拉玛泽分娩减痛呼吸法对母儿影响的研究

目的：探讨拉玛泽分娩减痛呼吸法对母儿的影响。方法将孕7个月后自愿接受拉玛泽分娩减痛呼吸法的孕妇57例设为观察组,同期未接受拉玛泽分娩减痛呼吸法的60例孕妇为对照组,比较两组产妇分娩方式、经阴道分娩产程时间、分娩时疼痛程度及新生儿窒息发生率等。结果观察组自然分娩率为92．98％,高于对照组的68．33％（χ2＝11．24,P＜0．01）,剖宫产率为7．02％,低于对照组的30．00％（χ2＝10．11,P＜0．01）;第一产程、第二产程及总产程时间少于对照组（ t＝8．94,8．16,9．96, P＜0．05）;第一产程活跃期及第二产程疼痛程度轻于对照组（z＝3．02,4．57,P＜0．05）;新生儿窒息发生率为1．75％,低于对照组的8．33％（χ2＝5．70,P＜0．05）。结论孕后期进行拉玛泽分娩减痛呼吸法训练,可有效提高自然分娩率,降低剖宫产率,缩短产程,减轻分娩疼痛,降低新生儿窒息发生率,适合临床推广应用。     

孕前分娩恐惧量表的汉化及其在大学生人群中的信效度评价

目的汉化孕前分娩恐惧量表(CFPP),并检验中文版CFPP量表在大学生人群中的信效度。方法遵循Brislin翻译模式将英文版CFPP量表翻译、回译,并通过文化调适形成最初汉化版。采用便利抽样,对527名在校大学生进行问卷调查。结果中文版CFPP量表共10个条目,3个维度(对疼痛和失控、对并发症、对分娩后身体变化的恐惧)。量表条目水平的内容效度指数(I-CVI)为0.8～1.0,总量表水平的内容效度指数(S-CVI)为0.96。探索性及验证性因子分析结果显示该量表的结构效度良好。CFPP量表的Cronbach’sα系数为0.916,重测信度为0.871。各维度的Cronbach’sα系数为0.815～0.907,重测信度为0.782-0.803。结论中文版CFPP量表在我国大学生人群中具有良好的信效度,为评估孕前分娩恐惧提供了重要参考。     

宝鸡市金台区中小学教师血脂水平分析

目的:了解宝鸡市金台区中小学教师健康状况、血脂水平,为该人群开展健康教育、改善生活方式、防治代谢类疾病的发生、发展提供科学依据。方法:收集2010年3月—2011年3月在体检中心体检的1 650名中小学教师血脂检验结果,并进行分析。结果:1 650例中,有309例存在不同程度的血脂异常,占18.73%。结论:宝鸡市金台区中小学教师血脂异常状况与其他行业国民血脂异常水平接近,且血脂异常检出率随年龄增长而逐渐增多;不同性别间,相同年龄段有不同的变化趋势。提倡社会人群定期进行血脂检测,调整饮食结构,改善生活方式,积极预防和控制血脂异常,预防心脑血管病及其他代谢类疾病的发生、发展。     

拉玛泽减痛分娩法结合头部按摩对初产妇分娩方式影响的研究

目的探讨拉玛泽减痛分娩法结合头部按摩对初产妇产程、分娩结局的影响。方法选择阴道试产的初产妇170例,采用随机和自愿原则分成实验组（拉玛泽减痛分娩法）85例,对照组85例,运用卡方检验、方差检验等统计方法对两组产妇在产程中的疼痛程度、产程时间、分娩方式等进行统计比较。结果实验组与对照组在分娩过程中的疼痛程度、第一产程与总产程时间、分娩方式上比较差异具有统计学意义（P〈0．01）,而在第二产程与第三产程时间上差异无统计学意义（P〉0．05）。结论拉玛泽减痛分娩法结合头部按摩可减轻分娩疼痛程度、缩短产程时间、提高顺产率,降低剖宫产率,值得临床推广。     

