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대한주산의학회> PERINATOLOGY (구 대한주산의학회잡지)> Recent Trend about Pregnant Women with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Infection

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Recent Trend about Pregnant Women with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Infection

Se Jin Lee , Sunghun Na
  • : 대한주산의학회
  • : PERINATOLOGY (구 대한주산의학회잡지) 31권1호
  • : 연속간행물
  • : 2020년 03월
  • : 1-6(6pages)

DOI


목차

서론
COVID-19의 증상과 진단
임산부에서 COVID-19
COVID-19 산모의 분만
결론
Conflict of interest
References

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초록 보기

WHO에서 2020년 3월 11일 COVID-19에 대한 세계적대유행(pandemic)을 선언한 이후 이에 대한 전 세계적 관심이 높아지고 있으며, 3월 14일 기준 현재까지 127개국에서 142,491명의 확진자와 5,388명의 사망자가 보고되었다. 이후 산모의 감염사례가 중국에서 보고되고 있으며, 최근 국내에서도 산모의 감염 사례 및 분만 사례가 있었다. 아직 COVID-19에 대한 치료제나 백신은 발견되지 않았으며, 상대적으로 질병에 대하여 고위험군인 산모의 처치에 대한 통일된 국내 지침은 없는 상태이다. 최근 미국 질병통제예방센터(Centers for Disease Control and Prevention), 미국 모체태아의학회(Society for Maternal-Fetal Medicine), 세계산부인과초음파학회(International Society of Ultrasound in Obstetrics and Gynecology) 및 영국산부인과학회(Royal College of Obstetricians and Gynaecologists)에서 여러 권고사항을 발표하고 있다. 현재까지는 COVID-19에 대한 데이터가 부족하지만 같은 코로나바이러스 감염인 중동 호흡기 증후군(MERS) 및 중증 급성 호흡기 증후군(SARS)과 비슷한 형태일 것으로 예상하고 이에 준하여 대비할 수 있다. COVID-19에 대하여 분만 시 수직 감염의 증거는 없으며, 모유 또한 바이러스가 검출되지 않았다. 분만 방법은 상황에 따라 고려되어야 하지만 음압병실에서 완벽한 개인 보호구를 착용한 채로 질식분만도 가능하다. 출생 후 신생아는 산모와 분리되고 COVID-19 의심 환자로 격리되어야 하며 추적검사를 해야 한다. 앞으로 더 많은 연구를 통하여 코로나바이러스와 관련된 산모의 관리에 대한 임상지침이 만들어져야 할 것이다.
Since the World Health Organization declared the pandemic of Coronavirus Disease 2019 (COVID-19) on March 11, there has been increasing worldwide interest in it. Since then, cases of maternal infection have been reported in China, and recent cases of maternal infection and delivery have also occurred in Korea. No cure or vaccine for COVID-19 has been found, and there is no unified domestic guideline for the treatment of relatively high-risk mothers against disease. Several recommendations from the Centers for Disease Control and Prevention, the American Society for Maternal-Fetal Medicine, the International Society of Ultrasound in Obstetrics and Gynecology, and Royal College of Obstetricians and Gynaecologists were suggested. So far, data on COVID-19 is scarce, but it is expected to be similar to the same coronavirus infections as a middle east respiratory syndrome and severe acute respiratory syndrome and can be prepared accordingly. For COVID-19, there was no evidence of vertical transmission at delivery, and the virus was not detected in breast milk. The delivery method should be considered depending on the situation, but vaginal delivery is also possible and should be performed with complete personal protective equipment in a negative-pressure isolation room. After birth, the newborn should be separated from the mother, and the newborn should be isolated as a suspected COVID-19 infection and followed up. In the future, further research should develop clinical guidelines for maternal care for COVID-19.

