湖南省产后出血监测分析

目的　探讨我省产后出血的发生状况、原因构成及影响因素。方法　设立３２ 个产后出血监测点，监测产妇８ １２６例。使用统一的监测个案卡，由监测点接生人员在产妇分娩２４小时后及时填写按季上报。然后计算机录入汇总并分析。结果　产后出血发生率为４３４％ （３５３／８１２６），城乡无显著差异（Ｐ＞ ００５）。产后出血死亡专率为９８６０／１０万。出血原因构成顺位依次为宫缩乏力、胎盘因素、软产道损伤、凝血功能障碍等。有前高危因素的产妇中产后出血的发生率显著高于正常产妇。结论　加强高危监护、处理好产程特别是第三产程是防治产后出血的重要环节。     

Epilepsy and postpartum depression

Purpose:   Postpartum depression occurs in 10–20% of women who have recently given birth, but less than half of cases are recognized. The purpose of this study was to examine whether there was a difference in the rate of postpartum depression between patients with epilepsy and healthy controls, and to determine the relationship between epilepsy and postpartum depression.
Methods:   The sample consisted of 55 patients with epilepsy and 55 patients without epilepsy. All patients were recruited at the Regional Epilepsy Center and at the Department of Obstetrics and Gynecology, University of Milan, St. Paolo Hospital (Italy). Every woman was assessed with the Edinburgh Postnatal Depression Scale and a clinical interview to screen for postpartum depression.
Results:   We found a statistically significant higher rate of postpartum depression in patients with epilepsy compared with controls (p < 0.05).
Discussion:   These findings highlight the importance of screening for postpartum depression; it can improve the recognition of the disorder and can provide adequate treatment and follow-up.     

心理支持对产后抑郁症的影响

目的 :探讨心理支持对产后抑郁症的影响。方法 :将 60例住院病人随机分为两组。研究组采用药物治疗和心理支持疗法 ,对照组采用单纯药物疗法。在病人入院及出院时分别进行汉密顿抑郁量表 (HAMD)和Becr抑郁问卷 (BDI)评定。结果 :研究组和对照组在入院时HAMD和BDI总分无显著性差异 (P >0 .0 5 ) ;出院时两组两量表总分均下降 ,但研究组较对照组下降明显 ,两组比较有统计学意义(P <0 .0 5 )。结论 :对产后抑郁症病人进行有效的心理支持可以提高疗效 ,改变病人的自觉无助、绝望、悲观厌世等抑郁症状 ,增强病人对生活的勇气 ,帮助其树立战胜困难的信心和决心     

Successful treatment of severe myocardial failure after postpartum haemorrhage with the use of an intra-aortic balloon pump

We report a 29-year-old primigravid who developed cardiac failure following postpartum haemorrhage unresponsive to volume resuscitation and therapy with catecholamines and phosphodiesterase-inhibitors. Transoesophageal echocardiography (TEE) demonstrated left atrial and ventricular dilatation and global left ventricular hypokinesis. No elevation of serum MB-isoenzyme fraction was detected and other organ functions remained stable. Although emergency cardiac transplantation was considered in the presented patient, the institution of intra-aortic counterpulsation was decided on as a first treatment option. Intra-aortic balloon counterpulsation rapidly improved cardiac function and led to weaning from pharmacological cardiac support within a few days. Mechanical circulatory assist devices can be life-saving in postpartum-haemorrhage-associated cardiac failure. Received: 11 June 1998 Final revision received: 6 October 1998 Accepted: 6 November 1998     

The Healthy Moms Study: the efficacy of brief alcohol intervention in postpartum women

