• Title/Summary/Keyword: Preterm labor

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Visualization of unstructured personal narratives of perterm birth using text network analysis (텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.205-212
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    • 2020
  • Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis

  • Yoo, Hyeji;Ahn, Sukhee
    • Women's Health Nursing
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    • v.27 no.3
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    • pp.180-195
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    • 2021
  • Purpose: This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor. Methods: The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality. Results: Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges' g=-0.67; 95% confidence interval [CI], -0.91 to -0.44), gestational diabetes (Hedges' g=-0.38; 95% CI, -0.54 to -0.12), and preterm labor (Hedges' g=-0.73; 95% CI, -1.00 to -0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias. Conclusion: Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

Effects of Abdominal Breathing on Anxiety, Blood Pressure, Peripheral Skin Temperature and Saturation Oxygen of Pregnant Women in Preterm Labor (복식호흡이 조기진통 임부의 불안, 혈압, 말초 피부온도와 산소 포화도에 미치는 효과)

  • Chang, Soon-Bok;Kim, Hee-Sook;Ko, Yun-Hee;Bae, Choon-Hee;An, Sung-Eun
    • Women's Health Nursing
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    • v.15 no.1
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    • pp.32-42
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    • 2009
  • Purpose: This study was done to examine the effects of abdominal breathing on VAS-Anxiety (VAS-A), blood pressure, peripheral skin temperature and saturation oxygen in pregnant women in preterm labor. Method: The study design was a matched control group interrupted time series. Forty-six women matched to gestational age were assigned to either the experimental group (26) or control group (20). Data were collected between March 2007 and May 2008. For the experimental treatment the women performed abdominal breathing 30 times, which took 5 minutes, and did one set of 5-minute abdominal breathing daily for three days. Data collection was done before and after the abdominal breathing to measure VAS-A, blood pressure, peripheral skin temperature and oxygen saturation. Descriptive, $X^2$, Mann-Whitney U tests were used to analyze the data with the SPSS/PC+Win 15.0 program. Result: For the experimental group there were significant decreases in VAS-A (Z=-4.37, p=.00), systolic blood pressure (Z=-3.38, p=.00), and an increase in skin temperature (Z=-4.50, p=.00) and oxygen saturation (Z=-3.66, p=.00). Conclusion: These findings suggest that abdominal breathing in pregnant women in preterm labor results in decreases in anxiety(VAS-A) including biological evidences such as systolic blood pressure, and increases in peripheral skin temperature and oxygen saturation. Further longitudinal study is needed on the lasting effects and obstetric and neonatal outcomes following abdominal breathing.

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Placental histopathology in late preterm infants: clinical implications

  • Ericksen, Kristina;Fogel, Joshua;Verma, Rita P.
    • Clinical and Experimental Pediatrics
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    • v.63 no.2
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    • pp.48-51
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    • 2020
  • Background: The etiopathogenesis of late preterm (LPT) birth is undetermined. Placental histopathology, which reflects an adverse intrauterine environment and is reportedly associated with preterm labor and neonatal morbidities, has not been studied in LPT infants. Purpose: We investigated placental pathological lesion as markers of an adverse intrauterine environment during LPT labor. Methods: This retrospective case-control study compared placental histopathological and clinical variables between LPT and term neonates. Placental variables included chorioamnionitis, funisitis, hemorrhage, abruption, infarction, calcification, and syncytial knots. Maternal variables included age, substance abuse, pregnancyassociated diabetes mellitus and hypertension, duration of rupture of membrane, antibiotic use, and magnesium sulfate, whereas, those of neonates included gestational age, birth weight, race, sex, and Apgar scores. Standard statistical proedures were applied to analyze the data. Results: Chorioamnionitis (50% vs. 17.8%, P<0.001) and funisitis (20% vs. 4.4%, P=0.002) were more common in term infants. Placental infarction rate was insignificantly higher in LPT infants (25.6% vs. 14.3%, P=0.08). The mothers in the LPT group were older (30.4 years vs. 28.1 years, P=0.05; odds ratio [OR], 1.06; 95% confidence interval [CI], 0.998-1.12, P=0.056) and more often suffered from hypertension (28.9 vs. 12.9 %, P=0.02), and received magnesium sulfate (48.9 vs. 20%, P< 0.001; OR, 2.86; 95% CI, 1.12-7.29, P<0.05). Duration of rupture of membrane was higher in term infants (13.6 hours vs. 9.1 hours, P<0.001). Chorioamnionitis (OR, 0.33; 95% CI, 0.13-0.79; P<0.05) was associated with a lower risk of LPT delivery. Conclusion: Placental infection is not a risk factor for LPT births. There is a nonsignificant predominance of vascular anomalies in LPT placentas. Higher maternal age, magnesium sulfate therapy, and maternal hypertension are clinical risk factors for LPT labor.

Prevention of Preterm Birth and Management of Uterine Contraction with Traditional Korean Medicine (조산 방지 및 자궁수축 관리의 한의학적 치료)

  • Kim, Eun-Seop;Jang, Eun-Ha;Kim, Nam-Hyoung;Jan, Sae-Byul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.4
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    • pp.24-33
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    • 2016
  • Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of Preterm Birth (PTB). Methods: It is a case report of a 38 year-old-woman hospitalized for irregular uterine contractions and cervical change at 33+3/7weeks of gestation. After 7 trials of IVF and artificial insemination, conception was successful via IVF with help of traditional Korean medicines. 2 TKMs were prescribed: Gami-danggui-san, and Antae-eum. 120 ml of Gami-danggui-san was given twice a day morning and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: As of 34+2/7 weeks of gestation, intermittent uterine contractions appeared (5-12 min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: Our report implies the potential of herbal medicine as a adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

Cystatin C as a novel predictor of preterm labor in severe preeclampsia

  • Wattanavaekin, Krittanont;Kitporntheranunt, Maethaphan;Kreepala, Chatchai
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.338-346
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    • 2018
  • Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

Management of Preterm Labor (조기 진통의 처치)

  • Park, Yoon-Ki
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.141-154
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    • 1999
  • Premature birth is the single largest cause of perinatal mortality and morbidity nonanomalous infants in developing countries. Advances in neonatal care have lead to increase survival and reduced short and long term morbidity for preterm infants, but the rate of preter birth has actually increased. This review provides recent multifactorial approaches to treatme and prevention of preterm birth.

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Influence of Fatigue, Depression and Anxiety on Quality of Life in Pregnant Women with Preterm Labor (조기진통 임부의 피로, 우울과 불안이 삶의 질에 미치는 영향)

  • Kang, Hyuna;Nho, Ju-Hee;Kang, Hyejin;Lee, Soojin;Lee, Hwangmi;Choi, Sunsook
    • Women's Health Nursing
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    • v.22 no.4
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    • pp.254-263
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    • 2016
  • Purpose: The purpose of this study was to identify effects of fatigue, depression and anxiety on quality of life in pregnant women with preterm labor. Methods: With a survey design, data were collected from 138 mothers who were admitted at a hospital in Seoul, between June 2014 and September 2015. Instruments used to collect the data for the study were: Fatigue Continuum Form, Depression anxiety stress scale (DASS-21) and maternal postpartum quality of life (MAPP-QOL). Results: The mean fatigue score was 68.30 with 50.7% of women being depressed and 79.7% of the 138 women being anxious. The mean quality of life was 18.92 with quality of life being associated with fatigue, depression and anxiety. Depression and fatigue explained 26% of the variance in quality of life. Conclusion: Depression and fatigue adversely affected women's quality of life. It is important to address appropriate management of depression and fatigue in order to improve quality of life in pregnant women with preterm labor.