• Title/Summary/Keyword: Pregnancy and delivery

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Double Tracheoesophageal Fistula (이중 기관식도루 1예)

  • Huh, Young-Sao;Lee, Hee-Sub;Kim, Geun-Woo
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.68-71
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    • 1996
  • Esophageal atresia(EA) with a double tracheoesophageal fistula(TEF) is rare. It accounts for only 0.7% of all cases of EA and TEF. A male newborn weighing 2860g was born by normal vaginal delivery at 41 weeks' gestation to a 27-year-old mother who had a normal pregnancy. But immediately developed recurrent choking and respiratory distress. Feeding tube was inserted and chest X ray showed the feeding tube coiled in the proximal pouch(T-2 level). With a preoperative diagnosis of EA and distal TEF, the thoracotomy was performed on the third day of life. At thoracotomy, TEF was proved to be a double fistula. Both fistulas were divided and an esophageal anastomosis was performed. The postoperative course was uncomplicated until the eighth postoperative day when a minor anastomotic leak. The patient was discharged at 103 days of age.

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A Case Study on Inferility with Obesity and Polycystic Ovary (다낭성난소 소견을 동반한 비만여성 불임 치험 1례 : 증례보고)

  • Lee, Jae-Sung
    • Journal of Korean Medicine for Obesity Research
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    • v.5 no.1
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    • pp.157-163
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    • 2005
  • Obesity may induce an amenorrhea and ovulation disorder resulted from endocrine dysfunction, and so it is closely linked to infertility. Recently I've experienced a case that a woman complained of infertility with ovulation disorder, polycystic ovary and obesity has succeeded in pregnancy and delivery by the treatment of weight reduction during 2 months.

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The Content Analysis of Childrearing Articles in the Korea Central Daily Newspapers: Focusing on Donga ilbo and Choseun ilbo from 1920's to 1930's (한국신문에 실린 아동양육에 관한 기사내용분석(I) -1920년대와 1930년대의 동아 조선일보를 중심으로-)

  • 신양재
    • Journal of the Korean Home Economics Association
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    • v.30 no.4
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    • pp.249-260
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    • 1992
  • The purpose of this study is to explore the ideas about childrearing represented in the Korean central daily newspapers. the method used for this study is the content analysis and the data are Donga ilbo and Choseun ilbo from 1920's to 1930's. It is found that the contents of childrearing articles were concerned on enlightening childrearing practices during the beginning towentieth century of Korea. They claimed to replace traditional childrearing by western practices in the pregnancy-delivery, nurturing, teaching, disciplining and interfacing between home and institutional education of school. Also, they put great emphasis on changing from an adult-centered manner to a child-centered manner in the childrearing. In conclusion, these articles played an important part as the enlightening instrument trying to bring about intenal reforms in opposition to Japanese imperialism.

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Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.153-173
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    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

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A Field Study on Managing System of Maternity Clinic at Public Health Centers in Seoul (서울시 보건소 모성실 운영실태에 관한 현장 연구)

  • Chung, Yeon-Kang;Kwon, Young-Mi;Kim, Hee-Young
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.259-274
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    • 1995
  • The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.

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A Concept Analysis of the Child-rearing (육아 개념분석)

  • Kim, Soon-Gu;Lee, Young-Mee
    • Korean Parent-Child Health Journal
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    • v.7 no.1
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    • pp.28-37
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    • 2004
  • This study intends to analyse the concept on the child-rearing of parents. Through analysis, several concepts on the child-rearing would be cleared, and therefore the groundwork of the theoretical framework can be constructed. The concepts were analyzed by the method of Walker & Avant(1995). The attribute of child-rearing is as follows; nutrition supply, affectionate mind, caring, growth development supporting, protecting, instructing, pregnancy, delivery etc. The proper child-rearing helps reinforce child development, mother-infant attachment, social disposition, parental-role contentment and family relationship. This study would be helpful to the establishment of child-rearing paradigm. And therethrough this result although helps construct proper child-rearing as well as theoretical groundwork.

