Comparative Study on Caesarian and Normal Delivery Childbirth in Bangladesh

The study is concerned with caesarian and normal delivery and its effectiveness on childbirth which has more impact on Bangladesh. We identified that, higher educated and higher income families are choosing caesarian section for childbirth because of improved safety of surgical skill to reduce the mortality rate. Although expensive, most caesarian operations are performed in private hospitals for modern medical equipment, experienced doctors and advanced medical care. A questionnaire survey design was applied in order to make a comparative study on caesarian and normal delivery childbirth. Respondents from all over Bangladesh participated in the survey. We collect 281 data from the respondents of different districts of Bangladesh by area sampling. We use descriptive and analytical research designs in determining the comparative study on caesarian and normal delivery childbirth in Bangladesh. The results of study show that the variance of children taken by caesarian delivery is less than children taken by normal delivery and children taken by caesarian delivery increase due to increased family income. It has been found that 39.5% (111) respondents are from the Urban area and 60.5% (171) from the rural zone. We can say that more than 50% of our respondents are well-educated. We also found that 53.4% of the respondents do not face any problem in C/S. We found that family income has a positive linear relationship with the C-section deliveries, which means that higher incoming people tend to have the C-section more. Finally, we observed that change in rate of caesarian delivery due to changing living places and normal delivery is recommended for the next generation. By Meta analysis we found that number of cesarean delivery baby is independent of locality and education level.

新型产时会阴按摩法结合控制胎头娩出速度助产方案的构建

目的 构建新型产时会阴按摩法结合控制胎头娩出速度助产方案。方法 结合文献及临床经验,构建新型产时会阴按摩法结合控制胎头娩出速度助产方案。2021年10—12月邀请来自郑州市的12名产科护理专家进行德尔菲专家咨询。结果 共实施专家咨询2轮,问卷均有效回收;2轮咨询各级指标肯德尔和谐系数分别为0.242~0.488、0.126~0.280,差异有统计学意义(P<0.01);第2轮咨询各指标变异系数为0.06~0.22,满分率为33.3%~91.7%;2轮咨询专家权威系数分别为0.85、0.89。最终确定的构建新型产时会阴按摩法结合控制胎头娩出速度助产方案包括一级指标4个、二级指标9个和三级指标49个。结论 构建的新型产时会阴按摩法结合控制胎头娩出速度助产方案具有科学性、针对性、实用性及可行性。

产妇在正常分娩中出现肩难产的临床特征及治疗方法研究

目的探究分析产妇在正常分娩中出现肩难产的临床特征及治疗方法。方法选取我院2022年1月至2023年1月这一年内正常分娩中出现肩难产的产妇90例作为研究组,另选取顺利分娩的90例产妇作为参照组。通过对比两组产妇的产程时长、产后出血数量及软产道损伤,分析正常分娩中产妇肩难产的临床特征及治疗方法。结果导致产妇出现肩难产的原因有:巨大儿(55.56%)、过期妊娠(20.00%)、盆骨狭窄(21.11%)、妊娠期糖尿病(14.44%);研究组产妇的第一产程时长、第二产程时长(9.62±1.43)、(1.32±0.54)均长于参照组(7.01±1.25)、(0.81±0.16),(P<0.05);研究组产妇的产后出血量(551.24±69.75)多于参照组(253.62±41.58),软产道损伤率(72.22%)高于参照组(13.33%),差异有统计学意义(P<0.05)。结论巨大儿、过期妊娠、盆骨狭窄及妊娠期糖尿病等都是导致正常分娩产妇出现肩难产的原因,肩难产对产妇和胎儿的危害较大,因此临床要做好密切监测,减少其出现率,助产人员还要掌握专业的应对技术,以便对肩难产产妇进行及时处理,最大限度地保障母婴安全。

