一对一全程陪伴分娩428例临床分析

目的探讨一对一全程陪伴分娩在产程中的作用以及对母婴健康的影响。方法428例实施一对一全程陪伴分娩的孕妇（实验组）与同期506例非陪伴分娩孕妇（对照组）比较分娩方式、产程时间、新生儿结局、产后出血率。结果实验组剖宫产率及阴道助产率低，产程时间短，新生儿窒息率低，产后出血发生率低，与对照组比较有统计学差异（P〈0．05）。结论一对一全程陪伴分娩有助于降低产科干预率、缩短产程，有利于母婴健康。     

一对一全程陪伴分娩428例临床分析

目的探讨一对一全程陪伴分娩在产程中的作用以及对母婴健康的影响。方法428例实施一对一全程陪伴分娩的孕妇(实验组)与同期506例非陪伴分娩孕妇(对照组)比较分娩方式、产程时间、新生儿结局、产后出血率。结果实验组剖宫产率及阴道助产率低,产程时间短,新生儿窒息率低,产后出血发生率低,与对照组比较有统计学差异(P<0.05)。结论一对一全程陪伴分娩有助于降低产科干预率、缩短产程,有利于母婴健康。     

全程陪伴分娩的临床应用与效果观察

目的通过全程陪伴分娩服务模式的应用,为产妇提供人性化的护理,并观察其效果。方法将在我院2006年8月至2007年10月正常足月妊娠孕妇(除外头盆不称、胎位异常及妊娠合并症和妊娠并发症),随机分为陪伴分娩组200例、传统分娩方式200例进行分析。结果200例陪伴分娩组孕妇的剖宫产率、胎吸助产率、产后2h出血量及新生儿窒息率明显低于对照组(p<0.01);陪伴分娩组孕妇第一产程、第二产程及总产程均低于对照组(p<0.05)。结论全程陪伴分娩模式在降低剖宫产率及产后出血率、缩短产程、减少母婴并发症方面明显优于传统分娩护理模式,能明显提高产科护理质量。     

产时“一对一”全程陪伴分娩的临床分析

目的:探讨产时“一对一”全程分娩对提高产科质量的作用。方法:对深圳市宝安区妇幼保健院2003年1~12月3 991例“一对一”全程陪伴分娩的产妇与2000年1~12月2 560例无人陪伴分娩的产妇从产后出血、新生儿窒息、死产的发生率进行对比统计分析。结果:“一对一”全程陪伴分娩组产后出血发生率为1.60%,无人陪伴组为2.23%,无显著性差异(P>0.05);而新生儿窒息发生率陪伴分娩组为2.68%,无人陪伴分娩组为4.18%,差异有显著性(P<0.05);死产发生率陪伴分娩组为0.10%,无人陪伴分娩组为0.39%,差异有显著性(P<0.05)。结论:产时“一对一”全程陪伴分娩改变了产时服务模式,做到责任到人,全程观察、及时处理异常产程,有效降低了新生儿窒息及死产的发生。     

全程导乐陪伴分娩对产后抑郁症发病的影响

目的:调查产后抑郁症的相关因素,探讨全程导乐陪伴分娩对产后抑郁症发病的影响。方法:选择在我院行产前检查并自愿要求全程导乐陪伴分娩的产妇856例为观察组,选择同期同数量定期产检,但未行全程导乐陪伴分娩的产妇为对照组。对两组孕妇进行孕期医院焦虑-抑郁情绪自评量表(HAD)测试(≥11分为焦虑-抑郁情绪)和产后艾迪产后抑郁量表(EPDS)测试(≥13分为产后抑郁症),部分病例采用艾森克个性量表(EPQ)做个性因素分析(N量表为情绪性,P量表为变态心理倾向或神经质)。观察两组产妇产后抑郁症发生率的变化。结果:①HAD≥11分者观察组为96例(11·2%),其中产后抑郁症发病17例,发生率为17·7%;对照组为95例(11·1%),其中产后抑郁症发病47例,发生率为49·5%。两组比较差异显著(χ2=21·68,P<0·01)。②EPDS≥13分者观察组为15例,其产后抑郁症发生率为1·75%;对照组73例,其产后抑郁症发生率为8·53%。两组比较差异显著(χ2=45·57,P<0·01)。③产后抑郁症患者EPQ中的N量表评分和P量表评分明显高于无产后抑郁症的正常孕妇,两者比较,差异有极显著性(t=8·67、9·66,P<0·01)。结论:全程导乐陪伴分娩能有效阻断产前焦虑-抑郁情绪、不良个性因素、产后心理及生理变化等高危发病因素;提高孕产妇的心理健康,显著降低产后抑郁症的发生率。     

