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姙産婦의 臨床,統計的 觀察

Clinical and Statistical Observation of Women Admitted into SNU Hospital for Deliveries and Postpartum Cares

공중보건잡지 1966년 3권 2호 p.125 ~ 143
강길원,
소속 상세정보
강길원 (  ) - 서울대학교 보건대학원

Abstract


A clinical and statistical study conducted by the Author on 1,914 women who underwent confinement at Seoul National University Hospital during the period from 1 April 1964 to 31 March 1966, 927 women who had received antepartum Cares and 987 women not received antepartum cares, and on their 1,952 newborn babies led to the following major findings:
1. By age, those belonging to the 25-29 group rated 52.5 per cent of the total or highest, the 30-34 group 25.9 percent and the 20-24 group 13.3 percent.Those in ages 20-34 constituted 90.8 percent of all women investigated.
2. The number of deliveries at Seoul National University Hospital has shown an upward shift. It increased from 78 in 1964 to 81.5 in 1965. The rate of antepartum cares has also increased, namely, from 48.2 percent of all women admitted in 1964 to 48.7 percent in 1965.
3. Obstetrical history at the moment of admission was as follows.
a. Among the total 1,914 women, 718(37.5%) were primigravidas and 1,196(62.5%) multigravidas.
b. There were 859(44.9%) primiparas and 1,055(55.1%) multiparas.
c. Eight hundred and eighty nine women(46.4%) had never experienced a fullterm delivery and 1,025(53.6%) had such experiences.
d. Out of total women investigated, 518(27.1%) had experienced artificial or spontaneous abortions, and 75(3.9%) had histories of premature delivery.
e. As many as 955 women(49.9%) turned to have no living child and 959(50.1%) had one or more living children.
f. The ratio of total abortions to total pregnancies was 1 : 3.56 and to total living children 1 : 1.99, and that of total living children to total pregnancies 1 : 1.78
4. The duration of hospitalization varied considerably by whether the patient had undergone antepartum cares or not in that the duration of hospitalization averaged 4.43 days for those having received such cares and 4.9 days for thoes not received them . Also, the duration of hospitalization averaged 4.9 days for primiparas and 4.5 days for multiparas.
5. The types of deliveries and those incidence were as follows; Spontaneous 57.1 percent, vacuum extradction 26.4 percent, version and extration 7.5 percent, forceps 4.3 percent, C-section 3.9 percent and destructive measures 0.2 percent. 6. Some differences have been noted with occurance of complications by groups of women undergoing and not undergoing antepartum cares, as follows :
a. The obstetrical complications occurred in 17.5 percent (162women) among 927 with antepartum cares and 32.9 percent (325women) among 987 without antepartum cares.
b. Of the 243 cases(49.9 percent of 623 with complications) of toxemias, 95(19.5%) were belonged to antepartum care group and 148(30.4%) to the non-antepartum care group.
c. Severe Complications such as abruptio placentae during labor were developed with a high rate(85%) with the non-antepartum care group.
d. Among primiparas 190 women (22.1%) developed complications and 297(28.2%) among multiparas.
7. The still-birth rate, neonatal mortality rate during 3 days after live-births and perinatal mortality rate by prenatal care group have demonstrated a marked difference between the women undergoing and not undergoing prenatal cares, as follows;
a. The still-birth rate was 3.2 per 1,000 deliveries in the prenatal care group and 60.03 in the non-prenatal care group.
b. The neonatal death rate of the newborn babies delivered after 20 weeks gestation period which occurred within 3 days after deliveries was computed at 13.93 per 1,000 live-births with the prenatal care group and 40.07 with the non-prenatal care group. The neonatal deaths within 24hours after births rated 81 percent and 87 percent among the group of women having received prenatal cares and the group not receiving, respectively.
c. The perinatal death rate by using the modified C thye formula of J. H. Holzwpfel was calculated at 17.09 per 1,000 deliveries with the prenatal care group and 103.34 with the non-prenatal care group.
d. Main causes of perinatal deaths included immaturity, prematurity and toxemias both in the two groups.
8. The incidence of premature live-births and the premature death rate by women belonging to prenatal care group have indicated some difference from those with the group not undergoing prenatal cares.
a. The incidence of premature live-births was computed at 4.6 percent (43 premature babies) with the prenatal care group and 12.5 percent(119) with the non-prenatal care group.
b. The ratio of premature live-births to mature ones turned out to be 4.8 percent among the prenatal care group and 14.2 per cent among the non-prenatal care group.
c. The rate of deaths of babies by the dates of discharge(mothers) was significantly low among the cases having received prenatal cares.
9. The incidence of delivery of twins was once in 50 births and the secondary sex ratio was 72.7 : 100. The average body weight was 2,470 grm. in male, 2,440 grm. in female and 2,453 grm. when both sexes were combined.
10. The average hemoglobin level of the mothers during labor was 11.17 gm with the antepartum care group and 10.93 gm with the non-antepartum care group. With the antepartum care group the mean hematocrit value was 33.47 percent and 32.76 per cent with the non-antepartum care group.
11. The secondary sex ratio of 1,952 newborn babies was 103.3 : 100 and the accepted secondary sex ratio(Eastman) of live-births was 101.7 : 100. The average weight of newborn babies including premature babies and twins was 3,207 grm. in male, 3,133 grm. in female and 3,171 grm. when combined. The average body weight by all babies excluding premature babies and twins was 3,382 grm. for male, 3,287 grm. for female and 3,335 grm. for both sexes combined.

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