This paper discusses the implications of South Korea's birth notification system and Protected Birth Act, which is set to take effect on July 19, 2024. The legislation aims to prevent infanticide and child abandonment by mandating birth reporting and allowing anonymous births for women in crisis. However, concerns have been raised about the Act's effectiveness in protecting both women and children, particularly regarding issues of disability and migrant families. This paper focuses on gender and healthcare issues, highlighting how the Act perpetuates discrimination against out-of-wedlock pregnancies and upholds normal family ideologies. It notes the absence of critical discussions on women's autonomy, safe pregnancy termination, and paternal responsibility. The importance of healthcare providers understanding and preparing for the Act's implementation is emphasized. The paper calls for strengthening social safety nets to improve healthcare access for vulnerable populations and eliminate discrimination against non-traditional families. Additionally, it addresses the need for comprehensive support systems for crisis pregnancies, including financial assistance, psychological support, parenting education, housing solutions, and expanded healthcare services. This paper acknowledges the Act's significance in providing a systematic state-level approach to protecting pregnant women in crisis, replacing the previous reliance on private organizations. Nonetheless, it also emphasizes the importance of continually reviewing and supplementing the system to address potential rights infringements and ensure its effectiveness. In conclusion, this paper advocates for ongoing discussions on gender and healthcare issues, and for future amendments to the law that reflect real-world circumstances and provide genuine protection for crisis pregnancies and infants.
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, Ka Hyun Lee, Ji-Won Han, Su Jin Cho The omphalomesenteric duct is an embryologic connection between the midgut and yolk sac, which typically disappears at 5th to 7th week of gestation. Failure of the obliteration process can lead to omphalomesenteric duct remnants. We report a case of a neonate with a patent omphalomesenteric duct fistula opening to the umbilicus presenting with meconium sprouting from the umbilical stump. Segmental resection of the ileum and end to end anastomosis were conducted. The patient was discharged on the 8th postoperative day without any complications, and no abnormalities were observed at the outpatient clinic follow-up up to 5 months after surgery. Here we describe the case and a review of the literature.
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, Eunkyo Park, Jungeun Shin, Eun-Hee Ha The accumulated evidence shows that adult disease may have origins during the fetal period and maternal environmental exposure may affect fetus and infant health. To assess the environmental health of fetus and infants and examine women's concerns about environmental health, we designed and conducted an environmental health survey in reproductive-aged women in 2011.
A stratified multi-stage design was adopted for our survey, and 1,000 reproductive-aged women aged 25 to 39 years participated. The participants were asked to complete an electronic questionnaire using the computer-assisted web interviewing method. All the participants were married woman, and 80% had experienced pregnancy before completing the survey.
In the study, 86.3% of the participants responded that they are worried about the environmental problems that may affect the fetus and infant. The participants responded that they were most worried about global warming and climate change (36.2%), electromagnetic waves (31.4%), and endocrine disrupting chemicals (25.1%). Moreover, participants responded that environmental problem can cause children's allergic disease, such as atopic dermatitis, metabolic syndrome and growth development.
We found reproductive-aged women have high awareness of children's environmental health. We also recommended that additional surveys on mother and child environmental health be conducted to make a health policy for women, fetus and infant.
, Se Hwan Ahn, Jong Han Kim, Su Yeong Kim, Ji-Eun Ban Although Atrial flutter (AFL) in newborn infant with normal cardiac anatomy has benign clinical course, an intractable AFL is associated with an increased risk of development of heart failure and sudden death, and is still difficult to manage. It requires multiple external electrical cardioversions, and it shows a poor response to antiarrhythmic drug therapy. We report a case of a premature infant with an intractable AFL, which we successfully treated with oral flecainide and propranolol in spite of recurred AFL. A 1-month-old, 34-week gestation, premature baby presented with an irregular heart beat and irritability. An AFL with 2:1 atrioventricular conduction was documented. Because of the intractable AFL, repeated electrical cardioversion and amiodarone were continued for 14 days. However, amiodarone was discontinued in favour of flecainide and propranolol because of the recurrent AFL and newly developed transient hypothyroidism. During 1-year follow-up period, in which oral flecainide and propranolol were continued, no AFL was observed.
, Hee Won Kang, Young Min Youn, So-Yeon Shim, Eun Ae Park, Su Jin Cho To compare the epidemiology, clinical presentation, laboratory findings, seasonality and hospital course of enteroviral meningitis (EM) and non-enteroviral meningitis (NEM) cases in infants under 3 months of age.
