偏远山区孕产妇孕期检查情况分析

目的:对孕产妇的孕期检查情况进行调查,以便有针对性的对孕妇提供指导。方法:选取在延庆县妇幼保健院建册、检查,并于2007年3月1日～2007年11月30日分娩的产妇334例进行调查,应用SPSS10.0统计软件进行分析。结果:不同产次、年龄、住址、职业、文化程度的孕妇孕期检查次数和初次检查时间有显著差异。结论:孕妇的产次、年龄、住址、职业、文化程度影响孕妇检查次数和初次检查时间,建议有针对性的对孕前及孕早期妇女进行宣传教育,增强孕期保健意识,提高基层孕检质量,发展经济和交通,使每个孕妇都能得到相应的检查治疗。     

导乐分娩镇痛仪结合体位管理与一对一陪伴分娩在促进自然分娩中的临床价值

目的探讨导乐分娩镇痛仪结合体位管理与一对一陪伴分娩在促进自然分娩中的临床价值,为孕妇提供一种舒适、安全分娩选择。方法选择2014年1月-12月期间收住玉林市妇幼保健院符合纳入标准的孕妇300例,将其按照入组顺序编号,采用随机数字表法将其分为A、B、C 3组,每组100例。A组孕妇实施导乐分娩镇痛仪配合体位管理与一对一陪伴分娩,B组孕妇实施导乐分娩镇痛仪辅助自然分娩,C组孕妇实施传统自然分娩。比较3组孕妇不同阶段产程时间、疼痛评分、自然分娩率、自然分娩产妇生殖道损伤情况及新生儿窒息率。3组孕妇生产结束后第2天对其进行满意度调查并比较。结果 3组孕妇年龄、体质量、体质指数(BMI)和孕周比较差异无统计学意义(均P0. 05)。A组产妇第一产程时间、第二产程时间、疼痛评分和自然分娩者生殖道损伤率均明显低于B组和C组产妇,且B组产妇上述指标明显低于C组产妇,差异有统计学意义(均P0. 05)。A组产妇自然分娩率和产妇满意率明显高于B组和C组产妇,且B组产妇自然分娩率和产妇满意率明显高于C组产妇,差异有统计学意义(均P0. 05)。3组新生儿窒息率比较差异无统计学意义(P0. 05)。结论导乐分娩镇痛仪结合体位管理与一对一陪伴分娩可有效提升产妇自然分娩率,降低分娩疼痛,对促进母婴健康水平具有重要的临床价值。     

高龄初产妇分娩恐惧影响因素分析

目的：调查分析高龄初产妇分娩恐惧情况及影响因素。方法：应用便利抽样法选取2021年12月-2022年6月本院拟分娩的160例高龄初产妇，以分娩恐惧量表(CAQ)调查产妇分娩恐惧情况，并收集产妇一般资料、焦虑自评量表(SAS)、围生期孕妇健康素养量表、分娩自我效能感量表(CBSEI-C32)、社会支持评定量表(SSRS)评分，以单因素分析及logistic多因素回归分析高龄初产妇分娩恐惧有关影响因素，应用Spearman相关性分析分娩恐惧与SAS、围生期孕妇健康素养量表、CBSEI-C32、SSRS评分的关系。结果：160例高龄初产妇CAQ(36.91±8.63)分，其中存在分娩恐惧产妇占86.3%。单因素分析显示，文化水平、不孕史及SAS、围生期孕妇健康素养量表、CBSEI-C32、SSRS评分有差异(P<0.05),logistic回归分析，文化水平非高龄初产妇分娩恐惧独立危险因素(P>0.05),不孕史及SAS为分娩恐惧独立危险因素，围生期孕妇健康素养量表、CBSEI-C32、SSRS评分为保护因素(均P<0.05)。Spearman相关性分析，分娩恐惧与SAS评...     

