Iodine Nutrition, Thyroid-stimulating Hormone, and Related Factors of Postpartum Women from three Different Areas in China: A Cross-sectional Survey

Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.

The prevalence,associated factors,and impact of urinary incontinence in pregnant and postpartum women in Nanjing,China:A cross-sectional study

Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors,and the impact of UI on daily life in pregnant and postpartum women in Nanjing,China.Methods:The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life.The associated factors were estimated by using logistic regression analysis.Results:UI affected 37.80%of pregnant women and 16.41%of postpartum women of the study population.Among the pregnant participants,the prevalence rates of stress UI,urge UI,and mixed UI were 25.77%,4.47%,and 7.10%,respectively.Among the postpartum women,the prevalence rates of stress UI,urge UI,and mixed UI were 11.15%,1.92%,and 2.69%,respectively.In both pregnant women and postpartum women,vaginal delivery had significantly increased the odds of reporting UI(p=0.007,p=0.003,respectively).The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment(p=0.000).Conclusion:The prevalence rates of UI were high in pregnant women in Nanjing,China.Vaginal delivery significantly increased odds of reporting UI.UI has a great impact on pregnant and postpartum women’s life,especially in social embarrassment.

Fatigue and Depression from Early Postpartum to 1 Month among Postpartum Women with Mental Disorders

Objective: This study aims to ascertain the prevalence of fatigue and depression from early postpartum to 1 month after delivery among postpartum women with mental disorders. Methods: The participants of this study were postpartum women who had delivered a child after a full-term pregnancy and were suffering from a mental disorder. We administered the Postpartum Fatigue Scale (PFS) on days 1, 3, and 4 (to multiparas), and 1, 3, and 5 (to primiparas), and 1 month after delivery to all participants. The Edinburgh Postnatal Depression Scale (EPDS), Japanese version, was also administered at the same time intervals as PFS except on day 3 after delivery. Results: A total of 7 primiparas and 9 multiparas participated in this study. The average age was 29.0 ± 7.0 years in primiparas and 32.0 ± 4.0 years in multiparas. The PFS scores were higher among the primiparas and peaked at day 1, and more than half the primiparas scored more than 9 points in EPDS. In addition, the EPDS score at 1 month had a strong correlation with the PFS subscale “mental stress situation” (r = 0.818/p = 0.047). In multiparas, the percentage of women who scored more than 9 points decreased. However, their EPDS scores at 1 month were related to the total scores of the PFS, “physical stress situation”, “mental stress situation”, and “sleep deprivation situation”. Especially, the score of “sleep deprivation situation” was higher than those during hospitalization. Conclusion: There was more fatigue 1 month after the discharge among postpartum women with mental disorders. The percentage of women whose EPDS scores were more than 9 points was high in both primiparas and multiparas. This study suggests assisting primiparas and multiparas by controlling the former’s disorder during childcare, and using family support for the latter, so that they get time to rest.

Nursing discharge teaching of hospitalized postpartum women in China:A cross-sectional study

Background:Postpartum women encounter a diverse array of physiological challenges following childbirth,and they may also contend with issues such as a lack of self-care knowledge childcare knowledge,and childcare experience.This study aimed to explore the quality of discharge teaching for hospitalized postpartum women.Methods:A total of 292 parturients who gave birth in a tertiary hospital were selected using the convenience sampling method and surveyed using a general data questionnaire and discharge teaching quality scale.Results:The total score for the quality of discharge teaching was 111.95±28.64.In bivariate analysis,significant differences were identified between postpartum women with differences in postpartum complications,ambulation time,wound pain,infant health status,and infant feeding methods(p<0.05).Wound pain and infant feeding methods were significant factors in a multiple linear regression model(p<0.05).Conclusions:Nursing staff should focus on psychological nursing care and give more personalized teaching to postpartum women with severe wound pain and who bottle feed their newborns.