专人全程陪伴分娩护理模式对分娩影响的研究

目的:探讨专人全程陪伴分娩护理模式对产妇的分娩方式、产程时间及产后出血量的影响。方法:选取100例无剖宫产指征的初产妇随机分为专人陪护组(观察组)和对照组,观察组由专人全程陪伴,对照组按产房常规分娩,观察两组产妇的分娩方式、产程时间长短及产后出血量。结果:观察组产妇自然分娩率明显高于对照组,阴道助产率、产程时间及产后出血量明显低于对照组,两组差别有统计学意义(P<0.05)。结论:专人全程陪伴分娩有助于提高自然分娩率、缩短产程、减少产后出血量。     

采用Doula陪伴分娩减轻产妇分娩痛效果观察

目的:为了探讨减轻产妇分娩痛的有效方法.方法:将212例产程进入活跃期的产妇随机分为观察组和对照组各106例.观察组采用家属陪伴下的Doula陪伴分娩,即由有分娩经验的助产士全程陪伴产妇分娩,持续给其心理、生理上的全程帮助.对照组则由丈夫陪伴分娩.结果:观察组分娩时疼痛程度明显降低.结论:Doula陪伴分娩可以加强产时保健,使产妇全方位的得到优质服务,提高了护理质量,真正把心理疗法融于医疗保健中,让产妇人人享受生殖健康.     

专人全程陪伴分娩护理联合自由体位分娩对产妇剖宫产率及产后抑郁的影响

目的探讨专人全程陪伴分娩护理联合自由体位分娩对产妇剖宫产率及产后抑郁的影响。方法选取2017年1月-2017年6月期间在无锡市第九人民医院院妇产科进行分娩的产妇90例作为对照组,2017年7月-2017年12月期间分娩的90例产妇作为观察组。对照组采用常规护理分娩,观察组采用专人全程陪伴分娩护理联合自由体位分娩。对比两组产妇产程时间、分娩方式及产后焦虑和抑郁程度。结果观察组产妇第一、第二和总产程时间均明显短于对照组,差异有统计学意义(P0. 05);观察组产妇的剖宫产率(6. 7%)显著低于对照组(24. 4%),差异有统计学意义(P0. 05)。两组产妇护理后SAS和SDS评分相较于护理前均显著降低,差异有统计学意义(P0. 05);且观察组护理后两项评分均显著低于对照组,差异有统计学意义(P0. 05)。结论专人全程陪伴分娩护理联合自由体位分娩能有效缩短产妇的产程时间,降低剖宫产率以及缓解产后抑郁,具有良好的临床应用前景。     

全程陪伴分娩服务模式探讨

目的　观察全程陪伴分娩对分娩方式、产程、产后出血和新生儿窒息的影响。　方法　选择无严重产科合并症和并发症的适龄足月产妇 2 14例 ,随机分为实验组和对照组 ,观察这两组产妇的分娩方式、产程及产后出血情况并进行比较。　结果　两组分娩方式、产程、产后出血情况 ,新生儿Apgar评分结果比较 ,差异均有显著性 (P <0 .0 5 )。　 结论　全程陪伴分娩可有效地降低剖宫产发生率 ,缩短产程 ,减少产后出血 ,减少新生儿窒息的发生。     

全程导乐陪伴分娩联合硬膜外麻醉分娩镇痛对产科质量的影响

目的:探讨全程导乐陪伴分娩联合硬膜外麻醉分娩镇痛对产科质量的影响。方法:选择在该院定期产前检查且自愿要求全程导乐陪伴分娩联合硬膜外麻醉分娩镇痛的产妇750例为观察组,选择同期528例定期产检、传统方式分娩的产妇为对照组。比较两组产妇的产程时间、产后出血量、分娩方式、新生儿窒息等。结果:两组产妇的产后出血量、剖宫产率、产钳助产率、新生儿窒息率等比较差异有统计学意义(P<0.05)。结论:全程导乐陪伴分娩联合硬膜外麻醉分娩镇痛是目前一种理想的以产妇为中心的产时服务模式,缩短产程、减少产后出血、降低剖宫产率及新生儿窒息率,有利于提高产科质量,促进母婴健康,值得推广。     

