Cesarean Sections according to the Robson’s Classification in Two University Hospitals of Yaoundé: Indications and Maternofetal Outcome

Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health facility. For this reason, in 2015, the World Health Organization (WHO) recommended the use of Robson’s classification to evaluate the practice of cesarean sections in order to identify the groups of women who had abnormally high rates. The objective of our study was to evaluate cesarean sections using the Robson’s classification in CHRACERH and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a retrospective cross sectional and descriptive study in two (02) university hospitals in Yaoundé which took place from December 2017 to May 2018. We included in our study all women who gave birth over a period of two (02) years from January 2016 to December 2017 in these two health facilities. Our sampling was exhaustive over the study period. The parturients’ information was collected using an anonymous and pretested questionnaire. The Robson’s group of every parturient was determined. Descriptive parameters like mean and proportions were calculated. We compared the rates and indications of cesarean sections between the both hospitals using Chi2 test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections;hence, a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean section, hence a rate of 24.8%. The women who belonged to groups 1, 3 and 5 contributed to the highest rates of cesarean sections in both hospitals: in CHRACERH, group 5 (31.1%), group 3 (20%) and group 1 (15.6%), at YCH: group 3 (22.5%), group 1 (21.6%) and group 5 (17.3%). The indications of the cesarean sections varied depending on the Robson’s group and the hospital, the principal indication in group 1 was acute fetal distress (28.6%) in CHRACERH and cephalopelvic disproportion (36.7%) at YCH. Cephalopelvic disproportion was the predominant indication in groups 3 of CHRACERH (44.4%) and YCH (39.2%). In groups 5, CHRACERH and of YCH, a scarred uterus was the principal indication for the cesarean section at 82.4% and 78.4% respectively. At CHRACERH, the maternofetal complications were more frequent in groups 1 and 2 at the YCH, this was the case mostly in groups 1 and 3. Conclusion: The Robson’s classification is an adequate tool for the evaluation and comparison of the rates of cesarean sections. The rates of cesarean section in CHRACERH (27.2%) and at YCH (24.8%) were higher than the rates recommended by WHO. Robson’s groups 1, 3 and 5 were identified as the groups most at risk for cesarean sections in the both hospitals.

Prediction of Success Rates of Vaginal Birth after Cesarean Delivery According to the Previous Indication for Cesarean Delivery

Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates of TOLAC according to specific parameters related to previous cesarean section and before TOLAC. We aimed to investigate the different indications of previous cesarean delivery as independent predictors for successful vaginal birth. Methods: A retrospective study was conducted in Armed Forces Hospitals of the Southern Region between December 15, 2019, and July 1, 2020. The included 566 patients with previous cesarean section who were willing to undergo a trial of labor were divided into two groups according to the success of vaginal birth (VBAC). Results: The nonrecurring indications for previous cesarean delivery were higher in the successful group (fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a significantly higher percentage of previous successful VBAC (47.7% vs 21.9%) and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%, respectively) than the unsuccessful group. Conclusion: During counseling regarding trial of labor after cesarean section, indications for previous cesarean section not related to arrest of labor can predict higher success of VBAC. Moreover, previous successful vaginal delivery or VBAC improves the success rates.

Cesarean Section Indications and Prognosis in Adolescents Girls at the Mother-Child Pool of the Teaching Hospital of Tengandogo (CHU-T) in Burkina Faso

Objective: Conduct a study on cesarean sections in adolescent girls at the mother-child pool of the CHU-T in order to reduce maternal-fetal morbidity and mortality. Patients and Methods: This was a descriptive and cross-sectional study with a retrospective data collection method from January 1st, 2018 to December 31st, 2019. Results: The frequency of caesarean sections in our series was estimated at 59.9% in adolescent girls. 68.7% of adolescent girls were married, the average age was estimated at 18.3 ± 1 years, primiparous women were the most represented group with a rate of 88%. Adolescent girls were housewives in 73.5% of cases, with 37.4% of them living in rural areas. The main indications for cesarean section were: pre-rupture syndrome (22.9%), fetal distress (19.3%), pre-eclampsia/eclampsia (18.1%) and bony dystocia (21.6%). The following results derive from the classification of the cesarean section indications into 2 groups according to one or the other member of the “mother-child” couple: maternal indications accounted for 57.8% while fetal adnexal indications were estimated at 36.1%. As for perinatal mortality, it reached 24.1%. Conclusion: Improving the maternal-fetal prognosis of cesarean section in adolescent girls necessarily requires the strengthening of pregnancies follow-ups among this population group where pregnancy is most often unplanned.