A Prospective Study on the Incidence and Predictors of Postpartum Depression among Pregnant Women Attending an Antenatal Clinic in Kano, Northern Nigeria

Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has significant implications to the physical and mental wellbeing of both the mother and her baby. Only non-depressed pregnant women (score of ≤ 6 on Edinburgh Postnatal Depression Scale) were recruited into this study. Data collection was done at 2 different stages;at recruitment stage (during the third trimester of pregnancy) and at the follow up stage (4th - 6th week postpartum). During the recruitment stage, intimate partner violence (IPV) and level of social support perception, among the women, were assessed using Hurt Insult Threaten Scream (HITS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires respectively. While at the follow up stage, the Obstetric questionnaire and Mini International Neuropsychiatric Interview (MINI-7) were used respectively to obtain obstetric-related data and to diagnose for occurrence of depression. The incidence of PPD was found to be 16.34%. Several factors such as level of education, husband’s socioeconomic status, stressful life events, low perception of social support, obstetric instrumentation and not having a baby of preferred gender were significantly associated with PPD. Positive predictors of PPD included not practicing breast feeding (OR = 186.72, 95% CI = 8.32 - 4188.35), family history of mental illness (OR = 4.95, 95% CI = 1.04 - 23.81) and pregnancy lasting beyond 40 weeks (OR = 7.26, 95% CI = 1.51 - 34.88). High incidence of PPD with numerous associated but largely modifiable risk factors call for more proactive measures, such as PPD screening among pregnant women.

Pilot Study on an Integrated Pilates and Yoga Program for Decreasing Postpartum Depression in Women

Objective: This study evaluated the effectiveness of a 10-week exercise intervention in reducing depression and fatigue in women with postpartum depression. Design: A one-group pretest/ posttest quasi-experiment was conducted. Setting: A postpartum ward in a medical center in Taipei city was used. Participants: Nineteen women at 7 - 12 weeks postpartum with an Edinburgh Postnatal Depression Scale score ≥ 9 were recruited. Methods: The women participated in a postpartum exercise support program 1 hour per week for 10 weeks. The program was led by a professional coach;it integrated yoga, Pilates, elastic band exercise, low-intensity aerobics, and motherhood role experience sharing. Results: After the postpartum exercise support program intervention, depression scores decreased from 10.4 ± 3.29 to 7.80 ± 2.73 (t = 3.632, P = 0.003);fatigue scores decreased from 8.73 ± 5.02 to 5.40 ± 3.89 (t = 2.988, P = 0.010). Conclusion: PESP administered to women with postpartum depression appeared to benefit their psychological wellbeing.

Autonomic Nervous Activity in Multiparous Women during Early Postpartum Period: A Descriptive Study

Background: The purpose of the present study is to analyze the autonomic nervous activity in multiparas while resting, nursing, and rooming-in/rooming-out during days 1 to 3 of early postpartum period. Methods: Subjects were asked to record the actions they performed while wearing a heart rate monitor. Changes in autonomic nervous activity from 9 am to 12 pm and relaxation based on the relaxation (RE) scale were surveyed in multiparous women experiencing a normal postpartum period, on postpartum days 1 to 3. Results: Thirteen subjects were enrolled but heart rate data for all 3 days were available for only 5 of them. In these patients, the autonomic nervous activity (heat rate, high frequency [HF], or low frequency [LF]/HF) showed no significant differences between the days during any of the time periods. However, of the 3 days, day 2 demonstrated a lower HF and higher LF/HF. Subjective sense of relaxation was higher on postpartum day 3 compared to days 1 and 2, but there was no significant difference observed in the 3-day total score. Though no significant differences in HF and LF/HF at rest and during nursing were observed for any of the 3 days, there was a tendency for HF to be lower and LF/HF to be higher during nursing than at rest. Conclusions: Autonomic nervous activity demonstrated no significant major changes between the 3 days of postpartum (day 1 to 3). However, the lower HF and higher LF/HF during nursing and rooming-in suggest that even multiparas, who are supposedly accustomed to nursing and child-rearing, can be tense. Results suggest that multiparas require monitoring, personal care, and attention so that they can be relaxed and less tense while nursing and caring for their children.

Knowledge, Attitudes of Pregnant Women and Practices of Women Who Have Recently Given Birth on Contraception in the Immediate Postpartum Period at Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

