宫缩抑制剂用于胎膜早破性早产

目的：了解产前运用宫缩抑制荆对胎膜早破早产新生儿结局的影响。方法：回顾性分析118例小于35孕周胎膜早破性早产（PPROM）的临床资料。结果：33～34“周孕龄组新生儿1 min Apgar评分〈7分的发生率、缺血缺氧性脑病（HIE）发生率及新生儿呼吸窘迫综合症（NRDS）发生率明显低于对照组。两组间比较有显著差异（P〈O．05）。28-32“周孕龄组新生儿的各项指标在治疗组与对照组间比较无显著差异（P〉0．05）。结论：33-34“周胎膜早破性早产孕妇产前用宫缩抑制剂能显著改善新生儿结局。对〈33孕周的胎膜旱玻性早产，宫缩抑制荆的治疗效果还有待进一步探讨。     

早产的药物治疗进展

我国关于早产的定义是指妊娠满28周至不足37周分娩者.早产是妊娠常见并发症,早产儿是围生儿死亡的重要原因之一,发生率为5％～15％,其中约15％死于新生儿早期,部分存活者可遗留智力障碍或神经系统后遗症,带来巨大的社会和经济问题.因此,如何防治早产,提高新生儿存活质量,降低围生儿死亡率,是围生医学亟待解决的重要课题.早产的治疗原则是若胎膜未破,胎儿存活、无胎儿窘迫、无妊娠严重并发症及合并症时,应设法抑制宫缩,尽可能延长孕周.若胎膜已破,早产不可避免时应设法提高早产儿的存活率.早产的治疗包括药物治疗及产科处理两方面,以下主要介绍早产的药物治疗.     

早产的药物治疗进展

我国关于早产的定义是指妊娠满28周至不足37周分娩者。早产是妊娠常见并发症,早产儿是围生儿死亡的重要原因之一,发生率为5％一15％,其中约15％死于新生儿早期,部分存活者可遗留智力障碍或神经系统后遗症,带来巨大的社会和经济问题。因此,如何防治早产,提高新生儿存活质量,降低围生儿死亡率,是围生医学亟待解决的重要课题。     

1例宫颈环扎术后先兆早产病人的护理

正宫颈机能不全是造成晚期流产和早产的主要原因之一。据统计,宫颈机能不全病人早产率高出非宫颈机能不全者3.3倍,占全部早产的8%~9%,占自然早产的40%~50%,占胎膜早破的20%~30%~([1])。通过宫颈环扎术修复并建立正常的宫颈内口形态和功能是治疗宫颈机能不全的有效方法~([2])。2016年5月我院收治1例因胎膜早破流产1次,再次妊娠后因宫颈机能不全行宫颈环扎术,于孕33+4周感下腹坠胀诊断先兆早     

B超监测羊膜腔滴注林格氏液治疗32～36周胎膜早破的临床观察

目的:探求一种简便、适用治疗32～36周胎膜早破的方法。方法:我们应用B超监测、经腹行动静脉留置针穿刺,间断滴注林格氏液治疗32～36周胎膜早破,同时选取基本相同背景,未经治疗的病例作为对照。结果:经过治疗后的病例自然促发产程的比例升高,剖宫产的比例下降,分娩时羊水情况明显改善,新生儿阿氏评分高、病死率下降。结论:B超监测下经腹羊膜腔滴注林格氏液治疗32～36周胎膜早破,是一种简单、有效、适用和有广泛前景的方法。     

早产的临床处理

早产易发生各种并发症,严重危害母婴健康,是围产儿发病率、病死率、致残率的首位原因,也是5岁以下儿童死亡及致残的主要原因。存活的早产儿也面临多种远期并发症如：神经系统疾病,视觉、听觉障碍等。而胎膜早破是指在临产前胎膜自然破裂,孕龄〈37孕周的胎膜早破又称为早产（未足月）胎膜早破。     

利托君联合应用硫酸镁治疗早期早产临产的效果分析

探讨利托君联合应用宫缩抑制剂治疗早期早产临产的临床效果。选取2014年6月~2015年7月在我院接受治疗的28~32周的早期临产孕妇80例。随机分为观察组和对照组各40例。对照组患者给予利托君治疗,观察组患者给予利托君联合硫酸镁治疗,比较两组孕妇治疗早期早产临产的显效时间、孕龄延长时间、产儿结局情况。观察组治疗后显效时间35.78±3.45min,显著短于对照组的40.12±3.48min,两组比较差异具有统计学意义(P0.05);观察组孕龄延长48h、孕龄延长7d以及保胎成功率均显著高于对照组患者,两组比较差异显著(P0.05);两组新生儿体重进行比较,差异无统计学意义(P0.05);观察组新生儿Apgar评分1分和7分以及围生儿死亡率,均低于对照组、,两组比较差异显著(P0.05)。利托君联合硫酸镁治疗早期早产临产孕妇效果显著,治疗后孕妇不良反应发生率小,值得在临床推广应用。     

