• 여성건강간호학회지
• /
• 제15권4호
• /
• pp.353-361
• /
• 2009

Purpose: This study aimed to provide fundamental information about childbirth and antenatal care for pregnancy women and to find differences in mother's antenatal care and delivery service satisfaction between vaginal delivery and cesarean section. Methods: This study was conducted in 4 residential areas and a study sample of 184 postpartum mothers who agreed to collect data. Data was collected from September 1 to October 20 2007 and a structured questionnaire were recruited by the survey. The data was analyzed by t-test and chi-squire test using SPSS/WIN 12.0. Results: There was a significant difference in delivery place between vaginal delivery and cesarean delivery. Only 10.7% of vaginal delivery group delivered in general hospitals, however 24.5% of the cesarean section group delivered in general hospitals. Early antenatal care also showed statistical difference in mode of delivery. 43.5% of vaginal delivery mothers visited hospitals for the detection of pregnancy but 28.3% of cesarean section mothers did that. Vaginal delivery mothers more satisfied with her own delivery method and suggested a vaginal delivery to others. Conclusion: These results suggest that cesarean section mother's sensitivity of early antenatal care was less than vaginal delivery mother. Satisfaction related to delivery care services were higher in the vaginal delivery group.

• Archives of Plastic Surgery
• /
• 제39권5호
• /
• pp.551-555
• /
• 2012

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a $9{\times}6$ cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

• The Korean Journal of Pain
• /
• 제7권2호
• /
• pp.193-198
• /
• 1994

The analgesic efficacy and side-effects of combined continuous epidural infusion of bupivacaine and morphine, in comparison with intramuscular (IM) administration of narcotics, for postoperative pain relief after cesarean section and hysterectomy were evaluated. We divided 60 patients into 4 groups randomly. IM (meperidine) group after cesarean section (Group 1, n = 20); Continuous epidural group after cesarean section (Group 2, n=20); IM (meperidine) group after hysterectomy (Group 3, n=10); Continuous epidural group after hysterectomy (Group 4, n=10). Following each operation, the epidural groups had an epidural catheter placed ($L_{2{\sim}3}$ or $L_{3{\sim}4}$), and a bolus of 1.5mg of morphine was injected, and followed by continuous infusion of 0.3% bupivacaine 2ml/hour and morphine 2.5mg/day for 48 hours. The IM groups had received meperidine 50mg IM injection every 4 hours as needed. We evaluated analgesic efficacy with VAS (visual analogue scale) at 1, 2, 24, 48, and 72 hours after operation. The side-effects (nausea &, vomiting, respiratory depression, pruritus and urinary retention) were evaluated with 4 points scale at day 1, 2, and 3 after operation. The results were as follows 1) The continuous epidural (bupivacaine+morphine) groups were superior to the IM (meperidine) groups with respect to postoperative analgesia at 1, 2, and 24 hours after cesarean section, and at 1, 2, 24, and 48 hours after hysterectomy. 2) Vomiting were more frequent in the epidural groups 2 days after cesarean section. 3) Pruritus was more frequent in the epidural groups 1 and 2 days after cesarean section.

• 가정∙방문간호학회지
• /
• 제8권1호
• /
• pp.38-49
• /
• 2001

The purpose of this study was to evaluate the self care focused home nursing' care outcomes of parturient women following Cesarean sections, The subjects included 56 parturient women following a cesarean section, and they were randomly assigned to an experimental group or a control group, The experimental group included women who were discharged early from the hospital. 4-5 days after having a cesarean section. Home nursing care for the experimental group consisted of stitch removal. wound care and education for parturient women. Home nursing care was provided for 2-3 days after early discharge. The outcomes of self care focused home nursing care were measured by self-care competency. Data collection was done by a self-reported questionnaire and by a telephone interview 2-3 days after discharge from the hospital(control) or after home care (experimental) from December, 20, 1998 to June, 10, 1999. The questionnaire consisted of 25 items on 9 self-care domains. Data was analyzed by a t-test. and as $x^2$-test. The study results were as follows: 1. The general characteristics of both groups were similar except for the total number of pregnancies, and whether or not they wanted the pregnancy at this time. 2. The self-care competency scores for the experimental group receiving self care focused home nursing care were higher than the scores for the control group(t=2.361. $p{\le}.05$). 3. There was no significant difference in the rate of OPD visiting, readmission, or emergency room use between the two groups. We concluded that self care focused home nursing care is effective in promoting the self-care competency of parturient women following Cesarean sections. It is suggested that further study is needed with a larger sample to be able to generalize these results.