34例产妇第一产程应用自由体位分娩的护理体会

目的探讨自由体位在第一产程中的应用效果。方法选取2014年6月17日-8月4日天津市中心妇产科医院住院待产孕妇34例,孕妇足月待产,无妊娠高血压、糖尿病等合并症。排除脐带绕颈、臀位、早产等相关因素。在产妇及家属知情同意下对孕妇于第一产程采取走、坐、分娩球、站立、行走、趴、蹲、跪及半坐卧位等自由体位,并严密观察产程进展。结果本组产妇6例经导尿后顺产,1例导尿后经产钳分娩,1例头盆不称行剖宫产,其余产妇均顺利经阴道分娩。结论第一产程自由体位分娩,产妇可自由选择活动方式。避免了传统的进入产程只能卧床的观念,充分调动产妇的积极性。提高了产妇的舒适度,有利于自然分娩。     

产妇分娩体位管理对分娩结局及新生儿的影响

目的研究产妇不同分娩体位对分娩结局及新生儿的影响。方法选择2013年11月-2015年4月间在该院分娩的480例足月妊娠孕妇进行回顾性研究,根据孕妇的实际情况采用不同分娩体位,将足月妊娠孕妇回顾性分为仰卧位组、侧卧位组、半卧位组、蹲位组、坐位组及跪位组,每组80例。观察产妇产程进展、产后出血情况、产后会阴保护程度以及新生儿窒息发生情况。结果仰卧位组产妇平均产程较其余分娩体位组产妇平均产程长(P0.01),而半卧位组产妇平均产程最短。坐位组产妇产后出血的情况最多,仰卧位组产妇产后出血的例数最少。蹲位分娩体位对产妇的会阴保护程度较其余分娩体位组产妇高(P0.01)。跪位分娩体位对产妇的会阴保护程度较其余分娩体位组产妇低。仰卧分娩体位组产妇新生儿窒息发生率较其余分娩体位组产妇高(P0.01)。结论仰卧分娩体位会增加产妇产程,新生儿窒息发生率也较其他分娩体位高。蹲位分娩体位对产妇会阴的保护程度较高。     

出生低体重儿的相关因素调查

目的:了解相关因素对出生低体重儿的影响。方法:采用现场问卷的方法对新会区妇幼保健院2005年4月～2006年9月分娩的58例低体重儿的产妇与58例正常体重儿的产妇进行相关因素的调查对比分析。结果:孕妇的家庭收入低、孕期合并疾病、孕妇食欲差、营养差、有不良嗜好、偏食以及孕期精神打击、精神压力、接触高温、有害物质等对胎儿体重有明显的影响,而孕妇的文化程度影响不明显。结论:应加强产前宣教,指导孕妇避免接触不良因素,减少低体重儿的出生。     

孕妇学校健康教育对分娩结局的影响

目的探讨孕妇学校健康教育对围产结局的影响。方法选择2008年5月1日至2009年4月30日在河池市妇幼保健院产科住院分娩产妇共1162人,其中到过孕妇学校全程听课一次或多次的有390人,从未到孕妇学校听课的有559人,随机抽取以上人群各200人,前者为观察组后者为对照组。采用t检验和χ2检验对两组产妇的产检次数、分娩方式的选择、孕产并发症、产后母亲乳汁分泌情况进行统计分析。结果两组产妇的孕检次数、自然分娩率、社会因素造成的剖宫产率、孕产并发症、产后母亲乳汁分泌情况进行比较,差异均有统计学意义(P0.05)。结论对孕妇进行孕期健康教育,能够帮助产妇全面掌握围产保健知识,提高孕妇的遵医行为,促使其正确应对分娩,有利于产后乳汁的分泌,提高母乳喂养。     

产前教育及医护人员干预对自然分娩率的影响

目的降低人为因素的剖宫产率,减少剖宫产给产妇、新生儿造成的不必要伤害及医疗资源的浪费。方法设计人为因素剖宫产率调查表,对2008年10月至2010年10月在我院分娩的2 336例产妇进行调查分析。2008年10月至2009年10月分娩产妇1 155例为A组,未实施任何干预;2009年11月至2010年10月分娩产妇1 181例为B组,实施产前教育、无痛分娩及导乐分娩,同时对医务人员进行干预。结果 A组人为因素剖宫产率占总剖宫产率的40.1%(260/649);B组人为因素剖宫产率占总剖宫产率的23.8%(98/412)。结论通过干预措施,从精神和身体上减轻孕妇的痛苦,增加孕妇自然分娩的信心;严格掌握剖宫产适应证,以降低剖宫产率和提高自然分娩率,保证母婴健康安全。     