Effect of Cesarean Section on the Severity of Postpartum Hemorrhage in Chinese Women： The Shanxi Study

Postpartum hemorrhage （PPH） is one of the most adverse obstetric outcomes. Our aim is to detect the risks of multilevel PPH in different cesarean section （CS） groups [including nulliparous CS with indications, nulliparous CS without indications, repeat cesarean （RC）, vaginal birth after cesarean （VBAC）, cesarean after vaginal birth （CAVB）]. We conducted a retrospective cohort study, and the data on 127 145 women collected from January 2014 to May 2016 and from 35 tertiary hospitals in Shanxi province, China, were reviewed. Based on the measuring results of PPH, an ordered logistic regression model was used to analyze the adjusted PPH risks for each of the CS groups, and comparisons were drawn between them. Finally, a total of 99 066 nulliparous （77.92%） and 28 079 multiparous （22.08%） women were observed. The number of CS cases was 61 117, and the rate for CS was 48.07%. A total of 10 029 women did not show indications for CS and accounted for 16.41% of the CS parturient, whereas 9103 women underwent a repeated cesarean, with a CS frequency of 14.89%. The number of VBAC cases was 989, whose rate was 9.88% in prior CS women. The number （proportions） of PPH was 3658 （2.88%） in L1 （PPH volume： ≥900 and 〈1500 mL）, 520 （0.41%） in L2 （PPH volume： ≥1500 and〈2100 mL）, and 201 （0.16%） in L3 （PPH volume： ≥2100 mL）. The Ln （n= 1, 2, 3, etc.） represented the increasing order of PPH severity. In the adjusted results, compared with spontaneous vaginal delivery （SVD） as the reference group, in the adjusted result for nulliparous, there was a decreased PPH risk in CS with indications （OR： 2.32; CI： 2.04-2.62）, which was lower than that of CS without indications （OR： 2.50; CI： 2.01-2.96）. The highest PPH risk in all subgroups （i.e. nulliparous and multiparous groups） was observed in the RC （OR： 3.61; CI： 3.16-4.17）, which was nearly twice higher than that of the VBAC （OR： 1.82; CI： 1.33-2.52）. CAVB （OR： 1.03; CI： 0.65-1.62） showed no significant difference with the reference group. Thus, we deemed that CS should be avoided in nulliparous pregnancies unless indicated, to prevent or reduce the rates for the use of RC or VBAC which are high risks of severe PPH to the parturient women.

Study on the Indications for and Factors Related to Cesarean Section at Three District Hospitals in Shanghai

Objective To understand the indications for and factors related to cesarean section （CS）. Methods Pregnant women who attended health examination at three selected district hospitals were investigated from May 2001 to February 2003. Results Among 933 puerperas, the CS rate was 37. 62%. The top four indications for CS were fetal distress （36. 5%）, social factors （35.9%）, relative cephalopelvic disproportion （18.5%） and pregnancy complications （6.3%） respectively, The result of regression analysis showed that puerperas who were overweight before pregnancy, had no confidence in vaginal delivery and had macrosomia were more likely to have CS. Conclusion At present, the CS rate in Shanghai was rather high, The main indications for CS were fetal distress and social factors. The high CS rate was associated with the psychological factor and some demographic factors such as birth weight and puerperas＇ weight before pregnancy.

