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Objective:To understand the current status of discharge planning nursing for primipara who separated from their infants during hospitalization and provide a reference basis for constructing a clinical nursing plan.Methods:From February to June 2023, a field research about situation of nursing practice in discharge planning service among primiparas who separated from their infants was conducted in the Department of Obstetrics, Obstetrics and Gynecology Hospital Affiliated to Tongji University. Data was collected by field observation and informal interviews with 12 nurses and analyzed by three-level coding method of qualitative research.Results:All 12 nurses were female with 24-46 (33.33 ± 1.83) years old. The work content of the observation subjects could be divided into 4 items including providing infants′ health information, breastfeeding, postpartum rehabilitation, psychological care and social support. All the 4 items needed to be improved in providing infants′ health information, evaluating psychological status and social support, and quality of discharge teaching.Conclusions:It still needs further development in discharge planning nursing for primipara separated from their infants during hospitalization. It is urgent to improve the quality of discharge planning nursing for primiparas who have separated from their infants by developing scientific and standardized discharge planning nursing process, conducting standardized training for nurses, improving nurses′ psychosocial assessment ability, homogenizing health education, and improving humanistic care, so as to promote the rehabilitation of primiparas and get used to being a mother.
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Objective:To explore the effect of timely induction intervention on postpartum urination in primipara during vaginal delivery, so as to provide the evidence for preventing the occurrence of postpartum urinary retention and relieving the pain of primipara.Methods:This study adopted a randomized controlled trial design, and selected 400 cases of primipara who were hospitalized for vaginal delivery in the Obstetric Department of Dalian Women and Children's Medical Group Sports New Town Hospital from June 2021 to September 2022 as the study objects by convenience sampling method. They were divided into the intervention group and the control group with 200 cases each by random number table method, and the control group received routine postpartum care. Instruct active urination within 6 hours after delivery. The intervention received timely induction urination intervention. The general condition and bladder urine volume of the women in the intervention group were evaluated at 2, 4, 6 h after delivery, respectively, and personalized guidance was implemented, including the frequency of massage of the bottom of the uterus, the control of water intake, the selection of methods and timing of inducing urination, etc., and routine postpartum care was given when the women completed their first urination and had no complaints of discomfort. The first urination time, first urination volume, first bladder irritation during the first urination and the incidence of postpartum urinary retention in different periods were compared between the two groups.Results:The patients in the control group were (29.60 ± 3.20) years old, while the patients in the intervention group were (28.81 ± 3.42) years old. The first urination time in the intervention group was (6.89 ± 2.18) h, which was shorter than that in the control group (9.11 ± 3.86) h, and the difference was statistically significant ( t=-2.49, P<0.01). The first urination volume in the intervention group was (322.36 ± 120.15) ml, which was higher than that in the control group (262.93 ± 105.68) ml, and the difference was statistically significant ( t=3.39, P<0.05). The incidence of the first bladder irritation in the intervention group was 22.0%(44/200), which was lower than that in the control group 33.5%(67/200), and the difference was statistically significant ( χ2=6.60, P<0.05). The incidence of postpartum urinary retention within 24 h in the intervention group was 5.5%(11/200), which was lower than that in the control group 11.5%(23/200), and the difference was statistically significant ( χ2=4.63, P<0.05). The incidence of postpartum urinary retention within 1 week in the intervention group was 9.5%(19/200), which was lower than that in the control group 16.5%(33/200), and the difference was statistically significant ( χ2=4.33, P<0.05). There was no significant difference in the incidence of postpartum urinary retention within 24 to 72 h between the two groups ( P>0.05). Conclusions:Timely induction intervention can reduce the incidence of postpartum urinary retention, shorten the time of first urination, increase the volume of first urination and improve the comfort of first urination, which is worthy of clinical application.