无创接生在正常分娩护理中的应用效果

目的探讨无创接生在正常分娩护理中的应用效果。方法选取220例正常分娩产妇为研究对象,根据随机数字表法分为对照组和观察组,每组110例。对照组采用传统接生护理,观察组采用无创接生护理,比较两组相关临床指标、不良事件发生情况、护理满意度。结果观察组产后2h出血量少于对照组,会阴伤口愈合时间及产后住院时间均短于对照组(P<0.05);两组总产程时间比较差异无统计学意义(P>0.05);观察组不良事件发生率低于对照组(P<0.05);观察组护理满意度高于对照组(P<0.05)。结论正常分娩产妇采用无创接生护理效果较好,可以缩短产妇会阴切口愈合及产后住院时间,减少产后出血量,且能够降低不良事件发生率,提高产妇满意度,改善紧张的护患关系,值得临床推广与应用。

正常足月顺产新生儿脐带动、静脉血pH值的相关性研究

目的探讨正常足月顺产新生儿脐静脉血pH值能否取代脐动脉血pH值来评估新生儿健康状况,及其影响因素。方法选取2020年1—12月符合纳入标准的150例产妇及新生儿为研究对象,用GEM Premier 3000进行血气分析,采用配对t检验,进行线性相关分析及回归分析。结果脐带动、静脉血平均pH值分别为(7.278±0.073)和(7.352±0.061),二者差异有统计学意义(P<0.001);脐带动、静血pH值在统计学上高度相关(r=0.782,P<0.05);脐带动、静脉血pH值、第二产程时长、产次、新生儿性别和需要吸氧分娩差异有统计学意义(P<0.05)。结论脐带动、静脉血pH值有显著差异,但是二者也显著相关;对于正常足月顺产新生儿,可以采集脐静脉血代替脐动脉血进行血气分析。

Mode of delivery, birth weight and the incidence of congenital nasolacrimal duct obstruction

AIM: To study any possible association of congenital nasolacrimal duct obstruction(CNLDO) with mode of delivery, birth weight and gestational age. METHODS: We retrospectively reviewed charts of all patients(n=2591) under the age of 3 y who were born between April 2015 and May 2017 and were examined at the Ophthalmology Clinic of Emsey Hospital Istanbul, Turkey. We identified patients(n=105) who were diagnosed as CNLDO. The mode of delivery, birth weight and gestational age along with any adverse event during or after delivery or any other health history were determined. Birth statistical data were obtained from the hospital’s medical records database. RESULTS: Gestational age of babies who were born via cesarean section(CS) was lower than gestational age of babies who were born via normal spontaneous vaginal delivery(NSVD;P=0.002). Babies who were born via CS were found to have 3.75 times higher risk of developing NLDO when compared to babies who were born via NSVD(OR=3.754). CONCLUSION: There is a possible association between CS and CNLDO.

3D numerical study of tumor blood perfusion and oxygen transport during vascular normalization

The changes of blood perfusion and oxygen transport in tumors during tumor vascular normalization are studied with 3-dimensional mathematical modeling and numerical simulation. The models of tumor angiogenesis and vascular-disrupting are used to simulate ＂un-normalized＂ and ＂normalized＂ vasculatures. A new model combining tumor hemodynamics and oxygen transport is developed. In this model, the intravasculartransvascular-interstitial flow with red blood cell（RBC） delivery is tightly coupled, and the oxygen resource is produced by heterogeneous distribution of hematocrit from the flow simulation. The results show that both tumor blood perfusion and hematocrit in the vessels increase, and the hypoxia microenvironment in the tumor center is greatly improved during vascular normalization. The total oxygen content inside the tumor tissue increases by about 67%, 51%, and 95% for the three approaches of vascular normalization,respectively. The elevation of oxygen concentration in tumors can improve its metabolic environment, and consequently reduce malignancy of tumor cells. It can also enhance radiation and chemotherapeutics to tumors.

