目的:观察低频神经和肌肉刺激仪用于分娩镇痛对产程、分娩方式、产后出血、会阴完整度、母婴结局的影响。方法:随机选择2019年8月~2020年3月在我院分娩的足月妊娠产妇220名,根据第一产程是否应用低频神经和肌肉刺激仪分为观察组112例及...目的:观察低频神经和肌肉刺激仪用于分娩镇痛对产程、分娩方式、产后出血、会阴完整度、母婴结局的影响。方法:随机选择2019年8月~2020年3月在我院分娩的足月妊娠产妇220名,根据第一产程是否应用低频神经和肌肉刺激仪分为观察组112例及对照组108例,两组均接受常规分娩护理,观察组为自愿接受低频神经和肌肉电刺激镇痛的产妇,比较两组患者产程时间、剖宫产、会阴侧切及裂伤、残留、新生儿结局、产后出血、产后血细胞计数。结果:对照组剖宫产率、部分胎膜残留发生率、分娩后白细胞计数均显著高于观察组(P<0.05),总产程和第一产程时间显著长高于观察组(P<0.05);两组侧切率、裂伤率、出血量、住院时长比较差异均无统计学意义(P>0.05)。两组新生儿1 min、5 min Apgar评分比较差异均无统计学意义(P>0.05)。两组分娩后血红蛋白、红细胞计数、血细胞比容和红细胞平均容量均较分娩前显著下降(P<0.05),组间比较差异无统计学意义(P>0.05)。结论:低频脉冲电刺激可有效缩短第一产程,降低残留率、剖宫产率及产后感染风险,加快子宫复旧;对第二产程、第三产程、产后出血量等无影响,且不影响围产儿结局,能够降低产后感染风险。展开更多
Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, ...Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, Sri Lanka, during the period 1st of February to 28th of May 2017 were invited into the study. Those who were already in active stage of labor (at least more than two moderate contractions per 10 minutes) on admission were excluded. Demographic data such as age, ethnicity, religion, educational level, occupation, latrine type in use, and booking Body mass index (BMI) were collected via an interviewer administered questionnaire. Data related to labor (modified Bishop score at onset of active labor, labor augmentation, pain relief, labor duration, mode of delivery, episiotomy or tears) and neonatal outcome (birth weight, APGAR score at 1, 5, 10 minutes) were collected from delivery notes. A pre tested interviewer administered questionnaire was used to obtain data regarding routine squatting activities during the previous 6 months. Pain visual analogue scale was used on day after delivery to assess the degree of labour pain. Duration of each squatting activity per day and number of days engaged with the activity per week;were used to calculate total squatting hours per week. In the absence of an accepted threshold for adequate squatting, we employed the sample mean as an operational data-driven threshold to define “more” against “less” squatting activities. Women who did not have squatting activities were considered as the controls. We used chi-square and Fisher’s exact tests to compare characteristics and outcomes between those engaging in more and less levels of squatting activity. We fitted a series of logistic regression models with each dichotomized outcome as the dependent variable, more/less squatting activity as the main independent variable of interest, and age, gestation period, BMI and patient’s occupation as covariates. The resulting adjusted odds ratios (AOR) and their 95% confid展开更多
目的分析椎管内硬膜外分娩镇痛后产时发热产妇分娩结局的影响因素。方法选取2020年1月至2021年3月江苏省常州市妇幼保健院收治的82例椎管内硬膜外分娩镇痛后产时发热产妇为研究对象,所有产妇均行椎管内硬膜外分娩镇痛,统计产后不良分娩...目的分析椎管内硬膜外分娩镇痛后产时发热产妇分娩结局的影响因素。方法选取2020年1月至2021年3月江苏省常州市妇幼保健院收治的82例椎管内硬膜外分娩镇痛后产时发热产妇为研究对象,所有产妇均行椎管内硬膜外分娩镇痛,统计产后不良分娩结局发生情况,根据产后是否出现不良分娩结局分为不良组(出现不良分娩结局)和良好组(未出现不良分娩结局),收集两组产妇的一般资料,以Logistic回归分析探讨椎管内硬膜外分娩镇痛后产时发热产妇产后出现不良分娩结局的影响因素。结果82例产妇中,产后出现不良分娩结局11例(不良组),不良分娩结局发生率为13.41%(11/82),良好分娩结局71例(良好组)。产妇不良产后结局8例,其中剖宫产4例、羊水污染1例,产后出血3例;新生儿不良结局3例,其中胎儿窘迫2例,Apgar评分≤7分1例。不良组年龄>35岁、妊娠期高血压、初次体温升高时宫口扩张范围≤4.6cm例数占比较良好组高(χ^(2)=25.623、23.993、18.147,P均<0.05),不良组孕前体质指数(body mass index,BMI)、产时胎心率、发热时血清C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平较良好组高(t=4.286、10.189、3.422、15.951,P均<0.05)。Logistic回归分析结果显示,妊娠期高血压、初次体温升高时宫口扩张范围≤4.6cm、年龄>35岁、孕前BMI数值较高均为硬膜外分娩镇痛后产时发热产妇不良分娩结局的影响因素(OR=2.754,95%CI=1.133~6.693;OR=2.735,95%CI=1.125~6.646;OR=2.776,95%CI=1.142~1.747;OR=3.074,95%CI=1.265~7.471;P均<0.05)。结论椎管内硬膜外分娩镇痛后产时发热产妇产后不良分娩结局的发生率较高,且合并妊娠期高血压、初次体温升高时宫口扩张范围小、年龄较高、孕前BMI数值较高的产时发热产妇产后出现不良分娩结局的风险较高。展开更多