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Objective:To investigate the diagnostic value of pelvic floor ultrasound combined with electromyography physiological parameters for postpartum stress urinary incontinence(SUI)of different degrees and pelvic floor function of primipara.Methods:A total of 160 SUI patients who admitted to Yan'an hospital of Kunming City from January 2019 to January 2022 were selected,and they were divided into abnormal group(110 cases)and normal group(50 cases)according to pelvic floor function(the muscle voltage values of different muscle fibers).The SUI was graded according to the Chinese Guidelines for Diagnosis of Urological Diseases and the International Incontinence Advisory Committee's Incontinence Questionnaire(ICI-Q-SF).The posterior horn(α)of bladder and urethra at rest,the displacements of the bladder neck on y-axis(△y)and x-axis(△x)after the rest to the fatigue action,the proximal urethral rotation angle after the rest to the fatigue action(γ),the posterior horn of bladder and urethra(β)after the fatigue action were observed.The electromyography was used to draw and record the pelvic floor myoelectric activity signals of the patients of two groups at five stages(pre baseline rest period,class II muscle fiber systole period,class II and I muscle fiber systole period,class I muscle fiber systole period and post baseline rest period).And then,the muscle voltage values of different muscle fibers on the surface of pelvic floor were quantified.Results:There was no statistically significant difference in Δ x between patients with postpartum SUI of different degrees.There were significant differences in △y,α,β and γ between patients with postpartum SUI of different degrees(F=7.162,7.655,14.998,2.758,P<0.05).The differences of the means of muscle voltages of pre and post baseline rest period,and class I muscle fiber systole period among patients with postpartum SUI of different degrees were not significant.The differences of the means of muscle voltages of class II,and the class II and I muscle fiber systole period among patients with postpartum SUI of different degrees were significant(F=12.062,24.501,P<0.05),respectively.There was no statistically significant difference in △x between the two groups.The △y,α,β and γ of abnormal group were significantly higher than those of normal group(t=8.991,8.691,9.389,27.552,P<0.05),respectively.There were no statistically significant differences in the means of muscle voltage values of the pre and post baseline rest period,and class I muscle fibers systole period between the two groups.The means of muscle voltage values of class II,and class II and I muscle fibers systole period in the abnormal group was significantly higher than them in the normal group(t=9.613,14.452,P<0.05),respectively.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 71.60%,79.40%,81.40%,91.20%,83.30%and 82.40%,and the specificities of them were respectively 41.40%,37.90%,37.90%,60.30%,41.40%,and 44.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivity and specificity of the combined diagnosis of them were respectively 92.20%and 82.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 79.10%,77.30%,88.20%,89.10%,77.30%,87.30%,and the specificities of them were respectively 64.00%,64.00%,52.00%,46.00%,70.00%and 66.00%in diagnosing pelvic floor function of primipara.The sensitivity and specificity of the combined diagnosis were respectively 98.20%and 80.00%in diagnosing pelvic floor function of primipara.Conclusion:Pelvic floor electromyography physiological parameters and pelvic floor ultrasonic parameters have a certain value in diagnosing postpartum SUI of different degrees and pelvic floor function,and the value of the combined diagnosis of them is higher.
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ABSTRACT Objective: To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor. Methods: 60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods. Results: At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05). Conclusion: Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.
