Influence of the upright position delivery in the second stage of labour on delivery outcomes in primiparas / 中国实用护理杂志

Objective:To investigate the influence of the upright position delivery in the second stage of labour on delivery outcomes in primiparas, so as to provide reference for the formation of systematic delivery management strategies.Methods:This study was a cohort study, 454 primiparas who delivered in Beijing Hospital from January 2022 to December 2022 were selected. In the second stage of labour, according to the willingness of the primiparas, they were divided into the upright group(delivered in upright position, 222 cases) and the supine group(delivered in supine position, 232 cases). The duration of the second stage of labour, perineal injury, vaginal midwifery, neonatal asphyxia, and the effect of pharmacological analgesia on delivery outcomes in two groups of primiparas were observed and compared.Results:The duration of the second stage of labour was 30 (22, 50) min in the upright group, which was shorter than 48 (30, 80) min in the supine group, with statistically significant difference ( Z=-5.90, P < 0.05). The rate of lateral episiotomy was 17.6% (39/222) in the upright group, which was lower than 28.0% (65/232) in the supine group, with statistically significant difference ( χ2=7.02, P <0.05). There was no significant difference in the incidence of second degree perineal injury, vaginal midwifery, shoulder difficulty rate and neonatal asphyxia in the two groups ( P>0.05). The incidence of vaginal midwifery was 10.9% (14/129) and 2.2% (2/93) respectively in the upright group with pharmacological analgesia and non pharmacological analgesia, and the difference was statistically significant (Fisher's exact test, P<0.05). The duration of the second stage of labour was 53 (32, 85), 41 (27, 59) min in the supine group with pharmacological analgesia and non pharmacological analgesia, and the difference was statistically significant ( Z=-3.28, P<0.05). Conclusions:The adoption of upright position in the second stage of labour for primiparas can shorten the duration of the second stage, and reduce the rate of lateral episiotomy which can optimize the delivery outcome. For primiparas with pharmacological analgesia, it is recommended to use an upright position for delivery if conditions permit.

Association between primiparas’ willingness of a second child and cesarean section / 上海预防医学

ObjectiveTo explore the impact of primiparas’ intention to have a second child on their delivery mode. MethodsDuring March 1st， 2019 and November 30th， 2020， the enrolled pregnant women were investigated by questionnaires at two points， first trimester pregnancy registration and post-natal visit at maternal and child healthcare community centers of Xuhui District. Logistic regression analysis was used to examine the association of willingness of a second birth and their mode of delivery. Results2 000 questionnaires were distributed and 1 664 valid questionnaires were analyzed. The overall cesarean delivery rate in nulliparous women was 40.08% （667/1 664）， with 8.95% （149/1 664） of non-medical indication cesarean delivery. Multiple Logistic regression analysis of overall delivery rate showed that age， willingness to have more children in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were associated with overall cesarean delivery rate， and women without the willingness to have more children in the future were more likely to undergo cesarean delivery （OR=1.350， 95%CI： 1.052-1.732）. Age， whether to have a second child in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were all factors associated with increased risks of non-medical indicated cesarean delivery， while women with no plan of a second child in the future had nearly 2 times of risk of non-medical indicated cesarean delivery （OR=1.909， 95%CI： 1.117-3.262）. ConclusionThe mode of delivery is affected by many factors， among which willingness to have more children in the future is an important factor associated with increased risks of overall cesarean delivery and non-medical indicated cesarean delivery.

Influence of group health care model during pregnancy on midwifery based primipara′s self-efficacy and quality of life / 中华健康管理学杂志