The Caesarean Section in Dakar: Indications and Analysis Prognosis

The objective of this study was to analyze the indications of cesarean sections performed in a Level II clinic and to evaluate early maternal and neonatal outcome in the context of decentralization of obstetric and emergency newborn care. Material and Method: This was a retrospective descriptive and analytical study conducted at the maternity CSNC over a period of 12 months from 1 July 2010 to 30 June 2011. It included all women in childbirth by caesarean section and excluded patients admitted for management of complications of cesarean section performed in another structure. Results: During the study period, 595 caesarean sections were performed on a total of 4410 births, a rate of 13.5%. The average age of patients was 27 years. The mean parity was 2. The patients came from them even 55%. They were admitted with a single uterine scar in 28.40% of cases and bi-scar in 25.4% of cases. A pathology was associated with pregnancy in 31.6% of cases. These pathologies were dominated by vascular and renal syndromes (75.5%), anemia (13.8%) and the obstacles previa (10.1%). Caesarean sections were performed in 517 patients in emergency. The technique of Misgav Ladach was the most common 75.1%. The average hospital stay was 4.2 days with extremes of 0 and 15 days. Postoperative maternal mortality was 0.34%. Operative follow-up was simple in 98.3% of patients. Two patients (0.34%) died after surgery. In 92.4% of the cases, the newborns were alive. The Apgar score in the first minute was favorable (greater than or equal to 7/10) in 503 newborns (95.1%) and unfavorable (less than 7/10) in 47 cases (8.55%). At the fifth minute, he was favorable in 98.5% of the cases. Overall stillbirth was 72.26‰ with a total of 43 stillbirths including 3 macerated stillbirths. Conclusion: Cesarean section is by far the most accomplished action in gynecology and obstetrics. Its ease of implementation and low cost, and of course his results in terms of reduction of maternal-fetal morbidity and mortality make a key intervention and allowed its extension.

2014-2020年东莞市某三级医院流动人口产妇剖宫产率及剖宫产指征分析

目的分析东莞市某三级医院2014-2020年流动人口产妇剖宫产率及剖宫产指征变化情况。方法收集2014-2020年东莞市某三级甲等医院住院分娩流动人口产妇的临床资料,剖宫产指征以第一指征为主,对其剖宫产指征构成及其变化进行回顾性分析。结果该组孕产妇32401例,剖宫产8721例,剖宫产率为26.9%。2014-2020年各年份的剖宫产率分别为29.8%、25.2%、26.6%、26.3%、25.1%、28.0%、27.1%。剖宫产指征以瘢痕子宫居首位,其他依次为胎位异常、胎儿宫内窘迫和社会因素。在高龄、非高龄产妇剖宫产指征中,瘢痕子宫和胎位异常均分别位居第1、2位,第3位剖宫产指征分别为产妇要求和胎儿宫内窘迫;高龄产妇的瘢痕子宫、前置胎盘、妊娠合并症、妊娠合并肿瘤构成比等均高于非高龄产妇,胎位异常、胎儿宫内窘迫、羊水过少、产程异常的比例则低于非高龄产妇(P<0.05)。结论该研究的剖宫产率仍高于WHO标准,剖宫产指征中以瘢痕子宫和胎位异常为主。

产后康复治疗仪联合早期乳房按摩对产妇产后泌乳康复效果及心理状态调整的效果分析

目的:分析产后康复治疗仪联合早期乳房按摩对剖宫产初产妇产后泌乳、康复效果及心理状态的效果。方法:将2021年10月至2022年3月在东南大学附属中大医院剖宫产分娩的初产妇96例,随机分为对照组和康复仪+早期乳房按摩组,每组48例。对照组采用常规产后康复护理,康复仪+早期乳房按摩组在常规产后康复的基础上采用产后康复仪结合早期乳房按摩。最后对两组产妇的产后泌乳、康复效果、心理状态及并发症进行比较。结果:两组产后泌乳开始时间、催乳素水平、产后第3天泌乳量、自主排尿时间、自主排气时间、VAS评分比较,差异均有统计学意义(P<0.05),康复仪+早期乳房按摩组康复效果明显。产后康复干预后,两组患者母亲抑郁自评量表(SDS)、焦虑自评量表(SAS)评分较治疗前均有改善,康复仪+早期乳房按摩组改善效果更好,两组差异有统计学意义(P<0.05)。康复仪+早期乳房按摩组(4.17%)并发症低于对照组(52.08%),两组间比较差异具有统计学意义(P<0.05)。结论:康复治疗仪+早期乳房按摩能够更好的进一步改善剖宫产初产妇的产后泌乳、康复效果和心理状态,同时降低了术后并发症发生率,从而保证了产妇能够顺利进行纯母乳喂养,同时提高产妇产后的生活质量。

