• Clinical and Experimental Reproductive Medicine
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• v.26 no.1
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• pp.31-41
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• 1999

To evaluate the effectiveness of intrauterine insemination (IUI) in the treatment of infertility, timed-intercourse and intrauterine insemination by husband in stimulated cycles with clomiphene citrate and gonadotropins were compared in a total of 105 cycles. Patients received 100mg of clomiphene citrate daily for 5 days starting on day 3 of the menstrual cycle followed by hMG or FSH. Doses of exogenous gonadotropins were adjusted by the follicular development and concentrations of serum estradiol $(E_2)$. More than 3 follicles reaching >16 mm were present in the ovary, 5,000 IU of hCG was administered intramusculary. Patients received a maximum of three intercourse or IUI cycles for the treatment. Severe male (<$10{\times}10^6$ motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. The overall clinical pregnancy rates were 17.1% per cycle (18/105) and 21.2% per patient (18/85). The pregnancy rates (per cycle) were 17.5% (11/63) in intercourse and 16.7% (7/42) in IUI groups, respectively. IUI had no significant improvement in pregnancy rate compared with timed-intercourse. The multiple pregnancy rates were 11.1% (1 twin and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rate was 28.6% (2/7) in IUI group only. The delivery and ongoing pregnancy rates were 15.2% per cycle (16/105) and 18.8% per patient (16/85). There were no differences in age, duration of infertility, follicle size and level of estradiol $(E_2)$ on the day of hCG injection in pregnant and non-pregnant groups. However, total doses of gonadotropins were higher in pregnant group than in non-pregnant group (p<0.01). Pregnancy rate was not affected by ovulatory status at the time of insemination. These results indicate that well timed-intercourse in stimulated cycles is as effective as IUI for infertile couples.

• Journal of the Korea Convergence Society
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• v.9 no.3
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• pp.279-287
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• 2018

This study was to investigate the factors affecting the obstetric outcomes of married immigrant women and to compare the results with the Korean women's and to provide basic data for establishing effective nursing interventions for the married immigrant women. The subjects were 302 married immigrant women and Korean women who were delivered in the university hospital from 2011 to 2015. Data were analyzed using frequency, mean, standard deviation and logistic regression using SPSS WIN 24.0 program. Factors affecting obstetric outcome were premature rupture of membranes, gestational hypertension, amniotic fluid abnormalities, and medical illness in both married immigrant women and Korean women. In addition, age, spouse's age, occupation, hemoglobin level, and placental abnormality were found to have an effect on obstetrical outcome in married immigrant women. Therefore, in order to improve the obstetric outcome of married immigrant women, a prenatal care program considering these influencing factors will be needed.

• Neonatal Medicine
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• v.28 no.1
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• pp.14-21
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• 2021

Purpose: Premature infants have immature respiratory control and cerebral autoregulation. We aimed to investigate changes in cerebral oxygenation during apnea with and without peripheral oxygen desaturation in premature infants. Methods: This prospective observational study was conducted at Inha University Hospital. Near-infrared spectroscopy (NIRS)-monitored regional cerebral oxygen saturation (rScO₂) and pulse oximeter-monitored peripheral oxygen saturation (SpO₂) were assessed during the first week of life in 16 stable, spontaneously breathing preterm infants. Apneic episodes that lasted for ≥20 seconds or were accompanied by desaturation or bradycardia were included for analysis. The average rScO₂ value during the 5-minute prior to apnea (baseline), the lowest rScO₂ value following apnea (nadir), the time to recover to baseline (recovery time), the area under the curve (AUC), and the overshoot above the baseline after recovery were analyzed. Results: The median gestational age and birth weight of the infants were 29.2 weeks (interquartile range [IQR], 28.5 to 30.5) and 1,130 g (IQR, 985 to 1,245), respectively. A total of 73 apneic episodes were recorded at a median postnatal age of 2 days (IQR, 1 to 4). The rScO₂ decreased significantly following apneic episodes regardless accompanied desaturation. There were no differences in baseline, nadir, or overshoot rScO₂ between the two groups. However, the rScO₂ AUC for apnea with desaturation was significantly higher than that for apnea without desaturation. Conclusion: Cerebral oxygenation can significantly decrease during apnea, especially when accompanied by reduced SpO₂. These results add the evidence for the clinical utility of NIRS in monitoring premature infants.

