• Title/Summary/Keyword: maternal mortality

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Environmental tobacco smoke and children's health

  • Hwang, Sang-Hyun;Hwang, Jong-Hee;Moon, Jin-Soo;Lee, Do-Hoon
    • Clinical and Experimental Pediatrics
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    • v.55 no.2
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    • pp.35-41
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    • 2012
  • Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on pediatric health, including preterm birth, intrauterine growth retardation, perinatal mortality, respiratory illness, neurobehavioral problems, and decreased performance in school. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. Nicotine and its major metabolite, cotinine, are commonly used as smoking biomarkers, and their levels can be determined in various biological specimens such as blood, saliva, and urine. Recently, hair analysis was found to be a convenient, noninvasive technique for detecting the presence of nicotine exposure. Because nicotine/cotinine accumulates in hair during hair growth, it is a unique measure of longterm, cumulative exposure to tobacco smoke. Although smoking ban policies result in considerable reductions in ETS exposure, children are still exposed significantly to tobacco smoke not only in their homes but also in schools, restaurants, child-care settings, cars, buses, and other public places. Therefore, more effective strategies and public policies to protect preschool children from ETS should be consolidated.

Developmental Toxicity Study in the Embryos/Fetuses with a Recombinant Human Granulocyte Colony-Stimulating Factor (YHB6211) in Pregnant Rabbits (임신토끼에 있어서 새로운 Recombinant Human Granulocyte Colony-Stimulating Factor(YHB6211)의 배.태자 발생독성평가)

  • 황재식;장호송;정은용;이수해;신지순;서동석;신장우;남상윤;김대중
    • Biomolecules & Therapeutics
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    • v.9 no.4
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    • pp.311-317
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    • 2001
  • YHB6211, a newly developed recombinant human granulocyte colonystimulating factor, was administered at dose levels of 0, 3, 15, and 75 $\mu$g/kg/day intravenously to the pregnant New Zealand White rabbits (20 rabbits per group) during the organogenetic period, days 6 to 18 of gestation. All dams were subjected to Caesarian section on day 28 of gestation and their fetuses were examined for external, visceral, and skeletal abnormalities. No abnormalities in clinical signs, body weight changes, gross findings, mortality, and external appearance were found in all dams and fetuses exposed to 0, 3, and 15 $\mu$g/kg/day of YHB6211. However, in the group treated with 75 $\mu\textrm{g}$/kg/day of YHB6211, maternal body and uterine weights, fetal body weights and length, and the number of live fetuses were significantly decreased and further fetal mortality was remarkably increased. It is suggested that YHB6211 may have no side effect up to the dose level of 15 $\mu$g/kg/day, and there would be no teratogenicity for fetuses of rabbits up to 75 $\mu\textrm{g}$/kg/day even if it may have some toxic effects over 75$\mu\textrm{g}$/kg/day for dams and fetuses of rabbits.

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The Seosan County Family Planning/Maternal & Child Health Service Research Project, Korea -Project Design and Findings of the Baseline Survey- (가족계획(家族計劃) 및 모자보건사업(母子保健事業)의 효율적 통합방안(統合方案)에 관한 연구(硏究)(서산군(瑞山郡)) -기초조사보고(基礎調査報告)-)

  • Bang, S.;Cho, T.H.;Lee, S.J.;Han, S.H.;Lim, K.J.;Ahn, M.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.163-192
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    • 1983
  • In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

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Embryonic Mortality and Pregnancy Rate in Bovine Embryo Transfer (소 수정란 이식에서의 배사멸과 임신율)