A retrospective chart review was performed of infants under 3 months of age or less with viral meningitis admitted to Ewha Womans University Mokdong Hospital between January 2010 and December 2016.
EM patients were more likely to have siblings compared with NEM. Most of EM was diagnosed during the summer season. Almost 80% of EM was diagnosed between July and September. Fever lasted longer in EM patients compared to NEM. White blood cell count (WBC) from the cerebrospinal fluid was higher in EM patients compared with NEM patients. WBC in blood were lower in EM patients compared with NEM patients. C-reactive protein was lower in EM patients compared with NEM patients. Most of the patients were initially started on antibiotics therapy to rule out bacterial meningitis. EM patients received shorter duration of antibiotic treatment compared with NEM patients.
This study was conducted to augment the understanding of the incidence, epidemiology, transmission in infants, clinical presentation, laboratory findings, seasonality and hospital courses of enteroviral meningitis compared to NEM. Early recognition, rapid diagnosis and proper clinical management can reduce duration of antibiotic treatment.
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, Jeonghyun Koo, Jeong Soo Suh, Chungsik Rhee Acute appendicitis is very rare in infancy and early childhood. Delayed diagnosis of appendicitis may result in catastrophic outcome with perforation. We performed a retrospective analysis of clinical and radiologic findings of acute appendicitis occurring in the first 2 years of life.
Nine patients of acute appendicitis who were are less than two years of age proved by surgery and pathology were analyzed in terms of clinical symptoms and signs, and findings on preoperative plain abdominal roentgenography(9 cases), barium or gastrografin enema(6 cases), ultrasonography(8 cases) and abdominal CT scan(1 case).
All patients presented with nonspecific clinical symptoms and signs, such as vomiting and fever. All were complicated with perforation. Six were associated with periappendiceal abscess, and four with appendicolith. Plain abdominal roentgenogram showed generalized paralytic ileus and increased density on right lower quadrant in all cases, and diffuse for right lower abdominal wall bulging in some cases. Most cases of perforated appendicities and periappendiceal abscess were diagnosed by ultrasound and some cases by contrast enema or abdominal CT scan.
When the patients less than 2 years of age have nonspecific acute abdominal symptom with the roentgenographic findings of aggravating ileus and haziness in the right lower abdomen, ultrasonography might be considered as a helpful diagnostic tool for the early diagnosis of appendicitis. CT and contrast enema also might be helpful.
Infantile hypertrophic pyloric stenosis (IHPS) is common surgical disease in infants having vomiting. This disease is still not fully documented despite of various hypotheses. This article reviews the literature on the etiology, clinical course, diagnosis and management of IHPS including recent opinion.
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Recently, the improvement of the economic conditions and the increasing application of abdominal sonography as a diagnostic tool makes the early diagnosis of infants with infantile hypertrophic pyloric stenosis(IHPS) easy and precise. And the cases with the classical pathophysiologic derangement of IHPS have a declining tendency. In this study the author analyzed and reported the trend at Ewha Womans University Hospital.
The author analysed the clinical features and management of 91 young infants who were undergoing pyloromyotomy by author for IHPS from January 1981 through December 1997 at Ewha Womans University Hospital. The findings were compared between the former(1981-1990) and the latter period(1991-1997).
Among the total 91 cases, 42 cases were included into the former and 49 cases were the latter period. There has been no difference in sex ratio, birth rank, and age at time of admission between the former and the latter period. The percentage of patients breastfed decreased from 23.8% to 0. And the percentage of patients with alkalosis decreased from 54.8% to 30.6%, hypochloremia from 57.1% to 39.6%, and hypokalemia from 45.2% to 29.2% under the influence of increasing the incidence of early diagnosis. The number of patients with palpable pyloric mass by palpation of the abdomen decreased from 83.3% to 71.4%. And the use of upper gastrointestinal series only as diagnostic test decreased from 71.4% to 18.4%, ultrasonography increased from 11.9% to 46.9%, and both increased from 11.9% to 34.7%. There was no specific postoperative complication during the latter period, and the postoperative hospital stay decreased from 7.1±1.5 days to 4.5±0.7 days.
In conclusion, the increasing use of ultrasonography as diagnositic tool enabled the early diagnosis of infantile hypertrophic pyloric stenosis before appearing the disturbed fluidelectrolyte balance of the body. Although the signification decrease of the postoperative hospital stay and complications in the latter period, there has been less change in areas controlled by other specilaties.
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