会阴体长度及弹性度测量在分娩中的应用

目的探讨分娩期测量会阴体长度及弹性度的应用价值。方法将320例经阴分娩的足月初产妇随机分为两组,观察组测量会阴体长度及弹性度并予相应干预,对照组常规处理。结果与对照组比较,观察组会阴侧切率、裂伤发生率、出血量、疼痛评分明显降低,切口甲级愈合率升高,住院时间缩短（P均〈0．01）。结论分娩期测量会阴体长度和弹性度并予相应干预,可降低会阴切开术及软产道严重损伤。     

Experiences of security associated with pregnancy and childbirth: a study of pregnant women

The aim of this study was to describe the sense of security associated with pregnancy and childbirth and to identify factors associated with it. Security was conceptualized in accordance with Kaufmann as a human need and as a human value. The instrument used was a questionnaire with a 4-point scale. The sample consisted of 481 pregnant Finnish women. The response rate was 69%. Rotated factor analysis was carried out and sum variables were produced. The effects of various background variables were calculated using the Kruskal-Wallis test and the Mann-Whitney U-test. The elements creating security were social support, knowledge, prenatal health-care experiences, support from the partner, livelihood, positive stories and, in multiparae, positive previous childbearing experiences. The most salient finding concerning factors related to security was that women who had no pregnancy-related problems in the current pregnancy reported social support, prenatal health-care experiences and support from the partner as security-creating elements more often than women with such problems. This was the only factor related to manifestation of security. The findings suggest that all pregnant women should be assisted by professionals to find security-creating elements in their particular situation to promote and strengthen the sense of security, paying special attention to women with pregnancy-related problems.     

Is a long period without childbirth a risk factor for developing endometriosis?

Endometriosis was found in 42 (20%) of 206 symptom-free, parous Norwegian women with a mean age of 37 years at the time of sterilization. Case-control analysis between the 42 women with endometriosis and the 164 without endometriosis revealed an increased risk of endometriosis with increasing number of years since the last childbirth. After 10 years without a birth, the odds ratio for endometriosis was 4.5 compared with the first 5 years after the last delivery. An increased risk of endometriosis with increasing age of the women could not be detected. If these findings from women with voluntary infertility are transferred to women with endometriosis associated with involuntary infertility, endometriosis could be a consequence of a long period without childbirth. This might explain why endometriosis is often diagnosed in infertile women.     

The experience of motherhood and the development of depression in the postnatal period

Summary

• ? This paper reports on an investigation of women's experience of motherhood as a possible factor in the development of postpartum depression.
• ? Several aspects of the experience of motherhood were found to be associated with depression in a sample of 60 first-time mothers. These included:

• — the social impact of motherhood,
• — the extent to which expectations of motherhood were met,
• — the adequacy of support received from partners or from the mothers' wider social networks.

• ? It is argued that these findings, while tentative, are consistent with a social model of depression.
• ? Implications for health professionals and other care providers are discussed.

     

心理契约式产前教育促进自然分娩率的效果观察

目的探讨心理契约式产前教育促进自然分娩率的效果。方法将168名孕妇分为观察组和对照组各84例,对照组给予常规产前教育,观察组通过激发孕妇对分娩知识的渴望,建立共同的心理契约目标,发挥心理契约的作用,实现共同心理契约目标。结果观察组孕妇对自然分娩的认识、产前教育后依从性和自然分娩率均高于对照组(P0.01)。结论心理契约式产前教育可提高自然分娩率,具有良好的临产应用价值。     

罗哌卡因联合舒芬太尼减轻镇痛分娩应激反应的临床研究

目的 探讨罗哌卡因联合舒芬太尼减轻镇痛分娩产妇应激反应,以及对诱导性一氧化氮合酶（iNOS）表达的影响.方法 随机将120例镇痛分娩产妇分别给予罗哌卡因（对照组）和罗哌卡因加舒芬太尼（干预组）.分别测定镇痛前、镇痛30 min和分娩后的心率（HR）、平均动脉压（MAP）、收缩压（SBP）和舒张压（DBP）水平,VAS评分,以及血丙二酯（MDA）和超氧化物歧化酶（SOD）水平.测定新生儿出生1、5和10min时的Apgar评分.同时使用western blot-ting法测定镇痛前和镇痛2小时时血iNOS的表达水平.结果 两组产妇在镇痛30 min和分娩后,HR、MAP、SBP和DBP以及VAS评分均较镇痛前明显下降（均P＜0.05）;与对照组相比较,干预组在各时间点的HR、MAP、SBP和DBP以及VAS评分下降更明显（均P＜0.05）.在镇痛30 min和分娩后,血MDA水平较镇痛前明显下降,血中SOD水平较镇痛前明显增加（均P＜0.05）;但与对照组比较,治疗组改变更显著（均P＜0.05）.两组新生儿在各时间点Apgar评分未见统计学差异（均P＞0.05）.在镇痛2小时后,血iNOS的表达水平较镇痛前明显下降（均P＜0.05）;与对照组比较,干预组下降更显著（P＜0.05）.结论 罗哌卡因联合舒芬太尼进行镇痛,提示可以通过抑制iNOS的表达改善镇痛分娩产妇应激反应水平.     

生物反馈训练与电刺激对产妇盆底功能的影响

目的 探讨生物反馈训练与电刺激联用对自然分娩产妇盆底功能的影响.方法 将2018年12月—2019年12月在本院分娩的224例产妇,按照其意愿分为研究组和对照组,各112例.对照组进行盆底功能训练,研究组在对照组基础上给予生物反馈训练与电刺激治疗.比较两组产妇盆底功能障碍评分(pelvic floor distress...     

初产妇自然分娩中应用无保护助产护理方法

目的对于初产妇自然分娩中应用无保护助产护理的具体方法以及应用效果加以分析。方法对过去一年之内接诊的自然分娩初产妇资料100例加以分析,100例自然分娩初产妇根据入院顺序奇偶法加以分组,给予50例自然分娩初产妇常规助产护理措施,将其作为对照组,另外50例自然分娩初产妇接受无保护助产护理措施,将其作为研究组,对比两组自然分娩初产妇的护理效果。结果两组自然分娩初产妇的疼痛评分、出血量以及住院时间对比差异明显;两组自然分娩初产妇的会阴侧切率以及会阴裂伤出现几率对比差异明显。结论临床中在初产妇自然分娩中开展无保护助产护理效果理想,能够显著提升分娩安全性,缓解分娩疼痛。