• Journal of Trauma and Injury
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• v.25 no.4
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• pp.132-138
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• 2012

Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.388-393
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• 2023

Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

• Journal of Nutrition and Health
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• v.32 no.2
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• pp.182-188
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• 1999

A study was conducted on a group of 107 women, attending the three peripheral community clinics in Seoul and Kyunggi area for their prenatal care, to ascertain the relationship between maternal serum zinc concentration measured in pregnancy and several pregnancy outcomes. The serum zinc concentration was adjusted for estimated gestational age at the time of drawing blood. Mean daily zinc intake of the pregnant women estimated by a 24-hour recall method was 7.68$\pm$3.70$\mu\textrm{g}$/dl, 51% of RDA. and mean serum zinc concentration of the women was 94.03$\pm$36.99ug/dl. Adjusted maternal serum zinc level was significantly related to gestational maternal weight gain(p<0.05) and infant birth weight(p<0.05). Pregnant women with tgreater than 9kg weight gain during the gestation period had higher adjusted serum zinc levels than the subjects with less than 8kg weight gain. Adjusted serum zinc levels of mothers who delivered 3.0-3.5kg and greater than 4.0kg birth-weight infants were higher than those of mothers of low-birth-weight infants. Any association between maternal serum zinc level and gestational length, complications and morning sickness was not observed. There results suggest that the maternal serum zinc level may predict perhaps the author could be none specific.

• Women's Health Nursing
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• v.17 no.4
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• pp.407-414
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• 2011

Purpose: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. Methods: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. Results: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. Conclusion: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.

• 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.

• Women's Health Nursing
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• v.10 no.3
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• pp.200-209
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• 2004

Purpose: This study was to investigate the types and seriousness of pregnancy-related physical and psychological symptoms among pregnant couples. Method: Subjects consisted of 77 pregnant couples at one hospital in Seoul, Korea. The pregnant couples had not been diagnosed with any medical complications. Data were analyzed by the SPSS WIN program. Result: In the degree of physical and psychological symptoms of pregnancy experienced by subjects, the mean score of perceived physical symptoms (2.40, 1.86) was higher than the mean score of psychological symptoms(2.13, 1.83) for both pregnant women and their spouses. In the couple's difference of physical and psychological symptoms of pregnancy experienced by subjects, there were not statistically significant differences in the physical symptoms: "I have hemorrhoids"(t=1.91, p=.06), "My body weight decreased"(t=1.78, p=.08), "I have colds more often"(t=1.77, p=.08), and "I became more active than ordinary times"(t=1.99, p=.05) or in the psychological symptoms: "I am more elated than ordinary times"(t=.83, p=.41), and "I feel inferior"(t=1.62, p=.11). Therefore, these symptoms are coincidental between couples. In the difference of physical and psychological symptoms of pregnancy experienced by subjects according to general characteristics, there were not significant differences. In the relationship between physical and psychological symptoms experienced by subjects, there were statistically significant correlations between subject's physical symptoms and psychological symptoms(r=.54, p<.001; r=.78, p<.001). Conclusion: Physical and psychological symptoms of pregnancy experienced by pregnant couples are an issue for nurses who perform an important role in the care of pregnant women and their spouses.

• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.150-152
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• 2022

Complications related to the vascular anastomosis of the placental vessels in monochorionic twins are fatal. The clinical syndromes of feto-fetal transfusion include twin anemia polycythemia sequence (TAPS), twin-twin transfusion syndrome, and twin reversed arterial perfusion sequence. We present an extremely rare case of TAPS in a dichorionic diamniotic pregnancy. A 36-year-old woman, gravida 0, para 0, was referred to our hospital with suspected preterm premature membrane rupture. Although her pelvic examination did not reveal specific findings, the non-stress test result showed minimal variability in the first fetus and late deceleration in the second one. An emergency cesarean section was performed. The placenta was fused, and one portion of the placenta was pale, while the other portion was dark red. The hemoglobin level of the first fetus was 7.8 g/dL and that of the second one was 22.2 g/dL.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.573-582
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• 1998