Background: The use of modern contraceptive methods contributes to the reduction of maternal and neonatal mortality. The initiation of a contraceptive method in the immediate postpartum period is one of the strategies to avoid missing out on contraceptive opportunities. This strategy will reduce the unmet need for contraception which is still high in the country. Objective: To describe the knowledge and attitudes of pregnant women and the practices of women who have given birth about immediate postpartum contraception. Methodology: This was a cross-sectional and descriptive study conducted at the main clinic of ATBEF from 20th March to 20th October 2020. Our study included pregnant women whose gestational age was greater than or equal to 37 weeks of amenorrhea who came for prenatal consultation or for any other consultation and then gave birth in the center. Data collection was based on a survey form. Data analysis and entry was done with the Epi info 2000 version 6.04 software. The parameters studied were: socio-demographic characteristics, knowledge and attitudes of pregnant women about contraception in the immediate postpartum period, and contraceptive practices of the women who gave birth. Results: During the study period, 201 women were selected for the survey. The average age of the respondents was 26.2 years. They were nulliparous in 41.3% of cases. Our respondents had knowledge of modern contraceptive methods in 82.10% of cases. About 59.2% of the respondents had an unfavourable attitude towards the adoption of contraceptive methods in the immediate postpartum period. The main reason was adverse effects in 33.6%. Of the 82 women who had a favourable attitude, 29 women had adopted a contraceptive method after delivery, which corresponds to a rate of use of 14.4% of the respondents. The main reason for non-adoption of a contraceptive method after childbirth for those who had a favourable attitude was the opposition of the husband in 34%. Conclusion: Couple counselling during prenatal and postnatal care and intensified awareness raising on planning and ideal spacing of pregnancies for health will increase the number of contraceptive users in the immediate postpartum period.

Comparison of Sexual Function in Primiparous Women Pre-Pregnancy and Postpartum: Difference of the Sexual Function after the Normal Vaginal Delivery and the Cesarean Section

Introduction: Sexual function is undoubtedly an important dimension of adult life. Due to all the conflicting results with regard to sexual function after the normal vaginal delivery (NVD) or the Cesarean Section (CS), in the present study, we aimed to compare the sexual function in women pre-pregnancy and postpartum and also after the NVD and CS. Materials and Methods: In this cohort study, two groups of healthy women, with antenatal normal pregnancies, who underwent NVD (n = 90) and CS (n = 113), were prospectively studied. The sexual function of the participants was assessed through a Female Sexual Function Index (FSFI) questionnaire in two stages: once before pregnancy and then within 3 to 6 months after delivery, which lasted from June 2011 to September 2012. The data were analyzed by descriptive and inferential statistics. Data were analyzed using chi-square test, Mann-Whitney test, and T Test. Results: Based on the data gathered from 206 women who completed the FSFI questionnaire in two stages, the mean (±SD) self-reported timing of the resumption of sexual activity was 8.9 ± 1.3. There was no significant statistical difference found between the two groups by timing of the resumption of sexual activity in NVD and CS groups. There was also no statistically significant difference found in the overall sexual function scores between the two groups (NVD vs. CS). The average score for female sexual function in desire, arousal, orgasm, and satisfaction within 3 to 6 months after delivery was significantly lower than that of their pre-pregnancy period (p < 0.004). The mean coitus in postpartum period was 1.84 ± 1.20 per week. Conclusion: Based on the findings of this study, there was no significant relationship between the mode of delivery and changes in sexual function. Therefore, it can be claimed that CS is not preferred to NVD with regard to preserving normal sexual functioning.

25-羟维生素D水平与产后抑郁的相关性分析及其对不良妊娠结局的预测价值

目的分析25-羟维生素D[25(OH)D]水平与产后抑郁的相关性及其对不良妊娠结局的预测价值。方法选择2021年1月至2023年1月于潍坊市妇幼保健院进行孕检的115例妊娠晚期(28~40周)孕妇,根据孕妇血清25(OH)D水平分为缺乏组(n=37,<50nmol/L)、不足组(n=46,50~75nmol/L)、正常组(n=32,>75nmol/L),比较不同25(OH)D水平孕妇产后抑郁程度(EPDS)、不良妊娠结局发生情况,分析25(OH)D水平与EPDS不良妊娠结局的相关性,并采用受试者工作特征(ROC)曲线分析25(OH)D对不良妊娠结局的预测价值。结果三组EPDS评分比较,差异有统计学意义(P<0.001);25(OH)D水平与EPDS评分呈负相关性(P<0.05);ROC曲线分析结果显示,25(OH)D预测不良妊娠结局的曲线下面积为0.855,敏感度为0.875,特异度为0.768。结论妊娠晚期孕妇血清25(OH)D水平与产后抑郁具有相关性,缺乏25(OH)D会增加产后抑郁发生的可能性,且25(OH)D可以预测不良妊娠结局,建议临床重视并加强对孕妇维生素D的监测及补充。