Objective:To explore the influence of a midwife-led group health care model on primiparas′ self-efficacy and quality of life.Methods:The study included 200 primiparas who registered with the obstetrics department of our hospital between January and December 2019. The puerperas were divided into two groups with 100 cases each according to the random number table method. The control group received routine health care during pregnancy. The T-test and χ 2 test were used, while the observation group received midwifery-led group health care during pregnancy. The scores of maternal role adaptability, self-efficacy, weight control, delivery mode, breastfeeding, mental state, and quality of life was compared between the two groups. Results:After nursing, the mother′s role adaptability (63.14±9.38) and self-efficacy (34.16±2.89) scores in the observation group were higher than those in the control group (52.89±8.41 and 31.28±2.43, respectively) ( t=8.136, 7.627, P<0.05). The weight gain of the observation group in the third trimester [(3.68±1.22) kg] was less than that of the control group [(5.49±1.76) kg] ( t=8.452, P<0.05). The vaginal natural delivery rate of the observation group was 91% higher than the 71% of the control group (χ2=12.966, P<0.05), the cesarean section rate of the observation group was 9% lower than the 29% of the control group (χ2=12.966, P<0.05), and the exclusive breastfeeding rate in the observation group was higher than that in the control group ( χ2 =6.258, P<0.05). After nursing, the SAS (40.74±4.93) and SDS scores (42.16±5.07) of the observation group were lower than those of the control group (47.10±5.27 and 48.59±5.42, respectively) ( t=8.813, 8.664, P<0.05), and the four-dimension quality of life scores of the observation group were higher than those of the control group ( t=7.293, 7.406, 7.357, 8.767, P<0.05). Conclusion:A midwife-led group pregnancy care model can effectively enhance the self-efficacy of primiparas and improve their quality of life.

Psychosocial factors affecting pregnancy reactions of primipara in Mianyang / 四川精神卫生

ObjectiveTo explore the psychosocial factors affecting pregnancy reactions of primipara， so as to alleviate pregnancy reactions in early pregnancy stage. MethodsBasic information scale， Symptom Checklist 90 （SCL-90）， Pregnancy Pressure Scale （PPS） and Pregnancy-unique Quantification of Emesis and Nausea （PUQE） were used to assess the primiparas in a hospital from April to June 2020， thereafter， multiple linear regression was used to screen the main psychosocial factors affecting pregnancy reaction. ResultsA total of 100 pregnant women completed the survey， and the scores of PUQE， PPS and SCL-90 were （4.39±1.14）， （10.89±6.94） and （112.75±22.27）， respectively. Analysis showed that the pregnancy reactions were mild in 93 cases （93%）， moderate in 6 cases （6%） and severe in 1 case （1%）. One-way ANOVA results showed that there was no significant difference in PUQE score among primipara of different age， working status， education levels and average annual family incomes （F=0.57， 0.07， 0.89， 0.51， P>0.05）. Multifactorial regression analysis showed that pregnancy stress， SCL-90 score， obsessive-compulsive symptoms， depression levels， hostility， paranoia and others had statistical significance （P<0.05 or 0.01）. ConclusionThe main psychosocial factors influencing pregnancy reaction are the pregnancy stress and psychosomatic symptoms including obsessive-compulsive symptoms， depression levels， paranoia， hostility， sleep status， diet and others.

Serum proteinogram and biochemistry of Holstein cows in the peripartum period / Proteinograma e bioquímica séricas de vacas da raça Holandesa no período periparto

In face of the few reports found in national literature analyzing the potential influence of parturition number in serum proteinogram and biochemical profile in the peripartum period of high yielding dairy cows, the aim of the present study was to comparatively evaluate the dynamics of these serum constituents' concentrations in blood samples obtained from primiparous and multiparous Holstein cows, 60 and 30 days prepartum and in the day of parturition. Data were analyzed by repeated measures variance analysis (ANOVA) and differences between groups and moments were analyzed by Tukey's test. Results were considered significant when P<0.05. Parity influenced levels of total protein, albumin, globulins, magnesium, cholesterol, which were higher in multiparous cows, as well as concentrations of ceruloplasmin, total calcium, chloride and alkaline phosphatase activity, which were higher in primiparous cows. Parturition influenced serum concentrations of ceruloplasmin (+58%), transferrin (-25%), haptoglobin (+33%), total protein (-17%), globulins (-25%), immunoglobulin A (-43%), immunoglobulin G (-24%), total calcium (-12%), inorganic phosphorus (-10%), chloride (+5%), sodium (+4%), cholesterol (-23%), triglycerides (-38.6%), as well as activities of aspartate aminotransferase (+14%) and alkaline phosphatase (+28%). A decrease in serum levels of total calcium, inorganic phosphorus, cholesterol and triglycerides was more pronounced in multiparous than in primiparous cows. These results demonstrate that the interpretation of proteinogram and serum constituents should take into consideration lactation number and the moment of parturition as relevant factors in high yielding dairy cows in the transition period.(AU)

