Music therapy-assisted labor and delivery

This article describes a new clinical music therapy program for application in the labor and delivery setting, and presents results of a preliminary study to evaluate effectiveness of the treatment. Over 50 women participated in the project; however, inclusion of patients in the data collection portion of the project was limited by criteria designed to minimize the effects of spurious variables. An experimental group of 13 patients participated in six individual predelivery music therapy training sessions during the third trimester of pregnancy. Experimental patients listened to preselected musical works throughout labor and delivery, with the music therapist in attendance. A control group of seven subjects participated in labor and delivery according to regular hospital routines. Data consisted of patients' responses to questionnaire items reflecting subjective perceptions and recollections of the labor/delivery experience and reports of frequency and duration of home practice. Experimental subjects achieved significantly higher "success" scores than did control subjects on five of seven indices (p less than .05). A moderate correlation between music home practice and successful childbirth outcome was demonstrated, with frequency/length of music home practice revealed as a significant predictor of success in the childbirth experience.     

不同助产方式对初产妇分娩产程及分娩结局的影响

目的：探讨不同助产方式对初产妇产程及分娩结局的影响。方法将我院2014年4～6月采用导乐无保护会阴接生技术的100例初产妇（观察组）与我院2014年1～3月采用常规助产技术的100例初产妇（对照组）进行比较,分析两组的会阴损伤情况、产程、分娩结局、住院时间及费用。结果两组产妇的会阴完整率、第三产程时间无统计学意义（ P＞0.05）。观察组的第一产程、第二产程均短于对照组,Ⅰ度裂伤率高于对照组,会阴侧切率低于对照组,有统计学意义（ P＜0.05）。观察组产后出血率、第1天、第3天的疼痛评分均低于对照组,护理满意度高于对照组,住院时间短于对照组,住院费用少于对照组,有统计学意义（P＜0.05）。结论导乐无保护会阴接生技术既能加快产程进展,又能减少会阴损伤和产后出血,促进产妇产后恢复。     

Complications of labor and delivery: shoulder dystocia

This article reviews one of the less common but most dreaded complications of labor and delivery, shoulder dystocia, an infrequent but potentially devastating event that results from impaction of the fetal shoulders in the maternal pelvis. Shoulder dystocia occurs most commonly in patients without identified risk factors, and can result in both maternal and fetal morbidity. Because the vast majority of cases of shoulder dystocia are unpredictable, obstetric care providers must be prepared to recognize dystocia and respond appropriately in every delivery. Detailed documentation is essential after any delivery complicated by shoulder dystocia.     

Effects of SP6 acupressure on labor pain and length of delivery time in women during labor

OBJECTIVE: The purpose of this study was to evaluate the effects of SP6 acupressure on labor pain and delivery time in women in labor. DESIGN: Randomized clinical trial. SETTING/LOCATION: Delivery room in a university hospital. PARTICIPANTS: Seventy-five (75) women in labor were randomly assigned to either the SP6 acupressure (n = 36) or SP6 touch control (n = 39) group. The participants were matched according to parity, cervical dilation, labor stage, rupture of amniotic membrane, and husband's presence during labor. There were no additional oxytocin augmentation or administration of analgesics during the study period. INTERVENTION: The 30-minute acupressure or touch on SP6 acupoint was performed. OUTCOME MEASURES: Labor pain was measured four times using a structured questionnaire, a subjective labor pain scale (visual-analogue scale [VAS]): before intervention, immediately after the intervention, and 30 and 60 minutes after the intervention. Length of delivery time was calculated in two stages: from 3 cm cervical dilation to full cervical dilatation, and full cervical dilatation to the delivery. RESULTS: There were significant differences between the groups in subjective labor pain scores at all time points following the intervention: immediately after the intervention (p = 0.012); 30 minutes after the intervention (p = 0.021); and 60 minutes after the intervention (p = 0.012). The total labor time (3 cm dilatation to delivery) was significantly shorter in the SP6 acupressure intervention group than in the control group (p = 0.006). CONCLUSIONS: These findings showed that SP6 acupressure was effective for decreasing labor pain and shortening the length of delivery time. SP6 acupressure can be an effective nursing management for women in labor.     

助产士护理联合产时体位护理对初产妇自然分娩率及产程时间的影响

目的：分析助产士护理联合产时体位护理对初产妇自然分娩率及产程时间的影响。方法：选定单县中心医院2019年8月至2021年8月120例初产妇为研究对象,以双盲随机抽样法分组,参照组(n＝60)采纳常规分娩护理,实验组(n＝60)采纳助产士护理+产时体位护理,对比两组SAS评分、SDS评分、产程、分娩结局、母婴并发症发生率。结果：实验组护理后SAS以及SDS评分均明显比参照组低,实验组第一、第二、第三以及总产程均显著短于参照组,实验组自然分娩率(86.67%)明显高于参照组(66.67%),剖宫产率(13.33%)明显低于参照组(33.33%),实验组母婴并发症发生率(3.33%)明显低于参照组(18.33%),差异均有统计学意义(P<0.05)。结论：助产士护理联合产时体位护理可显著提高初产妇自然分娩率,缩短产程,改善妊娠结局,值得借鉴。