the students were analyzed by making a qualitative content analysis. Results: Students showed a significant increase in score of learning motivation in the posttest (t=-4.47, p<.001). They had a mean of 3.90 in learning satisfaction out of possible five points. As a result of content analysis, three themes were selected: 'Improved attitude toward active learning', 'Burden caused by excessive workload', and 'Valuing to the team-based activity' To be specific, six sub-themes were selected, with three positive and three negative categories: 'improved class attention and understanding', 'positive class participation by preparing lessons in advance', 'peer interactions through discussion', 'A lot of time and effort consuming', 'stress caused by the burden of preparing lessons', and 'difficulties in cooperative activities'. Conclusion: This study supports and confirms that the flipped learning can be a creative instructional model of positive teaching-learning strategy in clinical nursing courses to enhance students' learning motivation.

Fetal Growth Rate and Determination of Weaning Time for Adoption of Kittens in Free-Roaming Cats

  • Kang, Yeon-Jeong;Kim, Ill-Hwa;Kang, Hyun-Gu
    • 한국임상수의학회지
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    • 제34권1호
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    • pp.34-38
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    • 2017
  • The aims of the present study were to determine the weaning time for adoption of kittens, and to evaluate the fetal growth rate during pregnant in free-roaming cats. This study was conducted on three pregnant free-roaming cats (one feral cat and two stray cats). Radiography and ultrasonography were performed on the feral cat and on one of the stray cats. In the feral cat, fetal head diameter was measured once during pregnancy to determine the cesarean section (C-sec) time. In the stray cat, serial fetal head diameter was measured from capture to parturition. The body weight of the feral cat's kittens was measured from 4 weeks postpartum because of their wildness. That of the stray cats' kittens was measured immediately after birth. In the feral cat, scheduled C-sec was performed at predicted parturition day by measurement of head diameter, and six healthy kittens were delivered. The stray cats had five and six kittens by natural delivery, respectively. In the body weight gain of feral and stray cat's kittens, two female kittens of the feral cat lost weight rapidly after they were separated from their mother, so they were returned to their mother for 1 more week. After that, the female kittens grew up without difficulty. Body weight gain of the ten kittens born to the two stray cats consistently increased, by approximately 14 g every day, until they were adopted. The body weight of kittens born by natural delivery was on average 77.5 g greater than that of kittens born by C-sec. However, the gap decreased with time. During the stray cat's pregnancy, fetal head diameter increased by 0.042 cm every day. Maximum head size before parturition was 2.43 cm. These results indicate that the weaning time for adoption of kittens was 5-week-old postpartum.

조기 파막 저체중아 분만의 관련 모성 요인 (Maternal Factors Associated with the Premature Rupture of Membrane in the Low Birth Weight Infant Deliveries)

  • 이강숙;이원철;맹광호;이충훈;김수평
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.207-216
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    • 1988
  • Premature rupture of membrane is the most frequent cause of low birth weight infant delivery which increase the maternal and fetal morbidity and perinatal mortality. A retrospective case-control study was performed on 315 mothers who delivered low birth weight infants($\leq$2.5kg) with premature rupture of membrane and as control group 546 mothers who delivered normal birth weight infants(2.9-3.7kg) without premature rupture of membrane were chosen. The results obtained from this study were as follows: 1. The proportion of low birth weight infants due to premature rupture of membrane among all low birth weight infant deliveries was 14.5%, and this is equivalent to 1.1% among all deliveries. 2. The most significant maternal risk factor of low birth weight infant deliveries with premature rupture of membrane was infections on vagina, cervix and uterus during pregnancy. Compared with control, adjusted odds ratio was 7.61(95% confidence interval(CI) 1.88-30.88, p=0.004). Other significant maternal risk factors were the history of induced abortion, spontaneous abortion, and the experience of premature delivery. The risk ratios were 1.82, 2.07, 4.42, respectively. 3. Breech presentation did increase the risk of low birth weight infant delivery with premature rupture of membrane compared with control(Adjusted Odds ratio=2.66, 95% CI 1.35-5.26, p=0.005). 4. Mothers who had not taken antenatal care were having higher risk of low birth weight infant delivery with premature rupture of membrane against control(Adjusted odds ratio=1.73, 95% CI 1.19-2.53, p=0.004). These study results show that maternal factors such as the infection of genital organs during pregnancy, the history of induced abortion and breech presentation are significantly associated with the premature rupture of membrane in the low birth weight deliveries, and that most of these risk factors are controllable ones through proper antenatal cares.

