• 제목/요약/키워드: pregnant patient

검색결과 136건 처리시간 0.03초

Acute cholecystitis in pregnant women: A therapeutic challenge in a developing country center

  • Mohamed Fares Mahjoubi;Anis Ben Dhaou;Mohamed Maatouk;Nada Essid;Bochra Rezgui;Yasser Karoui;Mounir Ben Moussa
    • 한국간담췌외과학회지
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    • 제27권4호
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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.

Solid pseudopapillary epithelial neoplasm of pancreas in pregnancy: A case report and review of literature

  • R K Hanumantha Naik;Anbalagan Amudhan;ArunKumar Ashokkumar;Anbarasu Inbasekaran;Selvaraj Thangasamy;Jeswanth Sathyanesan
    • 한국간담췌외과학회지
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    • 제28권1호
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    • pp.92-98
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    • 2024
  • The solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is an uncommon tumor that accounts for approximately 1%-2% of exocrine pancreatic neoplasms. It predominantly affects female in their second and third decades of life. In this case report, we present a clinical scenario of a 21-year-old pregnant woman who incidentally discovered a solid cystic lesion in her pancreas, exhibiting features suggestive of SPEN. The patient underwent surgery during the second trimester. Management of pregnant females with SPEN poses challenges due to the absence of definitive treatment guidelines, particularly in determining the ideal timing for surgical intervention. Notably, during pregnancy, the presence of a small SPEN does not necessarily require immediate resection. However, if the tumor is of significant size, it can give rise to complications such as tumor rupture, multivisceral resection, recurrence, spontaneous abortion, intrauterine growth restriction, or premature delivery if not addressed. In the existing literature, a common finding is that approximately two-thirds of pregnant females with SPEN underwent surgery in the second trimester, often without complications for the mother or fetus. All these tumors were larger than 8 cm. The decision to operate before or after birth can be individualized based on team discussion. However, delay in surgery may lead to larger tumors and higher risks like bleeding, rupture, multivisceral resection, and recurrence. Therefore, second-trimester surgery seems safer, and lessens dangers, emergency surgery, and tumor recurrence.

A Case of AML (M3) in Pregnancy

  • Shim, Moon-Jung;Kang, Yun-Jung
    • 대한임상검사과학회지
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    • 제45권3호
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    • pp.120-123
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    • 2013
  • Leukemia in pregnancy was first reported by Virchow in 1845, and acute Leukemia that occurs with pregnancy is extremely rare. About 350 pregnancies with leukemia have been reported in literature. The incident of acute leukemia during pregnancy has been reported in one case per 100,000 pregnancies case. A 40-year-old patient with 30 weeks of pregnancy, (by promyelocyte which is contained granules and auer rods in the bone marrow and biopsy) was diagnosed with acute promyelocyte leukemia WITH t (15;17) (q22;q12); PML-RARA. (M3) in peripheral blood and bone marrow examination, and gave a birth to the fetus normally, January 24, 2013, after receiving the complete remission decision from the bone marrow, complete blood cell count, PML-RARA PCR test, showed normal findings until March 2013. The treatment of acute leukemia during pregnancy should be considered as treatment of a pregnant mother and the impact on the fetus. Decisions about when and how birth takes place is difficult and has to consider both mother and fetus. It is preferable to start immediate treatment without delay so that the treatment time to achieve complete remission or full recovery of the pregnant mother is longer.

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조경종옥탕가미방(調經種玉湯加味方)을 병용한 원발성 불임환자 치험 5례(例) (5 Cases of Primary Infertility treated by Jokyungjongok-tang gamibang)

  • 구진숙
    • 대한본초학회지
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    • 제35권5호
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    • pp.41-46
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    • 2020
  • Objectives : According to 2013 statistics, the primary infertility rate is 13.5%. The current situation is much worse than that reported, so it is even emerging as a social problem. The purpose of this study is to analyze the 5 cases of successful infertility treatment with herbal treatment and to give hope to the infertile couple to become pregnant and to suggest the possibility of herbal treatment in infertility treatment. Methods : We administered Jokyungjongok-tang gamibang as a herbal medicine and treated with acupuncture, moxibustion. Treatment was done once or twice a week. The herbal medicines were taken 30 minutes after meals and 3 times a day. While taking the herbal medicine, they were prohibited from eating flour, pork, liquor, tobacco and coffee. Patient status was assessed by consultation through pulse, tongue and abdominal diagnosis. The diagnosis of pregnancy was confirmed by ultrasonography at hospitals and the success of the treatment was judged based on healthy birth. Results : Patients had common features, such as lower abdominal pain, menstrual cramps, and blood clots during menstruation. Herbal medicine combined with acupuncture, moxibustion improved patients' overall fatigue and reduced the body's coldness. Since then, the dysmenorrhea and blood clots have decreased, and the digestion condition has improved. Therefore they became pregnant and gave birth to a healthy baby. Conclusion : Jokyungjongok-tang gamibang was effective in improving the body's coldness and uterine condition and was successful in pregnancy and helped to give birth to a healthy baby.