优质护理在妊高征产妇产后出血护理中的应用研究

探讨优质护理在妊高征产妇产后出血护理中的应用效果。选取江南大学附属医院2021年7月—2022年8月收治的100例妊高征产后出血产妇为研究对象,采用乱数表法将产妇分为观察组(n=50)与对照组(n=50),对照组实施常规护理,观察组实施优质护理,对比两组产妇出血量、血压调控情况、生活质量、护理满意度、出现不良事件的概率以及心理状态评分。结果显示,护理后,观察组产妇出血量显著少于对照组(P<0.05),血压指标优于对照组(P<0.05),生活质量评分和护理总满意率高于对照组(P<0.05),SAS评分、SDS评分和不良事件出现率低于对照组(P<0.05)。研究发现,在妊高征产妇产后出血护理期间,优质护理干预可显著改善产妇心理状态和生活状态,减小产妇血压波动,减少产妇出血量,优化产妇护理体验,有着较高临床应用价值。

头位分娩评分法在4000例孕妇分娩过程中的应用

目的 探讨头位分娩评分法在孕妇分娩过程中的应用价值。方法 选取2020年1月—2022年12月于郑州市妇幼保健院进行建档住院的4 000例待产分娩孕妇作为研究对象,所有孕妇在宫口已开时都给予头位分娩评分,观察与记录所有孕妇的分娩方式与头位分娩评分法状况,记录新生儿出生1 min与出生5 min的Apgar评分,记录所有孕妇的产后并发症发生情况。结果 在4 000例孕妇中,Apgar评分≤8分者156例、9~10分者894例、≥11分者2 950例。不同头位分娩评分法孕妇的年龄、孕周、孕次、产次对比差异无统计学意义(P>0.05)。≤8分者的剖宫产率为100.0%,9~10分者、≥11分者分别为35.3%、5.7%,对比差异有统计学意义(P<0.05)。≤8分者、9~10分者、≥11分者的新生儿出生1 min与出生5 min的Apgar评分对比差异无统计学意义(P>0.05)。≤8分者、9~10分者、≥11分者的产后发热、产后出血、产后血肿、产后尿潴留等并发症发生率为分别为13.5%、2.0%、0.2%,对比差异有统计学意义(P<0.05)。结论 头位分娩评分法在产科中处理头位分娩时具有指导价值,值得推广应用。

孕产妇Rh表型分布特征及相容性输血的可行性探讨

目的:分析重庆地区孕产妇Rh表型分布特征,探讨Rh表型在孕产妇中的临床意义及实行Rh表型相容性输血的可行性。方法:采用微柱凝胶法对65161例孕产妇进行ABO血型和Rh表型检测,以同期48122例男性为对照,通过χ^(2)检验对数据进行比较分析。结果:113283例样本中,RhD+112870例(99.64%),以CCDee(48.39%)和Cc DEe(32.88%)为主要表型,并检出重庆地区首例Rh缺失型D--表型;Rh D-413例(0.36%),以ccdee(52.78%)和Ccdee(33.41%)为主要表型;RhD+组与Rh D-组的Rh表型分布差异有统计学意义(P<0.01)。在65161例孕产妇中,Rh5种抗原的阳性率由高到低为D>e>C>c>E,与男性相比差异无统计学意义(P>0.05);孕产妇Rh表型分布与男性相比差异无统计学意义(P>0.05);不同ABO血型的孕产妇间Rh表型分布差异无统计学意义(P>0.05)。在孕产妇中,正常妊娠人群、有不良流产史人群、采用人类辅助生殖技术人群和不孕症患者人群间Rh表型分布无明显差异(P>0.05),4个孕产妇人群与本地区综合性三甲医院住院患者和献血者相比,Rh表型分布差异无统计学意义(P>0.05)。RhD阳性孕产妇中,CcDEe表型找到相容性血液的概率为100%,CCDee、CcDee和CCDEe表型找到相容血液的概率为45%-60%,ccDEE、ccDEe、CcDEE表型找到相容血液的概率为5%-10%,其余表型的相容概率均低于0.5%;提供CCDee和ccDEE两个表型的血液即可满足99%以上患者7种Rh表型相容性输血需求。结论:应对孕产妇进行Rh表型检测,对需要输血的孕产妇推行Rh表型相同或相容性输血是切实可行的输血举措。