The purpose of this study was to investigate pregnancy, abortion and delivery rates among Korean teenagers. The subjects of this study were 11,433 teenagers aged 13-19 years in Seoul, Pusan, Taegu, Kwangju, Incheon, Taejeon and Ansan, Korea. Data were collected from Feb. 1994 to May 1995, 16 months, by schoolnurses or the researchers. The results showed pregnancy rate was 7.2 per 1,000 teenagers, the abortion rate was 4.3 per 1,000 teenagers, and the delivery rate was 1.2 per 1,000 teenagers. In the pregnancy experience, the main factors related to teenage pregnancy were love or marriage engagement. In the abortion experience, 53.9% of teenagers had had more than two abortion experiences, 38.1% midtrimester abortion, 22% complications after abortion, 36.0% sexual activity after abortion and 86.7% the financial support from partners or friends for abortion. In the delivery experience, 64.3% of teenagers delivered with no prenatal care and 42.9% had a delay in realizing they were pregnant. Fifty percent were delivered by non-professionals in non-medical institutions.

• IMMUNE NETWORK
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• v.15 no.1
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• pp.16-26
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• 2015

The female reproductive tract has two main functions: protection against microbial challenge and maintenance of pregnancy to term. The upper reproductive tract comprises the fallopian tubes and the uterus, including the endocervix, and the lower tract consists of the ectocervix and the vagina. Immune cells residing in the reproductive tract play contradictory roles: they maintain immunity against vaginal pathogens in the lower tract and establish immune tolerance for sperm and an embryo/fetus in the upper tract. The immune system is significantly influenced by sex steroid hormones, although leukocytes in the reproductive tract lack receptors for estrogen and progesterone. The leukocytes in the reproductive tract are distributed in either an aggregated or a dispersed form in the epithelial layer, lamina propria, and stroma. Even though immune cells are differentially distributed in each organ of the reproductive tract, the predominant immune cells are T cells, macrophages/dendritic cells, natural killer (NK) cells, neutrophils, and mast cells. B cells are rare in the female reproductive tract. NK cells in the endometrium significantly expand in the late secretory phase and further increase their number during early pregnancy. It is evident that NK cells and regulatory T (Treg) cells are extremely important in decidual angiogenesis, trophoblast migration, and immune tolerance during pregnancy. Dysregulation of endometrial/decidual immune cells is strongly related to infertility, miscarriage, and other obstetric complications. Understanding the immune system of the female reproductive tract will significantly contribute to women's health and to success in pregnancy.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.3
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• pp.165-172
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• 2005

The aim of this study was to determine the roles of ET-1 and NO on uterine blood flow in pregnancy. Uterine arteries were isolated from 17 nonpregnant and 12 pregnant women. Nonpregnant group included patients with median age of $48.6{\pm}2.3$ years who underwent hysterectomy, because of myoma. Pregnant group included patients with median age of $31.3{\pm}1.4$ years undergoing cesarean delivery. ET-1 and ET-2 induced concentration-dependent contraction in isolated nonpregnant and pregnant uterine arteries. The contractile response and maximal contraction were increased in pregnant uterine arteries. In nonpregnant uterine arteries, there was no contraction in response to ET-3, whereas pregnancy induced concentration-dependent contraction by ET-3. Tissue nitrite/nitrate level and immunohistochemical staining of eNOS and iNOS were increased in pregnant uterine arteries, compared with nonpregnant uterine arteries. In addition, the expressions of eNOS and iNOS mRNA were significantly increased in pregnancy. Moreover, contractions by ET isopeptides, including ET-1, were enhanced, and immunohistochemical staining of ET-1 and ET-1 mRNA expression was increased in pregnant uterine arteries. These results suggest that NO production by increased NOS activity, especially eNOS activity, is related to placental and uterine blood flow. Furthermore, ET-1 appears to play a pathophysiological role in pregnant complications such as hypertension.