조기진통으로 입원한 임부 배우자의 스트레스 영향요인 (Factors Influencing Stress in Spouses of Hospitalized Women Diagnosed with Preterm Labor)

  • 이정임;홍세훈
    • 여성건강간호학회지
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    • 제25권4호
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    • pp.459-473
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    • 2019
  • Purpose: The purpose of the study was to identify to identify the nursing needs and stress levels among spouses of women hospitalized with preterm labor, and to determine factors influencing spousal stress. Methods: Data were collected from 95 spouses of hospitalized pregnant women due to preterm labor at a hospital in Gyeonggi province from June to December of 2016. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression. Results: The mean score of spouses' nursing needs was 3.06±0.42 and stress was 1.85±0.44 out of 4.00. The highest score of nursing needs was 3.37±0.51 in assurance and the highest score for stress was 2.26±0.72 for patient's illness and prognosis. There was a significant positive correlation between stress in spouse and nursing needs (p=.004). Stress was explained by nursing needs (β=.28) and hospitalization days (β=.21). Conclusions: The results of this study suggest that appropriate nursing interventions are required to address the nursing needs at the beginning of hospitalization and to reduce the stress among spouses of hospitalized pregnant women diagnosed with preterm labor.

임산부의 방사선치료 시 태아선량 평가 (Estimation of Fetal Dose during Radiation Therapy of Pregnant Patient)

  • 정치훈;김찬용;김보겸;서석진;유숙현;박흥득
    • 대한방사선치료학회지
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    • 제19권1호
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    • pp.35-41
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    • 2007
  • 목 적: 임산부의 방사선치료시 태아에 조사되는 선량을 알아보고, 임상에 적용가능한 간단한 차폐방법을 적용하여 태아선량이 감소되는 정도를 평가하고자 한다. 대상 및 방법: 본원에 내원한 임신 24주째인 뇌전이 환자를 대상으로 전뇌 방사선치료를 시행하는 동안 태아에 조사되는 선량을 인체 팬톰(Anderson Rando Phantom, Alderson Research Laboratories Inc., USA)을 사용하여 평가하였다. 환자에 대한 치료처방은 일일선량 300 cGy, 10회, 총선량 3000 cGy, 그리고 치료조건은 에너지 6 MV, 조사야크기 $18{\times}22cm^2$이었다. 선량평가는 환자 치료조건과 동일한 상태로 조사야 하단에서 각각 30, 40, 50, 60 cm에서 전리함((TN30013, 0.6 cc Farmer type chamber, PTW Unidos, Germany)을 사용하여 측정하였고, 다음은 환자치료조건과 동일하지만 본원에서 고안한 추가 차폐방법(shielding wall, neck supporter, Pb sheets, acrylic bridge)을 이용하여 태아를 차폐한 다음 위의 측정점과 동일한 위치에서 측정하여 그 차폐효과를 비교 평가 하였다. 또한 추가 차폐한 상태에서 열형광선량계(4000, Harshaw, Solon Technologies Inc., USA)를 사용하여 30, 40, 50, 60, 70 cm 지점에서 측정하여 전리함 측정값과 비교 분석하였다. 결 과: 전리함을 이용하여 측정한 결과 환자가 총선량 3,000 cGy를 받는 동안 태아에 조사될 수 있는 선량은, 추가 차폐가 없는 경우 조사야 하단 30, 40, 50, 60 cm에서 각각 3.20, 3.21, 1.44, 0.90 cGy, 추가 차폐가 있는 경우 0.88, 0.60, 0.35, 0.25 cGy로 추가 차폐를 하였을 경우 하지 않았을 경우보다 약 $70{\sim}80%$의 차폐효과를 얻을 수 있었다. 그리고 열형광선량계 측정결과는 1.8, 1.2, 0.8, 1.2, 0.8 (70 cm) cGy로 나타났다. 이로서 태아가 전 치료 과정중 받을 수 있는 총선량은 1 cGy 이하로 측정되었다. 결 론: 임산부의 방사선치료가 필수적으로 요구될 경우 고려되어야 할 가장 중요한 인자는 태아선량의 최소화가 될 것이다. 방사선장애의 역치선량이 $10{\sim}20cGy$인 것을 감안하면 상기 방법에 의한 임산부의 방사선치료는 이러한 목적에 부합될 뿐만 아니라 사용방법 또한 비교적 용이하다고 생각된다.

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앙와위와 좌측 기울린위치에서의 좌심실의 공간적 관계 변화. 임신부 심폐소생술 측면에서 (Spatial Relationship of the Left Ventricle in the Supine Position and the Left Lateral Tilt Position (Implication for Cardiopulmonary Resuscitation in Pregnant Patients))