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Effect of Prenatal Education Program of Labor and Delivery Experience (분만 체험 산전교육 프로그램 효과)

  • Seong, Chun-Hee;Park, Kyung-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.9
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    • pp.5716-5725
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    • 2014
  • This study examined the effects of a prenatal education program of labor and delivery experience for primigravidas in mid-pregnancy. This investigation was designed as a one group pre-post quasi-experimental study, aiming to determine the effects of prenatal education on anxiety, confidence and knowledge in delivery by demonstrating knowledge and actual situations including understanding labor, breast-feeding, baby care and others, and experiencing the education program. Subjects were collected randomly from an on-line club in D city. The simulation education proceeded for 2 hours a week from April to June, 2014, and there were 6 sessions each in the first and second periods. We included 35 primigravidas who attended all 6 sessions. The data was analyzed using descriptive statistics, exploratory factor analysis and a paired t-test. According to the study results, the subjects showed a significant difference in knowledge in delivery (t=-9.07, p<001), confidence in delivery (t=-9.00, p<001) and anxiety (t=14.39, p<001) after participating in the prenatal education program. An evaluation of satisfaction revealed experience to be the most differentiating factor, and the simulation experience was identified as most effective. The desired appropriate number of class sessions was 4 times, and 88.6% of the pregnant women intended to attend the program at their next birth, indicating a high response rate.

Clinical Study on Prenatal care, and Dietary Intakes for Pregnant Women and new Mothers (임산부의 산전관리와 산욕기 영양실태에 관한 연구)

  • Chia, Soon-Hyang;Park, Chai-Soon
    • Journal of Nutrition and Health
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    • v.9 no.4
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    • pp.36-46
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    • 1976
  • This study was projected to provide basic data on prenatal care for future direction in maternity and child care, and also to investigate the diet of women during pregnancy and the period directly afterwards in order to offer to mothers appropriate advice for the improvement of nutritional standards. A clinical study on prenatal care was based on 1054 delivery cases. A nutritional survey was performed on 174 mothers admitted to the department of obstetrics at St. Mary's Hospital during the period of March, 1975 to February, 1976. The results obtained are summarized as follows; I. Clinical study on prenatal care 1) The age distribution showed 59.4% of the mothers were between the ages of 25 to 29 years old. 2) The gestational period was highest between the 37th and 40th gestational weeks. 33.7% of the mothers were primigravidae and 31.8% of them primiparae. 3) 41.3% of the mothers had not received prenatal care or had only received it once before. 4) Induced deliveries were 61.8% and spontantaneous deliveries 38.2%. 61.9% of the mothers had received prenatal care, while those without prenatal care accounted for 61.6% of the total induced deliveries. 5) Low birth weights were 7.7% and 5.0% of the mothers had received prenatal care, while 11.5% had no prenatal care. 6) There were 1.13% of still births, 0.32% of the mothers had prenatal care and the remainder did not have prenatal care. 7) Of those receiving prenatal care, 2.1% showed in the $0{\sim}3$ Apgar score group, 6.3% in the $4{\sim}6$ Apgar score group, and 91.6% in the $7{\sim}10$ Apgar score group. Among the non-prenatally cared for group 5.0% of the newborns were in the $0{\sim}3$ Apgar score group, 9.7% were in $4{\sim}6$ Apgar score group and 85.3% were in the $7{\sim}10$ Apgar score group. 8) Obstetrical complications were developed in 11.86% of the pregnant women when they were hospitalized. Among the group receiving the prenatal care 8.1% of the mothers had obstetrical complications. In the group without prenatal care 17.16% of the mothers had obstetrical complications. The most common obstetrical complication was malpresentation. 9) The first prenatal care was received between the 37th and 40th gestationl weeks. II. Food intake during pregnancy The following are the results from the questionnaires of the mothers concerning diets during pregnancy; 1) Main meals and snacks In 32.2% of the cases, their main meals during the diet amounted to more than was usually eaten at other times. In 67.8% of the cases, their main meals during the diet were the same as that usually eaten. In 22.4% of the cases, snacks during the diet amounted to more than usually eaten at other times. In 77.6% of the cases, snacks during the diet were the same as usually eaten. 2) Itemized list The mothers made a special effort to include certain items in their diets, the following is a breakdown of those items; a. egg, meat, fish 33.3% b. fruit, vegetables 32.2%. c. milk, fruit juice 18.4% d. cake, bread 2.9% e. nothing special 13.2% 3) Milk 44.8% of the mothers had at least one cup of milk everyday. 33.4% of the mothers had at least one cup of milk on occasion. 15.5% of the mothers did not have any milk. 4) Vitamins 39.7% of the mothers had vitamins everyday. 24.7% of the mothers had vitamins occasionally. 35.6% of the mothers did not have any vitamins. 5) Anemic symptoms 9.2% of the mothers very often had anemic symptoms during pregnancy. 39.1% of the mothers often had anemic symptoms during pregnancy. 51.7% of the mothers did not have anemic symptoms at all. 6) Taboos on food 23% of the mothers recognized 'taboos' on food during pregnancy 27% of the mothers displayed on uncertainty about the 'taboos' on food during pregnancy 50% of the mothers displayed indifference toward the taboos. III. Nutritional survey on the new mothers diet. 1) The diets for new mothers can be divided into four categories, such as general diet, low sodium diet, soft diet and liquid diet. 2) Cooked rice and seaweed soup were the main foods for the new mothers as has been the traditional diet for Korean mothers. 3) The average diet contained 1,783g. And the average consumption of the basic food groups per capita per day was 1,265g for cereals and grains, 456g for meats and legumes, 58g for fruits and vegetables, 0g for milk and fish and 4g for fats and oils. 4) In addition to the 1,783g of food in the main diet there was also 142.8g of food taken as snacks. 5) The average daily consumption of calories and nutrients was 2,697 Kcal and 123.4g for proteins, 44.9g for fats, 718.2mg for calcium, 14mg for iron, 2,101.4 I.U. for vitamin A, 0.43mg for thiamine, 1.02mg for riboflavin, 15.88mg for niacin, 5.26mg for ascorbic acid. When these figures are compared with the recommended allowances for new mothers in Korea, the calories and nutrients taken in were satisfactory. But the intake of minerals and vitamins was below the recommended allowance.