孕期身体活动障碍量表的汉化及信效度检验

目的汉化孕期身体活动障碍量表,并检验其信效度,为准确评估孕期身体活动障碍提供参考。方法运用Brislin翻译模型对孕期身体活动障碍量表进行翻译、回译和文化调适,形成中文版孕期身体活动障碍量表。采用便利抽样法,于2023年6-8月对南京市某三级甲等妇产医院的418名孕妇进行调查,评价量表的信效度。结果中文版孕期身体活动障碍量表包括与怀孕有关的个人内部障碍、与怀孕无关的个人内部障碍、人际关系障碍和环境障碍4个维度,共29个条目。该量表条目水平的内容效度指数为0.833~1.000,量表水平的内容效度指数为0.931。探索性因子分析提取出4个公因子,累计方差贡献率为68.383%。验证性因子分析显示模型适配度良好,χ^(2)/df=2.859,RMSEA=0.067,RMR=0.048,NFI=0.904,GFI=0.848,IFI=0.935,TLI=0.928,CFI=0.935。该量表的Cronbach′sα系数为0.947,重测信度为0.768。结论中文版孕期身体活动障碍量表具有良好的信效度,可作为评估孕期身体活动障碍的有效工具。

产后女性脑镜像同伦功能连接改变的静息态fMRI研究

目的基于体素镜像同伦连接(voxel-mirrored homotopic connectivity,VMHC)方法研究产后女性和未育女性大脑中同位点之间的功能连接差异,探索产后女性脑功能变化。材料与方法收集39名初次生育完后的女性和26名未育女性的静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)数据及结构像数据进行VMHC分析,并采用双样本t检验分析组间VMHC差异。同时收集两组人口统计学数据和人际反应指针量表(Interpersonal Reactivity Index-C,IRI-C)评分。结果IRI-C量表分析发现产后女性和未育女性在共情关心上存在显著性差异(P<0.001)。与未育女性组相比,产后女性组在双侧梭状回、海马旁回、额中回、额内侧回、中央前回、壳核和豆状核等脑区的VMHC值表现出显著降低(FDR校正,体素水平P<0.001,团块水平P<0.05,双尾),在双侧楔前叶、顶上小叶和顶下小叶的VMHC值显著增加(FDR校正,体素水平P<0.01,团块水平P<0.05,双尾)。结论初次生育后的女性部分脑区半球间功能连接发生改变,这可能是女性为产后期间的养育行为做出的适应性变化。

女性产后腹直肌分离的诊治进展综述

随着国家三孩政策的实施和现代女性生活质量水平的不断提高,产后女性对治疗腹直肌分离的关注度愈加显著,而国内针对治疗腹直肌分离的系统研究和科学指导较为欠缺。该研究系统地综述了国内外腹直肌分离的患病率、分离程度及类型,以及腹直肌分离的治疗方法,研究发现,治疗产后女性腹直肌分离的当前趋势和未来展望仍然是运动疗法,强烈建议对治疗性运动进行进一步的调查研究,为临床上治疗产后腹直肌分离提供依据。

北京市区域严重产后出血分级诊疗及转诊管理的现况调查

目的:探讨转诊中心与非转诊中心严重产后出血(SPPH)的救治现况,为区域内SPPH的预防和处理提供改进策略。方法:回顾性分析2021年1月至2023年6月北京市两区SPPH(产后出血量≥1500 ml或输血制品≥1000 ml)病例的临床资料,共纳入SPPH 201例,根据其是否为市级转诊中心分为转诊中心组(125例)和非转诊中心组(76例)。比较两组间的临床特征。进一步分层分析,采用Logistic回归模型分析大量产后出血,即产后出血量≥4000 ml,和(或)输注悬浮红细胞(RBC)>10 U和(或)输注血浆>1000 ml的危险因素。结果:对两组SPPH病例分析,转诊中心组较非转诊中心组患者的年龄大,分娩孕周小,伴有孕期产后出血高危因素的比例高,差异有统计学意义(P<0.05);转诊中心组SPPH的首要原因为胎盘因素,而非转诊中心组的首要因素为子宫收缩乏力,差异有统计学意义(P<0.05);非转诊中心组在剖宫产术中出血量高,采用B-Lynch缝合/血管缝扎的比例低,宫腔填塞比例高(P<0.05);非转诊中心组血浆输注量、重返手术室、剖腹探查、各种产后出血并发症的发生率均显著高于转诊中心组(P<0.05);非转诊中心组大量产后出血病例数显著多于转诊中心组(P<0.05)。在大量产后出血病例中,转诊中心组具有孕期产后出血高危因素者多于非转诊中心组(71.4%vs.33.3%,P<0.05),转诊中心组胎盘因素是主要出血原因(57.1%),非转诊中心组子宫收缩乏力和胎盘因素是主要出血原因(42.9%,28.6%)。多因素Logistic回归分析发现,非转诊中心分娩(aOR 3.47,95%CI 1.40~9.18)、多次宫腔操作史(aOR 12.63,95%CI 1.24~131.30)是大量产后出血的高危因素。结论:区域内高危孕产妇转诊管理效果较好,加强非转诊助产机构的高危因素识别、手术缝合技术和SPPH综合管理培训,预防SPPH、大量产后出血和输血的发生。

