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
Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery a...Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery and the actual intensity of labor pain. However, previous studies have generally evaluated labor pain in a retrospective setting. Purpose: This study examined the relationship between fear of childbirth immediately after vaginal delivery and the actual labor pain intensity and accumulated labor pain intensity without pharmacological pain relief during labor in Japan. Methods: A prospective observational study was conducted between July 2015 and April 2016. Forty-seven pregnant Japanese women were available for analysis. Fear of childbirth was measured by the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) version B on the third day after vaginal delivery. Participants with scores of 85 or higher were categorized in the high JW-DEQ group, having severe fear of childbirth. Labor pain intensity was examined chronologically in real time with stepwise usage of two types of Numeric Rating Scale (NRS). Accumulated labor pain intensity was calculated using the area under the curve (AUC). Results: Nine participants were in the high JW-DEQ group and eight of the nine were primiparae. Primiparae in the high JW-DEQ group experienced significantly longer duration and larger accumulated labor pain intensity between the onset of labor and 4 to 6 cm of cervical dilatation than those in the low JW-DEQ group (P = 0.024 and P = 0.021, respectively). Conclusions/Implications for Practice: The latent phase of labor was a key stage to improve fear of childbirth immediately after vaginal delivery without pharmacological pain relief among Japanese primiparae. Midwives should give assistance in the latent phase of labor by focusing on progressing labor smoothly and relieving labor pain to improve negative birth experiences.展开更多
目的分析全产程人文关怀式护理用于自然分娩产妇中的价值。方法选取2018年1月至2022年1月在我院自然分娩产妇86例为研究对象,依据随机数表法分为两组,对照组实施常规护理,观察组实施全产程人文关怀式护理,对比两组的干预效果。结果护理...目的分析全产程人文关怀式护理用于自然分娩产妇中的价值。方法选取2018年1月至2022年1月在我院自然分娩产妇86例为研究对象,依据随机数表法分为两组,对照组实施常规护理,观察组实施全产程人文关怀式护理,对比两组的干预效果。结果护理前两组产妇SAS、SDS评分差异无统计学意义,护理后两组产妇评分均下降,但以观察组产妇评分较低,差异有统计学意义(P<0.05)。护理前两组产妇OE-16、EE-16自我效能评分差异无统计学意义,护理后观察组总分(243.15±28.48)分,高于对照组产妇的(206.35±24.16)分,差异有统计学意义(P<0.05)。两组产妇第三产程时间对比差异无统计学意义,观察组产妇第一产程、第二产程时间短于对照组产妇,产后24 h出血量(159.52±30.47)mL,少于对照组产妇(198.52±32.65)mL,差异有统计学意义(P<0.05)。两组产妇产前、产后2 d VAS评分对比差异无统计学意义,产时、产后2 h均以观察组产妇VAS评分低于对照组,差异有统计学意义(P<0.05)。经新生儿Apgar评价,观察组新生儿窒息率为0,与对照组的9.30%对比较低,差异有统计学意义(P<0.05)。产后少数产妇发生产褥感染、会阴撕裂、产后感染并发症,其中观察组总发生率2.33%,与对照组的13.95%对比较低,差异有统计学意义(P<0.05)。经满意度评估,观察组产妇护理总满意度为95.35%,与对照组产妇的79.07%对比较高,差异有统计学意义(P<0.05)。结论将全产程人文关怀式护理模式用于自然分娩产妇中,具有减轻产妇不良情绪及预防新生儿窒息作用,且有利于缩短产程时间及降低产后并发症发生风险。展开更多