Diante da escassez de relatos encontrados na literatura nacional quanto à potencial influência do número de parições sobre o proteinograma sérico e perfil bioquímico no período periparto de vacas leiteiras de alta produção, o objetivo do presente estudo foi avaliar comparativamente a dinâmica de constituintes séricos em amostras de sangue obtidas de vacas da raça Holandesa primíparas e pluríparas, 60 e 30 dias pré-parto e no dia do parto. Os resultados foram avaliados por análise de variância (ANOVA) com medidas repetidas no tempo e as diferenças entre grupos e entre momentos foram analisadas pelo teste de Tukey, sendo os resultados considerados significativos quando P<0,05. O número de parições influenciou os teores de proteína total, albumina, globulinas, magnésio e colesterol, que foram maiores em vacas pluríparas, bem como as concentrações de ceruloplasmina, cálcio total, cloreto e atividade de fosfatase alcalina, que foram maiores em vacas primíparas. O número de parições influenciou as concentrações séricas de ceruloplasmina (+58%), transferrina (-25%), haptoglobina (+33%), proteína total (-17%), globulinas (-25%), imunoglobulina A (-43%), imunoglobulina G (-24%), cálcio total (-12%), fósforo (-10%), cloretos (+5%), sódio (+4%), colesterol (-23%), triglicérides (-38.6%), bem como as atividades de aspartato aminotransferase (+14%) e fosfatase alcalina (+28%). A diminuição do teor sérico de cálcio total, fósforo, colesterol e triglicérides foi mais acentuada em vacas pluríparas do que em vacas primíparas. Esses resultados mostram que a interpretação do proteinograma e dos constituintes séricos deve levar em consideração o número de lactações e a ocorrência do parto como fatores relevantes em vacas leiteiras de alta produção no período de transição.(AU)

Diferentes fontes energéticas durante o período de transição de vacas primíparas e os seus efeitos sobre metabólitos sanguíneos e hormônios / Different energy sources during the primiparous dairy cow transition period and its effects on blood metabolites and hormones

Objetivou-se com este estudo comparar os efeitos do fornecimento de dietas glicogênicas ou lipogênicas sobre metabolitos sanguíneos e hormônios em vacas primíparas (n=40) durante o período de transição. Os animais foram aleatoriamente distribuídos em quatro tratamentos: controle, sais de cálcio de ácidos graxos poli-insaturados (Megalac-E, 100g pré-parto e 250g pós-parto), soja tostada (400g pré-parto e 800g pós-parto) e propilenoglicol (300ml pré e pós-parto). Os suplementos foram fornecidos individualmente. Foram realizadas coletas de sangue para determinação das concentrações plasmáticas de insulina, glicose, ácidos graxos não esterificados (AGNE) e IGF-I. As concentrações de insulina e de glicose foram maiores nos animais do tratamento com sais de cálcio de ácidos graxos poli-insaturados. A maior concentração de AGNE foi observada no grupo controle. A concentração plasmática de IGF-I foi mais elevada para os animais do tratamento que receberam suplementos lipogênicos. A adição de sais de cálcio de ácidos graxos poli-insaturados a dieta foi capaz de amenizar as mudanças hormonais e metabólicas características do período de transição.(AU)

The aim of this study was to compare the effects of glycogenic supply or lipogenic diets on blood metabolites and hormones in primiparous dairy cows (n=40) during the transition period. The animals were randomly assigned to four treatments: control, calcium salts of polyunsaturated fatty acids (Megalac-E, 100g prepartum and 250g postpartum), roasted soybeans (400g prepartum and 800g postpartum) and propylene glycol (300ml pre- and postpartum). The supplements were provided individually. Blood samples were taken to determine plasma concentrations of insulin, glucose, non-esterified fatty acids (NEFA) and IGF-I. The glucose and insulin concentrations were higher in calcium salts of polyunsaturated fatty acids treatment. The highest concentration of NEFA was observed in the control group. The plasma concentrations of IGF-I were higher for the treatments with lipogenic supplements. Adding calcium salts of polyunsaturated fatty acids diet was able to ease the hormonal and metabolic changes of the transition period features.(AU)

Effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the second stage of labor in the primiparas / 中国针灸