  • 김창근
    • Journal of Embryo Transfer
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    • v.6 no.2
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    • pp.1-17
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    • 1991
  • It is widely recognized that the embryonic or fetal loss after breeding is common in the cattle and that it is an important factor affecting reproductive efficiency. The causes of this loss have been subject of extensive researches and the results indicate that the embryonic mortality may he primary factor responsible for low pregnancy rates in non-embryo transfer bovine populations as well as embryo transfer programs. However, it's causes are still not clearly understood. The embryonic mortality or pregnancy rate has been influenced by various embryonic and maternal effects related to genetic and environmental factors. The timing and extent of embryonic mortality vanes greatly according to authors and estimating methods, because it is difficult to make direct measurements. The major important factors that may influence the embryonic losses or pregnancy rates after embryo transfer can be summeirized. 1.When an embryo is transferred to unmated recipients, the contralateral transfer to corpus luteum results in a lower survival rate than ipsilateral deposition. When the embryos are transferred for the production of twin calves, their survivals and twin pregnancies have quite inconsistent according to the transfer methods either to the unmated-synchronized or already mated recipients and more works are needed to accurrately clarify the previous results. 2.Although embryos can be cultured in vitro some hours without the great declines in pregnancy rates, the rates differ markedly among culture times and media but may be improved by co-transfer systems. 3.Embryo developmental stages and quality grades clearly affect the survival rate following freezing and the pregnancy rate after transfer and the selection of embryos without chromosome abnormalities and of high fertile semen may also be considered to increase the pregnancy rates. 4.Many researches have attempted to relate the plasma progesterone levels to pregnancy rates and others have done either direct progesterone supplementation or luteal stimulation by hCG treatment in order to increase the pregnancy rates. However, these effects on pregnancy rates are inconsistent and also contradictory. 5.The asynchrony between donors or embryos and recipients may he a major cause of embryo death and low pregnancy rate and the sensitivity to uterine asynchyony differs in according to the quality and stages of embryos. 6.The extremes of poor or over nutrition during early pregnancy in the recipients are detrimental to the survival of embryos and the good body condition is required to prevent a reduejion of pregnancy rates. The uterine pathogens in embryonic mortality or fertility have been questioned but the infection of C.pyogenes and Campylobacter fetus is still important pathogens. 7.The heat stress during early pregnancy may reduce conceptus weight and possibly increase the embryonic mortality.

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쌍태임신에 관한 임상 간호학적 관찰

  • 이귀향;이성학;박성숙
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.103-110
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    • 1970
  • It is important to point out that the percental mortality rate of the multiple pregnancy is almost twice of the single pregnancy due mainly to their prematurity and the mothers of twins will also be suffered from the plural births to nurse and take care of them. We therefore studied the incidence, the sex ratio, the types of deliveries, the complications and the percental mortality rate of the twin deliveries in order to promote the development of our field of maternal and child nursing. We selected our materials from the 112 patients who had been admitted and delivered twins in the department of OB. & Gyn. of the S.N.U. Hospital from Jan. 1962 to Dec. 1969. The abstructed results of this study were as follows. 1. The incidence of twins among 7, 731 births was 1:69 2. The occurrence of twins from elder multigravida was 4 to 6 times higher than younger primigravida mothers under 35 years of age. 3. The generational length of 45.5% of all twins was under 38 weeks and the mean birth weight of 1st and 2nd twins were 2, 354.7gm and 2, 215.8gm respectively. 4. The sex ratio of twins was 99 males and 124 females. 5. Presentation of twins: 59 cases (52.69%) were in both vertex. 37 cases (33.03%) in vertex plus breech. 15 cases (13.39%) in both breech and one case (0.89%) in transverse presentation. 6. For the types of deliveries Spontaneous deliveries were in 90 babies (40.6%) Breech extraction in 60 babies (26.3%) Vacuum used in 33 babies (15.0%) Cesarean section in 33 babies (9.8%) Forceps in 9 babies (4.2%) and others such as version and destructive measures in 9 babies (4.1%) 7. Intervals between the 1st and 2nd delivery were analyzed and 93% of 2nd twins were delivered within minutes after 1st delivery. 8. The main complications of twin deliveries were totemic (45.5%), second was postmarital hemorrhage (19.6%) and third was hydrations (7.1%) 9. The mean percental mortality of 1st and 2nd twins was 12.52% and 16.96% respectively of which main cause of death were their prematurity.

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Effect of early postnatal neutropenia in very low birth weight infants born to mothers with pregnancy-induced hypertension

  • Park, Yang Hee;Lee, Gyung Min;Yoon, Jung Min;Cheon, Enn Jung;Ko, Kyung Ok;Lee, Yung Hyuk;Lim, Jae Woo
    • Clinical and Experimental Pediatrics
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    • v.55 no.12
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    • pp.462-469
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    • 2012
  • Purpose: In this study, we aimed to investigate the perinatal clinical conditions of very low birth weight (VLBW) infants born to mothers with pregnancy-induced hypertension (PIH) focusing on the effects of early postnatal neutropenia. Methods: We reviewed the medical records of 191 VLBW infants who were born at Konyang University Hospital, between March 2003 and May 2011. We retrospectively analyzed the clinical characteristics of the infants and their mothers and compared the incidence of perinatal diseases and mortality of the infants according to the presence or absence of maternal PIH and neutropenia on the first postnatal day. Results: Infants born to mothers with PIH showed an increased incidence of neutropenia on the first postnatal day (47.4%), cesarean delivery, and intrauterine growth restriction. When the infants born to mothers with PIH showed neutropenia on the first postnatal day, their incidence of respiratory distress syndrome (RDS) was increased (P=0.031); however, the difference was not found to be significant through logistic regression analysis. In all the VLBW infants, neutropenia on the first postnatal day was correlated with the development of RDS. The incidence of the other perinatal diseases involving sepsis and mortality did not significantly differ according to the presence or absence of neutropenia in infants born to mothers with PIH. Conclusion: In VLBW infants born to mothers with PIH, the incidence of neutropenia on the first postnatal day was increased and it was not significantly correlated with the development of perinatal diseases involving RDS, sepsis, and mortality.