Non-medical factors on choice of delivery (CS/NVD) in hospitals of Tehran University of Medical Sciences

Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospitals affiliated to Tehran University of Medical Sciences. Materials and Method: This cross-sectional study was performed to identify the factors involved in the choice of delivery (CS/NVD) among women attending hospitals affiliated to Tehran University of Medical Sciences. Data was derived from the medical records of women who gave birth in the hospitals. Results: A significant statistical relationship was found between factors such as age of mother, level of education, occupational status, type of previous delivery, person supervising the pregnancy and dissatisfaction about delivery were more frequent in women who underwent CS than those who gave birth by NVD. Conclusion: The highly increasing rise in the rate of unnecessary CS during throughout the world, and its adverse effect on maternal and child health, the financial burden imposed on families and health systems, has highlighted the importance of studies to identify the non-medical factors that affect decision-making concerning type of delivery as well as to determine the appropriate medical indications of CS.

Dissemination and Enrichment of Knowledge About Normal Birth to Bring About a Change to Society

The birth of a child is a pivotal time in the life of a mother,her family and society.The health and well-being of a mother and child at birth largely determines the future health and wellness of the entire family(World Health Organization(WHO),2005).Normal birth has enormous benefits for mothers,neonates,families,and societies.The growing supportive evidence for the promotion of normal birth certainly relies on multidisciplinary collaborations to continue spreading knowledge about the advantages of normal birth and enhancing the understanding of how knowledge about normal birth can change society.Knowledge about normal birth varies among different groups of healthcare professionals,and it would be useful to identify how it is clinically translated to become accessible to other professionals and research teams,consumers,the public,significant decision-or policy makers,the industry,funding bodies,and volunteer health teams.

基于时间窗约束的车间物料配送路径优化方法

针对混流生产车间物料配送需求的准确性和及时性,综合考虑实时生产状态和不确定因素,以实时生产数据为依据,动态计算各工位配送时间窗,并用正态模糊数的隶属度表示工位满意度。在此基础上,建立以配送成本最低为目标,以时间窗、运载能力和持续能力为约束的物料配送路径优化模型。采用基于禁忌搜索的改进遗传算法求解模型,该算法将禁忌搜索的记忆功能融入遗传算法中,防止遗传算法陷入局部最优。最后,通过实例验证该方法的有效性和可行性。

足月顺产产妇盆底康复治疗的时机及治疗效果分析

目的分析足月顺产产妇盆底康复治疗时机及治疗效果。方法88例足月顺产产妇,按照随机数字表法分为对照组及研究组,每组44例。两组产妇产后均接受盆底康复治疗,对照组产妇的治疗时间为产后12~20周,研究组产妇的治疗时间则为产后6~12周。比较两组产妇各项基础指标,满意度,治疗前后生活质量评分量表(QOL)评分。结果研究组产妇治疗后的Ⅰ类肌纤维持续收缩压(47.4±0.9)cm H_(2)O(1 cm H_(2)O=0.098 k Pa)、Ⅰ类肌纤维持续时间(18.2±1.1)s、Ⅱ类肌纤维收缩个数(13.9±0.6)个、Ⅱ类肌纤维持续收缩压(49.3±0.5)cm H_(2)O均优于对照组的(45.6±1.8)cm H_(2)O、(16.1±0.8)s、(12.3±0.4)个、(47.2±0.7)cm H_(2)O,差异具有统计学意义(P<0.05)。研究组产妇的治疗总满意度97.73%明显高于对照组的79.55%,差异具有统计学意义(P<0.05)。治疗前,两组产妇的QOL评分比较差异无统计学意义(P>0.05);治疗后,研究组产妇的QOL评分(87.2±1.3)分显著高于对照组的(67.1±2.9)分,差异具有统计学意义(P<0.05)。结论足月顺产产妇在产后6~12周接受盆底康复治疗的效果较好,产妇满意度高,值得推广。

基于视觉系统的智能送药小车设计

针对疫情时期医院场景下,医护人员进行药品配送时具有感染风险大、劳动强度高的问题,设计了一种无接触式智能送药车。小车以STM32为主控芯片,使用漫反射激光传感器与OpenMV等硬件模块,采用归一化互相关匹配算法和轮廓提取算法,实现了在有线路轨迹和数字病房号标识的场地中输送药品的任务。在多种不同距离场景下测试,小车均能平稳、准确地将药从药房送到指定的病房。