OBJECTIVE@#To observe the effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the 2nd stage of labor in the primiparas so as to improve the clinical delivery quality.@*METHODS@#A total of 146 primiparas who accepted the natural delivery willingly were collected. According to the visit sequence, they were divided into an observation group (72 cases) and a control group (74 cases). The free position and the unprotected perineal delivery were adopted in combination during the labor in both of the two groups. Additionally, in the observation group, the auricular-point pressure with semen vaccariae was intervened when entering the active phase. The points were pengqiang (TF), zigong (uterus), neishengzhiqi (TF), pizhixia (AT), shenmen (TF), jiaogan (AH), pi (CO) and wei (CO). Each point was pressed for 1 to 2 min each time, repeated once every 10 to 20 min until the end of the 2nd stage of labor. The episiotomy rate, perineal laceration degree, perineal pain degree, the duration of the 2nd labor stage, postpartum hemorrhage, postpartum urine retention and neonatal asphyxia rate were recorded and compared in the primiparas between the two groups.@*RESULTS@#The perineal laceration of the degree Ⅲ and Ⅳ did not occur in the two groups. Compared with the control group, the effect on the perineal laceration was better in the observation group (0.05). In the observation group, the neonatal asphyxia rate was 1.4% (1/72), the postpartum hemorrhage 6.9% (5/72) and the incidence of urine retention 5.6% (4/72), all lower than 10.8% (8/74), 18.9% (14/74) and 17.6% (13/74) in the control group respectively (all <0.05). In the observation group, on the 1st, 2nd and 3rd days after labor, the perineal pain degree and the duration of the 2nd stage of labor were superior to the control group (all <0.001).@*CONCLUSION@#The combined therapy of the auricular-point pressure intervention at the free position and the unprotected perineal delivery technique effectively reduces the episiotomy rate and perineal laceration degree, relieves the perineal pain, reduces the neonatal asphyxia rate and improves the delivery quality during the 2nd stage of labor in the primiparas.

Investigation of experiences of childbirth among spouses of primiparas / 中华护理杂志

Objective To describe experiences of childbirth among spouses of primiparas.Methods Both questionnaire and semi-structured interviews were utilized in this study.Totally 135 expectant fathers were recruited from one tertiary obstetrics and gynecology hospital.Fathers' Experiences of Childbirth Questionnaire developed by Katri was used to collect data.Eighteen fathers were invited to participate the interviews.Results The mean scores of childbirth experiences were (4.36±0.32) for feelings about the staff and the environment,(4.32±0.37) for feelings about the birth of his child,(3.74±0.43) for feelings concerning his wife,and (3.58±0.58) for father's own feelings.Four themes were extracted from the interviews,including concern about wife and child,information and support,feelings about the care and the environment,self-consciousness.Conclusion Fathers' feelings about the staff and the environment are the most satisfactory dimension in childbirth experiences.The helpless feelings caused by labor pain should be responded by medical stuff.

Research of the effect of periodic telephone follow-up on primiparas′ exclusive breastfeeding ;during puerperal period / 中国实用护理杂志

Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.

Incidence of the second parity syndrome in sows from a commercial farm / Incidência de síndrome do segundo parto em fêmeas suínas de uma granja comercial

O objetivo do presente estudo foi investigar a ocorrência da síndrome do segundo parto em uma granja comercial de suínos e apresentar alternativas para minimizar esse problema reprodutivo. Os dados foram obtidos de 363 fêmeas de genética comercial (DB-30) de primeiro e segundo partos, entre os anos de 2010 e 2011. Os animais pertenciam a uma granja comercial de ciclo completo com 1200 matrizes, cujos índices zootécnicos não permitiam detectar a presença da síndrome do segundo parto. O período de lactação foi de 24,6±3,3 dias. Foram analisados o número de nascidos totais e nascidos vivos, o peso da leitegada ao nascimento, o número de desmamados e o peso ao desmame do lote e também individualmente de cada marrã ao longo do ano. As médias e o desvio-padrão foram calculados, e os dados obtidos no primeiro e no segundo parto foram comparados pelo teste t pareado a 5%. Não houve diferença (P>0,05) no número de nascidos totais e no número de nascidos vivos entre o primeiro e o segundo parto. No entanto, constatou-se que 54% das fêmeas apresentaram igual ou menor número de nascidos no segundo parto, caracterizando a síndrome do segundo parto na maior parte dos animais. Nesse lote, o número de leitões nascidos a menos em relação ao primeiro ciclo reprodutivo foi de 3,6±2,9. Das 363 matrizes avaliadas, 153 (42%) apresentaram 16 ou mais leitões no primeiro parto. Destas, 92 (60%) tiveram menor número de leitões no segundo parto e 41 (27%) apresentaram maior número de leitões. Também se verificou maior incidência (50% ou mais) da síndrome do segundo parto nos meses de janeiro a março e de outubro a dezembro. Conclui-se que a síndrome do segundo parto é um problema que pode afetar 50% ou mais das matrizes, nem sempre detectada por meio dos índices zootécnicos da granja. Medidas como pesagem dos animais na primeira cobertura e logo após o desmame, além de programas de alimentação com dietas balanceadas, principalmente durante os meses mais quentes do ano, são ferramentas importantes para amenizar esse problema.(AU)

