Healthcare providers' role regarding the safe and appropriate use of herbal products by breastfeeding mothers: A systematic literature review

BackgroundBreastfeeding women often use herbal products to increase their milk supply. The aim of this study was to summarize the literature about the role of healthcare providers in advising breastfeeding women about herbal product use.MethodsPubmed, ScienceDirect, Web of Science, and CINAHL databases were searched for articles written in English using the Keywords: “breastfeeding” or “lactation” and “herbal medicine*“, “botanical*“, “dietary supplement*“, “natural product*“, “traditional medicine*” or “complementary medicine*“.ResultsTwenty-two articles were included in this review. A lack of inter-professional communication and guidelines, a lack of provider confidence and knowledge about the evidence for the efficacy and safety of herbal products were identified as causing a ‘gap’ between current practice and expectations of breastfeeding women seeking advice about their use herbal products.ConclusionsStrategic and collaborative efforts between key stakeholders are required to ensure the needs of women who are considering herbal product use while breastfeeding are met.     

工作压力对助产士身心健康的影响分析及对策

工作压力对助产士身心健康的影响如下:工作的特殊性对身心健康的危害;助产工作的高责任性和高风险性;临床技术的创新与发展,对护理人员的技能提出更高的要求;继续教育对助产士造成的压力影响。对策:通过多种途径增加助产士的理解与支持,并为助产士提供继续教育的条件,同时助产士必须注重自我心理素质的调节,以便拥有良好的身心健康状态。     

助产士产前门诊对初产妇情绪及满意度的影响

目的探讨助产土产前门诊对初产妇焦虑抑郁情绪和初产妇对门诊助产士提供护理服务态度和方式的满意度的影响。方法应用随机数字表法将2011年12月～2012年12月在本院产科建卡并定期产检的106例正常初产妇分为对照组和观察组，对照组给予常规产前门诊，观察组在对照组基础上给予助产士产前门诊，观察并比较两组初产妇焦虑、抑郁情绪和初产妇对门诊助产士提供护理的服务态度和方式的满意度。结果观察组焦虑、抑郁标准分均明显低于对照组，且观察组初产妇对门诊助产士提供护理的服务态度和方式的满意度明显高于对照组，差异均有统计学意义（P〈0．05）。结论助产土产前门诊能够有效减少初产妇的焦虑及抑郁程度，提高初产妇对门诊助产士提供护理服务态度和方式的满意度。     

Ultrasound guidance of embryo transfer: A role for midwife

ObjectiveEvaluate the role of midwife with no experience in assisting ultrasound guided embryo transfer.MethodsA prospective randomized study comparing results of IVF after ultrasound guided embryo transfer (ET) assisted either by a midwife with no formal training in US, or by a doctor trained to guide. ET procedure was performed on 553 patients undergoing ultrasound guided ET. The number of embryos transferred, the pregnancy rate (PR), the incidence of extrauterine pregnancy, ongoing pregnancy rate, the implantation rate (IR), difficulty of embryo transfer and quality of US assistance were compared among the groups.ResultsNo significant differences were observed between the two groups regarding the number of embryos transferred (2.5 + 0.7 Group A vs 2.4 + 0.8 Group B) implantation rate (15.6% Group A vs 15.2% Group B), pregnancy rate (34.3% Group A vs 36.2% Group B), ongoing pregnancy rate (23.4% Group A vs 23.9% Group B), and rate of extrauterine pregnancies (1.4% Group A vs 1% Group B). Difficult transfers (2.9% Group A vs 3.6% Group B) and unsatisfactory visualization of uterus and catheter (6.2% Group A vs 7.3% Group B) were also similar in both groups of patients.DiscussionHaving an inexperienced nurse or midwife to perform ultrasound guidance during ET does not markedly affect the clinical results compared to using experienced clinicians for this purpose.     

各国助产人员从事助产服务现状

了解各国助产人员从事助产服务情况及我国助产的政策、执业范围、助产教育,旨在积极倡导助产改革,制定新的助产政策。认为政府应重新认识助产士职能,在循证的基础上改革助产政策,促进中国助产专业的发展和母婴健康。     

Variabilidad en la tasa de episiotomías y su relación con desgarros perineales graves y morbilidad neonatal

ObjectiveTo determine the variability in the use of episiotomy among midwives and its relation to third and fourth-degree tears, and the impact on neonatal morbidity.MethodA study was conducted on historical groups from a total of 2,366 eutocic births with a single live fetus greater than or equal to 37 weeks gestation and 18 midwives over a three year period (2009, 2010 and 2011) in «Mancha-Centro» Hospital (Alcázar de San Juan).The outcomes variables for this analysis were the incidence of episiotomy, perineal lacerations, and neonatal morbidity.ResultsThe variability in the use of episiotomy ranged from 19.5% to 50.1% among the 18 midwives in the study, with an average rate of 34.9% (824). Grouped at intervals, 22.1% (524) had a rate of ≤ 25%, 26.1% (621) between 26-35%, 38% (898) between 36-44%, and 13.7% (323) a rate of ≥ 45%, with homogeneity between the groups for all the confounding factors.There was no statistical association between higher rates of episotomy and pH of umbilical artery < 7.10, Apgar score after 5 min < 7, and the level of neonatal resuscitation type iii and iv. There was also no relationship between the rate of episiotomy with perineal integrity and third and fourth-degree tears.DiscussionThe variability in the rate of episiotomy is high, and it is not related to the increased presence of third and fourth-degree tears or increased neonatal morbidity. Episiotomy rates should not be greater than 25%, in order to prevent perineal trauma or loss of fetal well-being.     

助产士工作压力源和心理健康状况的调查分析

目的了解助产士工作压力、心理健康状况以及相互关系,探讨改善护理管理、保障助产士心理健康的方法和途径。方法采用护士压力源量表、焦虑自评量表(SAS)以及抑郁自评量表(SDS)对在广州地区7所医院随机抽取的102名助产士进行问卷调查分析。结果助产士压力源主要存在于工作量与工作时间和护理专业方面。助产士的焦虑分值为(44.84±12.18)分,抑郁分值为(52.21±13.27)分,均高于常模,P<0.01。助产士焦虑和抑郁的发生均与护理专业工作、工作量及时间分配、患者护理和管理以及人际关系成正相关,P<0.01,而与工作环境及资源无关。结论缓解助产士工作压力,保障助产士心理健康急待社会的充分重视,特别是卫生行政管理部门,应积极采取有效的措施减轻助产士工作压力。     

252例产后出血的临床对策分析

目的研究产后大出血的临床表现,并通过不同的维护与治疗手段来研究正确、有效的预防方式,并为相应的产后大出血的急救以及避免提供可行的方案。方法针对我院从2008~2011年3年内收治的252例产后大出血的案例进行总结性分析,利用统计软件对其出血原因,临床表现等指标进行分析并找到相应的统计学依据。结果在针对不同的出血原因的分析方面得到因为子宫收缩异常而操作的产后大出血占到%的比例,由于胎盘异常而造成的产后大出血为5.6%的比例,由于软产道损伤而造成的产后大出血占到%的比例。结论针对对出血原因的判断在引产与接生的过程中进行及时的预判能够有效的增加对产后出血情况的预测进而降低由于产后出血带来的产妇死亡情况。