Evaluation of Maternal Toxicity in Rats Exposed to 1,3-Dichloro-2-propanol during Pregnancy

  • Lee, Jong-Chan;Shin, In-Sik;Kim, Gang-Hyeon;Park, Na-Hyeong;Moon, Chang-Jong;Bae, Chun-Sik;Kang, Sung-Soo;Kim, Sung-Ho;Shin, Dong-Ho;Kim, Jong-Choon
    • Toxicological Research
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    • v.24 no.4
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    • pp.307-314
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    • 2008
  • The present study was carried out to investigate the potential adverse effects of 1,3-dichloro-2-propanol on pregnant dams after maternal exposure during the gestational days (GD) 6 through 19 in Sprague-Dawley rats. The tested chemical was administered orally to pregnant rats at dose levels of 0, 10, 30, or 90 mg/kg/day. During the test period, clinical signs, mortality, body weights, food consumption, serum biochemistry, gross findings, organ weights, and Caesarean section findings were examined. In the 90 mg/kg group, decreases in the body weight gain and food consumption, and increases in the weights of liver and adrenal glands were observed. Serum biochemical investigations revealed increases in aspartate aminotransferase (AST), alanine aminotransferase (ALT), cholesterol (CHO), triglyceride (TG), alkaline phosphatase (ALP), and bilirubin (BIL) and decreases in glucose (GLU), albumin (ALB) and total protein (TP). In the 30 mg/kg group, a decrease in the food consumption and an increase in the liver weight were observed. Serum biochemical investigation also showed increases in CHO and TG and a decrease in glucose. Since there were no signs of maternal toxicity in the 10 mg/kg group, it is considered to be the no-observed-adverse-effect level (NOAEL) of 1,3-dichloro-2-propanol. It is concluded that successive oral administration of 1,3-dichloro- 2-propanol to pregnant rats for 14 days may cause significant toxicities in body weight and liver at a dose rate ${\geq}$ 30 mg/kg/day.

Epidural Analgesia for Labor Pain Management in a Parturient with HELLP Syndrome -A case report- (HELLP 증후군 산모에서 무통분만을 위해 시행한 경막외 진통법 -증례 보고-)

  • Yun, Chae-Sik;Lee, Jung-Yun;Hong, Sung-Ju;Lee, Jun-Hak
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.253-257
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    • 1999
  • Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, a variant presentation of severe preeclampsia/eclampsia is associated with high maternal morbidity and mortality. Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is relatively contraindicated in the presence of severe thrombocytopenia. Determining the pain management of choice depends on the parturient's condition, fetal well-being, and the urgency of the situation. We report a safe case of epidural analgesia in a HELLP syndrome parturient with severe thrombocytopenia for labor pain management without any neurologic complications or epidural hematoma.

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A Case Report of Heterotopic Pregnancy after IVF-ET (체외 수정후 발생한 병합임신 1예)

  • Park, Chul-Min;Kim, Sung-Yop;Son, Young-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.4
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    • pp.353-359
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    • 2005
  • Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.

Biomarkers and genetic factors for early prediction of pre-eclampsia

  • Kim, Hannah;Shim, Sung Shin
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.49-55
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    • 2017
  • Pre-eclampsia is known to cause considerable maternal morbidity and mortality. Thus, many studies have examined the etiopathogenesis of pre-eclampsia. While many pathophysiological factors related to pre-eclampsia have been identified, the precise etiopathogenesis of pre-eclampsia remains unclear. Numerous studies have identified factors for the early prediction for pre-eclampsia to lead to preparation and closer observation on pre-eclampsia when it occurs. This article reviews on current studies of biomarkers and genetic factors related to pre-eclampsia, which may be important for developing strategies for early prediction of pre-eclampsia.