• Title/Summary/Keyword: Premature rupture

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

  • Lee, Kang-Sook;Lee, Won-Chul;Meng, Kwang-Ho;Lee, Choong-Hoon;Kim, Soo-Pyung
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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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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Pterional or Subfrontal Access for Proximal Vascular Control in Anterior Interhemispheric Approach for Ruptured Pericallosal Artery Aneurysms at Risk of Premature Rupture

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.250-256
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    • 2017
  • Objective : Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. Methods : A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture. The proximal control is then switched to the pericallosal artery just proximal to the aneurysm and its intermittent clipping facilitates complete aneurysm dissection and neck clipping. Results : Three such cases are reported : a ruptured pericallosal artery aneurysm with a contained leak of the contrast from the proximal side of the aneurysm, a low-lying ruptured pericallosal artery aneurysm with irregularities on its proximal wall, and a multilobulated ruptured pericallosal artery aneurysm with the parasagittal bridging veins hindering surgical access to the proximal parent artery. In each case, the proposed combined pterional-interhemispheric or subfrontal-interhemispheric approach was successfully performed to establish proximal vascular control far from the ruptured aneurysm and facilitated aneurysm clipping via the interhemispheric approach. Conclusion : When using an anterior interhemispheric approach for a ruptured pericallosal artery aneurysm with a high risk of premature rupture, a pterional or subfrontal approach can be combined to establish early proximal vascular control at the bilateral A1 segments or the origin of the A2 segment.

Interpregnancy Interval and Adverse Birth Outcome in Term Premature Rupture of Membrane, 2017

  • Workineh, Yinager;Ayalew, Emiru;Debalkie, Megbaru
    • The Korean Journal of Food & Health Convergence
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    • v.5 no.2
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    • pp.1-11
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    • 2019
  • The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.

Surgical Complications and Its Management in Intracranial Aneurysm (두개강내 뇌동맥류에서 수술적 합병증 및 치료)

  • Han, Jong Woo;Hwang, Soo Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1113-1120
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    • 2000
  • Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

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Management of Persistent Pulmonary Hypertension in Preterm Infants

  • Lee, Byong Sop
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.1-6
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    • 2021
  • Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

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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    • v.29 no.4
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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.

An Urinoma in a Premature Infant with Renal Cadidiasis (신칸디다증에 합병된 요낭종 1 례)

  • Kim Yae-Jean;Kim Jung-Eun;Yoo Eun-Sun;Park Eun-Ae;Lee Sun-Wha;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.195-197
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    • 1997
  • An urinoma(uriniferous pseudocyst, pararenal pseudocyst) denotes an encapsulated collection of urine in the perirenal or paraureteral space. It was usually reported in relation to trauma and acquired obstructive uropathy but rarely reported in renal infection including renal candidiasis. The mechanism is believed due to rupture of fornix through weakened portion of suppurated kidney and pyelosinus backflow by increased intrapelvic pressure in obstructive uropathy and fungus ball obstruction. We report a case of urinoma in a premature as the first case in Korea which developed as a complication of renal candidiasis.

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Ruptured uterus in a 36-week pregnant patient with hemorrhagic shock after blunt trauma in Korea: a case report

  • Sebeom Jeon;Suyoung Park;Soohyun Oh;Jayun Cho
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.281-285
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    • 2023
  • Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.

Premature Failure Prevention design of Three-way Catalyst Substrate using DOE (실험계획법을 이용한 삼원촉매담체의 조기 파손 예방 설계)

  • Lee, Dong-Woo;Cho, Seok-Swoo
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.7
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    • pp.101-108
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    • 2010
  • Domestic three-way catalyst satisfies exhaust gas conversion efficiency or pressure drop etc. but doesn't satisfy thermal durability. Thermal stress analysis for three-way catalyst was performed based on experimental temperature distribution. Thermal safety of three-way catalyst was estimated by safety factor. Aspect ratio variable had the most significant effect on thermal stress. Thickness variable had the least significant effect on thermal stress. Optimal conditions for premature failure prevention of three-way catalyst were as follows : (1) aspect ratio of three-way catalyst : 0.6:1 (2) 2.84mm thick (3) silicon nitride. The safety of Taguchi-optimized three-way catalyst were 4.7 times higher than that of existent three-way catalyst.