旋后肩法处置肩难产对产妇分娩后盆底肌功能改善的临床研究

目的探讨旋后肩法用于肩难产产妇,对其产后盆底肌功能的改善作用。 方法选择2018年7月至2020年1月,在宁波市妇女儿童医院采用旋后肩法完成肩难产助产的28例产妇为研究对象,并纳入研究组。选取同期在本院分娩,采用耻骨联合上加压法完成肩难产助产的25例产妇纳入对照组。采用表面肌电图(sEMG),获取2组产妇分娩8周后盆底肌收缩运动肌电值。采用成组t检验,对2组产妇一般临床资料、盆底sEMG检测结果进行统计学分析。采用χ²检验,对2组产妇分娩巨大儿所占比例等进行统计学分析。本研究遵循的程序符合病例收集医院伦理委员会制定的伦理学标准,得到该委员会批准[审批文号：[2018]伦审字(28)号]。与所有受试者签署临床研究知情同意书。 结果①2组产妇身高、体重,分娩时人体质量指数(BMI)、孕龄、年龄等一般临床资料比较,差异均无统计学意义(P>0.05)。②2组产妇分娩新生儿的出生体重和巨大儿所占比例分别比较,差异亦均无统计学意义(P>0.05)。③研究组产妇前基线值、快肌收缩最大值、混合肌收缩最大值、混合肌收缩平均值、耐力肌收缩平均值、后基线值分别为(1.4±0.3) μV、(23.8±5.5) μV、(19.9±3.4) μV、(17.2±2.9) μV、(13.7±3.0) μV、(1.3±0.3) μV,均超过对照组的(1.3± 0.3) μV、(20.6±4.4) μV、(17.7±3.3) μV、(14.2±4.1) μV、(11.8±3.4) μV、(1.1±0.3) μV,并且差异均有统计学意义(P<0.05)。而2组产妇耐力肌收缩最大值比较,差异无统计学意义(P>0.05)。 结论旋后肩法用于肩难产产妇助产,较传统耻骨联合上加压法,可改善产妇产后短期内的盆底肌功能。     

盆底康复治疗对不同分娩方式再生育妇女盆底功能的影响研究

目的 探究盆底康复治疗对不同分娩方式再生育妇女盆底功的影响,为促进产妇盆底康复提供相关临床依据.方法 选择2016年1月至2019年12月在潍坊市妇幼保健院分娩的654例二胎产妇进行盆底功能检查,根据分娩方式及初产后是否行盆底康复治疗,分为顺产未治疗组330例,顺产治疗组70例,选择性剖宫产未治疗组204例,选择性剖宫...     

自由舒适型体位待产对产妇分娩的影响

目的研究自由舒适型体位待产对产妇分娩的影响。方法选取2013年1-9月在本院住院经阴道试产的初产妇1900例,采用随机数字表法将其随机分为观察组和对照组,每组950例。观察组产妇在第一产程采用自由舒适型体位待产,对照组产妇采取传统床上卧位体位待产,两组均在待宫口开全进入第二产程后,回到产床取膀肌截石位直至娩出胎儿。结果观察组第一产程时间和总产程时间均明显短于对照组,差异有统计学意义（P〈0．05）。观察组产妇剖宫产率、胎吸率、产钳率、产后2h阴道出血量、新生儿窒息率均明显低于对照组,差异有统计学意义（P〈0．05）。结论产妇在第一产程中应用自由舒适型体位待产,能够明显缩短产程时间,降低剖宫产率,减少产后2h出血量,降低胎儿窘迫发生率,该体位符合孕产妇身心需求,有利于自然分娩．值得临床开展应用。     

Childbirth anxieties in the shadow of COVID-19: Self-compassion and social support among Jewish and Arab pregnant women in Israel