分娩教育对初产妇心理及分娩方式的影响

目的　探讨分娩教育对初产妇孕晚期心理以及分娩方式的影响。方法　 1 2 0例初产妇 ,随机分为 2组。试验组在妊娠晚期接受分娩教育 ,对照组接受医院常规护理。观察 2组分娩教育前后焦虑和抑郁程度以及分娩方式。结果　试验组分娩教育后焦虑、抑郁程度减轻 ,自然分娩率提高 ,由社会原因引起的剖腹产率明显降低 ;与对照组相比差异有统计学意义 (P <0 0 1 )。结论　分娩教育能够减轻分娩对初产妇的不良心理应激 ,促进自然分娩 ,值得在国内推广     

孕妇心理健康状况与分娩自我效能感的相关性分析

目的:考察孕妇心理健康与分娩自我效能感的状况,并分析二者之间的相关性。方法:选用SCL-90和孕妇分娩自我效能感问卷,对119名孕妇进行问卷调查。结果:①孕妇的焦虑、恐怖等因子得分显著高于常模,而人际关系等因子的得分显著低于常模。②孕妇具有一定的分娩自我效能感水平。③孕妇焦虑、恐怖等心理健康问题与分娩自我效能感显著负相关。结论:孕妇的心理健康状况不佳。孕妇不良的心理健康状况不利于分娩自我效能感的提高。     

人性化护理在试管婴儿孕产妇分娩护理中的应用分析

目的 探讨人性化护理在试管婴儿的孕产妇手术分娩护理中起到的作用。方法 选取2017年2月至2018年2月在本院实施试管婴儿且妊娠成功的80例孕妇为研究对象,采用随机分组的方式,分为观察组(n=40)与对照组(n=40),对观察组从孕期初期开始就进行人性化护理,例如,进行试管婴儿方面的相关知识教育了解、及时疏导孕妇不良情绪、注重她们的生活习惯、产前指导等,对照组行常规护理, 采取十分制方式进行调查。结果 人性化护理后试管婴儿孕产妇手术分娩的妊娠情况:观察组护理后的自然分娩率为97.5%明显高于对照组为65.0%,差异有统计学意义(P<0.05)。结论 对试管婴儿孕产妇进行的手术分娩前人性化护理干预,不但能够提升她们对相关知识的知晓率,更能对其妊娠进行有效的临床指导,以帮助孕妇度过妊娠期和分娩期,值得临床进一步推广。     

Maternal fear associated with pregnancy and childbirth in Hong Kong Chinese women

BACKGROUND: Women's fear toward pregnancy and childbirth is a common and important health concern. This study examined the objects, causes, and manifestations of maternal fears and their associated demographic factors in a sample of Hong Kong Chinese pregnant women. METHODS: Three hundred Chinese pregnant women were recruited in an obstetric unit in Hong Kong in 2003. Data were collected using a 73-item questionnaire. Principal components factor analysis was applied to identify the objects, causes, and manifestations of fear toward pregnancy and childbirth. RESULTS: The mean maternal age was 30 (SD 5.6) years. All participants reported some degree of fear. The main objects of fear were "fear of childbirth" and "child's and mother's wellbeing." The first factor identified for causes of fear was "negative stories," followed by "negative attitude or mood." Regarding the various manifestations of fear, "stress symptoms" and "wish to avoid pregnancy and childbirth" ranked highest. Twenty-two percent of participants had considered requesting an elective cesarean section due to fear of childbirth. CONCLUSIONS: Even in a group of low-risk pregnant women, fear toward pregnancy and childbirth was frequently experienced. Better strategies to address women's psychological needs during pregnancy are warranted.     

Recovery from childbirth: Looking back 6 months after delivery

Women's perceptions of their recovery from childbirth were investigated by open‐ended interviews of 96 mothers of healthy, full‐term infants 6 months after delivery. Data included factors affecting physical, mental, and emotional recovery; sources of help and hindrance; ideas of what each woman would do differently after the delivery of another child; and overall evaluation of how the months after delivery compared with expectations. Content analysis of the data revealed that 25% of the women did not feel physically recovered from childbirth at 6 months postpartum. Husbands and other family members were major sources of help. Prolonged labor and cesarean delivery were the major hindrances to recovery. More household and child‐care help was desired after delivery of another child. Almost half of the women found the first 6 months after delivery more difficult than anticipated. The findings suggest that pregnant women need more information about lifestyle adjustments after childbirth.     

