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Objective:To investigate the current status of women′s level of birth experience and lactation initiation time and explore the effect of level of birth experience on lactation initiation time.Methods:This was a cross-sectional study. A convenience sampling method was used to select 622 maternal cases attending the Affiliated Hospital of Jining Medical College from November, 2020 to January, 2021, and the distribution of their labor experience level and lactation initiation time was investigated by questionnaire and follow-up assessment.Results:There were 622 women with transvaginal deliveries who had lactation initiation times of more than 72 h in 241 cases (38.75%). The scores for each dimension of the Childbirth Experience Questionnaire (CEQ) were (49.63 ± 8.58)points, and the scores for each dimension of CEQ were perceived safety, professional support, involvement and self-efficacy in descending order. The results of the correlation analysis showed that there was a negative correlation between the scores on each dimension of CEQ and the total score and lactation initiation time ( r values were -0.436 to -0.146, all P<0.01). Stratified regression analysis showed that after controlling for age, number of births, gestational weeks of labour, illness during pregnancy and labour analgesia as the underlying variables affecting lactation initiation time, the scores for self-efficacy, involvement, perceived safety and professional support in the CEQ all affected lactation initiation time after delivery ( t values were -6.76 to -2.02, all P<0.05). Conclusions:The birth experience and lactation of women who deliver via vaginal birth need to be taken into account. The more negative the birth experience, the longer the lactation initiation time. The women′s involvement in the birth process, their own competence, perceived safety and level of professional support are all valid influencing indicators of lactation initiation time.
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Objective:To investigate cases of delayed lactation initiation in women with transvaginal delivery and the influencing factors, in order to provide a basis for effective control of delayed lactation initiation and promotion of breastfeeding.Methods:Inpatients who were admitted to the obstetric ward of Affiliated Hospital of Jining Medical College from November 6, 2020 to January 16, 2021 were selected for the study using convenience sampling method and investigated by general information questionnaire and Chindbirth Experience Questionnaire (CEQ). Binary Logistic regression analysis was used to determine the factors influencing delayed lactation initiation.Results:The incidence of delayed lactation initiation in 622 women with transvaginal delivery was 38.75% (241/622). Binary Logistic regression analysis showed that age 20-35 years, full-term delivery, labor and delivery, use of labor analgesia, and good experience of transvaginal delivery were protective factors for delayed lactation initiation ( OR values were 0.012 to 0.868, all P<0.05); age >35 years, excessive weight gain during pregnancy, presence of pregnancy complications, use of induction of labor during delivery, long labor process, and damage to perineal skin after delivery were risk factors for delayed lactation initiation ( OR values were 1.097 to 13.235, all P<0.05). Conclusions:The high incidence of delayed lactation initiation in women with transvaginal delivery is influenced by a number of factors, which reminds the clinic that lactation in women after transvaginal delivery also needs to be taken into account, with priority assessment and prevention for those who are elderly (age≥35 years), primiparous, have other diseases during pregnancy, have gained too much weight during pregnancy, have preterm delivery, have a long duration of labor, have not received labor analgesia, have had a single or combined induction of labor, have had an episiotomy or perineal laceration during labor, and have a poor transvaginal delivery experience.
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The purpose of this study was to compare the performance of different commercial quality assurance (QA) systems for the pretreatment verification plan of stereotactic body radiotherapy (SBRT) with volumetric arc therapy (VMAT) technique using a flattening-filter-free beam. The verification for 20 pretreatment cancer patients (seven lung, six spine, and seven prostate cancers) were tested using three QA systems (EBT3 film, I’mRT MatriXX array, and MapCHECK). All the SBRT-VMAT plans were optimized in the Eclipse (version 11.0.34) treatment planning system (TPS) using the Acuros XB dose calculation algorithm and were delivered to the Varian TrueBeam® accelerator equipped with a high-definition multileaf collimator. Gamma agreement evaluation was analyzed with the criteria of 2% dose difference and 2 mm distance to agreement (2%/2 mm) or 3%/3 mm. The highest passing rate (99.1% for 3%/3 mm) was observed on the MapCHECK system while the lowest passing rate was obtained on the film. The pretreatment verification results depend on the QA systems, treatment sites, and delivery beam energies. However, the delivery QA results for all QA systems based on the TPS calculation showed a good agreement of more than 90% for both the criteria. It is concluded that the three 2D QA systems have sufficient potential for pretreatment verification of the SBRT-VMAT plan.
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Humans , Lung , Prostate , Radiosurgery , SpineABSTRACT
Objective To analysis pudendal nerve block anesthesia combined with noninvasive delivery on maternal vaginal delivery quality.Methods 60 primipara who were received vaginal delivery in our hospital were collected.All primipara were randomly divided into anesthesia group and no anesthesia group by the order of entry, 30 cases in each group.The no anesthesia group was given noninvasive delivery operation, and the anesthesia group received unilateral or bilateral nerve block anesthesia.Perineal laceration degree and incidence rate, time of the second stage of labor, neonatal asphyxia and two groups of maternal postpartum recovery were compared after the treatment.Results After the birth of a child, Compared with no anesthesia group, the incidence of maternal perineal laceration was lower in the anesthesia group, and the difference was statistically significant(P<0.05);the second stage of labor time of primipara was shorter in the anesthesia group(P<0.05); the pain score,getting out of bed activity time,average length of hospital stay,and incidence of postpartum complications of primipara were lower in the anesthesia group(P<0.05).Conclusions Pudendal nerve block anesthesia combined with noninvasive delivery operation can improve vaginal delivery quality, and have a guiding significance to clinical.
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Objective To observe the effect of Sopfrology-Lamaze childbirth breathing training on the delivery quality and negative mood of pregnant women.Methods 218 pregnant women were sampled and randomly divided into study group(A group,n =122) and control group(B group,n =96).A group learned the method and technique of Sopfrology-Lamaze childbirth breathing.From 28th week pregnancy to delivery,the times of training was more than 3 per week,and lasted 20 minutes.The rate of cesarean delivery,rate of severe pain,the time of labor,the amount of bleeding after 2h labor,and the dosage of patient controlled analgesia were observed.The selfrating anxiety scale (SAS) and self-rating depression scale(SDS) were used to assess the mood of prengnat women in 28th week pregnancy,before and after labor.Results There were significant difference in rate of cesarean delivery(A group 7.4％,B group 17.7％,x2 =5.46,P ＜ 0.01),rate of severe pain (A group18.8％,B group 59.4％,x2 =37.9,P ＜ 0.05),amount of bleeding after 2h labor (A group (219.43-± 31.47) ml,B group (287.5 ± 37.83)ml,t =14.50,P ＜ 0.05),and the dosage of patient controlled analgesia (A group(13.25 ± 1.89)ml,B group (19.87 ±2.52)ml,t=21.43,P＜0.05) between A group and B group.The SAS and SDS scores were lower in A group (SAS:before labor(44.3 ±7.6),after labor(42.2 ±4.7) ;SDS:before labor(45.2 ±4.7),after labor(42.2 ± 5.1),P ＜ 0.05) than those in B group (SAS:before labor(48.5 ± 6.6),after labor(47.35 ±5.1) ; SDS:before labor(47.7 ± 5.3),after labor (46.6 ± 6.3),P ＜ 0.05).Conclusion Sopfrology-Lamaze childbirth breathing training can improve the delivery quality and negative moods of pregnant women