Avaliação microbiológica uterina durante o puerpério de vacas Nelore primíparas / Evaluación microbiológica uterina durante el puerperio de vacas Nelore primíparas / Uterine microbiological assessment of primiparous nelore cows during puerperium

O objetivo deste estudo foi avaliar a microbiota uterina de vacas primíparas da raça Nelore durante o período puerperal. Foi coletado material do útero de 15 fêmeas recém-paridas, uma vez por semana, durante 60 dias. O material coletado foi inoculado em meio de cultura, e os microrganismos foram identificados por meio de coloração de Gram, coloração Azul de Algodão e testes bioquímicos. As amostras foram isolados Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, Streptococcus spp., S. intermedius, Bacillus spp., Actinomyces pyogenes, Sporothrix schenckii, Trichophyton verrucosum e Candida albicans, geralmente em associações. Com isso, concluímos que o puerpério é um processo séptico, e os agentes encontrados são os mesmos que provocam a maioria dos casos de infecções uterinas pós-parto. O número e a variação de microrganismos decrescem a cada semana, demonstrando o processo natural de autodefesa do útero que ocorre quando o animal apresenta-se sadio.

El objetivo de este estudio fue evaluar la microbiota uterina de vacas primíparas de la raza Nelore durante el puerperio. El material fue recogido del útero de 15 vacas que habían parido recientemente, una vez a la semana durante 60 días. El material recogido se inoculó en medios de cultivo y los microorganismos fueron identificados mediante las tinciones de Gram, Azul de Algodón, y por pruebas bioquímicas. En los cultivos se aislaron Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, Streptococcus spp., S. intermedius, Bacillus spp., Actinomyces pyogenes, Sporothrix schenckii, Trichophyton verrucosum y Candida albicans, generalmente con más de un microorganismo por muestra. Se concluyó que el puerperio es un proceso séptico, y que estos agentes son la causa de la mayoría de los casos de infecciones uterinas después del parto. El número y variedad de microorganismos disminuyeron cada semana, lo que demuestra un proceso natural de autodefensa del útero cuando el animal está sano.

It was aimed to evaluate the uterine microbiota of primiparous Nelore cows during the puerperal period. To 15 fifteen females immediately parous, secretions were obtained from the uterus once a week, during sixty days. Material obtained was inoculated in culture media, and microorganism identification was made by smears stained by the Gram method, cotton blue and biochemical tests. Microorganisms recovered were Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, S. intermedius, Streptococcus spp, Bacillus spp, Actinomyces pyogenes, Sporotrix schenckii, Trichophyton verrucosum and Candida albicans, generally recovering more than one microorganism per culture, demonstrating that the puerperium is a septic process. The number and type of microorganisms decreased every week, demonstrating the natural process of self-defense of the uterus that occurs by the end of puerperium.

Taxa de fertilidade de novilhas de diferentes grupos genéticos com primeiro serviço aos 14 meses de idade / Fertility rate of heifers of different genetic groups with 1st service at 14 months of age

Foram avaliadas as taxas de reconcepção de 98 novilhas primíparas (34 Guzerá - G, 32, 1/2 Guzerá x 1/2 Nelore - GN e 32,1/2 Red Angus x 1/2 Nelore - AN) com 14 meses de idade e peso médio de aproximadamente 249,65kg, criadas em pastos de Brachiaria brizantha cv Marandu. Na segunda estação de monta (EM), foram utilizadas apenas as 36 primíparas gestantes na primeira EM (três G, nove GN e 24 AN), com média de idade de 26 meses e peso corporal de 313,67±25,01kg, 336,50±45,84kg e 399,86±44,45kg, respectivamente, para as fêmeas dos grupos G, GN e AN. O grupo AN apresentou ganho médio diário (GMD) de 0,30±0,06 (kg/dia) e maiores taxas (58,33) de reconcepção (P<0,05), comprovando que a heterose resultante do cruzamento entre raças distintas com maior distância genética (Bos taurus taurus x Bos taurus indicus) proporciona maior desempenho produtivo e reprodutivo.