Our Experience of Childbirth Complications: A Case of Placenta Percreta

We present our own experience management in pregnant women with placenta percreta. For the timely diagnosis of placenta accreta or placenta percreta, it is recommended to conduct ultrasound and Magnetic Resonance Imaging (MRI) studies in women with placenta previa and a history of caesarean section. Objective signs of placenta accreta, identified before delivery, make it possible to make the right decision about delivery and minimize complications in the mother and newborn. A coordinated interdisciplinary approach to these complex cases and early resuscitation with blood products are critical factors in the successful management of patients affected by this disease.

助产士主导正常分娩服务模式建立的必要性

目的 探讨构建助产士主导正常分娩服务模式的必要性。方法 选取本院60例自然分娩产妇为研究对象,按照单双号分为两组,各30例。对照组开展常规分娩服务模式,试验组开展助产士主导正常分娩服务模式,比较两组的负性情绪、产程用时、不良结局及分娩满意度。结果 干预后,试验组焦虑自评量表、抑郁自评量表评分低于对照组(P<0.05);试验组第一产程、第二产程、第三产程、总产程用时均短于对照组(P<0.05);试验组产妇不良结局发生率、新生儿不良结局发生率低于对照组,分娩满意度高于对照组(P<0.05)。结论 助产士主导正常分娩服务模式应用于产妇正常分娩过程中,能缓解产妇的负性情绪,缩短产程,降低不良结局发生率,保证母婴安全,提升分娩满意度。

分娩球配合导乐陪伴分娩在正常分娩产妇中的临床研究

目的探讨分娩球配合导乐陪伴分娩对正常分娩产妇的影响。方法随机选择我院2005年12月-2006年8月住院入产房分娩的68例孕妇作为观察组,孕妇自入产房待产开始,经产科检查后,排除胎先露异常及存在严重妊娠并发症不能下床活动的孕妇。由导乐陪伴,并在宫缩间歇期骑坐在分娩球上,或者通过滚、靠、抱等方式来减轻疼痛。同时,随机抽取我院2005年1-9月入产房分娩的72例孕妇作为对照组。观察两组产妇分娩方式、产后出血、新生儿出生后Apgar评分及分娩并发症等。结果观察组手术产率降低,产后出血减少,新生儿窒息发生率降低,与对照组有统计学意义（P〈0.01）。结论分娩球配合导乐陪伴分娩能提高自然分娩率,降低手术产、产后出血及新生儿窒息发生率。

应用循证护理和人文关怀对正常分娩护理流程再造的研究

目的再造正常分娩服务流程及业务流程,提供有证据的护理服务,体现人文关怀,提高产科服务质量。方法通过查阅文献、临床工作调查,发现问题,开展相应的临床研究,综合分析得出结论,重新设计流程并实施。结果实施后,产前备皮方式采用不剃除毛发,与剃除毛发组比较,会阴感染率差异无统计学意义(P>0.05);实施后会阴切开率由95.83%降低至67.96%,平均住院日降低,差异具有统计学意义(P<0.01);脐带自然脱落法较二次断脐法脐带感染发生率低(P<0.05),且节约护理费用,提高了产妇及家属满意度。结论流程再造是提高临床护理服务质量的有效途径,业务流程设计要注重循证研究结果的应用,服务流程的设计要体现人文关怀精神。