Background:  The prevention and treatment of alcohol use disorders among women of reproductive age have been well described. However, there is limited information on women specifically during the postpartum period. This period in a woman's life is a time of transition and it provides an ideal opportunity for primary care providers to intervene.
Purpose:  The goal of this report was to present the results of a brief alcohol intervention conducted in 34 obstetrical practices with women seeking routine postpartum care.
Methods:  A randomized clinical trial was conducted from 2002 to 2005 in a diverse sample of women located in 15 Wisconsin counties. This report presents 6-month follow-up data.
Results:  A total of 8,706 women were screened for high-risk alcohol use during routine postpartum care with 997 (12%) of these women testing positive for at-risk drinking. A total of 235 women met inclusion criteria and were randomized to either "usual care" or "brief intervention." The 4-session intervention was delivered by outpatient obstetrical nurses and research staff. The mean age of the women in the sample was 28, 19.3% were from minority groups, 60.8% were married, 53.2% reported current tobacco use, and 17.9% had used marijuana in the previous 30 days. At the 6 month follow-up appointment, there were significant reductions in mean number of total drinks in the previous 28 days ( p  < 0.013), number of drinking days ( p  < 0.024) and heavy drinking days ( p  < 0.019). In addition to a statistical difference between groups, there was a 19% difference in the mean number of drinks and number of drinking days, and a 36% difference in the number of heavy drinking days in favor of the intervention group.
Conclusion:  The findings of the Healthy Moms Trial support the implementation of brief alcohol intervention during the postpartum period.     

《妇人大全良方》治疗产后外感的证治特点研究

产后外感是产后的临床常见病之一,中医认为产后外感往往病机错杂,处方用药与一般外感不同,有其临床产后外感疾病的论治特色。陈自明《妇人大全良方》有关治疗产后外感有其自身的证治特点,如鲜明的审证求因,较完善地体现了产后外感病辨证施治的精神,提供了一些行之有效的方剂,早期治疗以免变生它证,注意饮食和日常调摄等,对后世妇产科发展及治疗产后外感病证方面具有深远的影响。     

心理护理预防产后抑郁的临床疗效研究

目的：评价心理护理预防产后抑郁的临床疗效研究。方法整群选取2009年3月—2011年3月该院收治的产妇93例,随机分为两组,其中观察组46例,围产期采用心理护理干预,对照组47例,仅采用常规护理,观察并比较两组SAS(焦虑自评量表)、HAMD(汉密尔顿抑郁量表)、舒适度评分与产后抑郁发生情况。结果观察组治疗后SAS评分、HAMD评分与舒适度评分均明显优于对照组,比较差异有统计学意义(P<0.05);观察组产后抑郁发生例数明显低于对照组,比较差异有统计学意义(P<0.05)。结论心理护理预防产后抑郁的临床疗效好,能够明显缓解产妇抑郁与焦虑情绪,提高生活质量,降低发生抑郁者例数,值得在临床上予以推广。     

产妇产后出血的临床分析

目的 探讨产后出血的各种高危因素、病因及相关预防措施,减少产后出血的发生率,降低孕产妇病死率。方法 2008年1月1日至2010年12月31日在合肥市第二人民医院分娩发生产后出血的产妇为232例、2011年1月1日至2014年12月31日分娩发生产后出血的产妇为178例,回顾分析产妇临床资料、产后出血的高危因素及病因。结果 两个阶段产后出血部分病因构成比例稍有变化,高龄、巨大儿、产次、妊娠合并症是产后出血发生的相关危险因素(P<0.05),而分娩方式与产后出血的差异无统计学意义(P>0.05)。结论 产科需加强孕期管理,正确评估产后出血的高危因素及病因,积极采取预防措施,降低产后出血发生率, 降低孕产妇病死率。     

The birth of new neurons in the maternal brain: Hormonal regulation and functional implications

The maternal brain is remarkably plastic and exhibits multifaceted neural modifications. Neurogenesis has emerged as one of the mechanisms by which the maternal brain exhibits plasticity. This review highlights what is currently known about peripartum-associated changes in adult neurogenesis and the underlying hormonal mechanisms. We also consider the functional consequences of neurogenesis in the peripartum brain and extent to which this process may play a role in maternal care, cognitive function and postpartum mood. Finally, while most work investigating the effects of parenting on adult neurogenesis has focused on mothers, a few studies have examined fathers and these results are also discussed.