顺平县11年间产后出血相关因素分析和防治措施研究

目的分析与产后出血相关的因素，提出合理的防治措施。方法以12600例产妇为研究对象，将胎儿娩出后2h内出血量达到或超过400ml，或胎儿娩出后24h出血量达到或超过500ml定义为产后出血，测量产后出血量。通过非条件Logistic回归分析，筛选出与产后出血相关的主要危险因素，对比出血发生率的变化。结果在12600例分娩产妇中，符合产后出血的有198例，单因素分析中有10个因素有统计学意义。结论加强孕前宜教和孕期管理，提高助产技术，规范缩官素在产前的应用，降低了产后出血的发生。     

产后并发症341例分析

报告本院1981年1月至1985年12月,住院分娩4588例中产后并发症341例,发病率为7.43％。其中,产后出血1189例,占4.12％;分娩损伤71例,占1.55％;其它产后病81例,占1.76％。妊娠41—42周并发症发生率为11.14％;超过42周高达15.56％。分娩方式以剖腹产术后并发症最多,占12.48％,提示应对手术中无菌操作与环境,以及分娩后处理应予以足够重视。     

晚期产后出血问题的探讨(附52例临床分析)

本文对52例晚期产后出血病例进行了分析,结果认为晚期产后出血与感染密切有关;在处理上诊断性刮宫仍是重要措施之一,并提出对存在感染因素的产妇,术前、产前应用抗菌素预防感染.在剖宫产过程中,可用含抗生素的溶液冲洗宫腔,以达到预防感染的目的。     

产褥期脑病62例临床分析

目的研究产褥期脑病的临床特征、治疗方法及预后。方法选择62例产褥期突发精神症状并有全脑受累体征病人的临床资料进行回顾性分析。结果发现产褥期脑病的临床表现酷似病毒性脑炎,但病前无明显感染灶,病程较长,疗效和预后较差。结论对产褥期精神异常病人应进行神经病学方面检查,尽早诊治。病初要控制和缩短脑水肿期,防止和减轻脑细胞的变性和脱鞘;恢复期要耐心而持久地进行各种康复治疗,以便病人恢复到最佳健康水平。     

What Are the Maternal Factors that Potentially Intervenes in the Nutritional Composition of Human Milk?

Background: To evaluate the potential factors associated with the nutritional composition of human milk of puerperal women. Methods: cross-sectional study, conducted between March 2016 and August 2017, with 107 women, selected in a Tertiary Health Care Tertiary Health Facility of the Unified Health System (SUS) in the Municipality of Rio de Janeiro. Data were collected two months after delivery. The dependent variable of the study was the nutritional composition of human milk. We divided the independent variables into hierarchical levels: distal (age, schooling, parity and pregestational nutritional status), intermediate (number of prenatal visits and gestational weight gain) and proximal (alcohol consumption, smoking, diabetes mellitus and hypertension). For data analysis, we applied the multiple linear regression, centered on the hierarchical model. Only the variables associated with the nutritional composition of breast milk remained in the final model at a 5% level of significance. Results: The nutritional composition of human milk yielded by women with pregestational overweight, smokers and hypertensive had higher amounts of lipids and energy. Conversely, women with gestational weight gain below the recommended had lower amounts of these components. Conclusion: The evaluation of factors associated with the nutritional composition of human milk is extremely important to assist post-partum care practices. In this study, we observed that lipid and energy contents were associated to pregestational nutritional status, gestational weight gain, smoking and hypertension.     

剖宫产后病率与术后感染

目的:探讨剖宫产的术后病率、术后感染及感染相关因素.方法:选择剖宫产病历391例,按时间顺序分为二组.结果:第一组术后病率及术后感染率为30.45%和12.73%,第二组为26.32%和10.51%(P＞0.05).剖宫产的术后病率及术后感染染率为阻道分娩的7～l0倍.第一组病历与感染相关因素主要是头盆不称、活跃期停滞引起的产程延长,第二组病历主要见于胎儿宫内窘迫及脐带缠绕.引起感染的相关因素是产妇自身因素和高龄、贫血、水肿、肥胖、营养不良多种高危因素综合作用的结果.二组病历中胎膜早破分别占26.9%和31.1%.是引起术后感染的重要因素之一.结论:降低剖宫产率和剖宫产并发症是当今产科的重要任务之一.     

三痹汤加味配合蜂针治疗产后痹42例疗效观察

目的：观察三痹汤加味配合蜂针治疗产后痹的临床疗效。方法：选择经活蜂试针为阴性的产后痹患者42例，采用内服三痹汤加味配合蜂针治疗。结果：痊愈34例，有效6例，无效2例，总有效率95．2％。结论：三痹汤加味配合蜂针治疗产后痹能明显改善临床症状，疗效满意，操作简单方便，值得推广应用。     

38例晚期产后出血的临床分析

目的:探讨引起晚期产后出血的临床原因。方法:对1998年-2002年间收治产后出血发生晚期出血的38例资料进行回顾性分析。结果:38例中在基层乡镇医院分娩者占68.4％,在市级医院分娩者占31.6％。结论:晚期产后出血的主要原因是胎盘胎膜残留和子宫切口愈合不良。     

Puerperal psychosis – a qualitative study of women’s experiences

Objective: This study explored women’s experience of puerperal psychosis (PP) and their perceptions of its cause, in order to contribute to an increased understanding of PP and promote consideration of new management perspectives. Background: Out of every 1000 live births, approximately one to two women will develop PP. The numbers are relatively small, yet the consequences can be devastating. Key theoretical explanations for the aetiology of PP are genetic, biochemical and endocrine. A small and relatively tenuous evidence base considers PP from a psychological perspective, despite acknowledgement of the need for broader understanding. A stress–vulnerability model has offered a contemporary explanation of psychotic symptoms in other contexts and non-clinical populations and may offer useful insight in relation to a psychobiological model of PP. Methods: In a qualitative study, seven women who had been diagnosed with PP previously were interviewed and the data subjected to an inductive thematic analysis. Trustworthiness and rigour of the study was assured by careful monitoring of the research process and data checking. Results: Four themes were identified – The path to PP; Unspeakable thoughts and unacceptable self; ‘Snap out of it’; and Perceived causes. While women attributed their PP to the physiological changes associated with childbirth, their accounts of PP began before and during pregnancy. Women highlighted stressful pregnancies characterised by significant challenges and emotions, difficult births and unsupportive family relationships postnatally. The experience of PP was extremely distressing. Conclusion: Findings add to the debate about a more multifaceted explanation of PP and potentially offer a psychobiological model of understanding.