共情理念护理联合精细化护理对剖宫产初产妇心理状态及母乳喂养率的影响

目的:探究共情理念护理联合精细化护理对剖宫产初产妇心理状态及母乳喂养率的影响。方法:选取2020年5月—2021年9月湖北省红安县人民医院进行剖宫产的初产妇62例作为研究对象,根据随机数表法将其分为两组,对照组31例给予精细化护理,研究组31例在对照组基础上实施共情理念护理。比较两组产妇心理状态情况汉密尔顿焦虑量表(HAMA)、母乳喂养率及不良事件发生率。结果:护理干预前,两组产妇心理状态情况比较,差异无统计学意义(t=0.232,P>0.05);研究组产妇心理状态HAMA评分低于对照组,差异有统计学意义(t=5.340,P<0.05)。护理1周后,研究组产妇(96.77%)母乳喂养率高于对照组(77.42%),差异有统计学意义(χ^(2)=5.167,P<0.05)。研究组产妇不良事件发生率(3.23%),对照组不良事件发生率(19.35%),研究组产妇不良事件发生率低于对照组,差异有统计学意义(χ^(2)=4.026,P<0.05)。结论:共情理念护理联合精细化护理能够改善心理状态,提高新生儿母乳喂养率,有效降低护理期间不良事件的发生。

阴道试产中转剖宫产术前Ⅲ型安尔碘阴道灌洗预防产褥感染效果

目的:分析阴道试产中转剖宫产术前Ⅲ型安尔碘阴道灌洗预防产褥感染效果。方法:回顾性分析2022年1月-2023年12月本院产科阴道试产失败中转剖宫产产妇400例临床资料,其中2022年1-12月术前作外阴备皮、冲洗的200例纳入对照组,2023年1-12月术前作外阴备皮、Ⅲ型安尔碘阴道灌洗、冲洗的200例产妇纳入观察组,对比两组术后体温、24h出血量、产褥感染率、切口感染率及白细胞计数(WBC)、C反应蛋白(CRP)和降钙素原(PCT)水平变化情况。结果:观察组术后24h(36.90±0.17℃)、48h(36.70±0.15℃)、72h体温(36.50±0.12℃)均低于对照组(37.00±0.21℃、36.80±0.16℃、36.60±0.13℃),术后24h出血量(287.3±21.5ml)少于对照组(296.2±23.7ml),产褥感染率(0.5%)低于对照组(3.5%)(均P<0.05),两组切口感染率(0.5%、1.0%)无差异(P>0.05)。观察组术后72h WBC(10.07±2.28×10^(9)/L)、CRP(2.23±0.39mg/L)、PCT(4.05±0.62ng/ml)水平均低于对照组[(12.77±3.59)×10^(9)/L、5.06±1.28mg/L、7.33±1.51ng/ml](均P<0.05)。结论:阴道试产中转剖宫产术前Ⅲ型安尔碘阴道灌洗可有效控制术后产妇体温和WBC、CRP、PCT水平,减少产褥感染发生。