核心肌群稳定性训练联合电刺激对高龄产妇盆底肌力、尿控及性生活质量的影响

目的 探讨核心肌群稳定性训练联合电刺激对高龄产妇盆底肌力、尿控及性生活质量的影响。方法 选取2021年1月—2023年1月在淮安市妇幼保健院分娩的高龄产妇120例,按照随机数字表法分为A、B、C组,各40例。A组产妇产后进行核心肌群稳定性训练干预,B组产妇产后进行电刺激干预,C组产妇产后进行核心肌群稳定性训练联合电刺激干预。比较3组盆底肌力、尿控情况、尿失禁评分、性生活质量评分。结果 C组高龄产妇Ⅰ类肌纤维持续收缩压、Ⅱ类肌纤维收缩个数、Ⅱ类肌纤维快速收缩压、Ⅰ类肌纤维持续时间均高或长于A、B组(P <0.05)。C组尿失禁发生率低于A、B组(P <0.05)。C组治疗前后ICI-Q-SF评分的差值高于A、B组(P <0.05)。C组治疗前后性欲、阴道润滑、性高潮、性满意度评分的差值均高于A、B组(P <0.05)。结论 核心肌群稳定性训练联合电刺激对高龄产妇进行干预具有较好的临床疗效,有利于提高产妇产后盆底肌力,改善尿控情况,提高产后性生活质量。

低危产妇经阴道分娩产后出血风险预测模型的构建

目的:探讨低危产妇经阴道分娩产后出血的相关因素并构建产后出血风险预测模型,为预测产后出血的风险提供依据。方法:选取2019年6月—2022年12月在汕头大学医学院第二附属医院住院的429例经阴道分娩、无妊娠并发症及合并症的单胎低危产妇为研究对象。根据纳入时间排序,将研究对象分为训练集(331例)和验证集(98例)。以是否发生产后出血,训练集分为出血组(112例)、未出血组(219例),验证集分为出血组(32例)、未出血组(66例)。通过多因素logistic回归分析筛选产后出血的相关因素并构建列线图预测模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线下面积评估预测模型的区分度。采用Hosmer-Lemeshow(HL)拟合优度检验及校准曲线评估预测模型的校准度。结果:多因素logistic回归分析显示产妇的宫高(OR=1.326,95%CI:1.179~1.446)、产前体重指数(OR=1.111,95%CI:1.020~1.211)、孕次(OR=2.128,95%CI:1.167~3.879)、第三产程时间(OR=1.072,95%CI:1.022~1.124)、血小板计数(OR=0.990,95%CI:0.986~0.996)是产后出血的相关因素。由这5个因素构建的预测模型在训练集的ROC曲线下面积为0.786(95%CI:0.732~0.839),验证集ROC曲线下面积为0.840(95%CI:0.803~0.869),训练集HL检验的P值为0.529,验证集HL检验的P值为0.893,校准曲线均接近理想曲线,表明预测模型的区分度、校准度均良好。结论:本研究构建的预测模型对低危产妇经阴道分娩产后出血的风险有较好的预测能力。

育龄女性对盆底康复认知和需求的调查分析

目的通过调查分析育龄女性对产后盆底康复的认知和需求,探求其影响因素,为临床盆底康复提供依据。方法采用自行设计的《育龄女性对产后盆底康复认知和需求的调查分析》对育龄女性进行调查。结果经调查发现育龄女性中,有盆底功能障碍、没有盆底功能障碍、没做过检查不知情的占比分别为14.16%、27.43%、58.41%。大多数听说过产后盆底康复,但没进行过产后盆底康复训练;盆底康复知识中,对生活注意事项的需求为87.61%;康复锻炼的因素中42.48%的人不清楚什么是盆底康复治疗。结论育龄女性对盆底康复治疗手段了解较少,且“不清楚什么是盆底康复治疗”是影响治疗的主要阻力。