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Objective Less research has been done in the influence of two-child pohcy on mode of delivery.The article aimed to investigate the rates of cesarean section before and after two-child policy along with indications and complications in order to provide scientific basis and solution for improving the vaginal delivery rate.Methods Retrospective analysis was conducted on medical record data of 7044 puerperas in Nanjing General Hospital of Nanjing Military Region before (3,526 women from January 1,2012 to December 31,2013)and after (3,518 women from January 1,2015 to December 31,2016) two-child policy.Before the two child policy there were 3122 primiparas and 404 multiparas,after two-child policy there were 2546 primiparas and 972 muhiparas.Comparison was done between two groups in the aspect of vaginal delivery rate,cesarean section rate and the distribution of primiparas in choosing the mode of delivery.Results The vaginal birth rate of women before and after the policy was 59.22％ and 63.22％ respectively,among which the rate of vaginal delivery of primiparas increased dramatically from 60.57％ before the policy to 66.10％ after the policy(P＜0.05).After two-child policy,the primiparas cesarean section indication with social factors,macrosomia decreased,which was 12.67％ vs 5.68％、16.65％ vs 11.82％,respectively.However,the rate of cesarean section with in-vitro fertilization increased,which was 5.52％ and 10.10％ respectively (P ＜ 0.05).Conclusion After two-child policy,the puerperant,especially for the primiparas were more likely to choose vaginal spontaneous delivery.At the same time,the proportion of the primiparas caesarean section also changed.The mode of delivery should depend on corresponding indications properly.
ABSTRACT
Objective To conform the risk factors of childhood asthma and to provide accordance for the healthy management of children with asthma.Methods A cross-section investigation was carried out by multi-stage random sampling in Wuhan city.The investigation included questionnaire and clinic examination.The study population was the infant and children whose age were 0 to 14 years old,and the sample size was 4 132.One hundren and seventyfour children were diagnosed as asthma,and 173 non-asthma children with similar age in the same region were selected as controls.Chi-square test and multiple Logistic regression analysis were used to screen the risk factors of childhood asthma in Wuhan city.Results Family allergy history,allergic rhinitis,eczema,food allergy and drug allergy were the risk factors of childhood asthma.Furthermore,dust mites,mould,anther dust,mugwort,cat/dog hair were main allergize source.In addition,premature delivery,abdominal delivery,mildew stain in ceiling or floor,raise pets especially cat,chemical fiber pillow and blanket bedclothes will increase the incidence,while spontaneous delivery and breast feeding were with protection effect.The results of multiple Logistic regression analysis showed that children who were with allergic rhinitis,familiar allergic history,dust mites positive test,drug allergy and blanker bedclothes were the high risk group of childhood asthma.Conclusions Childhood asthma is high relative with atopy,and these children who are with allergic rhinitis,familiar allergic history and dust mites positive test should be strictly health management.Chemical fiber pillow,blanket bedclothes,raising pet cats and mould in ceiling and floor in atopy children family should be avoided.
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Objective:To investigate the effect on uterine involution in caesarean section.Methods:1230 cases of primipara were divided into group A(cesarean section,n=650),group B(spontaneous delivery,n=580),measuring the level of uterine fundus,descending speed of uterine fundus,observing the duration of lochia,routinely screening of uterine involution.Results:There was significant t difference between the two groups with regard to the average decending speed of uterine fundus within 5 days after delivery,group B was superior to group A;After 42 days,The cases whose lochia disappeared were 61.8%and 92.4%in group A and group B in turn;The day 5,30 and 42 ultrasound measurement of uterine volum,showing significant difference(P
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Objective:To investigate the occurrence of antenatal anxiety and possible influencing factors,and analyze its relationship with spontaneous delivery.Methods: 590 healthy puerperal women who delivered in Taihe hospital during Dec 2007 and Dec 2008 were randomly selected and investigated for their psychological status,with T-A1 anxiety scale and SDS depression scale employed.Results: 569 effective questionnaires were gathered,with 114 cases divided into the anxiety group and 159 cases into the depression group.Influencing factors of antenatal anxiety include fear of delivery,worry about the safety of babies,understanding of delivery knowledge,puerperal age,and the family financial status.Conclusion: Factors including a relatively older age of primipara,poor financial status,insufficient support from family,worry about the safety of oneself and baby,and fear for delivery pain all have close connections with antenatal mental disorders.Meanwhile,antenatal mental disorders have a direct influence on delivery quality and the choice of delivery modes,and increase the failure rate of spontaneous delivery.