Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a...Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a cross-sectional and analytical study at the maternity of the regional hospital annex of Ayos, a semi-rural locality in Cameroon, for the period between January 2012 and December 2020. The objective was to determine the frequency and the determinants of primipara delivery. Results: We recruited 440 cases. The frequency of primipara delivery was 31.8%. The ages of the participants ranged from 12 to 35 years with a mean age of 18.01 ± 3.52 years. Single women contributed to 95.5% of cases while 97.5% were unemployed. The delivery occurred at term in 90.2% and 98.4% of pregnancies were singleton. The delivery was vaginal in 91.6%, while caesarean delivery was done in 8.4% (8% emergency and 0.4% elective). The most frequent maternal complications were genital tract tears (15.7%), post-partum hemorrhage (12.5%) and endometritis (2.7%). The birth weight of newborns ranged from 1070 to 4500 g with a mean of 3024.5 ± 511.4 g. The single marital status, a gestational age between 37 and 42 weeks and a birth weight between 1500 g and 2499 g were significantly associated with vaginal delivery. Conclusion: The frequency of primiparous delivery was relatively high (31.8%) in the Ayos semi-rural health district of Cameroon. Major complications associated with delivery included genital tract tears, post-partum hemorrhage, cesarean section and neo-natal infection.展开更多
目的探讨转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法在初产妇自然分娩中的应用效果,为制定初产妇自然分娩护理干预方案提供参考。方法选取2021年4月—2023年3月河北北方学院附属第一医院收治的拟行阴道分娩的196例产妇,采用简...目的探讨转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法在初产妇自然分娩中的应用效果,为制定初产妇自然分娩护理干预方案提供参考。方法选取2021年4月—2023年3月河北北方学院附属第一医院收治的拟行阴道分娩的196例产妇,采用简单随机化法分为对照组与观察组,每组98例。对照组产妇采取常规助产护理模式干预,观察组产妇采取转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法干预。比较2组产妇最终分娩方式、各产程分娩疼痛程度、各产程时间、产后出血量与分娩控制感水平;比较2组新生儿动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血pH值、1 min Apgar评分等指标。结果观察组产妇经阴道分娩率为88.78%(87/98),高于对照组的76.53%(75/98),且观察组产妇中转剖宫产率为11.22%(11/98),低于对照组的23.47%(23/98),差异有统计学意义(χ^(2)=5.124,P=0.024)。观察组产妇第一产程、第二产程、第三产程视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(P<0.05)。观察组产妇第一产程、第二产程、第三产程时间均短于对照组,差异均有统计学意义(P<0.05)。观察组产妇产后出血量小于对照组,差异有统计学意义(P<0.05)。观察组产妇分娩控制量表(LAS)评分高于对照组,差异有统计学意义(P<0.05)。观察组新生儿PaCO_(2)水平均低于对照组,PaO_(2)水平、动脉血pH值、1 min Apgar评分均高于对照组,差异均有统计学意义(P<0.05)。结论转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法干预在初产妇自然分娩中应用价值较高,能有效降低产妇中转剖宫产率,增强产妇分娩控制感,减轻产妇分娩疼痛,降低新生儿窒息风险。展开更多
目的探讨自然分娩初产妇血清基质金属蛋白酶组织抑制因子-1(tissue inhibitor of metall oproteinase-1,TIMP-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平对产后压力性尿失禁(post partum stress urinary incon...目的探讨自然分娩初产妇血清基质金属蛋白酶组织抑制因子-1(tissue inhibitor of metall oproteinase-1,TIMP-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平对产后压力性尿失禁(post partum stress urinary incontinence,PSUI)严重程度的预测价值。方法选取2019年12月至2023年7月220例PSUI自然分娩初产妇为病例组,根据尿垫试验结果分为轻度组158例和中重度组62例。另纳入同期220例无PSUI的自然分娩初产妇作为对照组。采用ELISA法检测入组者血清TIMP-1、VEGF水平;采用Pearson法分析PSUI患者血清TIMP-1与VEGF的相关性;采用多因素Logistic回归分析PSUI患者疾病严重程度的影响因素;采用受试者工作特征曲线分析血清TIMP-1、VEGF对PSUI患者疾病严重程度的预测价值。结果病例组血清TIMP-1水平显著低于对照组,血清VEGF水平显著高于对照组(P<0.01)。中重度组血清TIMP-1水平显著低于轻度组,血清VEGF水平、年龄≥35岁比例、新生儿体质量显著高于轻度组(P<0.05,P<0.01)。PSUI患者血清TIMP-1与VEGF呈负相关(r=-0.671,P<0.05)。TIMP-1是PSUI患者疾病程度加重的保护因素(P<0.01),VEGF是PSUI患者疾病程度加重的危险因素(P<0.01)。TIMP-1、VEGF单独及联合预测PSUI患者疾病严重程度的曲线下面积(area under curve,AUC)分别为0.857、0.808、0.901,其中联合预测的AUC高于二者单独预测(P<0.01)。结论PSUI患者血清TIMP-1低表达,VEGF高表达,且TIMP-1、VEGF与病情程度密切相关,二者联合在预测PSUI患者疾病严重程度方面有较高的价值。展开更多
文摘Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a cross-sectional and analytical study at the maternity of the regional hospital annex of Ayos, a semi-rural locality in Cameroon, for the period between January 2012 and December 2020. The objective was to determine the frequency and the determinants of primipara delivery. Results: We recruited 440 cases. The frequency of primipara delivery was 31.8%. The ages of the participants ranged from 12 to 35 years with a mean age of 18.01 ± 3.52 years. Single women contributed to 95.5% of cases while 97.5% were unemployed. The delivery occurred at term in 90.2% and 98.4% of pregnancies were singleton. The delivery was vaginal in 91.6%, while caesarean delivery was done in 8.4% (8% emergency and 0.4% elective). The most frequent maternal complications were genital tract tears (15.7%), post-partum hemorrhage (12.5%) and endometritis (2.7%). The birth weight of newborns ranged from 1070 to 4500 g with a mean of 3024.5 ± 511.4 g. The single marital status, a gestational age between 37 and 42 weeks and a birth weight between 1500 g and 2499 g were significantly associated with vaginal delivery. Conclusion: The frequency of primiparous delivery was relatively high (31.8%) in the Ayos semi-rural health district of Cameroon. Major complications associated with delivery included genital tract tears, post-partum hemorrhage, cesarean section and neo-natal infection.
