The second-stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth.Midwives play a pivotal role in managing m...The second-stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth.Midwives play a pivotal role in managing maternal positions during the second-stage of labor.However,there is limited evidence to support an ideal maternal position during the second-stage of labor.Further,the difference between different maternal positions might not be apparent.This paper aims to review and compare the benefits and risks of common maternal positions during the second-stage of labor,thereby to provide midwives evidence-based practical guidelines.展开更多
Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnan...Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.展开更多
<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and fo...<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (44.9% versus 22.7%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and >2 hours (42.9% versus 22.7%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and 19.0% for SSLs ></span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.007).</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.</span></span>展开更多
Objective: Evaluating the effect of perineal length on the duration of the second stage of labor, the mode of delivery, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Partici...Objective: Evaluating the effect of perineal length on the duration of the second stage of labor, the mode of delivery, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Participants and Methods: It is a prospective hospital-based observational study done on 483 parturient women in a university hospital. Personal, medical and obstetric data together with the measurement of perineal length were recorded in the first stage of labor. We followed up the progress of labor until delivery. Regression models were used to consider possible risk factors of episiotomy or tears needed repair. Results: The mean duration of the second stage of labor was significantly longer among women with a perineum of ≥4 cm length when compared with those with a perineal length of Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. Obstetricians should expect the need of episiotomy when confronted with circumcised primigravida with long perineum. However, if the perineum is short they should not be deceived, short perineum is more probably torn.展开更多
目的了解第二产程侧卧位分娩的相关研究现状,明确该领域未来的研究方向,促进临床更合理地应用分娩体位。方法使用澳大利亚JBI更新版范围综述的制作指南和理论框架作为方法学指导,同时采用PRISMA-ScR作为报告清单,检索PubMed、Embase、We...目的了解第二产程侧卧位分娩的相关研究现状,明确该领域未来的研究方向,促进临床更合理地应用分娩体位。方法使用澳大利亚JBI更新版范围综述的制作指南和理论框架作为方法学指导,同时采用PRISMA-ScR作为报告清单,检索PubMed、Embase、Web of Science、CINAHL Plus、ProQuest Dissertations&Theses、中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、中国博士/硕士学位论文全文数据库、中国学位论文全文数据库中针对第二产程侧卧位分娩的相关研究,检索时限为建库至2022年11月25日,并对所纳入的文献进行数据提取和分析。结果共纳入45篇文献,各研究第二产程侧卧位分娩的干预措施差距不大,研究结果显示相较于传统体位,该干预措施能改善低危初产妇的母婴结局指标,但需满足更多助产士人力资源及助产护理等要求。结论第二产程侧卧位分娩在改善低危初产妇母婴结局指标上具有优势,可考虑作为一种新型分娩体位应用于临床,但未来仍需要更多的高质量及大样本研究验证该体位在临床中的可行性。展开更多
目的探讨中药穴位贴敷联合穴位按摩对初产妇第二产程及宫缩痛的影响。方法选取2022年10月至2023年9月于山东省聊城市东昌府区妇幼保健院产科分娩的92例初产妇,以随机数字表法分为研究组(n=46)和对照组(n=46)。对照组给予常规干预,研究...目的探讨中药穴位贴敷联合穴位按摩对初产妇第二产程及宫缩痛的影响。方法选取2022年10月至2023年9月于山东省聊城市东昌府区妇幼保健院产科分娩的92例初产妇,以随机数字表法分为研究组(n=46)和对照组(n=46)。对照组给予常规干预,研究组给予中药穴位贴敷联合穴位按摩干预,比较两组第二产程、宫缩痛(VAS)、不良妊娠结局及并发症发生情况。结果研究组第二产程短于对照组(P<0.05);研究组镇痛后30、60、120 min VAS评分低于对照组(P<0.05);研究组并发症及不良妊娠结局总发生率低于对照组(P<0.05)。结论中药穴位贴敷联合穴位按摩在初产妇中应用,可有效缩短第二产程,缓解疼痛,降低不良妊娠结局及并发症发生率,值得推广。展开更多
文摘The second-stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth.Midwives play a pivotal role in managing maternal positions during the second-stage of labor.However,there is limited evidence to support an ideal maternal position during the second-stage of labor.Further,the difference between different maternal positions might not be apparent.This paper aims to review and compare the benefits and risks of common maternal positions during the second-stage of labor,thereby to provide midwives evidence-based practical guidelines.
文摘Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.
文摘<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (44.9% versus 22.7%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and >2 hours (42.9% versus 22.7%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and 19.0% for SSLs ></span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.007).</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.</span></span>
文摘Objective: Evaluating the effect of perineal length on the duration of the second stage of labor, the mode of delivery, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Participants and Methods: It is a prospective hospital-based observational study done on 483 parturient women in a university hospital. Personal, medical and obstetric data together with the measurement of perineal length were recorded in the first stage of labor. We followed up the progress of labor until delivery. Regression models were used to consider possible risk factors of episiotomy or tears needed repair. Results: The mean duration of the second stage of labor was significantly longer among women with a perineum of ≥4 cm length when compared with those with a perineal length of Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. Obstetricians should expect the need of episiotomy when confronted with circumcised primigravida with long perineum. However, if the perineum is short they should not be deceived, short perineum is more probably torn.
文摘目的了解第二产程侧卧位分娩的相关研究现状,明确该领域未来的研究方向,促进临床更合理地应用分娩体位。方法使用澳大利亚JBI更新版范围综述的制作指南和理论框架作为方法学指导,同时采用PRISMA-ScR作为报告清单,检索PubMed、Embase、Web of Science、CINAHL Plus、ProQuest Dissertations&Theses、中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、中国博士/硕士学位论文全文数据库、中国学位论文全文数据库中针对第二产程侧卧位分娩的相关研究,检索时限为建库至2022年11月25日,并对所纳入的文献进行数据提取和分析。结果共纳入45篇文献,各研究第二产程侧卧位分娩的干预措施差距不大,研究结果显示相较于传统体位,该干预措施能改善低危初产妇的母婴结局指标,但需满足更多助产士人力资源及助产护理等要求。结论第二产程侧卧位分娩在改善低危初产妇母婴结局指标上具有优势,可考虑作为一种新型分娩体位应用于临床,但未来仍需要更多的高质量及大样本研究验证该体位在临床中的可行性。
文摘目的探讨中药穴位贴敷联合穴位按摩对初产妇第二产程及宫缩痛的影响。方法选取2022年10月至2023年9月于山东省聊城市东昌府区妇幼保健院产科分娩的92例初产妇,以随机数字表法分为研究组(n=46)和对照组(n=46)。对照组给予常规干预,研究组给予中药穴位贴敷联合穴位按摩干预,比较两组第二产程、宫缩痛(VAS)、不良妊娠结局及并发症发生情况。结果研究组第二产程短于对照组(P<0.05);研究组镇痛后30、60、120 min VAS评分低于对照组(P<0.05);研究组并发症及不良妊娠结局总发生率低于对照组(P<0.05)。结论中药穴位贴敷联合穴位按摩在初产妇中应用,可有效缩短第二产程,缓解疼痛,降低不良妊娠结局及并发症发生率,值得推广。