The effect of GB21 acupressure on pain intensity in the first stage of labor in primiparous women: A randomized controlled trial

IntroductionLabor pain is one of the most intensive pains experienced by women; it results in physical, emotional, and physiological changes in women’s body. The present study aimed to examine the effect of GB21 acupressure on labor pain.DesignIn this randomized clinical trial, 174 primiparous women in their first stage of labor were selected and assigned to three groups: GB21 acupressure group (n = 58), sham group (n = 58), and control group (n = 58).InterventionsThe acupressure and sham groups received routine labor care and acupressure in three different phases of cervical dilations to 3−5 cm, 6−7 cm, and 8−10 cm. The control group received routine care in labor.Main outcome measuresPain severity was measured using a pain scale ruler in three cervical dilations before and after intervention. The collected data were analyzed using the ANOVA, Kruskal–Wallis, paired-t test and Mann–Whitney tests.ResultsPain reduction was significantly higher in GB21 groups compared with sham and control groups (P = 0.001). No statistically significant difference was observed between the three groups in terms of delivery outcomes.ConclusionsIn this study, GB21 acupressure was effective in pain relief during labor, hence recommended as a practical, effective, inexpensive, and accessible method for labor pain management.     

265名文昌市妊娠妇女口腔健康知识及行为调查

目的 了解文昌市妊娠妇女的口腔健康知识和行为及相关因素.方法 采用问卷调查方式对文昌市人民医院妇和文昌市庆龄妇幼保健院265名产检妇女进行调查.结果 265名被调查者中,孕期口腔健康知识平均得分2.2分(总分5分),婴幼儿相关口腔健康知识2.1(总分6分).孕妇在怀孕前后每天刷牙次数均在2次以上占总人数的87.5％,而怀孕前后每天使用牙签次数都在2次以上20.0％,18.5％在怀孕前做过口腔检查,38.1％的孕妇认为口腔检查没有问题或没有必要.结论 该地区妊娠期妇女口腔健康知识和妊娠期口腔保健行为有待加强.     

围绝经期妇女月经状况与心血管疾病的关系

目的：调查城市社区围绝经期女性中心血管疾病的患病率及其危险因素,并探讨绝经与心血管疾病危险因素之间的关系。方法采用现况调查的方法入选社区年龄40岁～59岁围绝经期妇女,填写调查问卷,内容包括：人口学特征、月经情况、身高体重、心血管疾病患病情况。根据月经状况将入选人群分为月经规律组、月经不规律组和绝经后期组。结果入选女性中,高血压和冠心病患病率分别为23.5%和7.7%,超重、肥胖、高脂血症及糖尿病的患病率分别为25.3%、2.4%、10.4%和6.2%,三组中绝经后期组超重、肥胖、高脂血症及其糖尿病比例最高。绝经后期组、月经不规律组及月经规律组中高血压的患病率分别为13.6%、5.8%和4.1%,具有统计学意义（P＆lt;0.01）。月经不规律组中冠心病患病率高于月经规律组（P＆lt;0.01）,月经不规律组中高脂血症患病率高于月经规律组（P＆lt;0.01）。结论高血压、高血脂、冠心病、肥胖和超重是城市社区围绝经期女性中最常见的心血管疾病。心血管疾病患病率及其危险因素从绝经过渡期即开始增加。     

Management of Spigelian hernia caused by necrobiotic fibroma of the uterus in a pregnant woman

INTRODUCTIONSpigelian hernias are a rare type of hernia through the Spigelian aponeurosis. Spigelian hernias are very uncommon and constitute only 0.12% of all abdominal wall hernias. These hernias are located in the aponeurosis of the internal oblique muscle and transverse abdominal muscle.PRESENTATION OF CASEA 30-year-old woman at 28 weeks’ gestation was admitted to the obstetrics department due to pain and swelling in the anterior abdominal right region. On inspection, we suspected either a lipoma, a spontaneous hematoma, a tumor of the abdominal wall, or a Spigelian hernia. A Doppler USG and abdominal and pelvic Magnetic Resonance Imaging revealed necrobiotic fibroma of the uterus in Spigelian hernia. The patient was started on dual analgesic and corticotherapy. Overall, the patient improved one week after the acute episode and had no further pain during her gynecologic follow-up.DISCUSSIONWe have reported a first case of Spigelian hernia that was complicated by uterine fibroid. The clinical presentation varies, depending on the contents of the hernial sac and the degree of herniation. MRI is the preferred method for accurately identifying masses of the abdominal wall. Our treatment options were based on the extent of the acute-phase reaction and the venous thrombosis.CONCLUSIONIt is important to differentiate this rare Spigelian hernia from other hernias as the treatment for this hernia is medical rather than surgical. Before the final choice of treatment is made, digestive surgeons should bear this rare hernia in mind.     