• Women's Health Nursing
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• v.27 no.2
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• pp.104-112
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• 2021

Purpose: This study investigated the mediating effect of family support in the relationships of anxiety and depression with maternal-fetal attachment among pregnant women admitted to the maternal-fetal intensive care unit (MFICU) in Korea. Methods: The participants were high-risk pregnant women with a gestational age of at least 20 weeks who were admitted to MFICUs in Busan and Yangsan. The Korean versions of four measurement tools were used for the self-report questionnaire: Spielberger's State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, Cobb's family support measurement, and Cranley's maternal-fetal attachment scale. Data were collected from June 22 to September 20, 2020. Out of 124 participants, data from 123 respondents were analyzed. Descriptive statistics and regression analysis were done. Results: The average age of participants was 34.1 years. Their anxiety level was moderate (43.57±11.65 points out of 80) and 53.6% were identified as having moderate depression (average 10.13±5.48 points out of 30). Family support was somewhat high (average 43.30±5.03 points out of 55). The average score of maternal-fetal attachment was also somewhat high (73.37±12.14 points out of 96). Family support had a partial mediating effect in the relationships of anxiety and depression with maternal-fetal attachment among high-risk pregnant women admitted to the MFICU. Conclusion: Maintaining family support is challenging due to the nature of the MFICU. Considering the mediating effect of family support, establishing an intervention plan to strengthen family support can be helpful as a way to improve maternal-fetal attachment for high-risk pregnant women admitted to the MFICU.

• Women's Health Nursing
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• v.26 no.4
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• pp.318-325
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• 2020

Purpose: The purpose of this study was to identify the influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida. Methods: In total, 108 primigravida participated in this descriptive correlational study. The participants answered self-report questionnaires. Data were collected from January to May, 2020, and were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression with SPSS for Windows ver. 23.0. Results: The mean age of the primigravida was 31.66 years. The mean score for the degree of maternal-fetal attachment was 76.81 out of 96 points. Participants' scores for maternal-fetal attachment differed significantly based on age (t=2.08 p=.039) and marital status (t=2.05, p=.043). Maternal-fetal attachment was significantly negatively correlated with psychological discomfort (r=-.39, p<.001), and significantly positively correlated with self-differentiation (r=.36, p<.001) and marital dyadic adjustment (r=.36, p<.001). Self-differentiation explained 24.1% of variance in participants' maternal-fetal attachment, and its effect was statistically significant (F=7.79, p<.001). Conclusion: In primigravida, more self-differentiation was associated with stronger maternal-fetal attachment. To strengthen maternal-fetal attachment in primigravidae, educational program that increases the level of self-differentiation and minimizes psychological discomfort may be helpful for first time pregnant women. Additionally, it is recommended to provide nursing interventions to encourage couples to work together throughout the gestational period.

• Neonatal Medicine
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• v.17 no.1
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• pp.102-108
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• 2010

