Risk Factors for the Increased Seizure Frequency during Pregnancy and Puerperium

Abstract: Possible factors affecting the seizure frequency during pregnancy and puerperium were prospectively studied on 125 cases, paying particular attention to the drug compliance and the antiepileptic drug disposition. Of the subjects, 27% were under the poor compliance category. As the reasons for the poor compliance, anxiety about the side effects of antiepileptic drugs including teratogenecity and the harmful effects on their newborns by breast feeding were found in about half of them. In the cases with regular drug taking, 80% showed no change in the seizure frequency whereas only 16% exhibited an increase and 4% a decrease. The apparent serum clearance of phenytoin, primidone, phenobarbitone derived from primidone and valproic acid increased during pregnancy and puerperium. In some cases, the lowering of the serum level of drugs was associated with the aggravation of seizures.     

Maternity blues in Brazilian women

In this prospective study, a sample of 86 postpartum women was compared with a sample of 75 women from a random period of 8 consecutive days out of puerperium. Symptoms were evaluated each day using the Blues Questionnaire. Postpartum women and women out of puerperium showed a different distribution of percentile scores on the scale on the third, fourth and fifth days. The postpartum symptom peak occurred on the fifth day. Symptoms more significantly associated with the third, fourth and fifth postpartum days were overemotionalism and oversensitivity. It is concluded that maternity blues in Brazilian women appear to be characterized by maternal mental state alterations occurring on the third, fourth and fifth days postpartum. MB seems to be better defined as an emotional oversensitivity syndrome of cross-cultural dimension than as depression.     

产妇分娩时和产褥期心理状态及保健对策

从产妇的心理变化出发，分析产妇在分娩时和产褥期的心理特点和产生原因，探讨医务工作者在临床心理保健中的作用和保健对策，保证产妇分娩的顺利进行及产褥期的生理和心理的健康。在提高产科质量的同时，加强医患之间的交流，树立医务工作者高尚的医德医风。     

The longitudinal course of para-natal emotional disturbance.

Ninety-five nulliparous women were interviewed during pregnancy and 4 months post partum. The possibility of predicting mental disturbance post partum from that during pregnancy was studied. When the woman was mentally disturbed during pregnancy, the prognosis was better in the case of a poor social situation at the time of the pregnancy than in the case of a good social situation. Negative attitude towards further pregnancies and repudiation of the own mother, however, implied unfavourable prognosis. In the case of a woman without mental symptoms during pregnancy, denial of the pregnancy and sensations connected with it suggested poor adaptation post partum.     

Prescription drug use and medicine taking behaviour in pregnancy

Frequently in clinical practice, treatment regimens do not bring the expected results. In some of these cases, the underlying reason is non-adherence, which affects up to 50% of patients. It is well known that non-adherence can pose serious health risk; in pregnancy this risk extends not only to the mother but also to the fetus. However, little is known about the medicine-taking behaviour of pregnant women and thus little can be done to target at-risk groups. Clinical practice should be tailored to encourage adherence and optimize the efficacy of treatment plans, so as to effectively manage patients.     

探究健康管理对出院后产褥期母婴健康的影响

目的探究与分析健康管理对出院后产褥期母婴健康的影响。方法选取我院产科自2012年7月至2014年7月收治的560例正常分娩无并发症的产妇,采取随机数字表法分为对照组与试验组,每组各280例。对照组仅接受来电咨询,试验组在产妇出院后为其建立专业的健康档案、电话随访及家庭随访等护理干预措施。观察与对比两组产妇及新生儿经不同护理干预措施后的健康状况。结果试验组较对照组相比急性乳腺癌、痔疮肛裂、子宫复旧不良、体重超重、产后便秘及会阴切口愈合不良发生率明显降低,P〈0.05,具有统计学意义。试验组较对照组相比产褥期黄疸、脐带脱落延长、臀红、鹅口疮发生率明显降低,P〈0.05,具有统计学意义。结论对于产妇在出院后给予健康管理措施,可有效降低产褥期产妇及新生儿的患病率,提升其生存质量,值得推广。     