一对一责任制助产护理干预在初产妇护理中的应用效果

目的 观察一对一责任制助产护理干预在初产妇护理中的应用效果。方法 选取2022年3月至2023年3月滕州市中心人民医院妇产科收治的70名初产妇为研究对象,按照随机数字表法分为参照组(35人)与试验组(35人)。参照组采用常规护理干预,试验组采用一对一责任制助产护理干预,比较两组的剖宫产率、产程、产妇总满意率和分娩恐惧感。结果 试验组剖宫产率低于参照组(P<0.05);试验组产程短于参照组(P<0.05);试验组产妇总满意率高于参照组(P<0.05);试验组分娩恐惧感评分低于参照组(P<0.05)。结论 一对一责任制助产护理干预在初产妇护理中的应用效果显著,能够缩短产程,改善分娩结局,减少分娩恐惧感,值得推广。

人文关怀护理模式对剖宫产初产妇产后疼痛的影响

目的:探讨人文关怀护理模式对剖宫产初产妇产后疼痛的应用效果。方法:选取在医院建档立卡剖宫产的80例初产妇作为研究对象,选择随机数表法分为两组,对照组产妇给予常规护理,观察组产妇给予人文关怀护理模式,比较两组产后疼痛程度及首次下床时间、首次排气时间。结果:护理后,对照组产妇NRS评分高于观察组,差异有统计学意义(P<0.05)。观察组产妇首次下床时间、首次排气时间均短于对照组,差异有统计学意义(P<0.05)。结论:人文关怀护理模式可有效减轻剖宫产初产妇产后疼痛程度,能够更好地促进初产妇术后康复,值得临床推广与应用。

产前放松训练在初产妇中的应用效果

目的:观察产前放松训练在初产妇中的应用效果。方法:选取2018—2022年于该院分娩的70名初产妇进行前瞻性研究,按照随机数字表法分为观察组与对照组各35名。对照组采用常规产前护理,观察组在对照组基础上采用产前放松训练,比较两组分娩恐惧量表(CAQ)评分、积极心理问卷(PPQ)评分、第一产程Wong-Baker面部表情疼痛量表评分、产程时间、分娩方式。结果:护理后,两组CAQ评分低于护理前,且观察组低于对照组,两组PPQ评分高于护理前,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组第一产程Wong-Baker面部表情疼痛量表评分明显低于对照组,差异有统计学意义(P<0.05);观察组第一、第二、第三产程时间以及总产程均短于对照组,差异有统计学意义(P<0.05);观察组自然分娩率为60.00%,高于对照组的31.43%,差异有统计学意义(P<0.05);观察组剖宫产率为5.71%,低于对照组的31.43%,差异有统计学意义(P<0.05)。结论:在常规产前护理基础上采用产前放松训练可提高初产妇PPQ评分和自然分娩率,缩短产程时间,降低CAQ评分、第一产Wong-Baker面部表情疼痛量表评分和剖宫产率,效果优于单纯常规产前护理。

足月妊娠初产妇阴道试产失败中转剖宫产的影响因素

目的:分析足月妊娠初产妇阴道试产失败中转剖宫产的影响因素。方法:回顾性分析2019年3月至2022年3月在该院进行阴道试产的158例初产妇的临床资料。统计158例初产妇中转剖宫产发生情况,根据分娩结局不同将初产妇分为中转剖宫产组和阴道分娩组,对初产妇阴道试产失败中转剖宫产的相关因素进行单因素和多因素Logistic回归分析。结果:158例初产妇中阴道分娩135例(85.44%),中转剖宫产23例(14.56%)。两组胎膜早破、分娩镇痛占比及羊水污染程度比较,差异均无统计学意义(P>0.05);两组年龄、身高、孕前体质量指数(BMI)、孕期增重、新生儿体质量、妊娠时长、引产情况比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄、孕前BMI、孕期增重、妊娠时长、引产均为足月妊娠初产妇阴道试产失败中转剖宫产的危险因素(OR>1,P<0.05),而身高则是足月妊娠初产妇阴道试产失败中转剖宫产的保护因素(OR<1,P<0.05)。结论:年龄、孕前BMI、孕期增重、妊娠时长、引产均为足月妊娠初产妇阴道试产失败中转剖宫产的危险因素,身高是足月妊娠初产妇阴道试产失败中转剖宫产的保护因素,临床可针对上述影响因素制订预防措施,或提前调整分娩方式。