文摘目的:观察低频神经和肌肉刺激仪用于分娩镇痛对产程、分娩方式、产后出血、会阴完整度、母婴结局的影响。方法:随机选择2019年8月~2020年3月在我院分娩的足月妊娠产妇220名,根据第一产程是否应用低频神经和肌肉刺激仪分为观察组112例及对照组108例,两组均接受常规分娩护理,观察组为自愿接受低频神经和肌肉电刺激镇痛的产妇,比较两组患者产程时间、剖宫产、会阴侧切及裂伤、残留、新生儿结局、产后出血、产后血细胞计数。结果:对照组剖宫产率、部分胎膜残留发生率、分娩后白细胞计数均显著高于观察组(P<0.05),总产程和第一产程时间显著长高于观察组(P<0.05);两组侧切率、裂伤率、出血量、住院时长比较差异均无统计学意义(P>0.05)。两组新生儿1 min、5 min Apgar评分比较差异均无统计学意义(P>0.05)。两组分娩后血红蛋白、红细胞计数、血细胞比容和红细胞平均容量均较分娩前显著下降(P<0.05),组间比较差异无统计学意义(P>0.05)。结论:低频脉冲电刺激可有效缩短第一产程,降低残留率、剖宫产率及产后感染风险,加快子宫复旧;对第二产程、第三产程、产后出血量等无影响,且不影响围产儿结局,能够降低产后感染风险。
文摘Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, Sri Lanka, during the period 1st of February to 28th of May 2017 were invited into the study. Those who were already in active stage of labor (at least more than two moderate contractions per 10 minutes) on admission were excluded. Demographic data such as age, ethnicity, religion, educational level, occupation, latrine type in use, and booking Body mass index (BMI) were collected via an interviewer administered questionnaire. Data related to labor (modified Bishop score at onset of active labor, labor augmentation, pain relief, labor duration, mode of delivery, episiotomy or tears) and neonatal outcome (birth weight, APGAR score at 1, 5, 10 minutes) were collected from delivery notes. A pre tested interviewer administered questionnaire was used to obtain data regarding routine squatting activities during the previous 6 months. Pain visual analogue scale was used on day after delivery to assess the degree of labour pain. Duration of each squatting activity per day and number of days engaged with the activity per week;were used to calculate total squatting hours per week. In the absence of an accepted threshold for adequate squatting, we employed the sample mean as an operational data-driven threshold to define “more” against “less” squatting activities. Women who did not have squatting activities were considered as the controls. We used chi-square and Fisher’s exact tests to compare characteristics and outcomes between those engaging in more and less levels of squatting activity. We fitted a series of logistic regression models with each dichotomized outcome as the dependent variable, more/less squatting activity as the main independent variable of interest, and age, gestation period, BMI and patient’s occupation as covariates. The resulting adjusted odds ratios (AOR) and their 95% confid
文摘目的分析椎管内硬膜外分娩镇痛后产时发热产妇分娩结局的影响因素。方法选取2020年1月至2021年3月江苏省常州市妇幼保健院收治的82例椎管内硬膜外分娩镇痛后产时发热产妇为研究对象,所有产妇均行椎管内硬膜外分娩镇痛,统计产后不良分娩结局发生情况,根据产后是否出现不良分娩结局分为不良组(出现不良分娩结局)和良好组(未出现不良分娩结局),收集两组产妇的一般资料,以Logistic回归分析探讨椎管内硬膜外分娩镇痛后产时发热产妇产后出现不良分娩结局的影响因素。结果82例产妇中,产后出现不良分娩结局11例(不良组),不良分娩结局发生率为13.41%(11/82),良好分娩结局71例(良好组)。产妇不良产后结局8例,其中剖宫产4例、羊水污染1例,产后出血3例;新生儿不良结局3例,其中胎儿窘迫2例,Apgar评分≤7分1例。不良组年龄>35岁、妊娠期高血压、初次体温升高时宫口扩张范围≤4.6cm例数占比较良好组高(χ^(2)=25.623、23.993、18.147,P均<0.05),不良组孕前体质指数(body mass index,BMI)、产时胎心率、发热时血清C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平较良好组高(t=4.286、10.189、3.422、15.951,P均<0.05)。Logistic回归分析结果显示,妊娠期高血压、初次体温升高时宫口扩张范围≤4.6cm、年龄>35岁、孕前BMI数值较高均为硬膜外分娩镇痛后产时发热产妇不良分娩结局的影响因素(OR=2.754,95%CI=1.133~6.693;OR=2.735,95%CI=1.125~6.646;OR=2.776,95%CI=1.142~1.747;OR=3.074,95%CI=1.265~7.471;P均<0.05)。结论椎管内硬膜外分娩镇痛后产时发热产妇产后不良分娩结局的发生率较高,且合并妊娠期高血压、初次体温升高时宫口扩张范围小、年龄较高、孕前BMI数值较高的产时发热产妇产后出现不良分娩结局的风险较高。