城乡妇女产褥期生活及卫生习惯分析

目的了解城乡妇女产褥期生活及卫生习惯情况,探讨现代妇女科学的产褥期行为方式。方法采用整群随机抽样方法,抽取山东省青岛市市区(城市组)及莘县农村地区(农村组)2 342名产后1年以内的妇女进行问卷调查。结果农村组有2.6%的妇女产褥期从不下床活动,高于城市组的1.5%(P<0.05);农村组平均每天下床活动时间为2.59 h,低于城市组的3.35 h(P<0.05);农村组比城市组更注重保暖(P<0.05);农村组不洗澡、不洗头、不洗脚等行为发生率分别为52.0%、49.9%、26.6%,高于城市组的41.3%3、3.0%6、.7%,而不做产后体操、不做简单家务等行为的发生率分别为70.2%、26.4%,低于城市组的76.9%5、2.4%(P<0.05);农村组认为串门、吹风为产褥期行为禁忌的人数比例高于城市组,而认为晒太阳、洗澡、碰凉水、下床为禁忌的人数比例低于城市组(P<0.05)。结论城乡妇女产褥期不良行为发生率均较高,差异亦有统计学意义,需要引起足够的重视。     

产妇产后饮食行为对产褥期疾病的影响

目的探讨产妇产后饮食行为对产褥期疾病的影响。方法选择2012年5月~2013年5月在本院分娩的838例产妇为调查研究对象,于产后6周采用膳食调查法及知识态度行为量表(knowledge attitude practice,KAP)对其进行产后营养状况及饮食行为调查。结果 838例产妇有128例(15.3%)发生产褥期疾病,其中发生1种疾病58例(45.3%),发生2种疾病42例(32.8%),发生3种及以上28例(21.9%)。产褥期疾病组产妇蛋白质、钙、铁、锌、VitA、Vit B1、VitB2、Vit C摄取量明显低于产褥期非疾病组产妇,两组比较,差异具有统计学意义(均P0.05)。产褥期疾病组产妇营养知识评分、态度评分、行为评分及KAP总分明显低于无产褥期疾病组产妇,两组比较,差异具有统计学意义(均P0.001)。结论产后产妇饮食行为与产褥期疾病有密切关系,产后应加强对产妇营养指导,提高产妇健康行为,以减少产褥期疾病的发生。     

剖宫产术后并发血栓性静脉炎的诊治和预防

目的：探讨剖宫产术后并发血栓性静脉炎的诊断治疗及预防措施。方法：回顾性分析11年间9例剖宫产术后并发血栓性静脉炎患者的临床特点及诊断、治疗和预防方法。结果：剖宫产术后并发血栓性静脉炎的最佳诊断方法为彩色多普勒超声，经抗凝、溶栓、支持等保守治疗，预后良好。结论：剖宫产与产褥期血栓性静脉炎之间呈正相关，血栓性静脉炎的道选治疗方法是溶栓、抗凝治疗。     

ABO blood groups and risk of venous thromboembolism during pregnancy and the puerperium. A population-based, nested case-control study.

OBJECTIVES: To examine possible associations of ABO blood types with the risk of venous thromboembolism (VTE) in pregnancy and the puerperium. PATIENTS AND METHODS: We conducted a nested case-control study within a cohort of 71,729 women who gave birth to 126,783 children in the North Jutland County, Denmark, from 1980 to 2001. We identified 129 cases with VTE in pregnancy (n = 61) or the puerperium (n = 68), and 258 controls with no VTE. We collected information on ABO blood groups and possible maternal confounding factors and estimated the relative risk [odds ratio (OR)]. RESULTS: Women with an A or AB blood group had elevated risk estimates of VTE in pregnancy or the puerperium compared with women with a O blood group [adjusted ORs 2.4, 95% confidence interval (CI) 1.3, 4.3, and 2.0, 95% CI 0.7, 5.8, respectively]. No increased risk estimate was found for group B (adjusted OR 1.2, 95% CI 0.5, 3.0). The increased risk estimates of VTE for blood groups A and AB appeared present in both pregnancy (adjusted ORs of 3.9, 95% CI 1.5, 9.7, and 2.2, 95% CI 0.4, 12.5) and in the puerperium (adjusted ORs of 2.4, 95% CI 1.0, 4.9 and 2.7, 95% CI 0.8, 9.3). Furthermore, blood groups A and AB appeared to be associated with increased risk estimates for both DVT and pulmonary embolism. CONCLUSION: Keeping the modest statistical precision of our study in mind, blood groups A and AB may be associated with increased risk estimates for VTE in pregnancy and the puerperium.