产舒康颗粒预防产后恶露不绝的临床研究

目的　探讨产舒康颗粒对产后恶露不绝的预防作用。方法　 12 0例产妇随机分为预防组和对照组 (各6 0例 ) ,分别用产舒康颗粒和益母草片治疗 5d,观察产后子宫复旧情况。结果　两组产妇第 1d、第 2d子宫高度间差别均有显著性意义 (P <0 0 5 ) ;两组生理产产妇产后恶露干净的平均时间间差别有显著性意义 (P <0 0 5 ) ,而剖宫产产妇产后恶露干净的平均时间间差别无显著性意义 (P >0 0 5 ) ;两组产妇产后恶露不绝发生率间差别有显著性意义(P <0 0 5 )。结论　产舒康颗粒可促进子宫复旧 ,减少产后恶露 ,加速产妇产后恢复 ,对产后恶露不绝确有预防作用。     

刺激乳头对产后出血的影响：（附300例分析）

本文对1992年8月至1992年12月在辽宁省彰武县正常分娩、非高危妊娠的300例产妇进行产后出血的前瞻性研究。其中200例为实验组,当胎儿前肩娩出后刺激双侧乳头以增强子宫收缩;另选条件相似的100例产妇为对照,不作任何干预,对比第三产程时间及产后2小时和产后24小时的出血量。结果证明:胎儿前肩娩出后刺激乳头能减少产后出血发生率,对照组产后出血发生率为20％,刺激乳头组产后出血发生率仅为10.51％,二组差异显著,P<0.05。此方法简便易行,适于推广应用。     

The early detection of postpartum depression: midwives and nurses trial a checklist

OBJECTIVE: To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist. DESIGN: A prospective cohort design using repeated measures. SETTING: The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service. PARTICIPANTS: 107 pregnant women over 20 years of age. MAIN MEASURES: Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses. RESULTS: The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period. CONCLUSION: The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.     

Postpartum cerebral angiopathy: atypical features and treatment with intracranial balloon angioplasty

Postpartum cerebral angiopathy (PCA) is an uncommon cause of ischemic and hemorrhagic stroke in young women. It is usually clinically benign and not relapsing. We describe a patient with nonhemorrhagic PCA who had an atypical progressive neurological deficit from bilateral hemisphere watershed ischemia despite treatment with aggressive medical therapy and intracranial balloon angioplasty.     

Revision of the postpartum depression predictors inventory

Postpartum depression has been described as a thief that steals motherhood. Early recognition is one of the major challenges with this devastating mood disorder. This article describes a revised version of the Postpartum Depression Predictors Inventory (PDPI) based on the results of an updated meta-analysis. This revised inventory consists of 13 risk factors related to postpartum depression. Guide questions for each of the 13 predictors that clinicians can use during an interview process also are included. Included among these 13 predictors in the PDPI-Revised are four new risk factors: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy. Ideally, this checklist should be completed each trimester to update a pregnant woman's risk status. After a woman gives birth, the PDPI-Revised should be used to continue to monitor her risk status because she can develop postpartum depression at any time during the 1st year after childbirth.     

The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature

Summary ¶The incidence of postpartum depression (PPD) in Western societies is approximately 10–15% and its cause multi-faceted. Because mothers largely constitute infants social environment and mediate their experience of the external world, it is imperative to investigate the effects of PPD on child growth and development. PsycInfo, Medline, Embase, CINAHL, ProQuest, and Health Star databases were searched with key terms for English language abstracts from 1990 onwards, and key contents were searched. There are small effects of PPD on cognitive development such as language and IQ, seen particularly among boys. Behavioral effects are variably supported, but may persist up to 5 years postpartum and beyond. However, chronic or recurrent maternal depression, rather than postpartum depression per se is likely related to later effects on the child. These adverse effects of PPD based on sex of infant are discussed.Received February 7, 2003; accepted June 15, 2003 Published online August 12, 2003     

Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression

Interpersonal psychotherapy (IPT) has demonstrated efficacy in the individual treatment of antepartum and postpartum depression. The current investigation extends prior work by examining the efficacy of a group IPT approach for the treatment of postpartum depression. Depression scores of 17 women diagnosed with postpartum depressive disorder (DSM-IV criteria) decreased significantly from pre- to post-treatment. Follow-up assessments at 6 months revealed continuation of the treatment effect. Results indicate that IPT adapted for a group model has positive implications for the treatment of postpartum depression, demonstrating both short-term and longer-term effects in the reduction of depressive symptomatology. Study limitations include the small sample size, absence of control group, possible bias in therapist's assessments, and lack of monitoring adherence, which may have jeopardized the accuracy of the results.     

认知行为治疗对产后抑郁症的疗效分析

目的探讨认知行为治疗对产后抑郁症患者的功能失调性认知和抑郁症状的疗效。方法对48例产后抑郁症患者进行8周的认知行为治疗,对照组的45例产后抑郁症给予健康宣教等一般治疗,采用功能失调性态度问卷（DAS）、汉密尔顿抑郁量表（HAMD）等进行评估。结果治疗后干预组的DAS总分及脆弱性、完美化、依赖性及自主性态度等因子分均显著低于对照组（P〈0．05或0．01）,且干预组治疗前后的DAS总分及脆弱性、完美化、依赖性及自主性态度等因子分也有显著性差异（P〈0．05或0．01）;干预组总有效率为89．6％,对照组总有效率为53．3％（t=6．37,P〈0．01）。治疗后两组的HAMD总分有极显著性差异（t=6．37,P〈0．01）。结论认知行为治疗能显著改善产后抑郁症的功能失调性认知,对产后抑郁有较好的疗效。     

卡前列素氨丁三醇联合宫腔纱条填塞治疗宫缩乏力性产后出血效果观察

【摘要】 目的 探析剖宫产后再次妊娠剖宫产子宫收缩乏力应用卡前列素氨丁三醇联合宫腔纱条填塞治疗产后出血的临床效果。方法 选择2015年1月~2017年1月期间收治的剖宫产后再次妊娠剖宫产术中子宫收缩乏力患者70例为研究对象,随机分为两组,其中给予对照组常规止血治疗,而观察组则应用卡前列素氨丁三醇和宫腔纱条填塞联合治疗,对两组的治疗效果进行对比分析。结果 与对照组比较,观察组产后2h和24h出血量均较少,组间比较差异显著（P＜005）;观察组的术后并发症发生率较低,但是组间比较无明显差异（P＞005）;同时,两组的住院时间、血红蛋白含量比较差异有统计学意义（P＜005）。结论 卡前列素氨丁三醇联合宫腔纱条填塞治疗剖宫产后再次妊娠剖宫产子宫收缩乏力性产后出血,具有起效快、效果确切及不良反应少等优点,可安全地用于临床。     

卡孕栓预防剖宫产术后出血的临床观察

目的观察卡孕栓用于预防剖宫产术后出血的效果.方法选择50例有发生产后出血高危因素的剖宫产者,随机分为卡孕栓组及对照组,各25例.实验组术后30 min内经直肠置入卡孕栓1 mg.对照组无特殊处理,观察两组术中及术后出血量的差异.结果术中出血量两组差异无显著性,而术后平均出血量实验组为147 ml,对照组为184 ml,差异有显著性(P＜0.05).产后24 h出血量实验组平均为389 ml,对照组平均为422 ml,差异有显著性(P＜0.05).结论卡孕栓促进子宫收缩作用明显,能很好地预防剖宫产术后出血,且用药方便,安全.