620例妇女非意愿妊娠人工流产原因分析

人工流产是避孕失败的一种补救措施，近年来，在早孕人工流产中，非意愿妊娠有增高趋势，为了提高育龄妇女的避孕节育成功率，减少非意愿妊娠的发生，避免人工流产对妇女造成的身心伤害，笔者对2003年1月～2005年1月的620例非意愿妊娠施行人工流产术者进行分析。     

516例非意愿妊娠者紧急避孕知识调查

分析非意愿妊娠人群紧急避孕知识态度及相关因素，对516例非意愿妊娠者进行问卷调查。结果，紧急避孕知识知晓率35.5％，知道在无避孕措施的性行为或避孕套破裂滑脱72h内可服用紧急避孕药来防止妊娠；63．2%的调查对象表示使用紧急避孕药。应加紧对紧急避孕知识的宣传，尤其是对紧急避孕法的安全性、有效性以及正确使用时间的宣传。     

非意愿妊娠高危人群紧急避孕知识与态度及相关因素研究

目的:研究非意愿妊娠高危人群紧急避孕知识水平、态度及其相关因素,同时分析紧急避孕行为的影响因素.方法:以美国Kaiser Family Foundation紧急避孕调查表为基础设计问卷,对468例非意愿妊娠高危者进行横断面调查.结果:紧急避孕知晓率为88.5%;如果知道在无避孕措施的性行为或避孕套破裂72h内可以应用紧急避孕药来防止妊娠,95.7%的调查对象表示愿意使用紧急避孕药;紧急避孕知识平均得分12.72±4.65,紧急避孕态度平均得分为25.88±4.22,二者呈正相关关系(r=0.345);流产次数、职业、文化程度及紧急避孕知识等是采用紧急避孕措施的主要影响因素.结论:为提高育龄妇女紧急避孕措施的使用率,必须加强紧急避孕知识的宣传,尤其是对紧急避孕法的安全性、有效性以及正确的使用时间的宣传.     

非意愿妊娠妇女对紧急避孕知识接受程度的调查

目的了解非意愿妊娠妇女对紧急避孕知识接受的程度 ,以制定相应的咨询策略 ,预防意外妊娠 ,降低人工流产率。方法采用自行设计的问卷 ,随机对 2 2 0名非意愿妊娠妇女进行了调查。结果 6 4 .5 5 %的妇女完全不了解紧急避孕方法 ,在对紧急避孕知识的了解程度、使用情况上 ,病人的婚育状况不同 ,差异均无显著性意义 (P >0 .0 5 )而文化程度不同 ,差异有显著性或极显著性意义 (P <0 .0 5或P <0 .0 1 ) ,在表示了解的病人中 ,仅 38.4 6 %的病人所叙述的方法是完全正确的 ,曾经使用过紧急避孕方法的病人为 1 9.5 5 % ,经过指导 ,79.5 5 %的病人今后愿意选择紧急避孕。结论迫切需要加强紧急避孕知识的宣传教育工作 ,以降低非意愿妊娠的发生     

品管圈活动提高非意愿妊娠女性避孕知识知晓的作用

<正>流产仅是计划生育的补充手段,重复人工流产严重危害女性健康[1]。重复人工流产不仅可能带来出血、感染、穿孔和慢性盆腔炎等并发症,还会大大增加女性将来发生不孕的概率[2-3]。因此,减少非意愿妊娠、降低人工流产率,尤其是重复人工流产率,对保障女性身心健康具有重要意义。健康教育是流产后关爱     

