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Objective@#To explore the effects of delayed umbilical cord clamping on full-term newborns and maternal outcomes.@*Methods@#From January 2017 to April 2018, 287 normal full-term newborns delivered by vagina in the First People's Hospital of Xiaoshan District were selected in the research, and randomly divided into the control group (141 cases) and observation group (146 cases) according to the order of entering the delivery room.The control group was ligated the umbilical cord 15-20 s after delivery, while the observation group was ligated the umbilical cord 60 s after delivery.The level of hemoglobin, hematocrit, the incidence of anemia, polycythemia, hyperbilirubinemia and phototherapy time of full-term newborns were compared between the two groups 3 days after birth.The third stage of labor, the amount of postpartum hemorrhage and the incidence of postpartum hemorrhage were compared between the two groups.@*Results@#The hemoglobin[(181.49±16.84) g/L] and hematocrit (0.545±0.055) in the observation group were significantly higher than those in the control group[(175.90±17.49 )g/L, (0.515±0.062)] at the third day after birth (t=2.748, 3.409, all P<0.05). The incidence of neonatal anemia in the observation group was 0.68% (1/146), which was significantly lower than that in the control group [4.96% (7/141)], and the difference was statistically significant (χ2=4.848, P<0.05). The incidence rates of neonatal polycythemia, hyperbilirubinemia and phototherapy time in the observation group were 2.05% (3/146), 24.66% (36/146), (65.50 ±14.63)h, respectively, which in the control group were 0.17% (1/141), 22.70% (32/141) and (62.09±14.40)h, respectively, there were no statistically significant differences between the two groups (χ2=0.945, 0.153, t=0.953, all P>0.05). The third stage of labor time, postpartum hemorrhage volume, incidence of postpartum hemorrhage in the observation group were (5.97 ±4.17)min, (239.04±69.15)mL, 2.05% (3/146), respectively, which in the control group were (5.84±3.62)min, (227.73±56.99)mL, 0.71% (1/141), respectively, there were no statistically significant differences between the two groups (t=0.281, 1.504, χ2=0.945, all P>0.05).@*Conclusion@#Delayed umbilical cord clamping can increase the level of hemoglobin and hematocrit in newborns, reduce the incidence of anemia in newborns, and without increasing postpartum hemorrhage.
ABSTRACT
Objective To explore the effects of delayed umbilical cord clamping on full-term newborns and maternal outcomes.Methods From January 2017 to April 2018,287 normal full-term newborns delivered by vagina in the First People's Hospital of Xiaoshan District were selected in the research ,and randomly divided into the control group (141 cases) and observation group (146 cases ) according to the order of entering the delivery room.The control group was ligated the umbilical cord 15-20 s after delivery, while the observation group was ligated the umbilical cord 60 s after delivery.The level of hemoglobin ,hematocrit,the incidence of anemia,polycythemia,hyper-bilirubinemia and phototherapy time of full-term newborns were compared between the two groups 3 days after birth. The third stage of labor, the amount of postpartum hemorrhage and the incidence of postpartum hemorrhage were compared between the two groups.Results The hemoglobin [(181.49 ±16.84) g／L] and hematocrit (0.545 ± 0.055) in the observation group were significantly higher than those in the control group [(175.90 ±17.49 ) g／L, (0.515 ±0.062)] at the third day after birth (t＝2.748,3.409,all P＜0.05).The incidence of neonatal anemia in the observation group was 0.68%(1／146),which was significantly lower than that in the control group [4.96%(7／141)],and the difference was statistically significant (χ2 ＝4.848,P＜0.05).The incidence rates of neonatal polycythemia,hyperbilirubinemia and phototherapy time in the observation group were 2.05%(3／146),24.66%(36／146),(65.50 ±14.63)h,respectively,which in the control group were 0.17%(1／141),22.70%(32／141) and (62.09 ±14.40)h,respectively,there were no statistically significant differences between the two groups (χ2 ＝0.945,0.153,t＝0.953,all P＞0.05).The third stage of labor time ,postpartum hemorrhage volume ,incidence of postpartum hemorrhage in the observation group were (5.97 ±4.17)min,(239.04 ±69.15)mL,2.05%(3／146), respectively,which in the control group were (5.84 ±3.62 ) min, (227.73 ±56.99 ) mL,0.71%( 1／141 ), respectively,there were no statistically significant differences between the two groups (t＝0.281,1.504,χ2 ＝0.945, all P＞0.05).Conclusion Delayed umbilical cord clamping can increase the level of hemoglobin and hematocrit in newborns,reduce the incidence of anemia in newborns ,and without increasing postpartum hemorrhage.
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Objective To investigate the phenotypes and genotypes of extended -spectrum β-lacta-mases (ESBLs) and AmpC β-lactamases produced by cefoxitin-resistant Shigella strains isolated from Zhe-jiang province and the virulence of those strains .Methods Kirby-Bauer antibiotic testing was performed to screen cefoxitin-resistant strains from 356 Shigella isolates.The serotypes of the cefoxitin-resistant strains were detected .The phenotypes of ESBLs and AmpC β-lactamases from cefoxitin-resistant strains were detec-ted by ESBLs confirmatory test and AmpC-three-dimensional test ,respectively .The genotypes of ESBLs and AmpC β-lactamases were analyzed by PCR and sequence analysis .The virulence genes ( virA, ial, iapH, set1A, set1B and sen) in the cefoxitin-resistant strains were screened by PCR .Results Eight cefoxitin-re-sistant strains were identified from 356 Shigella isolates.Among them,six strains were identified as Shigella flexneri (S.fleaneri) strain (four F2a,one F2b and one F2c),and the rest were identified as Shigella sonnie (S.sonnei) strain.Among all eight cefoxitin-resistant strains,five strains showed positive results for ESBLs confirmatory test and two strains showed positive results for AmpC-three-dimensional test .Seven out of the eight strains harbor ESBLs genes (CTX-M-14,15,57 and/or OXA-30),two of which were positive for AmpC genes (DHA-1 and CMY-2).Five out of the eight cefoxitin-resistant strains carried all of the six tested viru-lence genes,while the other three strains possessed four virulence genes except for set1A and set1B.The two strains producing both ESBLs and AmpC β-lactamases were susceptible only to imipenem .Conclusion ESBLs positive isolates are prevalent strains of cefoxitin-resistant Shigella with potential high virulence .Some of them also produce AmpC β-lactamases ,and the DHA-1 type of AmpCβ-lactamase is identified for the first time in China .
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It makes discussion on the fixation to children superficial vein retention needle,viewing that in nursing retention needle,besides improving nurses' operation skill,the scientific and reasonable fixation can further improve retention success rate.