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사람면역결핍바이러스 수직감염 예방치료 3례 (Three Cases of Prevention Therapy to Reduce Perinatal HIV Transmission)

  • 이재요;박향미;황세희;김경은;신혜정;김재윤
    • Pediatric Infection and Vaccine
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    • 제18권1호
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    • pp.85-90
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    • 2011
  • The Joint United Nations Programme on HIV/AIDS (UNAIDS)의 통계에 의하면 2008년 한 해에 43만 명의 어린이가 HIV 에 감염된 것으로 보이며 대부분 수직감염에 의한 것으로 나타났다. 수직감염의 예방 프로그램은 이러한 감염을 줄일 수 있는 가장 효과적인 방법이다. 2009년 국립중앙의료원에는 HIV에 감염된 산모로부터 출생한 신생아 3명이 입원하였다. 이들의 산모 2명은 ARV 치료제를 투여하였고 1명은 투여하지 못했으며 3명의 환아에게는 모두 ARV 치료를 하였다. 추적관찰을 4개월에서 16개월 동안 실시한 결과 아직까지는 HIV 수직감염이 의심될 수 있는 혈청학적 검사의 특이 소견은 보이지 않고 있다. 임산부에 대한 HIV 산전검사의 확대, 조기진단 및 효과적인 ARV 치료만이 수직감염을 낮출 수 있을 것이며 저자는 이에 대한 수직감염 예방치료 3례를 경험하였기에 보고하는 바이다.

효과적인 산전관리를 위한 고객관계관리(CRM)의 도입 (The Application of Customer Relationship Management for the Effective Prenatal Care)

  • 신숙;백수경;강성홍;김유미
    • 한국병원경영학회지
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    • 제10권1호
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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산후우울증의 심리사회적 위험요인 (Psychosocial Risk Factors of Postpartum Depression)

  • 박시성;한귀원
    • 정신신체의학
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    • 제7권1호
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    • pp.124-133
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    • 1999
  • 연구목적 : 산후우울증은 여러 요인이 관여하여 발생하며, 이들 위험요인에는 다양한 심리사회적 요인이 포함된다. 이전의 여러 연구결과들을 통해 산후우울증의 위험요인이 알려지고 있지만 아직까지 국내에서 산후우울증을 대상으로 위험요인을 연구한 경우는 별로 없다. 본 연구는 국내에서 산후우울증의 심리사회적 위험요인으로는 어떤 것이 있는지를 알아보기 위하여 시행되었다. 방법 : 일신기독병원을 방문한 출산 후 약 6~8주에 있는 산모 119명을 대상으로 하였다. 설문지를 이용하여 산후우울증의 위험요인에 대하여 조사하고 산후우울의 정도를 측정하였다. 설문지는 이전 연구들을 통해 알려진 위험요인들을 참고하고 산모들의 스트레스와 관계되는 요인들을 추가하여 작성하였다. 산후 우울증을 평가하기 위해 EPDS(Edinburgh postnatal depression scale)를 번안해서 사용하였고, 산후우울의 정도는 측정된 EPDS 접수에 따라 판단하였다. 결과 : 총 대상 산모 119명 중 EPDS에 의해 산후우울증으로 진단될 수 있는 고위험군은 16명으로, 13.45%의 빈도를 보였다. 고위험군에서는 과거 우울증상을 경험한 경우와 결혼생활에 대한 만족도가 낮은 경우가 저위험군에 비해 유의하게 많았다, 또 과거 우울증상을 경험하였던 군, 임신중 우울과 불안증상을 경험한 군, 임신 및 산욕기동안 스트레스 생활사를 경험하였다고 보고한 군, 결혼생활에 대한 만족도가 낮은 군, 그리고 나이가 많을수록 EPDS 접수가 유의하게 높았다. 반면, 산모의 교육수준, 종교, 직업의 유무, 임신과 출산에 따른 직업중단 희망임신 여부 분만방법 수유방법, 유아의 입원여부, 그리고 기대했던 유아의 성별 및 실제 유아의 성별은 우울증상에 영향을 미치지 않았다. 결론 : 이상의 결과로 볼 때 산후우울증은 산후에 비교적 높은 빈도로 발생 가능하며, 우울증의 과거력, 임신동안 우울과 불안증상의 경험, 스트레스 생활사, 결혼생활에 대한 낮은 만족도, 그리고 산모의 연령과 같은 요소들이 산후우울증의 위험요인이었다. 임신과 산욕기 동안 산모에 대하여 적절히 정신의학적으로 개입함으로서 조기에 산후우울증을 발견하고 치료할 수 있으며, 산후우울증으로 인하여 산모와 유아에게 미치는 다양한 손실을 예방할 수 있을 것으로 생각된다.