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Objective To observe the effects of different epidural anesthesia regimens on pain degree and postpartum pelvic floor function of primiparas.Methods A total of 80 primiparas who underwent painless epidural anesthesia delivery in Xiangyang Hospital Affiliated to Hubei University of Traditional Chinese Medicine from September 2021 to September 2022 were selected as the research subjects.The primiparas were divided into control group(n=40)and observation group(n=40)according to the anesthesia plan.The primiparas in the control group received epidural anesthesia with ropivacaine combined with physiological saline,while the primiparas in the observation group received epidural anesthesia with ropivacaine combined with sufentanil.The rate of natural delivery,rate of cesarean section,rate of vaginal delivery and the duration of each labor of primiparas were compared between the two groups;the analgesic effect of primiparas in the two groups was evaluated by pain visual analogue scale(VAS)at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours;the asphyxia sta-tus of newborns in the two groups was evaluated by neonatal Apgar score at 1,5 min after birth;the complications of nausea and vomiting,cervical or perineal injuries,urinary retention of puerperas and neonatal asphyxia were recorded and the total inci-dence of complications was compared between the two groups.At 6-8 weeks after delivery,pelvic floor functional indicators such as fiber muscle strength,pelvic floor muscle closure contraction force,and static tension of pelvic floor muscles of postpar-tum women in the two groups were measured by biological stimulus feedback instrument.Results The natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the control group was 72.5％(29/40),7.5％(3/40),20.0％(8/40),respectively;the natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the observation group was 90.0％(36/40),5.0％(2/40)and 5.0％(2/40),respectively.The natural delivery rate of primiparas in the ob-servation group was significantly higher than that in the control group,and the cesarean section rate was significantly lower than that in the control group(P＜0.05);there was no significant difference in the vaginal delivery rate of primiparas between the two groups(P＞0.05).The first and second stages of labor of primiparas in the observation group were significantly shorter than those in the control group(P＜0.05),and there was no significant difference in the third stage of labor of primiparas be-tween the two groups(P＞0.05).The VAS score of primiparas in the observation group was significantly lower than that in the control group at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours(P＜0.05).There was no signifi-cant difference in the Apgar score of newborns between the two groups at 1,5 min after birth(P＞0.05).The total incidence of complications in the control group and the observation group was 42.50％(17/40)and 20.00％(8/40),respectively;the total incidence of complications in the observation group was significantly lower than that in the control group(x2=4.713,P＜0.05).The fiber muscle strength and pelvic floor muscle closure contraction force of postpartum women in the observation group were significantly higher than those in the control group,the static tension of pelvic floor muscles was significantly lower than that in the control group(P＜0.05).Conclusion Sufentanil combined with ropivacaine epidural anesthesia can improve the analgesic effect of primiparas during childbirth,reduce the cesarean section rate,shorten the labor process,and facilitate the recovery of pelvic floor function in primiparas,reduce maternal and infant complications.
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Objective To study the effect of family empowerment combined with online and offline health education on breastfeeding rate and self-efficacy of primiparas.Methods A total of 98 primiparas who were admitted to Linping District,the Second Affiliated Hospital,Zhejiang University School of Medicine for delivery from January 2020 to June 2022 were selected and divided into control group and experimental group according to random number table method,49 cases in each group.From 37 weeks gestation to 6 months postpartum,the control group was given routine health education,while the experimental group was given family empowerment combined with online and offline health education.The mastery of breastfeeding knowledge,self-efficacy,skills before and after intervention and breastfeeding rate of two groups were compared.Results After the intervention,the mastery of breastfeeding knowledge,breastfeeding self-efficacy scale scores and Bristol breastfeeding assessment tool scores of experimental group were significantly higher than those of control group(P<0.05).The breastfeeding rate of experimental group was significantly higher than that of control group(95.92%vs.83.67%,χ2=4.009,P=0.045).Conclusion The implementation of family empowerment combined with online and offline health education for primiparas has a good effect,which can improve their self-care ability and health behaviors,and improve the breastfeeding rate.
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Breastfeeding is a traditional practice that comes ' naturally' to Indian mothers. This study sought to assess the prevalence of lactation insuffi ciency and to fi nd out the association between prevalence of lactation insuffi ciency among primipara mothers with selected background variables. This descriptive cross-sectional study was conducted in a selected maternity hospital of South India between May'ndash;July 2020. A total of 103 moth0ers in the post-natal wards were selected. Lactation insuffi ciency was assessed using LATCH scoring system. Data were analysed using descriptive and inferential statistics. Majority of the mothers (53, 52.48%) were in the age group 26-30 years; 56 (54.37%) studied higher secondary; 93 (90.29 %) received information on breastfeeding; 61 (59.23%) had least favourable and 42 (40.77%) had favourable LATCH scores. Chi square revealed no signifi cant association between lactation insuffi ciency and selected background variables among mothers. To conclude, there is a need to strengthen nurse-led lactation support to achieve successful breastfeeding practices.