文摘目的探讨转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法在初产妇自然分娩中的应用效果,为制定初产妇自然分娩护理干预方案提供参考。方法选取2021年4月—2023年3月河北北方学院附属第一医院收治的拟行阴道分娩的196例产妇,采用简单随机化法分为对照组与观察组,每组98例。对照组产妇采取常规助产护理模式干预,观察组产妇采取转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法干预。比较2组产妇最终分娩方式、各产程分娩疼痛程度、各产程时间、产后出血量与分娩控制感水平;比较2组新生儿动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血pH值、1 min Apgar评分等指标。结果观察组产妇经阴道分娩率为88.78%(87/98),高于对照组的76.53%(75/98),且观察组产妇中转剖宫产率为11.22%(11/98),低于对照组的23.47%(23/98),差异有统计学意义(χ^(2)=5.124,P=0.024)。观察组产妇第一产程、第二产程、第三产程视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(P<0.05)。观察组产妇第一产程、第二产程、第三产程时间均短于对照组,差异均有统计学意义(P<0.05)。观察组产妇产后出血量小于对照组,差异有统计学意义(P<0.05)。观察组产妇分娩控制量表(LAS)评分高于对照组,差异有统计学意义(P<0.05)。观察组新生儿PaCO_(2)水平均低于对照组,PaO_(2)水平、动脉血pH值、1 min Apgar评分均高于对照组,差异均有统计学意义(P<0.05)。结论转变助产服务模式下瑜伽球训练联合拉玛泽呼吸减痛法干预在初产妇自然分娩中应用价值较高,能有效降低产妇中转剖宫产率,增强产妇分娩控制感,减轻产妇分娩疼痛,降低新生儿窒息风险。
文摘目的探讨自然分娩初产妇血清基质金属蛋白酶组织抑制因子-1(tissue inhibitor of metall oproteinase-1,TIMP-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平对产后压力性尿失禁(post partum stress urinary incontinence,PSUI)严重程度的预测价值。方法选取2019年12月至2023年7月220例PSUI自然分娩初产妇为病例组,根据尿垫试验结果分为轻度组158例和中重度组62例。另纳入同期220例无PSUI的自然分娩初产妇作为对照组。采用ELISA法检测入组者血清TIMP-1、VEGF水平;采用Pearson法分析PSUI患者血清TIMP-1与VEGF的相关性;采用多因素Logistic回归分析PSUI患者疾病严重程度的影响因素;采用受试者工作特征曲线分析血清TIMP-1、VEGF对PSUI患者疾病严重程度的预测价值。结果病例组血清TIMP-1水平显著低于对照组,血清VEGF水平显著高于对照组(P<0.01)。中重度组血清TIMP-1水平显著低于轻度组,血清VEGF水平、年龄≥35岁比例、新生儿体质量显著高于轻度组(P<0.05,P<0.01)。PSUI患者血清TIMP-1与VEGF呈负相关(r=-0.671,P<0.05)。TIMP-1是PSUI患者疾病程度加重的保护因素(P<0.01),VEGF是PSUI患者疾病程度加重的危险因素(P<0.01)。TIMP-1、VEGF单独及联合预测PSUI患者疾病严重程度的曲线下面积(area under curve,AUC)分别为0.857、0.808、0.901,其中联合预测的AUC高于二者单独预测(P<0.01)。结论PSUI患者血清TIMP-1低表达,VEGF高表达,且TIMP-1、VEGF与病情程度密切相关,二者联合在预测PSUI患者疾病严重程度方面有较高的价值。