导乐式分娩在初产妇分娩中的应用

目的探讨全程导乐在初产妇分娩中的作用。方法以江西省南昌市第一医院妇产科2012年7月-2013年6月收治的360例自愿阴道分娩孕妇作为研究对象,随机分为研究组和对照组,各180例。其中研究组采用一对一陪伴方式,指导正确运用拉玛泽减痛分娩法,密切监测母婴与产程情况。对照组按照常规方法进行护理。结果研究组疼痛程度0度和I度产妇人数比例明显高于对照组,但Ⅱ度和Ⅲ度人数比例低于对照组,差异均有统计学意义（P〈0.05）。研究组剖宫产率低于对照组,且产程进展快于对照组,差异均有统计学意义（P〈0.01）。结论全程导乐分娩可降低初产妇疼痛程度、缩短产程,降低手术产率,分娩预后效果优良。     

Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth, and obstetric techniques.

OBJECTIVES: This study examined the association between pregnancy, vaginal childbirth and obstetric techniques, and the prevalence of urinary incontinence among adult women aged 20 to 59 years. METHODS: A cross-sectional survey enrolled a random sample of 6240 women aged 20 to 59 years who were mailed a self-administered questionnaire focusing on urinary incontinence and other health variables. More than 75% of the women responded. The present analysis includes 4345 women who were not pregnant and did not experience a vaginal childbirth during 1994. RESULTS: Multivariate prevalence odds ratios showed increases in relation to urinary incontinence during pregnancy, urinary incontinence immediately after a vaginal childbirth, and age of 30 years or more at the second vaginal childbirth. No multivariate associations were found for forceps delivery or vacuum extraction delivery, episiotomy, or perineal suturing. CONCLUSION: Not only the process of childbirth itself but also processes during pregnancy seem to be strongly associated with prevalent urinary incontinence. Perineal suturing may be associated with prevalent urinary incontinence, whereas other obstetric techniques inspected do not seem to be so.     

The Finnish family competence study: characteristics of pregnant women with low childbirth knowledge

The present paper characterizes the socio-demographic background, health behaviour and attitudes of 1443 nulliparous women in relation to their level of childbirth knowledge. The response rate was 92%. Those women who refused to participate were not significantly occupationally different from the study subjects. Practically all pregnant women in Finland use maternity health care services. However, those with a low childbirth knowledge needed more health counselling and were largely characterized by the same factors that identify mothers in other countries who do not use such services. This finding emphasizes the importance of a wide coverage of antenatal care. Mothers with low childbirth knowledge were more often than those with high knowledge, unemployed, somewhat younger, living near or with their parents, and less well educated. They felt that they had had no education in child rearing, but they also felt no need for such guidance. They smoked more than mothers with high knowledge both before and during pregnancy. They had less physical exercise, ate more fatty foods and less vegetables. They also used more drugs during the first trimester of pregnancy and had fewer leisure time activities, read fewer books and used fewer cultural services. They assessed themselves as emotionally closer to their own mothers than did those with high childbirth knowledge. A low level of childbirth knowledge seems to be associated with risks in health-connected behaviour, which has important implications for prenatal health education.     

拉玛泽分娩减痛呼吸法对母儿影响的研究

目的：探讨拉玛泽分娩减痛呼吸法对母儿的影响。方法将孕7个月后自愿接受拉玛泽分娩减痛呼吸法的孕妇57例设为观察组,同期未接受拉玛泽分娩减痛呼吸法的60例孕妇为对照组,比较两组产妇分娩方式、经阴道分娩产程时间、分娩时疼痛程度及新生儿窒息发生率等。结果观察组自然分娩率为92．98％,高于对照组的68．33％（χ2＝11．24,P＜0．01）,剖宫产率为7．02％,低于对照组的30．00％（χ2＝10．11,P＜0．01）;第一产程、第二产程及总产程时间少于对照组（ t＝8．94,8．16,9．96, P＜0．05）;第一产程活跃期及第二产程疼痛程度轻于对照组（z＝3．02,4．57,P＜0．05）;新生儿窒息发生率为1．75％,低于对照组的8．33％（χ2＝5．70,P＜0．05）。结论孕后期进行拉玛泽分娩减痛呼吸法训练,可有效提高自然分娩率,降低剖宫产率,缩短产程,减轻分娩疼痛,降低新生儿窒息发生率,适合临床推广应用。