UCI(KEPA)

I410-ECN-0102-2021-500-000989521

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  • : 연속간행물
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1Recent Trend about Pregnant Women with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Infection

저자 : Se Jin Lee , Sunghun Na

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 1-6 (6 pages)

다운로드

(기관인증 필요)

초록보기

WHO에서 2020년 3월 11일 COVID-19에 대한 세계적대유행(pandemic)을 선언한 이후 이에 대한 전 세계적 관심이 높아지고 있으며, 3월 14일 기준 현재까지 127개국에서 142,491명의 확진자와 5,388명의 사망자가 보고되었다. 이후 산모의 감염사례가 중국에서 보고되고 있으며, 최근 국내에서도 산모의 감염 사례 및 분만 사례가 있었다. 아직 COVID-19에 대한 치료제나 백신은 발견되지 않았으며, 상대적으로 질병에 대하여 고위험군인 산모의 처치에 대한 통일된 국내 지침은 없는 상태이다. 최근 미국 질병통제예방센터(Centers for Disease Control and Prevention), 미국 모체태아의학회(Society for Maternal-Fetal Medicine), 세계산부인과초음파학회(International Society of Ultrasound in Obstetrics and Gynecology) 및 영국산부인과학회(Royal College of Obstetricians and Gynaecologists)에서 여러 권고사항을 발표하고 있다. 현재까지는 COVID-19에 대한 데이터가 부족하지만 같은 코로나바이러스 감염인 중동 호흡기 증후군(MERS) 및 중증 급성 호흡기 증후군(SARS)과 비슷한 형태일 것으로 예상하고 이에 준하여 대비할 수 있다. COVID-19에 대하여 분만 시 수직 감염의 증거는 없으며, 모유 또한 바이러스가 검출되지 않았다. 분만 방법은 상황에 따라 고려되어야 하지만 음압병실에서 완벽한 개인 보호구를 착용한 채로 질식분만도 가능하다. 출생 후 신생아는 산모와 분리되고 COVID-19 의심 환자로 격리되어야 하며 추적검사를 해야 한다. 앞으로 더 많은 연구를 통하여 코로나바이러스와 관련된 산모의 관리에 대한 임상지침이 만들어져야 할 것이다.

2Neonatal Outcomes in Term Births according to Gestational Weeks

저자 : Yun Jeong Park , Young Hwa Kwak , Hee Yon Kim , Sang Won Han , Eui Hyeok Kim

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 7-13 (7 pages)

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Objective: This study aimed to determine neonatal outcomes and morbidities according to gestational weeks in term births.
Methods: This was a retrospective observational study of 626 singleton deliveries from 37 0/7 to 41 6/7 gestational weeks in National Health Insurance Service Ilsan Hospital using electronic medical record data from January 1, 2011 to December 31, 2017 Neonatal outcomes and morbidity in women who attempted vaginal delivery were compared at each gestational week.
Results: Early term births (37 0/7 to 38 6/7) accounted for 38.7% of full-term births (242/626). The rate of neonatal intensive care unit (NICU) admission was the lowest at 39 gestational weeks (25.0%) and highest at 41 weeks (30.8%). Compared to 39 gestational weeks, the rate of NICU admission days for more than 5 days and 5-minute Apgar score less than 7 were higher at 37 gestational weeks (26.6% vs. 11.3%, P=0.028 and 7.6% vs. 2.0%, P=0.011, respectively). The intubation rate was lower in 39 weeks than in 37 weeks without statistical significance. The incidence of meconium-stained amniotic fluid increased with gestational weeks from 37 weeks (1.3% at 37 weeks, 30.8% at 41 weeks, P<0.001). Severe neonatal morbidities were very low and not different according to gestational weeks.
Conclusion: Among term births, our study showed that the prevalence of neonatal morbidities was highest at 37 gestational weeks and lowest at 39 gestational weeks. However, there was no significant difference in severe morbidities. Further studies are urgently required to determine the appropriate timing of delivery to avoid common neonatal complications.

3Cerebroplacental Ratio to Predict Adverse Perinatal Outcomes in Small-for-Gestational- Age Pregnancies

저자 : Jaeyoung Park , Minji Ko , Byung Soo Kang , Jihyun Park , Hyun Sun Ko , In Yang Park

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 14-19 (6 pages)