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인공수정시술주기에서 내인성 LH, GnRH Agonist 및 hCG를 이용한 배란유발후 임신율의 비교연구 (Comparison of Pregnancy Rates by Intrauterine Insemination after Ovulation Trigger with Endogenous LH Surge, GnRH Agonist or hCG in Stimulated Cycles)

  • 이종인;허영문;전은숙;윤정임;정구성;홍기언;유승환;이현숙;홍정의;이지삼
    • Clinical and Experimental Reproductive Medicine
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    • 제26권3호
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    • pp.389-398
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    • 1999
  • Objective: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days starting on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG $5,000{\sim}10,000$ IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol ($E_2$) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. Conclusion: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.

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The impact of COVID-19 on human reproduction and directions for fertility treatment during the pandemic

  • Lee, Dayong
    • Clinical and Experimental Reproductive Medicine
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    • 제48권4호
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    • pp.273-282
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    • 2021
  • Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, resulting in a pandemic. The virus enters host cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2). These enzymes are widely expressed in reproductive organs; hence, coronavirus disease 2019 (COVID-19) could also impact human reproduction. Current evidence suggests that sperm cells may provide an inadequate environment for the virus to penetrate and spread. Oocytes within antral follicles are surrounded by cumulus cells, which rarely express ACE2 and TMPRSS2. Thus, the possibility of transmission of the virus through sexual intercourse and assisted reproductive techniques seems unlikely. Early human embryos express coronavirus entry receptors and proteases, implying that human embryos are potentially vulnerable to SARS-CoV-2 in the early stages of development. Data on the expression of ACE2 and TMPRSS2 in the human endometrium are sparse. Moreover, it remains unclear whether SARS-CoV-2 directly affects the embryo and its implantation. A study of the effect of SARS-CoV-2 on pregnancy showed an increase in preterm delivery. Thus, vertical transmission of the virus from mother to fetus in the third trimester is possible, and further data on human reproduction are required to establish this possibility. Based on analyses of existing data, major organizations in this field have published guidelines on the treatment of infertility. Regarding these guidelines, despite the COVID-19 pandemic, reproductive treatment is crucial for the well-being of society and must be continued under suitable regulations and good standard laboratory practice protocols.

출산여성의 산후관리수행의 관련요인 (Related Factors to Postpartum Care Performance in Postpartum Women)

  • 김증임
    • 여성건강간호학회지
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    • 제13권2호
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    • pp.98-104
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    • 2007
  • Purpose: The purpose of this study was to explore the barriers and the enhancing factors and predictors to postpartum care performance. Methods: The Research design in this study was a cross-sectional correlational survey. Subjects were 145 women at 6 to 10 weeks post delivery at an OB & GY clinic. Data was gathered with postpartum care performance, and other related variables including emotional status during pregnancy, fatigue, health recovery status, maternal role and identity. Data was analyzed using the SPSS WIN(version 11.0) program. Results: The mean score of postpartum care performance was 3.08 of 5, it had significant differences in emotional status during pregnancy, coincidence of expected sex, health recovery status, postpartum fatigue and postpartum depression. The maternal role and health recovery status were enhancing factors of postpartum care performance. Also, the barrier factors were fatigue, depression and coincidence of expected sex. Among these factors, the present health recovery status had an predictability of 11.7%, postpartum fatigue 3.2%, and coincidence of expected sex 2.5%, for a total predictability factor of 17.4% on postpartum care performance. Conclusion: Among these related factors to postpartum care performance, present health recovery status was the most predictable factor and then postpartum fatigue, and coincidence of expected sex. We need to establish a strategy to reduce postpartum fatigue and implement nursing interventions for health related consequences in postpartum women.

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