正常妊娠中、晚期与分娩期血流动力学变化的研究

目的探讨正常妊娠中、晚期与分娩期母亲血流动力学的变化.方法采用无创胸电生物阻抗法血流动力学监测仪检测30名孕妇在正常妊娠中、晚期及分娩期的血流动力学变化.结果①与妊娠中期(孕24～28周)比较,妊娠晚期(孕28～32周)血流动力监测仪检测心率和心排出量增加13.0%和11.0%(P＜0.05),平均动脉压下降8.6%,外周血管阻力下降14.8%(P＜0.05).②与妊娠晚期比较,第一产程心排出量增加9.2%(P＜0.05),平均动脉压增加5.4%,收缩时间比率下降21.0%(P＜0.05),左心室做功量增加16.4%(P＜0.05);第二产程心率、平均动脉压和外周血管阻力均达峰值,平均动脉压和外周阻力较第一产程增加11.5%和23.0%(P＜0.05),心排出量下降6.5%,左室做功量增加11.3%.结论妊娠晚期心排出量明显增加,通过心率加快、增加心肌收缩、降低后负荷以适应血容量的增加,并维持在高水平直至足月.分娩期第一产程和第二产程血流动力学改变更明显,而第二产程心脏负担最重.

细支和常规卷烟主流烟气常规成分和5种关键烤甜香味成分逐口释放量的差异分析

建立了测定5种烤甜香味成分逐口释放量的分析方法,采用相同烟丝配方卷制细支和常规卷烟,考察细支和常规卷烟主流烟气常规与5种关键烤甜香味成分逐口释放量差异。结果表明:①分析方法重复性、灵敏度和准确度较好,适合于卷烟逐口烟气中5种烤甜香味成分的定量分析;②细支卷烟常规成分逐口释放量均低于常规卷烟,总粒相物(TPM)、焦油、水分的逐口释放变化幅度大于常规卷烟,烟碱变化幅度小于常规卷烟;③细支卷烟糠醇、5-甲基糠醛和3-甲基-2-环戊烯-1-酮的逐口释放量高于常规卷烟(除第1口外),4-羟基-2,5-二甲基-3(2H)呋喃酮(呋喃酮)和麦芽酚的逐口释放量略低于常规卷烟;抽吸中段细支卷烟糠醇和5-甲基糠醛的逐口释放稳定性优于常规卷烟,3-甲基-2-环戊烯-1-酮劣于常规卷烟,呋喃酮和麦芽酚差异不大;细支卷烟5种香味成分总量中糠醇和5-甲基糠醛所占比例高于常规卷烟,3-甲基-2-环戊烯-1-酮、呋喃酮和麦芽酚低于常规卷烟。

正常分娩临床护理路径的应用及效果评价

目的探讨正常分娩临床护理路径在临床护理中的应用效果。方法分别对正常分娩的初产妇进行临床护理路径的对比研究。结果实验组产妇的平均住院日和平均住院费用低于对照组 (P <0 .0 5 ) ;健康知识掌握程度和产妇满意度高于对照组 (P <0 .0 1 )。结论按正常分娩临床护理路径实施诊疗、护理及自我康复 ,可以减少住院时间 ,降低住院费用 ,提高健康教育的效果和产妇的满意度 。

会阴无保护接生技术应用于低危孕妇正常分娩的临床观察

目的:探讨会阴无保护接生技术应用于低危孕妇正常分娩的临床效果。方法:选取2013年7月-2014年1月于本院分娩的80例低危孕妇作为研究对象,采用随机数字表法将其分成研究组和对照组,每组40例。对照组采取常规技术分娩,研究组采取会阴无保护接生技术分娩,分析比较两组第二产程时间,新生儿窒息、产后出血、宫颈裂伤、会阴侧切、会阴Ⅲ度裂伤发生情况及住院天数、住院费用。结果:研究组第二产程短于对照组,疼痛级别低于对照组,新生儿窒息率、产后出血率、宫颈裂伤率、会阴侧切率、会阴Ⅲ度裂伤率均低于对照组,住院天数及住院费用均少于对照组,满意度高于对照组,比较差异均有统计学意义(P<0.05)。结论:采取会阴无保护接生技术分娩能够明显降低会阴侧切率,缩短产程,同时可减少产后出血及疼痛感,有利于新生儿健康,值得临床推广应用。