2011-2017年孕妇生殖道无乳链球菌检出及其耐药性变化

目的了解某地区孕妇生殖道无乳链球菌的感染及其耐药状况,为临床诊断与治疗提供依据。方法收集2011年1月—2017年12月广东省人民医院产科病区及门诊孕妇送检的生殖道分泌物培养的结果,比较分析各年份无乳链球菌检出情况及耐药率变化趋势。结果共送检31 569份生殖道分泌物标本,检出病原菌1 940株,其中无乳链球菌591株,占30.46%。无乳链球菌在生殖道分泌物标本中的检出率为1.87%;2011—2017年无乳链球菌药敏结果中,未发现对青霉素、氨苄西林、奎奴普丁/达福普汀、利奈唑胺、替考拉宁、万古霉素耐药菌株;对环丙沙星、左氧氟沙星、克林霉素、红霉素的耐药率较高,分别为19.80%～28.97%、19.80%～28.95%、26.73%～39.29%、44.05%～66.34%;对四环素的耐药率最高,为80.37%～94.29%,但有逐年下降的趋势（P＜0.05）。结论无乳链球菌为孕妇生殖道感染的主要病原菌,分析其耐药性,合理、规范的使用抗菌药物,可减少孕妇及新生儿无乳链球菌感染的发生。     

胎盘早剥程度及母儿预后的临床危险因素

目的探讨胎盘早剥程度以及母儿预后的相关临床危险因素,以期改善母儿结局。方法收集2007年1月-2012年12月在该院住院确诊的167例胎盘早剥孕妇的临床资料,采用Logistic回归方法对年龄、产次、外伤、脐带情况、是否催产等影响胎盘早剥程度及母儿预后的高危因素进行单因素和多因素分析。结果 167例胎盘早剥孕妇中,胎盘早剥Ⅰ度91例(轻型组),Ⅱ度38例(中型组),Ⅲ度38例(重型组);单因素回归分析显示,重型组孕妇产次、产时出血量、输血量、子宫胎盘卒中率、新生儿窒息、死胎率与中、轻型组比较,差异有统计学意义(P<0.05)。多因素分析显示,产次、子宫胎盘卒中、休克及死胎是胎盘早剥的独立高危因素(P<0.05)。结论重视发生胎盘早剥的经产妇、休克及死胎孕妇,警惕重度胎盘早剥的发生。     

3099例孕妇的孕期营养知识知晓情况及影响因素分析

目的了解孕妇的营养知识水平及其相关因素,为孕期营养教育提供科学依据。方法采用自行设计的一般情况调查表和孕期营养知识问卷对3 099例产检孕妇进行调查。结果孕期营养知晓率为73.73%。肥胖导致孕期糖尿病、体重指数、正常体重孕妇理想增重范围、早孕反应进食少是否会影响胎儿的生长发育等方面知晓率低,分别为39.98%、33.49%、49.34%、29.85%。本人户籍、本人教育程度、丈夫教育程度、家庭月收入、年龄、分娩史为孕期营养知识知晓率的相关因素。结论要针对不同文化程度、不同地域孕妇开展多种形式的营养知识教育,尤其针对文化程度低及初产妇实施个体化教育,宣传范围应扩展到孕妇的配偶及其他家庭成员,从而全面提高孕妇的孕期营养知识水平,形成正确的行为。     

Central concepts in the midwife-woman relationship

The relationship between the midwife and the woman is essential for a positive experience for woman during childbearing period, i.e. pregnancy, childbirth and the first postpartum phase. Thereby, the aim of this study was to delineate central concepts in the midwife-woman relationship, in normal as well as high-risk situations. A secondary analysis was performed on original texts from eight Swedish qualitative studies, all with a phenomenological or phenomenological-hermeneutic approach. Six pairs of concepts were elucidated; each one describing one aspect from the woman's perspective and one responsive aspect from the midwife. The pairs of concepts are: surrender-availability, trust-mediation of trust, participation-mutuality, loneliness-confirmation, differenceness-support uniqueness and creation of meaning-support meaningfulness. Disciplinary concepts about the midwife-woman relationship have evolved that are essential for care in both normal and high-risk contexts, and we suggest that they should be implemented as a guide for midwifery care.     

母乳喂养指导路径对产妇泌乳时间、泌乳量及母乳喂养成功率的影响分析

目的：探讨母乳喂养指导路径对产妇泌乳时间、泌乳量及母乳喂养成功率的影响,为产妇提供更优质的护理服务。方法选取本院产科于2011年6月～2012年5月收治的144例初产妇,设为对照组,采取常规产科护理方法与措施;选取本院产科于2012年6月~2013年5月128例初产妇,设为研究组,在对照组基础上采用母乳喂养指导路径指导母乳喂养。观察并比较两组产妇的泌乳时间、泌乳量及母乳喂养成功率。结果观察组产妇的泌乳始动时间短于对照组（P＜0.05）,观察组的产后1周泌乳量明显多于对照组（P＜0.05）,观察组的产后6个月母乳喂养成功率明显高于对照组（P＜0.05）。结论对产妇行母乳喂养指导路径的效果明显,可促进产妇早期泌乳,增加产后泌乳量,并帮助产妇树立母乳喂养的信心,提高产后6个月内的母乳喂养成功率,有利于保证产妇及婴儿的身心健康。     

剖宫产与阴道分娩对产妇近期并发症的影响

目的：探讨剖宫产和阴道分娩对产妇近期并发症的影响。方法选取2010年7月~2012年6月在本院分娩的1878例产妇,根据产妇的要求按分娩方式将产妇分成阴道分娩组（782例）和剖宫产组（1096例）,比较两组的并发症发生率。结果两组的子宫破裂发生率差异无统计学意义（P>0.05）,阴道分娩组的产褥感染、产后出血、产后尿潴留发生率明显低于剖宫产组（P<0.05）。结论剖宫产方式会明显增高产后并发症发生率,阴道分娩的产后并发症发生率则明显较低,应提倡阴道分娩。