目的探讨生育舞蹈对初产妇分娩疼痛和分娩结局的影响。方法选取2022年1月-6月在笔者所在医院建档并定期产检的200例孕妇为研究对象,采用随机数字表法将其分为对照组和研究组,各100例。对照组采用常规孕期保健及临产指导,研究组在对照组...目的探讨生育舞蹈对初产妇分娩疼痛和分娩结局的影响。方法选取2022年1月-6月在笔者所在医院建档并定期产检的200例孕妇为研究对象,采用随机数字表法将其分为对照组和研究组,各100例。对照组采用常规孕期保健及临产指导,研究组在对照组基础上增加生育舞蹈干预。比较2组自然分娩率、产程时间、分娩疼痛程度及新生儿结局。结果研究组自然分娩率高于对照组(χ^(2)=8.665,P=0.003),总产程时间短于对照组(t=31.297,P<0.001);研究组临产时及胎儿娩出前的疼痛评分均低于对照组(t=4.525,P<0.001;t=2.227,P=0.027)。2组早产、新生儿窒息及新生儿出生后1 min Apgar评分比较,差异均无统计学意义(均P>0.05)。结论实施生育舞蹈干预,可提高自然分娩率,缩短产程时间,并减轻分娩疼痛,值得临床推广应用。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Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery and the actual intensity of labor pain. However, previous studies have generally evaluated labor pain in a retrospective setting. Purpose: This study examined the relationship between fear of childbirth immediately after vaginal delivery and the actual labor pain intensity and accumulated labor pain intensity without pharmacological pain relief during labor in Japan. Methods: A prospective observational study was conducted between July 2015 and April 2016. Forty-seven pregnant Japanese women were available for analysis. Fear of childbirth was measured by the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) version B on the third day after vaginal delivery. Participants with scores of 85 or higher were categorized in the high JW-DEQ group, having severe fear of childbirth. Labor pain intensity was examined chronologically in real time with stepwise usage of two types of Numeric Rating Scale (NRS). Accumulated labor pain intensity was calculated using the area under the curve (AUC). Results: Nine participants were in the high JW-DEQ group and eight of the nine were primiparae. Primiparae in the high JW-DEQ group experienced significantly longer duration and larger accumulated labor pain intensity between the onset of labor and 4 to 6 cm of cervical dilatation than those in the low JW-DEQ group (P = 0.024 and P = 0.021, respectively). Conclusions/Implications for Practice: The latent phase of labor was a key stage to improve fear of childbirth immediately after vaginal delivery without pharmacological pain relief among Japanese primiparae. Midwives should give assistance in the latent phase of labor by focusing on progressing labor smoothly and relieving labor pain to improve negative birth experiences.
文摘目的分析全产程人文关怀式护理用于自然分娩产妇中的价值。方法选取2018年1月至2022年1月在我院自然分娩产妇86例为研究对象,依据随机数表法分为两组,对照组实施常规护理,观察组实施全产程人文关怀式护理,对比两组的干预效果。结果护理前两组产妇SAS、SDS评分差异无统计学意义,护理后两组产妇评分均下降,但以观察组产妇评分较低,差异有统计学意义(P<0.05)。护理前两组产妇OE-16、EE-16自我效能评分差异无统计学意义,护理后观察组总分(243.15±28.48)分,高于对照组产妇的(206.35±24.16)分,差异有统计学意义(P<0.05)。两组产妇第三产程时间对比差异无统计学意义,观察组产妇第一产程、第二产程时间短于对照组产妇,产后24 h出血量(159.52±30.47)mL,少于对照组产妇(198.52±32.65)mL,差异有统计学意义(P<0.05)。两组产妇产前、产后2 d VAS评分对比差异无统计学意义,产时、产后2 h均以观察组产妇VAS评分低于对照组,差异有统计学意义(P<0.05)。经新生儿Apgar评价,观察组新生儿窒息率为0,与对照组的9.30%对比较低,差异有统计学意义(P<0.05)。产后少数产妇发生产褥感染、会阴撕裂、产后感染并发症,其中观察组总发生率2.33%,与对照组的13.95%对比较低,差异有统计学意义(P<0.05)。经满意度评估,观察组产妇护理总满意度为95.35%,与对照组产妇的79.07%对比较高,差异有统计学意义(P<0.05)。结论将全产程人文关怀式护理模式用于自然分娩产妇中,具有减轻产妇不良情绪及预防新生儿窒息作用,且有利于缩短产程时间及降低产后并发症发生风险。
文摘目的探讨生育舞蹈对初产妇分娩疼痛和分娩结局的影响。方法选取2022年1月-6月在笔者所在医院建档并定期产检的200例孕妇为研究对象,采用随机数字表法将其分为对照组和研究组,各100例。对照组采用常规孕期保健及临产指导,研究组在对照组基础上增加生育舞蹈干预。比较2组自然分娩率、产程时间、分娩疼痛程度及新生儿结局。结果研究组自然分娩率高于对照组(χ^(2)=8.665,P=0.003),总产程时间短于对照组(t=31.297,P<0.001);研究组临产时及胎儿娩出前的疼痛评分均低于对照组(t=4.525,P<0.001;t=2.227,P=0.027)。2组早产、新生儿窒息及新生儿出生后1 min Apgar评分比较,差异均无统计学意义(均P>0.05)。结论实施生育舞蹈干预,可提高自然分娩率,缩短产程时间,并减轻分娩疼痛,值得临床推广应用。