• 한국임상수의학회지
• /
• 제24권2호
• /
• pp.160-163
• /
• 2007

Patients often present with spontaneous bleeding, or a bleeding disorder may be discovered when an otherwise healthy dog develops marked bleeding during or after surgery. In this study, we were aimed to elucidate whether the cesarean section in dogs has influence on the coagulation profiles. And we gained the normal data on a panel of screening laboratory tests which allow accurate characterization of a hemostatic defects in dogs. Of the 20 healthy adult dogs, buccal mucosa bleeding time (BMBT) was $83.0{\pm}10.5$ seconds, platelet count was $24.0{\pm}3.5{\times}10^4/{\mu}l$, activated partial thromboplastin time (APTT) was $8.8{\pm}2.0$ seconds, the concentration of fibrinogen was $288.5{\pm}77.9mg/dl$, and the concentration of fibrin degradation products (D-dimer) was <250.0 ng/ml. Coagulation profiles before and after cesarean section of 13 cesarean sectioned dogs were in the normal range and there were no statistical differences in coagulation profiles between normal dogs and cesarean sectioned dogs (p>0.05). The results suggested that labor and cesarean section in healthy dogs did not alter coagulation profiles.

• Journal of Preventive Medicine and Public Health
• /
• 제34권4호
• /
• pp.347-353
• /
• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• Journal of Yeungnam Medical Science
• /
• 제40권2호
• /
• pp.202-206
• /
• 2023

Cesarean scar pregnancy (CSP) is a rare complication that occurs in less than 1% of ectopic pregnancies, and uterine didelphys is one of the rarest uterine forms. We report a successful laparoscopic excision and repair of CSP in a woman with uterine didelphys and a double vagina. A 34-year-old gravida one, para one woman with a history of low transverse cesarean section presented to our hospital with a suspected CSP. She was confirmed to have uterine didelphys with a double vagina during an infertility examination 7 years earlier. Magnetic resonance imaging showed a 2.5-cm gestational sac-like cystic lesion in the lower segment of the right uterus at the cesarean scar. We decided to perform a laparoscopic approach after informing the patient of the surgical procedure. The lower segment of the previous cesarean site was excised with monopolar diathermy to minimize bleeding. We identified the gestational sac in the lower segment of the right uterus, which was evacuated using spoon forceps. The myometrium and serosa of the uterus were sutured layer-by-layer using synthetic absorbable sutures. No remnant gestational tissue was visible on follow-up ultrasonography one month after the surgery. This laparoscopic approach to CSP in a woman with uterine didelphys is an effective and safe method of treatment. In women with uterine anomalies, it is important to confirm the exact location of the gestational sac by preoperative imaging for successful surgery.

