다태임신의 적절한 관리

강윤단 대한산부인과학회 2021 대한산부인과학회 학술대회 Vol.107 No.-

모체태아의학 : 임신 전자간증 산모 혈청에서 highly sensitive C-reactive protein 농도와 생화학적 및 임상적 지표와의 연관성 (초)

강윤단,정윤희,양정선,김종수,박만철 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

선택적 제왕절개술을 위한 부위 마취 시 산모의 저혈압: 위험 인자 및 신생아에 미치는 영향

강윤단 한국모자보건학회 2016 한국모자보건학회지 Vol.20 No.1

Purpose: This study was performed to determine the prevalence and risk factor of hypotension among pregnant women undergoing elective cesarean section under regional anesthesia, and whether hypotension has any impact on neonate outcome. Methods: Retrospective analysis of 440 mother-infant pairs after elective cesarean section under regional anesthesia. Data collection included information on maternal blood pressure during the cesarean section, cord blood pH and Apgar score. Results: This study revealed that 20.5% of the mothers underwent a decrease in mean arterial blood pressure by ≥30% and 1.1% of the mothers underwent a decrease in mean arterial blood pressure by ≥50%. Hypotension was more severe among the mother in those with preoperative hypertension and high body weight. The occurrence of maternal hypotension during cesarean section were not found to predict any complications like low Apgar score, need for oxygen treatment, even though fetal cord blood pH. Conclusion: Despite a maternal hypotension during elective cesarean section under regional anesthesia, healthy term infants seem to tolerate decreased placental blood perfusion.

Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

강윤단,김유미 대한초음파의학회 2016 ULTRASONOGRAPHY Vol.35 No.2

Purpose: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. Methods: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscessdiameter, pus culture results, the number of interventions, the healing time, and the cure ratewere reviewed and compared between these two groups. The Student’s t test and the chi-squaretest were used to compare the variables. Results: No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However,the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days)than in the needle aspiration group (9.0 days) (P=0.001). Conclusion: Vacuum-assisted biopsy is a viable option for the management of lactational breastabscesses and was found to lead to a shorter healing time than needle aspiration. However,further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in themanagement of lactational breast abscesses.

비만여성의 적절한 산전관리

강윤단 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

A case of pregnancy-associated Sweet`s syndrome (초)

강윤단,정윤희,양정선,박만철,김종수 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

산전 부신피질호르몬 일회 투여 후 분만까지 기간이 조산아 예후에 미치는 영향

강윤단 ( Yun Dan Kang ),박만철 ( Man Chul Park ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.1

목적: 산전에 투여한 부신피질호르몬 일회 요법의 장점이 시간이 지남에 따라 어떻게 변하는지 알아보기 위함이다. 연구 방법: 본원 산부인과에서 산전 부신피질호르몬 일회 요법의 전 과정을 투여받은 후, 임신 26주 이후 및 35주 이내에 분만하였던 신생아 203명을 대상으로 신생아 입원 차트를 후향적으로 검토하였다. 첫 부신피질호르몬 투여부터 분만까지의 기간이 48시간 후 7일 이내군 (78예), 8일에서 14일 사이군 (65예) 및 15일 이상군 (60예)으로 구분하여 신생아 이환율을 비교하였다. 결과: 각 군의 임상적 특징 및 산전 부신피질호르몬 투여 적응증의 분포, 분만을 시도하게 된 적응증의 분포에 차이는 없었다. 24시간 이상 인공호흡기 부착률은 7일 이내군이 32.1% (25/78)로 8~14일군의 50.8% (33/65)(P=0.023) 및 15일 이상군의 51.7% (31/60)(P=0.02)보다 의미 있게 낮았으며, 8~14일군과 15일 이상군 사이에 유의한 차이는 없었다. 그러나 평균 인공호흡기 부착 기간, 표면활성제 투여율, 임신 연령 36주에 산소의존율, 분만 후 28일에 산소의존율, 뇌실내출혈 발생 빈도, 괴사소장 대장염 발생 빈도, 패혈증 발생 빈도 및 입원 기간 등에서는 차이가 없었다. 모든 군에서 뇌측실부 백질 연화증과 신생아 사망은 없었다. 결론: 산전 부신피질호르몬 투여 후 7일이 지나면 24시간 이상 인공호흡기 부착률이 증가할 수 있으나, 다른 모든 이환율엔 차이가 없었다. Objective: To determine whether the beneficial effects of a single course of antenatal corticosteroids for neonatal morbidity change with time Methods: A retrospective chart review was performed of women who received a single complete course of antenatal corticosteroid and delivered a viable singleton infant between 26 and 35 weeks of gestation. Patients were divided into 1 of 3 groups on the basis of the interval from first corticosteroid dose to delivery (48 hr~7 days, 8~14 days and ≥15 days). Neonatal morbidities were compared between each groups. Results: Two hundred three pregnancies were included, of which 78 women delivered at 48 hr-7 days, 65 women delivered at 8~14 days and 60 women delivered at ≥15 days. The 3 groups were similar in clinical characteristics and indications for antenatal steroids and delivery. Neonates delivered within 7 days had a lower incidence of receiving ventilatory support for more than 24 hours than 8~14 days group (32.1% vs 50.8%, P=0.023) and ≥15 days group (32.1% vs 51.7%, P=0.02). But there were no significant differences between the groups in ventilator days, surfactant use, oxygen dependency at 36 weeks of gestation, oxygen dependency at 28 days after delivery, intraventricular hemorrhage, necrotizing enterocolitis, sepsis and length of hospital days. There were no periventricular leukomalacia and neonatal death in all groups. Conclusion: Neonates delivered more than 7 days after first corticosteroid dose needed more short-term ventilatory support, but there were no differences in other neonatal outcomes.