A total of 98 heifers of three genetic groups: 34 Guzerá (G), 32, 1/2 Guzerá x 1/2 Nelore (GN) and 32 1/2 Red Angus x 1/2 Nelore (AN), 14 month old and average body weight of 249,65kg, raised in Brachiaria brizantha cv Marandu were used to evaluate reconception rates. In the second breeding season (BS), only those 36 pregnant in the first BS (three G, nine GN and 24 AN), age 26 months and body weight of 313.67±25.01kg, 336.50±45.84kg and 399.86±44.45kg, respectively, G , GN and AN were evaluated. The highest reconception rate (58.33%, P<0.05) was registered for the AN group and showed that average daily gain of 0.30±0.06kg, showing that crosses between Bos taurus taurus x Bos taurus indicus leads to higher reproductive and productive performances.

Effect of non-invasive labor analgesia on postnatal depression among primiparas / 现代临床护理

Objective To explore the effect of non-invasive labor analgesia on postnatal depression among primipara. Methods Three hundred primipara of spontaneous labor in our hospital from February 2014 to April 2014 were assigned as control group and another 300 primiparas of spontaneous labor from May 2014 to August 2014 as experiment group. In the control group, one-to-one responsibility system was conducted for the delivery with an accompanying midwife and in the experiment group, non-invasive labor analgesia was done apart from one-to-one responsibility system. The two groups were compared in terms of analgesic effect at three stages of labor, postnatal depression scores and incidence of postnatal depression. Result The analgesic effect of the experiment group was better than that of the control group during the three stages of labor (all P<0.01), and postnatal depression scores and the incidence of postnatal depression in the experiment group were significantly lower than those in the control group (both P<0.05). Conclusion Non-invasive labor analgesia can relieve the labor pains and decrease the incidence of postnatal depression among primiparas.

Research in influence of humanistic care on role competency of primiparas with natural labor / 中国实用护理杂志

Objective To investigate the effects of humanistic care on primiparas' role competency during pregnancy and delivery.Methods Data of 21 cases were collected using semi-structured interviews and phenomenological qualitative method was used to analyze the data.Results The effects of humanistic care on maternal role competency during pregnancy included:to participate in related curriculum,to get ready for delivery actively.The effects of humanistic care on maternal role competency during delivery included:nurses' carefulness gave psychological support,nurses' instruction gave professional support,nurses' encouragement gave spiritual power,nurses' support enhanced belief,successful delivery experience gave.satisfaction.Conclusions Humanistic nursing is helpful to improve delivery experience,to increase maternal satisfaction and confidence,to promote matemal role competency and harmonious relationship between mothers and nurses.

Inseminação artificial em tempo fixo em primíparas Nelore lactantes acíclicas / Fixed-time artificial insemination in primiparous lactating Nelore acyclic cows

Avaliou-se a eficiência de um protocolo de inseminação artificial em tempo fixo (IATF), para melhorar o desempenho reprodutivo de vacas Nelore primíparas, lactantes e acíclicas. Utilizaram-se 350 vacas com escore de condição corporal médio de 2,65±0,01 e média de dias pós-parto de 67,35±1,0 dias. A estação de monta (EM) foi de 180 dias. Os animais foram distribuídos em: G1(n=61) e G3(n=116) - vacas com presença de folículos ovarianos ≤8mm de diâmetro e sem corpo lúteo (CL); G2(n=57) e G4(n=116) - vacas com folículos ≥8mm e sem CL. As vacas do G1 e do G2 permaneceram em monta natural (MN) a partir do dia zero da EM. G3 e G4 foram tratados (dia zero) com 2mg de benzoato de estradiol (BE), IM, e dispositivo com 1,0g de P4 por oito dias. Retirou-se a P4, administraram-se 400UI de eCG e 75µg de cloprostenol, IM, 24h após, e 1mg BE, IM. A IATF foi realizada 51-54h após retirar P4. Aos cinco dias após término da IATF, as vacas do G3 e do G4 também foram mantidas em MN. Avaliou-se, por ultrassonografia, a presença de CL e realizou-se o diagnóstico de gestação, aos 45 e 210 dias após início da EM. Aos 45 dias, mais animais do G3, 42,2%, e do G4, 51,7%, estavam gestantes (P<0,05), em relação aos do G1, 0%, e do G2, 3,5%. A porcentagem de CL foi de 6,6%; 28,1%; 50,9%; 62,9% em G1, G2, G3 e G4, respectivamente. Aos 210 dias, 22,9% do G1; 45,6% do G2; 40,5% do G3 e 65,5% do G4 estavam gestantes. Os períodos de serviço foram: em G1, 134,00±11,70 dias; em G2, 119,65±8,27 dias; em G3, 79,91±5,38 dias; e em G4, 81,40±4,59 dias. A IATF foi eficiente para melhorar o desempenho reprodutivo de vacas Nelore primíparas lactantes acíclicas em relação ao manejo apenas da MN.

