Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place with...Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place without any medical supervision. Method: All patients who reached the hospital with a full cervix dilation were included in the study. The outcomes of those childbirth labors without medical supervision were evaluated at the maternal and neonatal level. Results and Discussion: The average age of the patients was 28.1 ± 13 years with 47% nulliparous and 30% pauciparous. These patients represented 14% of all births;59% of the patients had had three and five prenatal consultations. 71% of them came straight from home and had meconium-stained amniotic fluid. The APGAR score was greater than 6 in 94% of newborns, and 66.7 of them weighed between 2500 and 3500 g. Only 0.9% of patients coming from home needed a caesarean section. Conclusion: Home birth is not yet possible in Africa because it is not supervised by professionals who know the risks of childbirth, its complications and recognize the warning signs;however, the results of this preliminary study show that the issue of home childbirth in Côte d’Ivoire can be reconsidered subject to greater involvement of medical staffs.展开更多
目的探讨叶酸服用时机对妊娠孕妇血同型半胱氨酸、血压及母婴预后的影响。方法选取2012年6月至2014年6月于延安大学附属医院产科进行产检及分娩的387例孕妇为研究对象,按是否服用叶酸及叶酸服用时间分为未服用组(148例)、孕早期服用组(...目的探讨叶酸服用时机对妊娠孕妇血同型半胱氨酸、血压及母婴预后的影响。方法选取2012年6月至2014年6月于延安大学附属医院产科进行产检及分娩的387例孕妇为研究对象,按是否服用叶酸及叶酸服用时间分为未服用组(148例)、孕早期服用组(135例)及孕晚期服用组(104例),对比三组的妊娠高血压疾病发生率、产前叶酸及同型半胱氨酸水平,统计顺产率、早产率及初生儿生后5 min的Apgar评分。结果孕早期服用组妊娠高血压疾病发生率低于未服用组[3.0%(4/135)比11.5%(17/148)],差异有统计学意义(P<0.01)。孕早期服用组和孕晚期服用组叶酸水平高于未服用组[(9.8±1.9)μg/L、(9.0±1.6)μg/L比(6.4±1.4)μg/L],同型半胱氨酸低于未服用组[(7.5±1.9)μmol/L、(9.1±2.1)μmol/L比(12.2±2.1)μmol/L],差异有统计学意义(P<0.05)。孕早期服用组和孕晚期服用组的顺产率高于未服用组[91.9%(124/135)、89.4%(93/104)比64.9%(96/148)],孕早期服用组和孕晚期服用组早产率、胎儿窘迫发生率低于未服用组[早产:0.7%(1/135)1.0%(2/104)比3.4%(5/148);胎儿窘迫:0%、0%比8.1%(12/148)],孕早期服用组和孕晚期服用新生儿生后5 min Apgar评分正常者的比例高于未服用组[96.3%(130/135),88.5%(92/104)比80.4%(119/148)],差异均有统计学意义(P<0.05)。结论对于妊娠期孕妇而言,及早服用叶酸对降低妊娠高血压疾病风险,改善母婴预后具有重要作用。展开更多
文摘Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place without any medical supervision. Method: All patients who reached the hospital with a full cervix dilation were included in the study. The outcomes of those childbirth labors without medical supervision were evaluated at the maternal and neonatal level. Results and Discussion: The average age of the patients was 28.1 ± 13 years with 47% nulliparous and 30% pauciparous. These patients represented 14% of all births;59% of the patients had had three and five prenatal consultations. 71% of them came straight from home and had meconium-stained amniotic fluid. The APGAR score was greater than 6 in 94% of newborns, and 66.7 of them weighed between 2500 and 3500 g. Only 0.9% of patients coming from home needed a caesarean section. Conclusion: Home birth is not yet possible in Africa because it is not supervised by professionals who know the risks of childbirth, its complications and recognize the warning signs;however, the results of this preliminary study show that the issue of home childbirth in Côte d’Ivoire can be reconsidered subject to greater involvement of medical staffs.
文摘目的探讨叶酸服用时机对妊娠孕妇血同型半胱氨酸、血压及母婴预后的影响。方法选取2012年6月至2014年6月于延安大学附属医院产科进行产检及分娩的387例孕妇为研究对象,按是否服用叶酸及叶酸服用时间分为未服用组(148例)、孕早期服用组(135例)及孕晚期服用组(104例),对比三组的妊娠高血压疾病发生率、产前叶酸及同型半胱氨酸水平,统计顺产率、早产率及初生儿生后5 min的Apgar评分。结果孕早期服用组妊娠高血压疾病发生率低于未服用组[3.0%(4/135)比11.5%(17/148)],差异有统计学意义(P<0.01)。孕早期服用组和孕晚期服用组叶酸水平高于未服用组[(9.8±1.9)μg/L、(9.0±1.6)μg/L比(6.4±1.4)μg/L],同型半胱氨酸低于未服用组[(7.5±1.9)μmol/L、(9.1±2.1)μmol/L比(12.2±2.1)μmol/L],差异有统计学意义(P<0.05)。孕早期服用组和孕晚期服用组的顺产率高于未服用组[91.9%(124/135)、89.4%(93/104)比64.9%(96/148)],孕早期服用组和孕晚期服用组早产率、胎儿窘迫发生率低于未服用组[早产:0.7%(1/135)1.0%(2/104)比3.4%(5/148);胎儿窘迫:0%、0%比8.1%(12/148)],孕早期服用组和孕晚期服用新生儿生后5 min Apgar评分正常者的比例高于未服用组[96.3%(130/135),88.5%(92/104)比80.4%(119/148)],差异均有统计学意义(P<0.05)。结论对于妊娠期孕妇而言,及早服用叶酸对降低妊娠高血压疾病风险,改善母婴预后具有重要作用。