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Perineal tear is a common complication of vaginal delivery and will seriously affect the quality of life of these women, if is severe. Given to there was no evidence-based clinical guideline for the prevention and management of perineal tear in China, this evidence-based guideline was developed, based on the methods of WHO handbook for guideline development. Systematic reviews were conducted according to the Cochrane handbook and GRADE was used to assess the quality and certainty of the evidence. Detailed recommendations are provided for 19 clinical questions in the prevention and management of perineal laceration, aiming to guide clinical practice and improve the quality of life of this group of women.
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Breast milk is the optimal source of nutrition for newborns, and it can bring them important nutritional and neurodevelopmental benefits. Studies have shown bidirectional interactions between the brain and gut flora, which started during the embryonic period. Breastfeeding may play a positive role in neonatal neurodevelopment through gut flora. We outline the effects of breast milk on the neurodevelopment of newborns from the perspective of brain-gut axis to better understanding the benefits of breastfeeding.
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Objectives:To explore the related factors that influence the postpartum loss to follow-up of women with gestational diabetes mellitus and the corresponding countermeasures to improve management of postpartum loss to follow-up in order to improve its rate.Methods:A total of 212 patients were selected from women diagnosed with gestational diabetes before delivery in Women′s Hospital School of Medicine Zhejiang University between December, 2018 and March, 2019. These patients were reminded by hospital education and telephone call-back and followed up by questionnaire at 12 weeks after delivery. The rates of follow up and the rate of postpartum blood glucose screening after delivery were calculated. The demographic and social data, clinical data during pregnancy and delivery, and postpartum blood glucose screening were compared between the follow-up group and the group of loss to follow up. The group of loss to follow up was contacted by telephone to inquiry the reason of loss.Results:Totally 159 out of 212 cases completed postpartum follow-up with the rate of 75.00% (159/212) and the loss rate was 25.00% (53/212). 52 cases underwent postpartum blood glucose screening with the rate of 24.53% (52/212), 22.64% (48/212) in the follow-up group and 1.89% (4/212) in the group of loss to follow up. Permanent residence, occupation, monthly family income, medical payment method, obstetric complications, family history, management doctor's own quality, attendance of pregnancy specialist from outpatient service, acceptance of complication propaganda and education, attitude to postpartum follow-up, etc are the influencing factors, the difference was statistically significant ( χ2 value was 4.392-65.328, P<0.01 or 0.05). Conclusion:Women with gestational diabetes mellitus have a high rate of postpartum loss to follow up. Medical personnel should improve their professional quality and strengthen the multidisciplinary and joint management model, establishing a standardized and targeted postpartum follow-up procedure and strengthening the focus of postpartum follow-up education to improve the quality and efficiency of postpartum follow-up management.
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Objective To study the status quo of nursing human resource configuration and structure of neonatology department in China's economically developed areas.Methods Using judgment sampling and multi-stage stratified sampling,investigations were conducted by the self-designed questionnaire in letter in 2012.Results In 2012,both the bed nurse ratio(1:0.79) and doctor nurse ratio (1: 1.22) met the Health Ministry's standards (1:0.58-0.61 and 1: 2) respectively.Age distribution of neonatology nursing staff was from 25 to 34 years old (55％).The distribution of wordng experience was average.Nurses with junior college degree as the main body took up 48％,with primary title as the main body 66％,and the appointment system accounted for 42％.The nursing personnel with young ages,senior skilled,higher education degree,and advanced titles were concentrated in Grade Ⅲ-A hospitals and public hospitals of women and children.In terms of distribution equity,two Gini coefficients of geographical and population distribution were both less than 0.35 and near zero,which indicated relatively perfect equity.Conclusions The stock and per capita of neonatology nursing human resources in China's economically developed areas were insufficient in the long run and showed imbalanced allocation among hospitals with different levels.The allocation structure failed to meet the needs of nursing disciplinary development.
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This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.
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We establish the new student-centered teaching mode and reform the evaluation system in clinical teaching of nursing obstetrics and gynecology. We have got more satisfied teaching quality.