Purpose : The goal of this study was to measure bilirubin levels over 6 hours using a transcutaneous bilirubinometer. The change in the bilirubin levels were recorded in anomogram. The natural progress of jaundice in neonates was monitored using the nomogram and cases were identified that needed further follow-up observation and treatment. Methods : The subjects of this study were 986 healthy term or near-term infants at the age of 35 weeks or older who were born at Sung-Ae General Hospital during the period from October 1, 2007 to April 30, 2009 and whose parents were both Koreans. Transcutaneous bilirubin measurements were obtained using a transcutaneous bilirubinometer (Minolta, JM-103) from 6 hours of life to discharge at intervals of 6 hours. A nomogram was derived from the obtained data and compared to the delivery method, gestational age, and feeding method. Results : Percentile graphs were drawn according to time. Based on the graphs, phototherapy was necessary in more than 90 percent of the infants between 35 and 37.6 weeks of age and in 95 percent of the infants 38 weeks and older. The mean bilirubin level at 24, 48, 72 and 96 hours after birth were compared according to the delivery method, gestational age, and feeding method. The bilirubin level in 48 hours was significantly higher in neonates born via cesarean section delivery compared to the neonates born via vaginal delivery, however the levels were not statistically different at the other hours. Conclusion : The results of this study show the nomogram derived from hour-specific transcutaneous bilirubin levels. This information can be used to predict the risk for subsequent significant hyperbilirubinemia.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.44-52
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• 2011

Purpose: Cytogenetic analysis of spontaneous abortions (SABs) provides valuable information to establish the causes of fetal loss, information that is essential to provide accurate reproductive and genetic counseling couples. Such analysis also provides information on the frequencies and types of chromosomal abnormalities and associated risks of recurrence. However, there have only been a few reports of chromosomal abnormalities in small samples of SABs in the Korean population. Here, we report the incidence and spectrum of chromosomal abnormalities for cases of 470 SAB in Korea. Material and Methods: Between 2005 and 2010, a total of 470 products of conception (POC) resulting from SABs were submitted to our laboratory for cytogenetic analysis from various medical sites in Korea. The incidences and types of specific chromosomal abnormalities were determined. The abnormalities were distinguished by gestational age at the time of SAB and by maternal age. Results: The frequency of chromosomal abnormalities in POCs was 54.3% (255/470), including 228 (89.3%) numerical and 27 (10.7%: 3 balanced and 24 unbalanced) structural abnormalities. Among the numerical abnormalities, trisomy was predominant (67.0%), followed by monosomy X (12.5%), polyploidy (8.2%), triple X (0.8%), and autosomal monosomy (0.8%). The overall sex ratio (male: female) among the 470 POCs with normal and abnormal karyotypes were 0.58 and 0.65, respectively. Trisomies were identified for each autosome, with the exceptions of 1, 3, and 19. Among the 171 autosomal trisomies, trisomy 16 was the most common (19.9%), followed by trisomy 22 (13.5%), trisomy 21 (12.3 %), trisomy 15 (9.9%), and trisomies 18 and 13 (5.3%). The frequency of chromosomal abnormalities decreased with gestational age and increased with maternal age, but only because of increases in trisomies and complex abnormalities. Conclusions: We have presented a large collection of cytogenetic data for SABs collected during the past 6 years and provided a database for prenatal genetic counseling of parents who have experienced SABs in Korea.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.154-162
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• 2011

Purpose : The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods : We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results : There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0${\pm}$6.0 days and 12.6${\pm}$21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21${\pm}$4.9 months and the mean gestational age was 33.1${\pm}$4.3 weeks, and the mean birth weight was 2,152${\pm}$950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion : Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country.

• The Journal of the Korea Contents Association
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• v.20 no.8
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• pp.685-691
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• 2020

Standard values for fetal bio index measurements should be applied differently depending on the past present and general characteristics of the target population. Therefore, we tried to predict the number of gestational week(GA) and analyze the differences by country based on the measurements of Korean fetal bio index. 480 fetal bio index measurements between 15~38 weeks of pregnancy using ultrasound were compared retrospectively with USA ad Japanese data. One Way ANOVA was used for the analysis of differences by country, and quadratic regression model was designed to predict the GA of fetal bio index in order to predict the standard pregnancy number of Korean fetuses(p<0.005). Mean difference in the 95% confidence interval is BPD was Korea and USA 0.17, Korea and Japan 0.11, AC was Korea and USA -0.35, Korea and Japan 0.42, FL was Korea and USA -0.18, Korea and Japan 0.14. Therefore, fetal bio index for GA predict is considered to be the standard of the fetal growth assessment by applying the country specific standard in consideration of differences between races.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.