人工流产后关爱咨询指导对剖宫产术后非意愿妊娠女性避孕行为和心理健康的影响

目的探讨人工流产后关爱(PAC)咨询指导对剖宫产术后非意愿妊娠女性的避孕行为和心理健康的影响。方法选择因剖宫产术后2年内发生非意愿妊娠且自愿行人工流产的568例患者,以人工流产后接受PAC咨询指导的346例为观察组、接受无PAC的常规医疗咨询指导的222例为对照组。收集2组患者一般情况、流产方式、人工流产前非意愿妊娠的原因、人工流产前和人工流产1年后采取的避孕措施,以及术后1年内再次非意愿妊娠的情况,并在人工流产前和人工流产2周后采用焦虑自评量表(SAS)评估患者的精神状态。结果 2组患者的年龄、妊娠时间、人工流产前剖宫产次数、人工流产距前次剖宫产的时间及流产方式比较差异均无统计学意义(P均> 0.05)。导致2组患者非意愿妊娠的原因为避孕失败、未避孕和不知晓避孕,2组比较差异无统计学意义(P> 0.05)。经过不同形式的宣教和指导,观察组与对照组患者在人工流产前与人工流产1年后的避孕方式均有所改变(P均<0.05),观察组中高效避孕者比例高于对照组。人工流产2周后观察组中焦虑者比例低于人工流产前(P <0.05),对照组中焦虑者比例与人工流产前比较差异无统计学...     

85例早期人工流产妇女避孕节育现状调查

目的通过对人工流产的非意愿妊娠的妇女进行调查,了解她们对避孕节育知识的掌握状况,为减少非意愿妊娠和流产发生率提供护理依据。方法在自愿的前提下,以自填式问卷的方法。对85例自愿要求早期流产的妇女进行问卷调查,了解其对避孕节育知识的掌握情况。结果本次调查的妇女,避孕节育的相关知识缺乏,对意外妊娠的危害性了解不够。结论应加强对育龄妇女避孕节育知识和流产危害性的宣传教育,提高其自我保护意识,把采取避孕措施变成自觉行动。     

品管圈活动在提高非意愿妊娠女性避孕知识知晓率中的应用

目的 提高非意愿妊娠女性对避孕知识的知晓率。方法 组成品管圈,首先在传统健康教育后,对非意愿妊娠的女性对避孕知识的知晓率进行调查作为基础数据。然后通过要因分析,针对性制作了视频和文字资料,并结合使用集体宣教和一对一指导等进行改进。改进措施实施后,对非意愿妊娠女性对避孕知识的知晓率进行再评价。结果 通过品管圈活动,改进后的健康教育措施显著提高非意愿妊娠女性对避孕知识的知晓率。对反复非意愿妊娠危害的知晓率由66.2%提高到93.2%,短效口服避孕药的优点知晓率由40.9%提高到93.8%,安全期避孕的缺点知晓率由44.1%提高到99.0%,紧急避孕药缺点的知晓率由42.3%提高到93.8%,避孕套正确使用方法的知晓率由89.3%提高到97.6%（均P=0.000）。结论 品管圈活动显著改善健康教育效果,有效提高了非意愿妊娠女性对避孕知识的知晓率,可望降低重复流产率。     

530例未婚非意愿妊娠原因分析

目的：分析未婚青少年妊娠的原因,为采取干预措施提供依据。方法：选择门诊要求人工流产的未婚青少年为调查对象,以匿名方式进行问卷调查,认真填写相关内容。结果：530例中≤20岁未婚非意愿妊娠青少年221例,占41．70％;首次妊娠215例,再次妊娠315例;未避孕236例,避孕失败294例;避孕知识缺乏、避孕措施使用不当、方法低效是未婚非意愿妊娠的主要原因。结论：加强性道德、性观念、生殖健康及避孕知识教育,提供各类避孕工具和药品,指导避孕方法,从而有效降低未婚非意愿妊娠的发生率。     

妊娠丢失与非意愿妊娠患者人工流产术前心理和社会支持状况的调查分析

目的了解妊娠丢失与非意愿妊娠患者行人工流产术前的心理和社会支持情况,为妊娠丢失患者临床护理方案的设计提供依据。方法采用便利取样法,对82例妊娠丢失患者和84例非意愿妊娠患者在行人工流产术前进行焦虑自评量表、抑郁自评量表和社会支持评定量表测评。结果妊娠丢失组患者的焦虑自评量表评分(50.34±8.66)分、抑郁自评量表评分(60.68±4.96)分,非意愿妊娠组患者的焦虑自评量表评分(47.26±5.42)分、抑郁自评量表评分(55.93±7.17)分,比较差异均有统计学意义;两组患者社会支持评定量表评分相近,比较差异无统计学意义。结论妊娠丢失患者的焦虑和抑郁水平明显高于非意愿妊娠患者,但并未获得更多的社会支持。     