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Objective: To evaluate the cerebroplacental ratio (CPR) to predict adverse perinatal outcomes in small-for-gestational-age (SGA) pregnancies.
Methods: The study was a retrospective study of cases of pregnant women with SGA babies delivered between 32 and 41 weeks' gestation, in Seoul St. Mary's Hospital between January 2009 and December 2015. We analyzed the neonatal adverse outcomes and the risk of emergency cesarean section due to non-reassuring fetal heart rate in pregnancies with norrnal CPR and abnormal CPR in Doppler ultrasonography.
Results: The abnormal CPR in SGA pregnancies was significantly associated with neonatal intensive care unit admission (P=0.042) and neonatal seizure (P=0.042), in multivariate logistic regression analysis. In receiver operating characteristic curves, the area under the curve (AUC) of abnormal CPR and severe SGA (less than 5th percentile) was 0.59, with sensitivity of 28.4% and specificity of 90.6% (P=0.038), in the emergency cesarean section due to non-reassuring fetal heart rate. However, between 32-36 weeks' gestation, AUC of abnormal CPR was 0.7 with sensitivity of 70.6% and specificity of 69.2% (P=0.019) and AUC of abnormal CPR and severe SGA was 0.77, with sensitivity of 64.7% and specificity of 84.6% (P=0.001), in the emergency cesarean section due to non-reassuring fetal heart rate.
Conclusion: When SGA is expected after 32 weeks' gestation, measurement of CPR might be useful in predicting neonatal adverse outcome. Abnormal CPR was highly predictive of cesarean section due to non-reassuring fetal heart rate, in severe SGA, between 32-36 weeks' gestation.

4Effect of a Combined Hemostatic Technique during Cesarean Section in Placenta Previa

저자 : Dong Hyun Lee , Won Ku Choi , Da Jeong Park , Young Ju Jeong , Jeong Heon Lee

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 20-25 (6 pages)

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Objective: Only a few methods, besides cesarean hysterectomy, are available for controlling intractable bleeding in placenta previa. We aimed to evaluate the effect of the combined hemostatic technique during cesarean section for placenta previa.
Methods: We retrospectively reviewed all cesarean deliveries for placental previa performed from April 2013 to December 2018 at Jeonbuk National University Hospital. Medical records were reviewed to determine the amount of red blood cell transfusion, degree of blood loss, and incidence of postpartum hysterectomy and uterine artery embolization between the conventional method and combined technique. Conventional hemostatic technique group undergo usual cesarean section surgery, and combined hemostatic technique comprises temporary bilateral ovarian artery clamping, bilateral uterine artery ligation, and intrauterine Bakri balloon (Cook Medical, Bloomington, IN, USA) tamponade.
Results: There were 135 cesarean deliveries for placenta previa during the study period (conventional hemostatic method, n=100; combined hemostatic technique, n=35). The index of blood loss (conventional vs. combined, 0.22±}0.13 vs. 0.22±}0.11, P=0.90) was not different between the two groups. However, the mean amount of intraoperative red blood cell transfusion (0.88±}2.12 vs. 0.55±}0.93 units, P=0.02) was significantly lower in the combined technique group. The incidence of postpartum hysterectomies (5 vs. 0, P=0.025) and postpartum treatments (13 vs. 0, P=0.006) for continuous bleeding after cesarean section was also significantly lower in the combined technique group.
Conclusion: Our findings suggest that combined hemostatic technique is associated with less intraoperative red blood cell transfusion and a decreased rate of postpartum hysterectomy and additional hemostatic procedures after cesarean section for placenta previa.

5The Effect of Holder Pasteurization and Storage on Macronutrients in Donor Human Milk

저자 : Jinjoo Kim , Na Mi Lee , Dae Yong Yi , Sung-hoon Chung , Yong-sung Choi

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 26-31 (6 pages)

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Objective: Milk delivered to human milk banks should be pasteurized and stored at -20°C in order to inactivate any microbial agents that may be present. We aimed to quantify the changes in the macronutrient composition of donor human milk (DHM) that underwent Holder pasteurization (HoP) and subsequent storage.
Methods: A total of 54 breast milk samples from 26 healthy lactating mothers were collected at different time points after delivery, at intervals ranging from 1-6 months. We measured the carbohydrate, protein, fat, and energy content before and after HoP. After HoP, DHM was stored at -20°C, and the nutrients were measured at 1, 2, 4, 8, 12, 16, and 20 weeks after storage commenced.
Results: The difference in time between expression of milk and pasteurization did not affect the concentration of macronutrients. However, the protein, fat, and energy contents decreased significantly during HoP. The mean values of the protein, fat, and energy contents in DHM pre-HoP were 1.2 g/dL, 3.7 g/dL, and 72.1 kcal/dL, compared with post-HoP values of 1.0 g/dL, 3.1 g/dL, and 65.2 kcal/dL, respectively. Although HoP reduced the protein, fat, and energy contents of donor milk by 16.7%, 16.2%, and 9.6%, respectively, the carbohydrate content was not reduced. Moreover, there was a significant decrease in the content of all the analyzed macronutrients following storage for up to 20 weeks.
Conclusion: The post-HoP storage period affected nutrients, with several human milk components decreasing in content after HoP. As such, DHM after HoP may need fortification to ensure normal infant growth.