导乐分娩在产程中的作用

即墨市妇幼保健院自 1999年 1月至 2 0 0 0年 6月共住院分娩 4 5 0 0人 ,根据孕妇的要求对其中 5 0 0名孕妇实行了导乐分娩 ,各产程明显缩短 ,剖宫产率明显降低 ,产后并发症明显减少。1　对象与方法1 1　对象　以 1999年 1月至 2 0 0 0年 6月到我院分娩的孕妇 5 0 0名采用导乐分娩 ,随机选择同期于我院非导乐分娩的 5 0 0名孕妇为对照。两组的年龄、文化程度、孕产次及产前预测胎儿体重均无显著差异。1 2　方法　产妇住院后提出导乐分娩的请求并选择她信任的医护人员作为导乐医生。被选择的导乐医生自产妇宫缩开始至产后 2ｈ内一直陪伴在产…     

江西省孕妇分娩方式及分娩意愿调查

目的分析江西省孕妇分娩意愿及实际分娩方式,为政府制定相关政策提供科学依据,以有效降低我省剖宫产率。方法采用横断面研究的方法,对2013年10-12月在调查医院分娩的孕产妇进行面对面询问调查。结果 12 143名产妇中,4 752名产妇行剖宫产术,剖宫产率为39.1%;超过3/4的孕妇、配偶及其父母产前均希望阴道分娩;仅约半数的孕妇产前接受了分娩知识宣教;孕妇产前意愿选择剖宫产的有94.2%实施了剖宫产,而意愿选择阴道分娩的有21.8%实施了剖宫产手术,差异有统计学意义(P0.01);意愿选择剖宫产的孕妇中仅50.9%有剖宫产医学指征,其次主要原因是怕痛,选择阴道分娩的主要原因是认为这是一个自然过程,无需剖宫产。结论目前江西省剖宫产率较高,孕妇自身意愿影响了剖宫产率;孕妇是否接受产前教育对剖宫产意愿无影响,社会因素导致孕妇意愿选择剖宫产的比例较高。应加强孕妇学校的建设,提高产前宣教质量,改变孕妇及家属的观念,以降低剖宫产率。     

怀柔区10年妇女生育健康指标监测

目的为了解怀柔区妇女健康状况,掌握妇女健康发展趋势,总结经验,为制定今后妇女发展规划提供依据。方法参照《北京市妇幼保健信息管理指南》、《怀柔区妇女儿童发展规划监测评估方案》,对怀柔区16个医疗保健机构1995年10月1日至2005年9月30日上报数字进行监测、评估。结果孕产妇死亡人数由"九五"时期的5例减少到"十五"时期的2例。围生儿死亡率由1996年的13.12‰下降到2005年的7.57‰。出生缺陷发生率2005年在2000年的基础上下降了21.67个百分点。孕产妇系统管理率呈逐年上升趋势,2005年为91.42%。孕产妇产前医学检查率、住院分娩率、高危孕妇住院分娩率均在99%以上。妇科疾病普查率逐年提高。婚前医学检查率2005年为1.38%。结论孕产妇系统管理模式的建立,产科结构的优化,急诊急救网络的建立,贫困孕产妇救助资金的启动等围绕"两纲"采取的措施对保障妇女的身心健康起到了重要作用。     

上海剖宫产率影响因素研究

目的:探讨妇女在怀孕不同时期选择分娩方式的影响因素。方法:用自填问卷方式对分娩后42天内的300例妇女进行调查,用Pearson卡方、配对卡方检验和logistic回归进行统计分析。结果:在上海市妇产科医院分娩妇女的剖宫产率为57.4%;影响妇女在怀孕初期选择分娩方式的因素主要是孕妇对分娩方式的认知;影响妇女在怀孕中后期对分娩方式选择的因素主要有产检医生、周围亲戚朋友的建议及孕妇运动情况;影响妇女最终采取的分娩方式的因素是年龄、怀孕初期选择的分娩方式、产检医生的建议、住院分娩期间周围孕产妇的分娩方式以及产科医生的建议。结论:孕妇分娩方式的选择在怀孕早期和中期主要受妇女和亲戚朋友因素影响;而住院分娩期主要受医生的建议和周围孕产妇选择的分娩方式的影响。     