Preventing and Terminating Unwanted Pregnancies in Turkey

PURPOSE: To determine the methods used to prevent pregnancy by women seeking abortion of unwanted pregnancy, their knowledge and use of emergency contraception, and reasons for wanting the abortion. DESIGN: The sample was 144 randomly selected women, who requested abortion for termination of their pregnancies at two hospitals in Izmir, Turkey, during the study period. METHODS: A questionnaire was completed by the researcher in face-to-face interviews. Findings: In this sample 43.8% had had previous abortions; 77.1% used some method of family planning; 7.0% used emergency contraceptives. The methods selected after unprotected sexual intercourse by these women included vaginal douche (37.5%), waiting to see whether the menstrual cycle would begin (27.0%), going to a hospital or maternal-child health center (24.3%), and two other alternatives (4.2%). One-fifth of the women said that, if they get pregnant again, they will have another abortion. CONCLUSIONS: The number of unwanted pregnancies is high and many women seek abortions as a birth control method. Women in this sample needed information about effective methods for preventing pregnancy.     

未婚先孕者实施人工流产术情况调查分析及避孕指导

目的 通过对未婚先孕行人工流产术者状况的调查分析，探讨避孕相关知识指导的必要性及方法。方法 采用自行设计的调查问卷对2005年1月-2006年9月3187例实施人工流产术者进行调查。结果 未婚先孕行人工流产术者1823例，占同期人流总数的57．20％，其中17～20岁占23．69％，大学文化程度者占34．00％，初次行人工流产术者占65．99％，2次或以上行人流术者占34．01％；初次行人流术者不了解人流并发症的占92．10％，2次或以上行人流术者不了解人流并发症的占93．87％；初次行人流术者不懂避孕知识的占75．39％，2次以上行人流术者不懂避孕知识的占35．16％。结论 未婚先孕行人流术者日益低龄化且职业分布呈多元化，人员文化程度较以往提高，但是严重缺乏生殖健康常识和避孕知识。建议：加强中学生及大学生在校期间生殖健康知识的教育，把人流的危害性及必要的避孕常识作为必修内容，同时医务人员也要抓住时机对未婚先孕行人工流产术者进行有效的避孕指导。     

北京市妊娠少女避孕知识态度和行为调查分析

目的了解北京市妊娠少女避孕知识、态度和行为现状。方法采用自行设计的避孕知识、态度、行为问卷对2007年4-6月在北京市城区4所妇幼保健院因非意愿妊娠而要求终止妊娠的53名16～19岁少女进行避孕知识、态度和行为调查。结果调查对象对避孕知识掌握在较差水平占70%;避孕态度上,89%的少女认为自己有必要了解避孕知识,但在选择避孕方法的优先性上,考虑应用方便的占67%,不妨碍对方感觉的占13%,认为应确保避孕效果的仅占13%;避孕行为方面,调查对象首次性经历使用避孕措施的占53%,近12个月内坚持每次使用避孕措施的仅占30%,采取的避孕措施多为避孕套。本次妊娠的原因47%由于没有采用避孕措施,47%的少女由于避孕套、体外排精等常规避孕方法失败后未采取补救措施而怀孕,还有6%的少女因为常规避孕失败后服用紧急避孕药失败而受孕。结论仅对少女开展避孕知识教育尚不能改变其行为,需要改善避孕态度,提高对意外妊娠风险和人工流产并发症的认识,促进避孕措施的使用,降低少女妊娠率。     

Contraception and Women with Intellectual Disabilities

Background Contraception is widely prescribed to women with intellectual disabilities, yet little is known about what the women think and feel about this. One of the aims of the study was to explore what women understood and to what extent they were able to exercise choice and control. Method Twenty‐three women with mild and moderate intellectual disabilities in South East England were interviewed about their current and past use of contraception, their knowledge of contraception more broadly, the process of being prescribed contraception and sources of information and support. Results Knowledge of how contraception works was very limited and approximately half the women also lacked basic knowledge about reproduction. Few women attended medical appointments alone and none had been given any accessible information about contraception. Conclusions There is a role for increased education, support and advocacy for women with intellectual disabilities when they are prescribed contraception. This would help to ensure women are prescribed methods which are best for them as individuals and to help maximize their participation in the process.     