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Objective:To investigate the current status of primiparas′ postpartum fatigue and paternal involvement, and to explore the relationship between primiparas′ postpartum fatigue and paternal involvement, and to provide reference basis for developing targeted intervention measures to alleviate postpartum fatigue of primiparas.Methods:A cross-sectional survey was conducted on 347 primiparas from Affiliated Hospital of Yangzhou University, Yangzhou Maternal and Child Health Care Hospital from September to December 2020 by convenience sampling. The survey instruments included the general information questionnaire, the Parenting Alliance Inventory (PAI), and the Postpartum Fatigue Scale (PFS).Results:The total score of PAI was (86.51 ± 12.07) points, and the level of paternal involvement was high. The total score of PFS was (16.68 ± 4.12) points. 95.97% (333/347) of primiparas had varying degrees of postpartum fatigue. There was a significant negative correlation between paternal involvement and primiparas′ postpartum fatigue ( r=-0.327, P<0.01). The results of multiple stratified regression analysis showed that paternal involvement was included in the influencing factor model of primiparas′ postpartum fatigue, which could independently explain 9.7% variation of primiparas′ postpartum fatigue. Conclusions:The higher level of paternal involvement could predict the lower level of primiparas′ postpartum fatigue. Medical staff should pay attention to the participation level of the spouses of primiparas in childcare, and improve the participation level of the spouses of primiparas in scientific ways to alleviate the postpartum fatigue of primiparas.
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Objective:To investigate the effect of neonatal breast crawling exercise on breastfeeding and psychological state of primiparas who delivered vaginally.Methods:Using convenience sampling method, 86 pairs of normal term infants and mothers who delivered vaginally in the First People′s Hospital of Yancheng from January 2019 to January 2020 were selected as the research objects, and divided into experimental group and control group according to the random number table method, there were 43 pairs in each group. The control group was given routine postpartum care, while the experimental group was given neonatal breast crawling exercise on the basis of routine postpartum care. The time of initiation of lactation, the success rate of first breastfeeding and the score of first Breastfeeding Assessment Tool (BAT) were compared between the two groups. The rates of exclusive breastfeeding, the scores of Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and the scores of Edinburgh Postnatal Depression Scale (EPDS) were compared between the two groups at 72 h and 42 d after delivery respectively.Results:The time of initiation of lactation was (48.36 ± 6.12) h in the experimental group, which was significantly earlier than that in the control group(52.86 ± 7.29) h, the difference was statistically significant (t=3.08, P<0.05). The success rate of first breastfeeding and the BAT scores of the experimental group were 88.1% (37/42) and (9.74 ± 1.33), respectively, which were significantly higher than those in the control group 69.8% (30/43) and (8.84 ± 1.60), the differences were statistically significant (χ 2=4.28, t=2.82, both P<0.05). At 72 h and 42 d after delivery, the rate of exclusive breastfeeding were 42.9%(18/42) and 86.49%(32/37) in the experimental group, significantly higher than those in the control group 20.9% (9/43) and 60.00% (24/40), the differences were statistically significant (χ 2=4.71, 3.93, both P<0.05). At 72 h and 42 d after delivery, the BSES-SF scores were (38.48 ± 6.34) and (45.43 ± 11.45) in the experimental group, which were significantly higher than those in the control group (35.21 ± 4.87) and (40.10 ± 10.82), the differences were statistically significant (t=2.66, 2.10, both P<0.05); the EPDS scores were (5.52 ± 1.53) and (7.38 ± 2.25) in the experimental group, which were significantly lower than those in the control group (6.26 ± 1.63) and (8.73 ± 2.39), the differences were statistically significant (t=2.13, 2.54, both P<0.05). Conclusions:Neonatal breast crawl is an effective way to promote the breastfeeding. It can also enhance maternal confidence and alleviate maternal psychological status.
