• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.64-76
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• 1970

This report will present a clinical and statistical analysis of 210 case of Ectopic pregnancies who were treated at the Department of Obstetrics and Gynecology at Chung Nam Medical Center from January, 1966 to March, 1970. The results obtained are as follows; 1. The total number of Ectopic pregnancies was 8.22%. 2. The occurrence of Ectopic pregnancy was high in June(13.81%), low in October(2.98%). There was a higher occurrence of Ectopic pregnancy in the summer than in the winter. 3. The average age of all patients was 33.25 years. The most frequent age for this type of pregnancy was 31-35 years (32.86%) . The youngest patient was 18 years old and the oldest was 50. 4. Multipara occurred in 82.38% of the cases; Mulipara in 17. 62% and the occurrence of primipara was especially high, 20.95%. 5. 48.09% of the women had previously experienced normal deliveries; 42.8% had received artificial abortions and 5.23% had experienced spontaneous abortions. 3.8% had a previous history of Ectopic pregnancy. It was found that the occurrence of Ectopic pregnancy was more frequent in those women who had a D & C in the Past. 6. The average length of infertility was 21.7 months. The shortest length was 60 days; longest period of infertility was 19 years. 7. The occurrence of Ectopic pregnancy is higher (29.27%) in patient who have experienced only one previous D & C. The total number of patients who received a D & C was 58.57%. 3. Ectopic symptoms appeared during the first 4.7 weeks (mean) and most frequently occurred between the 5th and 6th weeks (48.57%) of pregnancy. The Symptoms were: -99.04% complained of lower abdominal pains. -80.95% experienced abnormal uttering bleeding. -42.38% experienced bleeding before the occurrence of pain. -18.57% experienced pain before the occurrence of bleeding. -8.57% experienced both pain and bleeding. -7.62% experienced only bleeding. -22.86% experienced only pain. 9. In-77.62% of the cases the annexal mass palpated. 91.42% complained of abdominal tenderness. 42.38% complained of pain when the cervix was examined. 10. Culdocentesis was performed in 86.19% of the cases. In 92.82% of the cases the presence of an Ectopic pregnancy was accurately diagnosed 11. 71.90% of the Ectopic pregnancies occurred in the ampule portion of the ovarian tube, of the total number of gestations, 40.95% were tubal abortions and 59.05% were ruptured. The ruptured group occurred more frequently in the islamic portion and interstitial portion of the tube than the aborted group. The aborted group occurred more frequently in the fimbrial extremities of the tube. 12. The blood pressure (systolic) was noted at 119-80mmHg in 81.89% of the total cases. Hemoglobin value was noted at over 8gm/㎗ in 58.57% of the cases. The average blood transfusion was 2.3 pints. 13. In 52.86% of the Ectopic pregnancies the right side of the ovarian tube was affected. The left side of the tube was affected in 47.14% of the cases. 14. 3.33% of the patients were not given an accurate diagnosis. 15. The kinds of operation performed were as follows; Salpingectomy, 41.43%; Adnectomy, 38.57% and Adnectomy with total hysterectomy, 19.05%. 16. The patient mortality rate was significantly small; only 1 case out of 210 died. This patient most likely had a profuse hemorrhage because of a ruptured tube before her admission to the hospital. 17. The patients personal feelings and attitudes must be treated with care. Particularly patients who are concerned about vaginal bleeding or the impossibility of another pregnancy.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.2
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• pp.331-338
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• 2004

Folate nutrition in early pregnancy is crucial in order to prevent neural tube defects (NTDs) in the fetus and maternal folate deficiency in late pregnancy If the influencing factors on maternal folate status are identified we may be able to detect the women at most risk of folate deficiency. This study intends to determine folate intakes, assess the levels of serum folate, erythrocyte folate, and plasma homocysteine, and reveal theinfluencing factors on maternal folate status in early pregnancy. A total of 151 healthy women in their first trimester volunteered for this study. The average length of gestation period was 9.1$\pm$ 2.3 weeks and seventy subjects were primipara. They consumed 1599$\pm$589 ㎉/day of energy and 230.8$\pm$145.2 $\mu\textrm{g}$/day of folate. This represented 72.5％ and 46.2％ of the Korean RDA respectively for pregnant women in the first half of Pregnancy. Results show that they consume less folate and energy due to morning sickness. Morning sickness correlated negatively with the intakes of energy, folate, ana Kimchi also. Their levels of serum folate, erythrocyte folate, and plasma homocysteine were 5.5$\pm$1.9 ng/mL, 266.6$\pm$75.0 ng/mL, and 7.0$\pm$1.8 $\mu$mol/L, respectively. Results indicate that 7.8% were deficient and 60.3% were borderline deficient in serum folate, 4.3% were deficient in erythrocyte folate, however, all had normal levels of plasma homocysteine. Results indicate that the folate status was not poor Contributing factors influencing serum folate concentrations ($R^2$= 0.724, p = 0.0001) were self-reported health status (+), folate intake (+), age (-), length of gestation (-), and homocysteine levels (-). Factors influencing erythrocyte folate concentrations ($R^2$ = 0.570, p = 0.0029) were the infant birth height of the last pregnancy (+), energy intake (+), age (-), plasma homocysteine concentration (-), and education level (-). Factors influencing plasma homocysteine concentrations ($R^2$= 0.450, p = 0.0051) were income level (+), prepregnancy weight (+), serum folate concentration (-), and the infant birth weight of the last pregnancy (-). These results indicate that pregnant women are likely to have a folate deficiency if they are in poor health status, having a history of delivering small infant and low energy and/or folate intake, and/or are older. And folate status is likely to decline as pregnancy progresses.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.249-260
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• 1986

Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows : 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent(60.2%). 3. The most common indications for cesarean section were previous cesarean section(30.2%), CPD (26.9%), Malpresentation(22.7%), and fetal distress(3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion(31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499gm was the most prevalent(39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most(97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7%. Among the causes of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin, and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased(44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbity of lower segment transverse cesarean section was the least(14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.293-299
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• 1986

Obstetric problems concerning macrosomia were evaluated by retrospective review of 91 pregancies that resulted in the delivery of an infant weighing 4,000gm or more at the Yeungnam University Hospital during 3 1/2 years from Jun. 1983 to Oct. 1986. The results obtained were as follows. 1. Macrosomic infants weighing 4.000gm or more occured in 2.8% of the deliveries. 2. 65.9% of macrosomic infants and 53.5% of total infants were male. The ratio of male was statistically higher in the macrosomic infants than in the total infants(P<0.05). 3. The incidence of macrosomia was higher with increasing qestational age, and deliveries at 42 weeks or more gestation were more common in the macrosomic infants than in the total infants(P<0.01). 4. The incidence of macrosomia was highter with increasing parity, and stastically higher in the multipara than in the primipara(P<0.01). 5. There was no difference in the incidence of macrosomia between the mothers aged 24 or less and that of 30 or more. 6. The cesarean section rate of macrosomia(30.8%) was stastically higher than that of the total infants(15.7%)(P<0.01) 7. With the pregnacy and delivery of macrosomic infants, 22 antepartum anemia(24.2%), 10 postpartum hemorrhage(11.0%), 9 birth canal injury(10.0%), 7 prolonged second stage of labor (7.7%), 4 breech presentation, and 3 pregancy induced hypertension occured in the mothers, and 10 asphyxia(or Apgar score 6 or less), 2 shoulder dystocia, 1 intrauterine fetal death, and 1 sacrococcygeal teratoma occured in the infants.

• 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.