805例早期妊娠超声图像分析

本文回顾分析805例早期妊娠超声显像表现。805例中超声检查确诊或拟诊早期妊娠802例，误诊3例。将805例早期妊娠声像图分为三型：I型，回声增强型;Ⅱ型，妊娠囊型;Ⅲ型，胎芽型。作者对妊娠囊的形态、大小等作了初步分析。     

生育期癫痫女性妊娠及妊娠结局的临床分析

目的:比较癫痫女性与正常女性妊娠期合并症及妊娠结局。方法:有癫痫病史的孕妇85例为癫痫组,同期无癫痫病史的孕妇170例为正常组,对比分析2组妊娠合并症及妊娠结局。结果:癫痫组自然流产、妊娠高血压综合症(妊高症)、围产期癫痫发作及妊娠期焦虑抑郁的发生率高于正常组(P<0.05);2组胎儿结局差异无统计学意义。结论:癫痫导致部分妊娠合并症发病率的增加,对胎儿结局影响不大。     

Contraception and women over 40 years of age: mixed-method systematic review

Title.  Contraception and women over 40 years of age: mixed-method systematic review.
Aim.  This paper is a report of a mixed-method systematic review to identify barriers to, and facilitators of, contraceptive needs and choices of women over 40 years old.
Background.  Women over 40 years of age who do not want to conceive have specific needs for contraception to prevent unwanted, unplanned and unintended pregnancies prior to menopause.
Data sources.  Six databases were searched for published and grey literature from September 1997 to September 2007, along with the Cochrane Central Register of Controlled Trials. The Internet, professional networks and hand searching were also used.
Review methods.  Mixed-method synthesis using Evidence for Policy and Practice Information and Co-ordinating Centre phased design.
Findings.  Guidelines to inform clinical decision-making were located but did not take account of age-related social factors affecting women's choices or local service availability. Women's access to services and contraceptive choices were influenced by educational level, general awareness of available methods, fear of side effects, women's social standing, religious and cultural beliefs, personal control, and confidentiality. The main factors influencing compliance and continuation rates were knowledge, positive experience and confidence, unacceptable side effects and safety concerns, information, support and advice, and ongoing husband/partner influences.
Conclusion.  The utility of clinical guidelines could be improved by incorporating socio-cultural factors and women's views. Novel approaches to evidence translation and facilitation are required. Focusing on user-led, age-appropriate services rather than a 'one size fits all' approach could improve the contraceptive choices and outcomes for women over 40 years old.     

Cholinesterase Activity in Pregnant Women and Newborns

Abstract

Plasma and red blood cell cholinesterase activity in blood samples from 259 pregnant women and cord blood from some of their newborn were compared with samples from 25 nonpregnant female volunteers and with laboratory norms (Ellman method). Plasma cholinesterase was significantly lower (p < 0.05) and red blood cell cholinesterase higher (p < 0.05) in pregnant women than in nonpregnant controls in a repeated measures analysis. By the sixth post-partum week, both plasma and red blood cell cholinesterase were similar to nonpregnant control activity. Fetal cord red blood cell cholinesterase activity was also lower than in nonpregnant women, but plasma levels were not significantly different. When compared with standard laboratory normal ranges, most (98-100%) plasma cholinesterase values in pregnant women and newborn were within range, whereas the majority (59-87%, depending on trimester) of red blood cell levels were above range in pregnancy and below range in 53% of newborns. A low red blood cell cholinesterase in pregnant women is more consistent with a possible overexposure to anticholinesterases than a low plasma cholinesterase. Periods of altered sensitivity to specific cholinesterase inhibiting drugs and environmental agents are suggested by these findings.