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OBJECTIVE@#To investigate the perinatal outcome and risk factors of precipitate labor in term primipara.@*METHODS@#A total of 6951 full-term singleton primiparas with cephalic vaginal delivery in Women's Hospital, Zhejiang University School of Medicine from January 2020 to December 2020 were enrolled, among whom 381 cases of precipitate labor were classified as the precipitate labor group and 762 cases of normal labor were randomly selected as the control group. The perinatal outcomes of the two groups were compared, and the risk factors of precipitate labor were analyzed by multivariate logistic regression.@*RESULTS@#The incidence of precipitate labor in full-term, singleton pregnancy and cephalic primiparas was 5.48% (381/6951). The durations of the first and second stages of labor in the precipitate labor group were significantly shorter than that in the control group ( P<0.01); while there was no significant difference in the duration of the third stage of labor between the two groups ( P>0.05). Compared with the control group, the incidence of soft birth canal laceration in the precipitate labor group was increased ( P<0.01). However, there was no significant difference in postpartum hemorrhage and neonatal related perinatal outcomes between the two groups (all P>0.05). Multivariate logistic regression analysis showed that maternal height ( OR=1.038, 95% CI: 1.010-1.067, P<0.01), gestational age at delivery ( OR=0.716, 95% CI: 0.618-0.829, P<0.01), late miscarriage ( OR=1.986, 95% CI: 1.065-3.702, P<0.05), membrane rupture before labor ( OR=1.802, 95% CI: 1.350-2.406, P<0.01), labor induction by transcervical balloon ( OR=3.230, 95% CI: 2.027-5.147, P<0.01), labor induction by propess ( OR=2.332, 95% CI: 1.632-3.334, P<0.01) and labor induction by oxytocin ( OR=0.291, 95% CI: 0.219-0.386, P<0.01) were independently associated with precipitate labor.@*CONCLUSIONS@#The incidence of precipitate labor in full-term, singleton pregnancy was not low. Precipitate labor could lead to a significant increase in perineal laceration. Maternal height, history of late miscarriage, membrane rupture before labor and labor induction by transcervical balloon, labor induction by propess are risk factors, while labor induction by oxytocin and late gestational time of delivery are protective factors for precipitate labor in term primipara.
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Recién Nacido , Embarazo , Femenino , Humanos , Oxitocina , Aborto Espontáneo , Laceraciones/etiología , Trabajo de Parto Inducido/efectos adversos , Factores de Riesgo , Estudios RetrospectivosRESUMEN
ObjectiveTo explore the effect of incentive spouse collaborative psychological intervention on delivery outcomes of primipara. MethodsFrom July 2019 to July 2020， 300 primiparas with an uneventful pregnancy were recruited and divided into the control group and the intervention group， with 150 cases in each group. The control group was managed by routine nursing care， and the intervention group was managed by incentive spouse collaborative psychological intervention. The delivery outcomes in two groups， including delivery route， postpartum blood loss， and perineal laceration were compared. ResultsAfter intervention， the cesarean section rate， the 2-hour postpartum blood loss and perineal laceration in the intervention group were less common than those in the control group and the difference was statistically significant （P<0.05）. The first， second and total stages of labor duration in the intervention group were shorter than those in the control group and the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of neonatal asphyxia between these two groups （P>0.05）. In terms of vaginal delivery experience scores of the two groups， the intervention group was better than the control group and the difference was statistically significant （P<0.05）. ConclusionThe mode of incentive spouse collaborative psychological intervention can reduce the rate of cesarean section， the amount of bleeding 2 hours after delivery， and perineum injury. It can shorten the labor process， and effectively improve the delivery outcome of primiparas.
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ObjectiveTo explore the effect of incentive spouse collaborative psychological intervention on delivery outcomes of primipara. MethodsFrom July 2019 to July 2020， 300 primiparas with an uneventful pregnancy were recruited and divided into the control group and the intervention group， with 150 cases in each group. The control group was managed by routine nursing care， and the intervention group was managed by incentive spouse collaborative psychological intervention. The delivery outcomes in two groups， including delivery route， postpartum blood loss， and perineal laceration were compared. ResultsAfter intervention， the cesarean section rate， the 2-hour postpartum blood loss and perineal laceration in the intervention group were less common than those in the control group and the difference was statistically significant （P<0.05）. The first， second and total stages of labor duration in the intervention group were shorter than those in the control group and the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of neonatal asphyxia between these two groups （P>0.05）. In terms of vaginal delivery experience scores of the two groups， the intervention group was better than the control group and the difference was statistically significant （P<0.05）. ConclusionThe mode of incentive spouse collaborative psychological intervention can reduce the rate of cesarean section， the amount of bleeding 2 hours after delivery， and perineum injury. It can shorten the labor process， and effectively improve the delivery outcome of primiparas.