• Journal of Yeungnam Medical Science
• /
• 제3권1호
• /
• pp.249-260
• /
• 1986

1983년 5월부터 1986년 11월까지 영남대학교 의과대학 부속병원 산부인과에서 제절로 분만한 510예를 대상으로 임상적 관찰분석을 함으로써 다음과 같은 결론을 얻었다. 1. 제절발생빈도는 15.7%였으며 그중 일차제절은 10.9%, 반복제절은 4.7%였으며 제절수술이 점차 증가되는 경향이었다. 2. 연령분포는 26세에서 30세사이의 연령군에서 60.2%로 가장 높은 분포를 보였다. 3. 적응증은 기왕제절 30.2%, 아두골반불균형 26.9%, 이상태위 22.7%의 순이었으며, 일차초산 부제절은 아두골반균형이 일차경산부제절은 이상태위가 가장 많았다. 4. 제절시행 임신주수는 40주에 31.6%로 가장 많았다. 5. 신생아체중분포는 3,000~3,499gm군이 39.8%로 가장 많았으며 미숙아가 9.1%, 거대아는 5.6%였다. 6. 제절술식은 자궁협부횡절개술이 97.5%였다. 7. 제절술시 병행한 수술로는 난관결찰술, 난소낭종제거술, 자궁적출술, 충수제거술, 자궁근종제거술의 순이었다. 8. 마취방법으로 전신마취가 83.5%였다. 9. 모성이환율은 14.7%였으며 그 원인은 창상 감염, 요로감염, 불명열, 산후출혈의 순이었다. 10. 입원당시 빈혈의 정도별 모성이환율은 혈색소치가 10이하인 경우 18.4%의 모성이환율을 보였고, 낮을수록 모성이환율이 증가되었다. 11. 양수파막 24시간이상 경과군에서의 모성이환율이 44.4%였다. 12. 분만진통시간이 12시간이상군에서 24.6%의 모성이환율을 보였고, 진통시간이 길수록 되었다. 13. 자궁협부절개술에서 14.1%로서 가장 낮은 모성이환율을 보였다. 14. 응급수술시행군에서 선택적수술군보다 모성이환율이 2배정도 높았다. 15. 모성사망은 1예도 없었다.

• 한국간호교육학회지
• /
• 제5권2호
• /
• pp.267-284
• /
• 1999

The purpose of this study are 1. Evaluate the degree of knowledge of Vaginal Birth After Cesarean(VBAC) of Korean nurses. 2. To gather and develop educational material for VBAC. The sample was surveyed Korean Nurses knowledge about VBAC, from November 1998 through March 1999. For the data analysis, the SPSS computer program percentage and frequency were used for descriptive statistics. The x2 and the t-test were used to compare the results of the two sample groups. Open questions asked in the survey were sorted out by content, then displayed in chart form. For the education material, the Internet was the main source of information. Information on the Internet was provided by professional doctors and prenatal educational nurses. The results of the survey are as follows: 1. Out of 97 Nurses 15.3% answered that cesarean deliveries do not need to be performed after previous cesarean sections : however. 46.4% answered that cesarean sections must be performed after previous cesarean sections. 2. Of the nurses surveyed 14% had no knowledge or had never heard of VBAC. 3 Nurses did not have questions from patients concerning VBAC was 34.7%. This led to the conclusion that patients either do not have knowledge about VBAC or patients have no interest in the trial of labor. 4, Nurses indicated that their information about VBAC originated from other people's experiences (31%), Nursing School (25%), Media information (9%), and through literature review (6%). This data led to the conclusion that the knowledge about VBAC may not be extensive enough to counsel and guide patients who are willing to endure the trial of labor. 5. Nurses preferred hospital education programs to develop their knowledge concerning VBAC. Based upon survey, the conclusion was made that General Nurses and Maternity Nurses did not have knowledge about VBAC success rates and the possibility of a trial of labor. In order for nurses to help patients make decisions concerning VBAC, nurses have to gam more knowledge through hospital educational programs. Further more, the study suggests that through hospital educational programs, the possibility and importance of VBAC must be emphasized to nurses who work in maternity areas. Second, through prenatal educational programs, the possibility and importance of VBAC must be explained and emphasized to patients who had previous cesarean sections. Third, the clinical pathways of VBAC need to be developed. Fourth, each hospital needs to develop multi-disciplinary teams, consis-ting of obstetricians, risk management/quality management, staff registered nurses, and the director for perinatal services. This team can review cesarean section rates and help to increase the practice of VBAC.

• 대한간호
• /
• 제11권3호통권59호
• /
• pp.31-37
• /
• 1972

This clinical observation was based on retrospective investigation of 97 Cesarean sections performed at the Department of Obst. & Gynec. Jeonju Provincial Hospital from Jan. L, 1969 to Aug. 31, 1971. The results were as follows: 1. Cesarean section rate w