The aim of this experiment was to evaluate the efficiency of a fixed-time artificial insemination protocol to improve the reproductive performance of lactating primiparous acyclic Nelore cows. A total of 350 cows with average body condition score of 2.65±0.01 and average postpartum days of 67.35±1.0 were used. The breeding season (MS) was 180 days. The animals were distributed into G1 (n = 61) and G3 (n = 116) - cows with ovarian follicles ≤8mm in diameter and without corpus luteum (CL). G2 (n = 57) and G4 (n = 116) groups - cows with follicles ≥8mm and without CL. Cows in G1 and G2 remained in natural mating (NM) from day 0 of MS. G3 and G4 were treated (Day 0) with 2mg of oestradiol benzoate (EB), IM, and 1.0g P4 device for eight days. The withdrawal of P4 was administered with 400IU of eCG and cloprostenol 75μg, IM, after 24h, and 1mg BE, IM. The artificial insemination was performed at 51-54h after removing the P4 device. Five days after the end of the artificial insemination, cows from G3 and G4 were also held in MN. Ultrasonography was performed to evaluate the presence of CL and the pregnancy diagnosis at days 45 and 210 after the onset of MS. At 45 days more animals in G3, 42.2% and G4, 51.7% were pregnant (P <0.05) than in G1, 0% and G2, 3.5%. The CL percentage was 6.6%, 28.1%, 50.9%, 62.9% in G1, G2, G3 and G4, respectively. At 210 days 22.9% in G1, 45.6% in G2, 40.5% in G3 and 65.5% in G4 were pregnant. The service periods were: G1, 134.00±11.70 days; G2, 119.65±8.27 days, in G3, 79.91±5.38 days, and G4, 81.40±4.59 days. The fixed-time artificial insemination was efficient to improve the reproductive performance of primiparous lactating Nelore acyclic cows compared to animals that remained only with natural mating.

Effects of health education on diet and daily behaviors in stegmonth / 现代临床护理

Objective To investigate the effects of health education on diet and behaviors in stegmonth. Methods Three hundred and forty three primiparas were divided into the experiment and control group.The 163 primiparas in the experiment group took the courses in the pregnant women’s school and 180 primiparas in the control group did not.The differences of diet and daily behaviors in stegmonth were compared between the two groups.Results There were statistically significant differences in the rate of diet,health behaviors,breast feeding between the two groups(P<0.01).Conclusion The health education for the pregnant woman can enhance their sense of self care,change their wrong behaviors,and improve the rate of breast feeding.

Estrias de distensão na gravidez: fatores de risco em primíparas / Striae distensae in pregnancy: risk factors in primiparous women

Fundamentos: Estrias ocorrem em mais de 70 por cento das gestantes. Elas tendem a se desenvolver a partir da 25ª semana gestacional. Apesar de sua etiologia não ser bem compreendida, aceita-se que a combinação de fatores genéticos com alterações endócrinas e estiramento mecânico da pele tem papel significante. Em função dos diferentes resultados encontrados na literatura, os autores avaliaram os fatores de risco comumente citados com o objetivo de determinar se estão associados com a ocorrência de estrias na gestação. Objetivo: Avaliar em primíparas os supostos fatores de risco para o aparecimento de estrias. Métodos: Estudo observacional transversal não controlado e descritivo em primíparas. O período avaliado foi de quatro meses (janeiro a maio de 2008), em uma maternidade pública. Foram incluídas 164 primíparas de feto único após 48 horas do parto. Um total de 14 variáveis foi registrado em cada paciente. Resultados: Das 164 mulheres em estudo, 59,8 por cento desenvolveram estrias durante a gestação. Foi estatisticamente significante a associação entre a faixa etária materna (p < 0,01), o peso materno adquirido durante a gestação (p < 0,01) e o peso de recém-nascido (p = 0,01) com o aparecimento de estrias na gestação. O teste de associação utilizado foi o qui-quadrado. Conclusão: As estrias foram mais frequentes em pacientes mais jovens, nas que adquiriram maior peso na gestação e/ou nas que deram à luz bebês mais pesados. Este estudo sugere que a idade materna mais avançada poderia ser um fator protetor contra a presença de estrias na gestação.