6Perinatal Risk Factor and Morbidity in Term Large-for-Gestational-Age Infants according to Classification by Ponderal Index

저자 : Yeon Ho Kang , Eun Song Song , Ga Eun Choi , In Ji Hwang , Young Youn Choi

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 32-38 (7 pages)

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Objective: Large-for-gestational-age (LGA, birth weight ≥90th percentile) infants have increased risks of adverse perinatal outcomes. Further classification within the LGA group enables identification of infants at highest risk for neonatal morbidity. The objective of the study is to investigate the difference of perinatal risk factors and morbidity in LGA infants born at 37-41 weeks of gestation according to classification by the ponderal index (PI).
Methods: 195 LGA infants between January 2016 and December 2018, were enrolled in this retrospective study. They were divided into two groups base on PI; symmetric LGA (PI ≤90th percentile) and asymmetric LGA (PI >90th percentile). Neonatal and maternal demographics with clinical characteristics, and neonatal morbidity were compared between two groups.
Results: The gestational age of term LGA infants was 38.6±1.2 weeks and birth weight was 3,963±326 g. Maternal pre-pregnancy body mass index was 25.8±6.6 kg/m2 and diabetes mellitus was 23.6%. Maternal diabetes mellitus and placental infarction were also significantly higher in the asymmetric LGA infants. Asymmetric LGA infants had higher incidence of hypoglycemia, clavicle or humerus fracture and had higher initial hemoglobin and hematocrit levels than the symmetric LGA infants.
Conclusion: In the asymmetric LGA group, maternal diabetes and neonatal morbidity such as clavicle or humerus fracture and hypoglycemia were higher than in the symmetric group. Early identification of fetuses for being the asymmetric LGA gives a chance to optimize management of these newborns associated with increased morbidity. Thus, the combination of birth weight and PI helps a more appropriate parameter than birth weight alone.

7A Novel Mutation of KRT14 Gene in a Newborn with Epidermolysis Bullosa Simplex (Dowling-Meara Type): Case Report

저자 : Sung-min Lim , Jin Hee Kim , Yeseul Kim , Seung Sam Paik , Jeong Eun Kim , Joo Yeon Ko , Jinsup Kim , Hyun-kyung Park , Chang-ryul Kim , Hyun Ju Lee

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 39-43 (5 pages)

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Epidermolysis bullosa simplex (EBS) is a group of inherited skin diseases characterized by intraepidermal blistering upon mild trauma. They are classified into three major types based on the severity and distribution of blisters, age of onset, and histological findings. These three major types are caused by KRT5 and KRT14 gene mutations. EBS Dowling-Meara (DM) is one of the most severe subtypes which mostly affects neonates. Electron microscopy is a primary diagnostic tool for EBS; however, mutation analysis has recently become more important for its diagnosis, prognosis, genetic counselling, and prenatal diagnosis. Several studies have reported that almost all mutations in EBS-DM patients are found in the highly conserved rod domains of the KRT5 and KRT14 genes and have also demonstrated a genotype-phenotype correlation. Here, we report an EBS-DM case diagnosed by mutation analysis in a newborn and a missense mutation not identified in humans previously.