胎膜早破致早产的临床探讨

回顾分析132例胎膜早破致早产的孕周与分娩方式及与母婴并发症发生的关系。结果胎膜早破引起早产,其孕周越小,新生儿的发病和死亡率越高。为减少早产的发生,应尽可能延长胎龄,以获得可成活的新生儿及提高生存质量。     

宫颈环扎术防治早产32例临床分析

目的通过对习惯性流产和早产患者行宫颈环扎术进行临床分析,探讨宫颈内口环扎术治疗孕中期宫颈机能不全的疗效,分析影响手术成功率的相关因素。方法对我院2002年12月至2008年9月收治的宫颈机能不全患者行宫颈环扎术32例临床资料进行回顾性分析。结果32例手术均顺利完成,术后流产3例,早产5例,足月产24例,32例中无一例发生并发症,无一例发生感染。结论宫颈环扎术手术操作简单易行,安全可靠,成功率高,并发症少,术后新生儿存活率高,对宫颈机能不全患者适时实行宫颈内口环扎术,对挽救1次不可避免的胎儿损失,提高妊娠成功率是一种积极有效的治疗方法。孕13—19周手术效果较好,术前诊断明确、适应证掌握得当、手术缝合水平及术后的相关治疗和护理也是提高手术成功率的重要因素。     

安宝治疗早产的临床分析

目的：探讨安宝治疗早产的效果。方法：对68例早产者应用安宝抑制宫缩治疗作为研究组，并与同期49例早产未用宫缩抑制剂者作为对照组。结果：应用安宝组抑制宫缩成功58例，成功率为85．32％，平均延长妊娠时间为7．50天，最长达26天；对照组仅2例宫缩自行缓解，余全部在48小时内分娩。安宝组新生儿窒息率低于对照组，产后出血率及出血量两组无差异。仅1例服安宝出现心动过速，但心率不超过130／min无自觉症状，停药后自行缓解。结论：安宝通过抑制子宫收缩，延长妊娠期，对治疗早产安全、有效。     

早产126例临床分析

目的：探讨引起早产的原因和影响预后的因素。方法：对我院126例早产进行回顾性分析。结果：早产发生率为5.0%,胎膜早破（PROM）、妊娠高血压综合征（PIH）是引起早产的主要因素。剖宫产与阴道分娩对早产儿结局无明显差异。破膜时间12 h内和12 h以上两组间宫内感染发生率差异无统计学意义。结论：早产儿预后与早产病因相关。不同分娩方式对新生儿结局没有影响。     

Preterm Birth: Implications for Family Stress and Coping

The event of preterm birth represents a significant risk to the equilibrium of the family, often placing the family under significant stress. This paper is intended to assist neonatal nurses in understanding factors related to a family's appraisal of stress and strategies used for coping. Such factors are an important consideration in planning the most effective interventions to support optimal family adaptation to their preterm infant's birth. In identifying the best clinical approaches to supporting a family coping with the event of a preterm birth, nurses need to consider levels of the evidence that supports adoption of clinical intervention strategies. Working to reduce family stress and improve family coping ensures the most optimal home environment for the preterm infant to grow and thrive in after discharge.     

盐酸羟苄羟麻黄碱治疗先兆早产的护理

盐酸羟苄羟麻黄碱是目前治疗先兆早产的首选药,它能有效抑制子宫收缩,防止早产和延长妊娠期。总结了２３例羟苄羟麻黄碱治疗先兆早产的护理体会如下：（１）早期发现病情、及早治疗;（２）及早用药其疗效更佳,并确保单位时间内给药量准确;（３）注意观察药物的副作用;（４）督促患者坚持口服用药;（５）加强心理护理,做好卫生宣教。     

Preterm Birth Prevention: A Mandate for Psychosocial Assessment

Reviews panels on the prevention of preterm birth (PTB) conducted by the Office of the Surgeon General and the Eunice Kennedy Shriver National Institute of Child Health and Human Development made numerous novel recommendations for research on the assessment of risk factors for PTB and the development of personalized, specific interventions for the prevention of PTB. This paper discusses the particularly significant roles for nurses in assessment and intervention based on their education in pregnancy and in multiple health-related disciplines. General differences and specific anxiety assessment are presented based on the goals of research. An emphasis is placed on assessment of pregnancy-specific anxiety, and assessment and intervention methods that include the father/partner and couple using family system methodologies. The risks occurring with differences in partner intentions for pregnancy are discussed, and especially the benefits of male partner involvement and support. It is noted that interventions may need to be varied based on differences in gender, ethnic, cultural, and socioeconomic status. Differences in individual or group intervention psychotherapy approaches are considered. The special risks and needs of pregnant military couples, especially those with deployed partners are presented. Variations in anxiety are discussed in terms of implications for maternal/paternal fetal and child attachment from birth to adulthood. Discussion includes the considerable and varied parenting and financial strains that continue long after birth, with significant impact for parent-child mental and physical health, and the need for development of long-term interventions that include parental coping strategies and parental empowerment.