Background: Striae occur in over 70 percent of pregnant women and tend to develop after 25 weeks of gestation. Despite the fact that their etiology has not yet been fully understood, it is accepted that a combination of genetic factors, endocrine alterations and mechanical stretching of skin play a significant role. Due to different results reported in the literature, the authors assessed commonly cited risk factors to determine whether they are associated with the development of striae in pregnancy. Objective: To assess hypothetical risk factors for the development of striae in primiparous women. Methods: This was a cross-sectional, observational, non-controlled, descriptive study with primiparous women. the study was conducted in a public maternity unit and Lasted for four months (from January to May 2008). 164 Primiparous women who had had a single fetus pregnancy took part in the study 48 hours after delivery. Fourteen Variables were recorded for each patient. Results: From the total sample, 59.8 percent developed striae during pregnancy. The association of maternal age range (p < 0,01), maternal weight gain during pregnancy (p < 0,01) and birth weight of newborn infants (p = 0,01) with the development of striae during pregnancy was statistically significant. The chisquared test of association was used. Conclusions: Striae were more frequently observed in younger women, in those who gained more weight during pregnancy and/or those who had babies with higher birth weight. This study suggests that increased maternal age could be a protecting factor against striae during pregnancy.

Factors Influencing Parenting Stress in Primiparas / 아동간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.

Etiologia das infecções intramamárias em vacas primíparas no período pós-parto

A total of 664 foremilk samples from 83 Holstein cows were cultured. Quarter samples were collected at parturition and 7 days post the first parturition. From 664 milk samples examined, 488 (73.50%) were bacteriologically negative and 176 (26.50%) were positive. A high incidence (20.48%) of clinical mastitis was observed. The most frequently encountered isolates were coagulase negative staphylococci (64.20%), coagulase positive staphylococci (8.52%), streptococci (7.96%), Actinomyces pyogenes (4.55%), Mycoplasma bovigenitalium (3.40%) and Escherichia coli (2.84%). The frequency of mastitis pathogen isolation was highest at parturition (17.62%) and decreased markedly during the first week (8.88%).

Foram analisadas 664 amostras de leite de 83 vacas primíparas da raça Holandesa. As amostras foram colhidas no primeiro e no sétimo dia após o parto. Das 664 amostras analisadas, 488 (73,50%) foram bacteriologicamente negativas e 176 (26,50%), positivas para microrganismos aeróbios. Foi observado um alto índice de mastite clínica (20,48%). Os agentes isolados com maior freqüência foram os Staphylococcus spp coagulase negativo (64,20%), Staphylococcus spp coagulase positivo (8,52%), Streptococcus spp (7,96%), Actinomyces pyogenes (4,55%), Mycoplasma bovigenitalium (3,40%) e Escherichia coli (2,84%). Foi observado um maior índice de isolamento de patógenos no primeiro dia (17,62%) em relação ao sétimo (8,88%).

Stress and Related Factors in Spouses of Primiparas / 中国心理卫生杂志

0.05);Single factor analysis showed that,8 factors such as planned pregnancy,gender expectation of mother and father of spouses,relation of primiparas with mother and father of their spouses were independently related to depression in spouse of primiparas;multiple stepwise regression analysis revealed that,social support,books and media with postpartum health care knowledge,gender expectation of mother and father of spouses were main factors that related to stress in spouses of primiparas(?=-0.68,-0.15,-0.13).Conclusion:Spouses of primiparas experience the same medium-leveled stress as primiparas.The related factors were multifold and the main factors were social support,books and media with postpartum health care knowledge,gender expectation of mother and father of spouses.