城市孕妇产前检查现状及影响因素分析

目的:分析城市孕妇产前检查现状及其主要影响因素,为提高孕期保健服务质量和效果提供基础依据。方法:选取2006年12月～2007年8月在某三级医院住院分娩的390名城市孕妇为研究对象,对其孕期及产前检查信息进行收集,应用卡方检验和ordinal回归分析等方法对孕期产前检查状况及其影响因素进行分析。结果:孕妇产前检查率为80.8%,其中孕12周内接受第一次产前检查的孕妇占23.8%。Ordinal回归分析发现,孕妇产前检查影响因素包括出生孕周、阴道流血、孕妇家族史及孕次,丈夫的文化程度和待业状况。结论:城市孕妇大部分都能按照要求进行产检,孕期产前检查受出生孕周、阴道流血、孕妇家族史及孕次,丈夫的文化程度和待业状况等因素的影响,应有针对性地开展健康教育,促进妇女的生殖健康。     

贫困农村地区妇女的产时保健：问题与对策

本文对云南贫困农村地区产时保健存在的问题进行了分析,结果表明,贫困地区住院分娩率低,新法接生率低,且短期内难以大幅度提高;产时并发症发生率高;贫困妇女不愿意住院分娩。针对上述情况,可考虑提供住院分娩,在家由受训人员接生分娩和在家由家人接生分娩三级服务,并采取其他相应的配套措施以加强贫困地区的产时保健工作。     

江门市郊区妇女常见病普查结果分析

目的:了解江门市郊区已婚育龄妇女常见病普查情况,为制定干预措施提供依据。方法:对江门市郊区11 672例已婚妇女进行妇科、白带、宫颈刮片脱落细胞及乳腺(包括触诊和乳腺B超)检查,并对普查结果进行统计分析。结果:11 672例妇女中患病7 104例,患病率为60.86%。其中妇科疾病的患病率为48.67%,根据其患病率顺位排名前3位为宫颈炎、阴道炎、子宫肌瘤;乳腺疾病的患病率为35.23%,主要疾病为乳腺增生及乳腺肿块。结论:江门市郊区妇女常见病患病率高,应定期开展妇女常见病的普查工作,同时应与多部门合作,采取相应干预措施降低妇女病的患病率。     

Quality of midwifery led care: assessing the effects of different models of continuity for women's satisfaction.

BACKGROUND: Changing Childbirth (1993), a report on the future of maternity services in the United Kingdom, endorsed the development of a primarily community based midwifery led service for normal pregnancy, with priority given to the provision of "woman centred care". This has led to the development of local schemes emphasising continuity of midwifery care and increased choice and control for women. AIMS: To compare two models of midwifery group practices (shared caseload and personal caseload) in terms of: (a) the extent to which women see the same midwife antenatally and know the delivery midwife, and (b) women's preference for continuity and satisfaction with their care. METHODS: A review of maternity case notes and survey of a cohort of women at 36 weeks of gestation and 2 weeks postpartum who attended the two midwifery group practices. Questionnaires were completed by 247 women antenatally (72% response) and 222 (68%) postnatally. Outcome measures were the level of continuity experienced during antenatal, intrapartum, and postnatal care, women's preferences for continuity of carer, and ratings of satisfaction with care. RESULTS: The higher level of antenatal continuity of carer with personal caseload midwifery was associated with a lower percentage having previously met their main delivery midwife (60% v 74%). Women's preferences for antenatal continuity were significantly associated with their experiences. Postnatal rating of knowing the delivery midwife as "very important indeed" was associated with both previous antenatal ratings of its importance, and women's actual experiences. Personal continuity of carer was not a clear predictor of women's satisfaction with care. Of greater importance were women's expectations, their relations with midwives, communication, and involvement in decision making. CONCLUSIONS: Midwifery led schemes based on both shared and personal caseloads are acceptable to women. More important determinants of quality and women's satisfaction are the ethos of care consistency of care, good communication, and participation in decisions.     