分娩方式对初产妇盆底功能和母婴结局的影响

目的探讨不同分娩方式下初产妇产后早期盆底功能的差异,观察不同分娩方式对母婴结局的影响,为孕妇对于分娩方式的选择提供参考。方法选择2020年10月至2021年4月169例于福建医科大学附属漳州市医院产科分娩的初产妇作为研究对象,所有产妇均于产后6~8周复检并行盆底超声检查,根据分娩方式不同分为阴道分娩组(n=71)、剖宫产组(n=98),比较两组产后盆底肌肌力、分娩情况,盆底功能相关临床症状、器官脱垂情况与母婴结局。结果阴道分娩组盆底肌肌力正常率为43.66%,低于剖宫产组62.24%,差异有统计学意义(P<0.05);阴道分娩组膀胱膨出、肛提肌裂孔扩大均显著高于剖宫产组,差异有统计学意义(P<0.05);阴道分娩组产后2 h出血量、住院时间均低于剖宫产组,差异有统计学意义(P<0.05);两组产妇不良妊娠结局率比较,差异无统计学意义(P>0.05)。结论剖宫产和阴道分娩各有优缺点,剖宫产对初产妇产后早期盆底功能影响较小,而阴道分娩产后2 h出血量更少,住院时间更短,临床上可综合评估母胎情况,合理选择分娩方式。

卡前列甲酯栓联合缩宫素预防剖宫产产后出血的应用研究

目的探讨卡前列酯栓联合缩宫素在预防剖宫产产后出血中的效果。方法选择2021年5月至2022年11月于我院行剖宫产的产妇80例,随机分为两组各40例。对照组采用缩宫素,观察组采用卡前列酯栓联合缩宫素治疗。对比两组的产后出血情况、凝血指标及不良反应。结果观察组产后大出血发生率为5.00%,低于对照组的20.00%(P<0.05)。观察组产后2 h、24h出血量均少于对照组(P<0.05)。产后24 h,观察组的PT、APTT短于对照组,FIB水平高于对照组(P<0.05)。两组的不良反应发生率比较差异无统计学意义(P>0.05)。结论卡前列甲酯栓联合缩宫素预防剖宫产产后出血能够降低产后大出血发生率,减少产后出血量,改善凝血功能,安全性较高。

高危初产妇剖宫产后发生PPH的危险因素分析

目的探究高危初产妇剖宫产后引发产后出血(postpartum hemorrhage,PPH)的危险因素。方法选取2021年8月—2023年8月富川县人民医院妇产科收治的高危初产妇78例作为研究对象,依据是否发生PPH分为发生组(19例)与未发生组(59例)。对两组患者一般资料给予单因素分析,将单因素分析具有统计学差异的项目通过自变量赋值后纳入多因素logistic回归分析,并构建回归方程以验证模型拟合度,在模型拟合度较好的情况下,提出预防性措施。结果单因素分析发现两组体质量指数、学历、妊娠期糖尿病、孕周、人血白蛋白水平的比较差异无统计学意义(P>0.05);年龄、妊娠期高血压疾病、前置胎盘、宫缩乏力、血小板水平与PPH发生有关(P<0.05)。将以上差异项纳入多因素Logistic回归分析发现,年龄≥35岁、存在妊娠期高血压疾病、存在前置胎盘、存在宫缩乏力、血小板水平≤100×10^(9)/L是高危初产妇剖宫产后发生PPH的危险因素(P<0.05)。构建高危初产妇剖宫产后发生PPH的危险因素方程,得到Logit(P)=-5.204+1.623×(年龄≥35岁)+0.824×(存在妊娠期高血压疾病)+1.715×(存在前置胎盘)+0.769×(存在宫缩乏力)+0.803×(血小板水平≤100×10^(9)/L)。利用模型系数Omnibus检验评价模型总体,χ^(2)=76.298,自由度=5,P<0.001,提示模型总体有意义;利用Hosmer-Lemesho检验对拟合优度效果予以质性评价,χ^(2)=7.601,DF=8,P=0.533,说明该模型拟合优度较好。结论存在年龄≥35岁、妊娠期高血压疾病、前置胎盘、宫缩乏力、血小板水平≤100×10^(9)/L因素的高危初产妇剖宫产后发生PPH的风险较高,护理人员应对其多加注意,并及时采取有效措施以降低PPH发生率。