The study examined two angles of childbirth anxieties of Jewish and Arab pregnant women in Israel during the COVID-19 pandemic (March-April, 2020). Specifically, we examined the contribution of personal resources: self-compassion and perceived social support, as well as a couple of COVID-19-related fears of being infected and concern for the foetus, to both the woman's global fear of childbirth (FOC) and her COVID-19-related childbirth anxiety. Participants were Jewish and Arab pregnant women (n = 403) aged 20–47, who completed a set of structured self-report questionnaires from 18 March to 9 April 2020. Findings indicated that Arab women reported higher level of COVID-19-related childbirth anxiety and COVID-19-related fears of being infected and concern for the foetus. In addition, poorer health, being an Arab woman, being in the third trimester, lower self-compassion, and higher COVID-19-related fears contributed significantly to greater COVID-19-related childbirth anxiety. Furthermore, poorer health, being primiparous, at-risk pregnancy, lower self-compassion and higher fear of being infected contributed significantly to greater FOC. Importantly, social support was found to moderate the association between self-compassion and FOC. The results highlight the need to be attentive to pregnant women in times of crisis, and in particular to especially vulnerable subgroups, such as cultural minorities. They also highlight the importance of personal resources that may be applied in targeted interventions to reduce distress in vulnerable populations.     

Negotiating risky bodies: childbirth and constructions of risk

Policy makers, practitioners and researchers have identified risk as a key concept in relation to maternity care and childbirth. There is however a lack of research exploring women’s discursive constructions of risk and childbirth in relation to sociological risk theories. In this article we explore pregnant women’s everyday negotiations of risk in relation to the self-chosen plan to birth either at home or via an elective Caesarean section. We use sociocultural risk theories to contextualise our findings. This article draws on data from a study conducted in 2005–2006 in which we interviewed 24 pregnant middle-class South African women who were planning a home birth or elective Caesarean section and used social constructionist discourse analysis to analyse the data. We found that women’s risk constructions were related to three different conceptions of birthing embodiment: technocratic bodies, vulnerable bodies and knowing bodies. Women who planned Caesarean sections were committed to biomedical constructions of risk and birth. Woman who planned home births shifted between endorsing and subverting biomedical models of risk. They also resisted definitions of birthing bodies as inherently abject (unclean, polluting, unruly) and constructed the process of giving birth as risky in medicalised settings. In such settings, the birthing body was constructed as vulnerable to objectification, loss of dignity and shaming. Women who planned to give birth at home constructed an alternative approach to birth which emphasised embodied ways of knowing, relational connection and empowerment over normative and medicalised risk constructions. In the process, biomedical risk definitions were destabilised.     

Assessment of the hepatitis B birth dose vaccination program,Papua New Guinea, 2014

IntroductionPapua New Guinea (PNG) implemented hepatitis B birth dose (BD) vaccination in 2005 yet since that time coverage has remained low, allowing mother-to-child transmission to occur. We conducted a field assessment of the BD vaccination program to develop strategies for improving the BD coverage.MethodsWe selected five provinces with higher hepatitis B prevalence and five with lower prevalence based on the results of a 2013 hepatitis B serological survey. Within each province, we interviewed district and provincial health officers, health workers, village volunteers, and caregivers from ten randomly selected health facilities. Data were collected on knowledge, practice, vaccine management and data recording/reporting. To identify enabling factors and barriers, we compared health facilities with higher BD coverage with those with lower coverage, and compared caregivers whose children received BD with those whose children did not.ResultsOverall timely BD coverage was 31% and BD vaccination was taking place in 81% of sampled health facilities. Lack of cold chain and vaccine were the major reasons for not providing the BD. Insufficiencies in supervision, vaccine management, community outreach, and data management were identified as obstacles to achieving high timely hepatitis B BD coverage. Good supervision, knowledge of hepatitis B and hepatitis B vaccination, antenatal care including information about the hepatitis B BD, provision of vaccine refrigerators in maternity wards, and outreach vaccination for home deliveries were associated with higher timely BD coverage.DiscussionSeveral steps will likely be effective in improving BD coverage: strengthening training and supervision among health workers and officers, educating caregivers on the benefits of the BD and delivery in health facilities, improving vaccine management, and improving data quality. Considerable effort and leadership will be needed to achieve these steps.