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Objective:To explore the effects of nursing intervention with pregnant body mass management combined with role -based health education on stage of labor, pelvic floor function recovery, psychological status changes, maternal and neonatal outcomes in primiparas. Methods:From March 2019 on, pregnant body mass management combined with role -based health education nursing was implemented in the hospital. On basis of the theory, nursing regimens of pregnant body mass management combined with role-based health education we formulated. During the period from August 2018 to February 2019, 120 primiparas who underwent delivery in the hospital were randomly enrolled as control group. During the period from August 2019 to February 2020, 120 primiparas were randomly enrolled as observation group. The duration of labor stages, postpartum pelvic muscle strength, scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), and delivery outcomes were compared between the two groups. Results:After nursing, the cesarean section rate was 20.83% (25/120) in observation group and 32.50% (39/120) in control group, there was significant difference between the two groups ( χ 2 value was 4.176, P<0.05). The spending time of ending the first, second and third stage of labor was (517.27±8.95), (48.33±5.62), (10.26±1.63) min in observation group and (537.31±7.92), (57.29±5.58), (18.28±1.61) min in control group, there was significant difference between the two groups ( t values were 18.369, 12.393, 38.347, P<0.001). After nursing, normal rate of pelvic floor muscle strength was 68.33% (82/120) in observation group and 54.17% (65/120) in control group, there was significant difference between the two groups ( χ 2 value was 5.074, P<0.05). After nursing, scores of HAMD and HAMA were (4.43±1.02), (5.56±0.87) points in observation group and (6.09±1.15), (6.88±0.93) points in control group, there was significant difference between the two groups ( t values were 11.830, 11.354, P<0.05). After nursing, adverse outcome rates of primiparas and neonates were 3.33% (4/120) and 5.83% (7/120) in observation group, and 10.00% (12/120), 15.83% (19/120) in control group, there was significant difference between the two groups ( χ 2 values were 4.286, 6.211, P<0.05). Conclusions:Pregnant body mass management combined with role-based health education nursing is conducive to shortening labor stages of primiparas, improving postpartum pelvic floor muscle strength and adverse emotions, and thus reducing the occurrence of maternal and neonatal adverse outcomes.
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Objective:To explore the effects of problem-solving therapy on breastfeeding self-efficacy and psychological status among primiparas, to provide basis for improving the breastfeeding of primipara.Methods:A total of 102 primiparas were divided into experimental group and control group by random number table method, each group contained 51 cases. Finally, 47 cases in the experimental group and 49 cases in the control group completed the study. The control group received routine nursing, while primiparas in the experimental group carried out problem-solving therapy. Before and after 6-week intervention, the effects was assessed by Breastfeeding Self-Efficacy Scale (BSES), Edinburgh Postnatal Depression Scale (EPDS) and General Well-being Schedule (GWB), respectively.Results:After intervention, the scores of primapara feedig cognition, feeding feeling, feeding skills and BSES total scores were (21.13±2.97) points, (65.47±6.63) points, (31.94±2.59) points, (118.53±8.47) points in the experimental group, significantly higher than (19.43±3.28) points, (61.76±5.20) points, (30.53±2.01) points, (111.71±6.11) points in the control group ( t values were 2.658-4.507, P<0.01); the scores of EPDS were (6.04±1.49) points in the experimental group, significantly lower than (6.92±2.08) points in the control group; the scores of life satisfaction and interest, depression and pleasure, energy, relaxation and tension in General Well-Being (GWB) and total scores were (7.51±1.71) points, (20.19±2.47) points, (21.68±2.32) points, (17.06±2.74) points, (90.45±4.96) points in the experimental group, significanlty higher than (6.41±1.82) points, (18.71±2.98) points, (20.57±1.87) points, (15.78±1.79) points, (84.61±5.26) points in the control group, the difference was statistically significant ( t values were 2.380-5.587, P<0.05 or 0.01). Conclusion:Problem-solving therapy can improve breastfeeding self-efficacy and alleviate postnatal depression as well as enhance subjective well-being of primipara women.