初产妇剖宫产术后实施中医体质辨证护理的效果

目的分析中医体质辨证护理对初产妇剖宫产术后母乳分泌及产后恢复进程的影响。方法选取100例行剖宫产术的初产妇为研究对象,随机分为对照组与观察组,每组50例。对照组采用常规护理,观察组在此基础上采用中医体质辨证护理。对比两组初产妇的母乳分泌情况及产后恢复进程。结果观察组产后泌乳情况优于对照组,出院当天纯母乳喂养率为98.00%,高于对照组的76.00%(P<0.05)。观察组产后恢复情况优于对照组,自护能力、生活质量评分均高于对照组(P<0.05)。结论中医体质辨证护理可有效改善初产妇剖宫产术后的母乳分泌情况,加快产后恢复进程,提升其生活质量。

水中待产分娩与传统待产分娩对产后盆底功能障碍性疾病预防效果分析

目的:分析水中待产分娩与传统待产分娩对产后盆底功能障碍性疾病(PFD)预防效果。方法:回顾性分析2022年4月—2023年4月驻马店市中医院进行阴道试产的60例产妇临床资料,依据产妇意愿分为两组,32例采用传统待产分娩的为传统组,28例采用水中待产分娩的为水中组。比较两组产妇盆腔器官脱垂(POP)、压力性尿失禁(SUI)发生率、盆底电生理指标、产程时间、产后2 h出血量、新生儿1 min Apgar评分、新生儿体重和剖宫产率。结果:水中组POP及SUI发生率低于传统组,差异均有统计学意义(χ^(2)=4.115、4.391,P<0.05);水中组盆底肌肉Ⅰ类、Ⅱ类肌纤维肌力分级高于传统组,差异均有统计学意义(Z=2.781、2.401,P<0.05);水中组第一产程时间短于传统组,差异有统计学意义(t=2.227,P<0.05);两组产妇第二、第三产程时间、产后2 h出血量、新生儿1 min Apgar评分、新生儿体重比较,差异均无统计学意义(t=0.501、0.339、0.980、0.478、0.255,P>0.05);水中组剖宫产率低于传统组,差异有统计学意义(χ^(2)=4.391,P<0.05)。结论:水中待产分娩对产后PFD预防效果优于传统待产分娩,能够缩短第一产程时间,促进产妇自然分娩,降低POP及SUI发生率,减轻对盆底肌纤维的损伤,且对母婴结局无明显影响。

综合体温保护护理在剖宫产术中的应用效果

目的探究对剖宫产产妇实施术中综合体温保护护理的效果。方法选取2020年4月—2023年4月本院收治的92例剖宫产产妇为研究对象,通过随机数字表法分为常规组(n=46)和研究组(n=46)。常规组给予常规保温护理干预,研究组术中进行综合体温保护干预。比较两组围手术期不同时间点(术前、麻醉起效时、胎儿娩出时、手术结束时)体核温度和低体温、寒战发生率及热舒适度以及手术前后凝血指标。结果常规组麻醉起效时、胎儿娩出时、手术结束时的体温比研究组显著更低(P<0.05)。常规组的低体温、寒战发生率比研究组显著更高,热舒适度评分显著更低(P<0.05)。常规组的凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)水平比研究组显著更高,纤维蛋白原(FIB)水平比研究组显著更低(P<0.05)。结论在剖宫产产妇术中应用综合体温保护干预,能够保持产妇体温和凝血指标,降低低体温、寒战发生率,提高热舒适度。