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Factors Affecting Complete Fetal Loss Following Multifetal Pregnancy Reduction (다태임신 감수술 (Multifetal Pregnancy Reduction) 후 완전태아손실에 영향을 미치는 인자)

  • Kim, Hye-Ok;Kim, Mun-Young;Song, Hyun-Jeong;Park, Chan-Woo;Hur, Girl;Kim, Jin-Yeong;Yang, Kwang-Mun;You, Keun-Jae;Song, In-Ok;Jun, Jong-Young;Koong, Mi-Kyoung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.39-45
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    • 2003
  • Objective : To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). Design: Retrospective clinical study. Methods : A total of 256 consecutive treatments of MFPR in IVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. Results: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean ($\pm$SEM) gestational age at delivery was $36.2{\pm}1.0$ and $34.1{\pm}0.5$ weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses -12.07), (p<0.05). Conclusions: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in IVF pregnancy.

The Impact of Delayed Interval Delivery on Neonatal Mortality and Morbidity (지연 분만이 신생아의 사망률과 이환율에 미치는 영향)

  • Lee, Eun-Hee;Sohn, Jin-A;Lee, Ju-Young;Choi, Eun-Jin;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Jun, Jong-Kwan;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.111-116
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    • 2011
  • Purpose: To evaluate the impact of delayed interval delivery on neonatal outcomes. Methods: This was a retrospective study of infants who were born at Seoul National University Hospital by delayed interval delivery from June 2005 to July 2010. Outcomes (neonatal mortality and morbidity) of later babies were compared to those of the first babies and the control group whose gestational ages and birth weights were similar to them. Results: There were 4 twin and 5 triplet pregnancies. The first babies (group 1, n=9) were delivered at $22^{+6}$ to $27^{+5}$ weeks of gestational age, and the later babies (group 2, n=14) were born at $24^{+6}$ to $28^{+0}$ weeks. The mean interval between the first and later deliveries was 10 days, and there was no delay between the second and third deliveries in all triplet pregnancies. There were more small for gestational age (SGA) infants in group 1 than group 2 (66.7% and 21.4% respectively, P=0.03). Two of three babies who died in group 1 were born before 24 weeks of gestational age and expired within a week after birth. The mortality rate of group 2 (7.1%) was lower than group 1 (33.3%), but not significantly (P=0.106). The control group matched to group 2 consisted of 28 infants. There were no significant differences in neonatal mortality and morbidity between the two groups. Conclusion: Although there is a limitation to the number of infants in this study, it suggested that delayed delivery in a multiple pregnancy could decrease the incidence of SGA of the remaining fetuses and that prolonged gestation would not be harmful to those fetuses after birth.