  • 윤종근;이병국
    • 한국화재소방학회논문지
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    • 제27권5호
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    • pp.75-79
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    • 2013
  • 임신부의 경우 심폐소생술동안 좌측 기울림을 적용하도록 권장하고 있다. 하지만, 이 좌측으로 기울리면 임신부의 자궁 뿐만이 아니라 좌심실도 좌측으로 편위되어 심폐소생술의 심장펌프기능이 떨어질 가능성이 있다. 이에 좌측 기울림이 심폐소생술동안 흉골 운동 방향을 대변하는 전후축과 좌심실의 공간적 관계에 미치는 영향을 알아보고자 하였다. 컴퓨터 단층촬영을 이용한 가상내시경검사를 받은 90명의 환자를 대상으로 의무기록과 컴퓨터단층촬영결과를 후향적으로 조사하였다. 가상내시경은 앙와위와 좌측 기울림 위치 모두에서 실시되었다. 좌심실 단면적이 가장 넓은 축면에서 전후축과 좌심실축사이의 각도($Angle_{AP-LV}$), 전후축과 좌심실 중앙사이 최단거리($D_{AP-MidLV}$), 및 전후축과 좌심실첨부사이 최단거리($D_{AP-Apex}$)를 측정하였다. 대상환자 중 87명(96.7%)에서는 앙와위에서 좌심실이 전후축의 좌측에 위치하였다. 좌측으로 기울인 영상에서의 기울림 각도는 $43.4{\pm}11.0^{\circ}$였다. $D_{AP-MidLV}$$D_{AP-Apex}$는 좌측 기울린 위치에서 의미있게 길었지만 (p<0.001), AngleAP-LV는 두 자세 사이에 비슷했다. 심장정지인 임신부에서 좌측으로 기울림은 흉부압박의 심장펌프 효과를 떨어뜨릴 수도 있다.

A Successful Bilateral Lung Transplantation in a Patient with High Panel Reactive Antibody and Positive Cross Matching

  • Bok, Jin San;Jun, Jae Hyun;Lee, Hyun Joo;Park, In Kyu;Kang, Chang Hyun;Yang, Jaeseok;Kim, Young Tae
    • Journal of Chest Surgery
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    • 제47권4호
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    • pp.420-422
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    • 2014
  • A 44-year-old pregnant female patient gave stillbirth while being treated for pneumonia. She developed acute respiratory failure, which resulted in mechanical ventilator support. Diagnostic lung biopsy revealed a cryptogenic organizing pneumonia. The patient's condition deteriorated and a venous-venous extracorporeal membrane oxygenation was placed. She was listed for lung transplantation. Because of her worsening condition lung transplantation was performed despite positive cross matching result. She was treated with rituximab, intravenous immunoglobulin, and plasmapheresis and recovered without event. There is no sign of rejection at the time of last follow-up.

초고속 통신망을 이용한 재택산전간호관리 시스템 개발 (Development of the Home-Based Prenatal Care System via Information Superhighway)

  • 김정은;박현애
    • 대한간호학회지
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    • 제25권4호
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    • pp.774-789
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    • 1995
  • Due to the rapid socioeconomic development and the introduction of the national health insurance system the general population's need for health care and utilization of health care services have increased dramatically. As a result of this change. Korea is experiencing a shortage of health care facilities and health manpower, and this leads long wailing line at doctor's offices. One of the solutions of this problem could be home health care system for those who have minor health related problems. With this background, this study was conducted to look at the feasibility of a home-based prenatal care system using information superhighway and nursing informatics specialists. With the home-based prenatal care system, the pregnant woman checks her blood pressure, tests her urine for sugar and protein, and measures her body weight at home and sends the information to a hospital computer via the information networks such as public telephone line and information superhighway. Nursing informatics specialist at the hospital will go through each patient record and screen those who have abnormal values and notify them to see a doctor as soon as possible. Besides telemonitoring features, the proposed system will include tole-education capabilities for the patients so that patient can learn whatever they need to know ragarding the prenatal care via information networks. If this system develops and operates, patient can save time in terms of travel to and from the hospital and waiting time in the hospital. And the health care institute can utilize its resource more efficiently.

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양수과소증으로 인한 사산 후 산모 치험 1례 (A Case Report of Patient Treated after Stillbirth Caused by Oligohydramnios)

  • 이승환;이인선;조혜숙;배경미;김종원;전수형
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.164-175
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    • 2010
  • Purpose: The purpose of this study is to report the effect of Traditional Korean Medicine therapy for patient in the state of post stillbirth by oligohydramnios Methods: The patient in this case was 33-year-old female who was pregnant by artificial insemination in 2010. Intrauterine growth restriction was discovered at 17 weeks after gestation. And oligohydramnios was found at 20 weeks after gestation. Amnioinfusion was done three times, amniotic fluid infection occurred in the process of amnioinfusion and she had a stillbirth. After stillbirth she came to our clinic with symptoms of abdominal tenderness, distention, mammalgia. The patient was treated by traditional herbal medicine therapy such as Saenghwa-tang(生化湯), Gungguijohyeol-eum(芎歸調血飮), Silso-san(失笑散) and Sasang constitution medicine(荊防地黃湯, 荊防敗毒散, 荊防瀉白散). The progresses of symptoms were evaluated by visual analogue scale. Results: After Traditional Korean Medicine therapy, the patient's symptoms caused by stillbirth was improved. Conclusion: This case study shows that the postpartum treatment in Traditional Korean Medicine therapy and Sasang constitution medicine is effective for the patient in the state of post stillbirth.