厦门育龄妇女分娩时期的生殖健康状况趋势分析

目的:以促进优生优育和生殖健康。方法:采取整群抽样方法。结果:对2004年10月~2005年1月200例分娩妇女病例统计分析发现:平均分娩年龄29.9岁。第1胎分娩为188例,占94.0%,2胎12例,占6.0%。其中顺产137例,占68.5%,生产前选择顺产的妇女176例,占88.0%;剖腹产63例,占31.5%,产前选择剖腹产妇女24例,占12.0%。孕前未婚者17例,占8.5%;孕次分析101例,占50.5%为第1次妊娠;99例(占49.5%)曾有2~6次的妊娠史。产前有非意愿妊娠终止史的92例,占46.0%。其中对有人工流产史的妇女分析39例,占19.5%有过1次人流史,21例(占10.5%)有过2次人流史,有5%的妇女曾有3~6次人流史;有13.5%的产妇有1~2次药物流产史;有1.5%有过中期引产史。出生男女性别比为1.15∶1,新生儿出生平均体重为3 307.21 g。结论:实行计划生育,稳定低生育水平,提高出生人口素质是我们工作的重点。     

Perception of health care delivery in Israel: women's voices

In this article, we describe the results of nine focus groups in which women were asked to discuss their perception of the women's health care delivery system in Israel. The focus groups, held in Israel in 2001, included nearly 150 women with diverse demographic characteristics. This project solicited focused input from women of different ages from the periphery as well as highly populated areas. The responses were categorized into designated themes and are presented here to demonstrate the range of women's feelings toward health care. The qualitative findings of this research show that place of residence affects the women's sense of responsibility for their health and their use of private care. Age was found to affect knowledge and use of health information, the frequency of visits to the doctor, and the general level of satisfaction with the system. These findings are important to improve health care delivery and can serve as a basis for forging policy changes in Israel.     

Choice of a childbirth method after cesarean

Concern about the rising cesarean-section rate and the high percentage of elective repeat cesareans led to an exploratory, retrospective examination of women's decision-making about a childbirth method after cesarean. Fifty women who had delivered by a repeat cesarean (RC) or vaginal birth after cesarean (VBAC) participated in a telephone interview. Three questions were addressed: (1) who made the decision for a birth method; (2) what factors were associated with the choice of method; and (3) was the choice of method associated with the actual method of delivery? The majority of women (90%) perceived that they were the primary decision-maker for a birth method, and choice of birth method was positively associated with actual method of delivery. The major reason for VBAC choice was to experience a vaginal birth, whereas the primary reason for RC choice was to avoid an unsuccessful labor. Other factors associated with choice of a birth method were: sources of information and support, beliefs, previous cesarean experience and locus of control. These findings have important implications for enhancing women's health-care decision-making, as well as for reducing the rate of repeat-cesarean deliveries.     

Women users' views on the role and value of the practice nurse

Aspects of the views of women aged 16–65 years on practice nurses in the primary health care setting are explored. The extent to which women consult practice nurses and the reasons for consultation are first identified. Women's assessments of practice nurses are then examined. The findings are from a 3-year research project where 1251 women completed a postal questionnaire and 70 women were interviewed in depth about issues concerning women's perceptions and experiences of both general practitioners (GPs) and practice nurses. Two thirds of the sample had consulted the practice nurse; 22% about specific women's health issues (including 13% for cervical screening). For most women's health issues, more women expressed a preference to be seen by a general practitioner (GP) than a practice nurse, except for breast examination among women aged 49 to 65 years where 57% expressed a preference for a practice nurse compared with 43% for a GP. Women gave similarly positive evaluations of the approachability of practice nurses and GPs. Positive views of practice nurses were high among older women, women who saw practice nurses in well-women clinics and women who saw practice nurses in relation to women's health issues. Among women who had not consulted a practice nurse, there was both a lack of awareness of the level and range of expertise of practice nurses, and a perception that in the main they offered only minor routine services. Health promotion, disease prevention and family planning do not appear to feature centrally in women's expectations of services provided by the practice nurse.