임상 ; 태반 기능장애가 악화된 경증 전자간증 산모에서 입원 시 실시한 체계적 평가

강윤단 ( Yun Dan Kang ),유우정 ( Woo Jeong Yu ),박만철 ( Man Chul Park ) 대한주산의학회 2007 Perinatology Vol.18 No.3

목적: 체계적 평가에서 경증 전자간증으로 판명되었던 산모를 대상으로, 태반 기능장애가 악화되지 않았던 군과 분만 전에 태반 기능장애가 악화된 군으로 나누어 이들 사이에 체계적 평가 검사 결과가 어떤 차이를 보이나 알아보기 위함이다. 방법: 입원하여 체계적 평가 실시 후 경증 전자간증으로 판명되었던 산모 76명 중, 분만까지 태반 기능장애가 악화되었던 산모는 28예이었고, 악화되지 않았던 산모는 48예이었다. 악화군의 판단 기준은 초음파 검사에서 양수지수가 5 cm 이하로 양수 양이 감소하였거나 진통 중 전자 태아심박 감시 장치에서 후반 심박동 감소 또는 다양성 심박동 감소의 반복, 지속적인 빈맥이 변동성 소실과 함께 나타나거나, 장기적인 심박동 감소가 나타났던 경우로 하였다. 중증 전자간증으로 발전된 경우도 악화군에 포함시켰다. 결과: 혈중 총 단백질의 농도 및 24시간 단백뇨의 양은 차이가 없었으나, 알부민 농도는 악화군에서 의미있게 낮았다. 혈중 크레아티닌 농도는 두 군 간에 유의한 차이가 없었으나, 혈중 요산 농도는 악화군에서 의미있게 높았다. 요중 크레아티닌 농도 및 크레아티닌 청소율은 악화군에서 의미있게 낮았다. ALT, AST 및 적혈구용적율은 두 군 간에 유의한 차이가 없었으나, LDH 농도는 악화군에서 의미있게 높았다. 결론: 체계적 평가에서 경증 전자간증으로 판명되더라도 혈중 알부민, 요중 요산 농도 및 크레아티닌 청소율이 낮고, 혈중 요산 농도 및 LDH가 높게 나오면 태반 기능장애가 악화될 가능성이 높으므로 분만 전까지 철저한 산전 검사와 분만 중에 각별한 주의가 필요할 것으로 사료된다. Objectives: To compare the systematic evaluations in hospitalization of mildly preeclamptic women whose placental dysfunction was exacerbated with those whose placental dysfunction was not exacerbated. Methods: There were seventy six mildly preeclamptic women after systematic evaluations in hospitalization, in which twenty eight women showed exacerbated placental dysfunction. Outcome markers considered suggestive of exacerbation of placental dysfunction included oligohydramnios (amniotic fluid index less than 5 cm), clinical diagnosis of intrapartum fetal distress and progression to severe preeclampsia. A clinical diagnosis of fetal distress was made when the monitoring revealed recurrent late, persistent tachycardia with loss of variability or prolonged decelerations. Results: There were no significant differences in the amount of 24 hours urine protein, the concentrations in serum protein, creatinine, aspartate transaminase and alanine transaminase and hematocrit. But in exacerbated group, the concentrations of serum albumin and urine creatinine and creatinine clearance were significantly lower and the concentrations of serum uric acid and lactate dehydrogenase were significantly higher than not exacerbated group. Conclusion: In mildly preeclamptic women diagnosed after systematic evaluation in hospitalization, we must give attention to those whose concentrations of serum albumin and urine creatinine and creatinine clearance are low and concentrations of serum uric acid and lactate dehydrogenase are high.

갑상선 기능항진증 산모에서 제왕절개 분만후 진단된 비대칭성 울음 안면 1 예

강윤단 ( Kang Yun Dan ),송언호 ( Song Eon Ho ),박진완 ( Park Jin Wan ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.2

Asymmetric crying face is caused by unilateral weakness of the depressor muscles of lower lip, which is most obvious during crying and is associated with other congenital anomalies, especially congenital heart disease. We experienced a case of asymmetric crying face after cesarean delivery in mother with hyperthyroidism and present it with a brief review of literature.

산전 초음파로 진단된 태아 두개강 내 출혈

강윤단 ( Yun Dan Kang ),정윤희 ( Yun Hee Jeong ),진건 ( Keon Jin ),박만철 ( Man Chul Park ) 대한주산의학회 2008 Perinatology Vol.19 No.2

Fetal intracranial hemorrhage is quite rare. Antenatal fetal intracranial hemorrhage may occur spontaneously, or in association with various maternal or fetal conditions. Currently, antenatal fetal intracranial hemorrhage may be diagnosed by imaging techniques including ultrasonography and less frequently, magnetic resonance imaging (MRI). We report a case of spontaneous fetal intracranial hemorrhage that was diagnosed antenatally in the third trimester with a brief review of literatures.