8Terminal Deletion of the Chromosome 4q with Hemivertebra: Case Report

저자 : Seung-hyun Ko , Hyun Ju Lee , Chang-ryul Kim , Hyun-kyung Park , Ja Hye Ahn

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 44-49 (6 pages)

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The terminal deletion of the long arm of chromosome 4 is a very rare autosomal abnormality with an approximate incidence of 1 in 100,000 and overall mortality of 28%. This syndrome is characterized by craniofacial and digital anomalies, developmental delay, growth retardation, skeletal and cardiac anomalies, and autism spectrum disorder. We experienced a case of the terminal deletion of the long arm of chromosome 4 in a 2 day-old female neonate who showed developmental delay, craniofacial anomalies, skeletal and extremity defects, and cardiovascular defects. Here, we first report hemivertebra in an infant with terminal deletion of chromosome 4q and discussion previous case with a brief review of the literature.

9Epidermal Necrosis of Forearm and Wrist due to Extravasation of Sodium Bicarbonate and Application of Epidermal Growth Factor for Therapy in Extremely Low Birth Weight Infant

저자 : Hak Kyoun Cho , Hyee Jae Yang , Jae Young Cho , Hae Woon Jung , Yong Sung Choi

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 50-54 (5 pages)

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Extravasation occurs when an intravenous drug is inadvertently administered into the perivascular space or subcutaneous tissue. This can have various consequences, from local irritation to severe tissue loss. Extravasation occur more frequently in neonatal populations, especially in younger gestational ages and with lower birth weights. There is no established method of treatment for extravasation. Conservative treatments such as saline wash, wet dressing, hyaluronidase, and hydrogel dressing should be performed. Recently, two full-term newborns have been reported to successfully treat skin necrosis with recombinant human basic fibroblast growth factor. We report for the first time that extravasation in extremely very low birth weight infants can be successfully treated with recombinant human epidermal growth factor.

10Thyroid Function of Preterm Twins Having Breastmilk from Their Mothers Consuming Seaweed Soup Might Be Variable between Siblings: A Case Series

저자 : Wook Jin , Dong Woo Son , Hye Jung Cho , Eun Jin Kim

발행기관 : 대한주산의학회 간행물 : PERINATOLOGY (구 대한주산의학회잡지) 31권 1호 발행 연도 : 2020 페이지 : pp. 55-60 (6 pages)

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Thyroid dysfunction is common in preterm infants. Breastmilk-fed (BMF) preterm infants in Korea often develop hypothyroidism because of excessive maternal iodine ingestion. Recently in our neonatal intensive care unit, we encountered three pairs of BMF preterm twins showing discrepancies in thyroid function at 1 month of age. Their mothers consumed seaweed soup daily during that time. Within each BMF pair, the amount of breastmilk intake was almost similar. However, thyroid function differed within twins. Urinary iodine concentrations were different within twins and not correlated with thyroid dysfunction. The clinical characteristics within each pair were not significantly different. In conclusion, thyroid function would be different even between BMF premature twin siblings despite the same amount of iodine intake and the similar conditions that are currently known to affect thyroid function. Therefore, serial evaluation of thyroid function in BMF preterm infants would be crucial.

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24권 7호 ~ 24권 7호

KCI등재

대한폐경학회지
26권 3호 ~ 26권 3호

KCI등재

PERINATOLOGY (구 대한주산의학회잡지)
31권 4호 ~ 31권 4호

KCI등재 SCI SCOUPUS

Journal of Gynecologic Oncology (JGO)
31권 6호 ~ 31권 6호

KCI등재 SCOUPUS

Obstetrics & Gynecology Science
63권 6호 ~ 63권 6호

대한산부인과학회 학술발표논문집
106권 0호 ~ 106권 0호

KCI등재

PERINATOLOGY (구 대한주산의학회잡지)
31권 3호 ~ 31권 3호

KCI등재 SCOUPUS

Obstetrics & Gynecology Science
63권 5호 ~ 63권 5호

KCI등재 SCI SCOUPUS

Journal of Gynecologic Oncology (JGO)
31권 5호 ~ 31권 5호

KCI등재

대한폐경학회지
26권 2호 ~ 26권 2호

KCI등재 SCOUPUS

Obstetrics & Gynecology Science
63권 4호 ~ 63권 4호

KCI등재 SCI SCOUPUS

Journal of Gynecologic Oncology (JGO)
31권 4호 ~ 31권 4호

KCI등재

PERINATOLOGY (구 대한주산의학회잡지)
31권 2호 ~ 31권 2호
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

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