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ABSTRACT: This research aimed to investigate the genotypic relatedness of 18 Staphylococcus aureus strains isolated from intramammary infections in primiparous cows and extramammary sites on five dairy herds by rep-PCR using RW3A primers, and by PFGE using the endonuclease SmaI. The isolates were also evaluated in vitro for the susceptibility against beta-lactam antimicrobials drugs (penicillin and oxacillin), considering that beta-lactams are frequently used for treating staphylococcal intrammamary infections. The rep-PCR typing was highly discriminatory (D value= 0.9804) and a total of 15 patterns were detected. The PFGE method was also highly discriminatory (D value= 0.9667) and a total of 13 patterns were observed. A total of 15 out of 18 (83%) isolates were resistant to penicillin and one out of 18 (6%) to oxacillin. In conclusion, these findings confirmed the occurrence of a high genetic diversity of S. aureus strains at the herds and the presence of clonally-related strains only at the same herd, emphasizing a variety of genotypic profiles among the isolates.
RESUMO: Objetivou-se com este estudo investigar a correlação genética de 18 cepas de Staphylococcus aureus isoladas de infecções intramamárias em vacas primíparas e de locais extramamários em cinco propriedades leiteiras através das técnicas de PCR por sequências palindrômicas extragênicas repetitivas (rep-PCR), usando iniciadores RW3A, e de eletroforese em gel de campo pulsado (PFGE), usando a endonuclease SmaI. Os isolados também foram avaliados in vitro quanto à suscetibilidade aos antimicrobianos beta-lactâmicos (penicilina e oxacilina). A tipagem por rep-PCR foi altamente discriminatória (valor D = 0,9804) e um total de 15 padrões foram detectados. Os isolados de S. aureus foram agrupados em três grupos diferentes (A a C), com 80% de similaridade. A técnica de PFGE também foi altamente discriminatória (valor D = 0,9667) e um total de 13 padrões foi observado. A análise do dendrograma com um coeficiente de similaridade de 80% gerou dois grupos diferentes (A e B). Além disso, cepas clonais isoladas do leite foram identificadas na mesma propriedade pelos dois métodos de tipificação e, apesar da presença de cepas dominantes, nossos resultados sugerem uma alta diversidade genética dentre as cepas de S. aureus analisadas. Um total de 15, dos 18 (83%) isolados, eram resistentes à penicilina e um dos 18 (6%) à oxacilina. Assim, esses achados confirmam a ocorrência de uma alta diversidade genética de cepas de S. aureus nas propriedades e a presença de cepas clonalmente relacionadas apenas na mesma propriedade, enfatizando uma variedade de perfis genotípicos entre os isolados.
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Objective:To explore the risk of adverse pregnancy outcomes in the primiparas and the multiparas with advanced maternal age. Methods:Through a retrospective cohort study, 6 129 elderly women who gave birth to a single child from January 2014 to December 2016 in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine were collected to compare the differences in pregnancy outcomes between the primiparas and the multiparas (parity=2). Logistic regression analysis was used to evaluate the risk of adverse pregnancy outcomes in the two groups of pregnant women. Results:Compared with the multiparas, the primiparas with advanced maternal age had a higher risk of premature rupture of membranes (adjusted OR=1.35, 95% CI 1.18-1.54), preeclampsia/eclampsia (adjusted OR=1.99, 95% CI 1.45-2.73), gestational diabetes mellitus (adjusted OR=1.32, 95% CI 1.15-1.51), small-for-gestation age (adjusted OR=2.49, 95% CI 1.78-3.48), and cesarean section (adjusted OR=1.45, 95% CI 1.30-1.62). The birth weight of infants delivered by the primiparas was slightly lower than that of the multiparas. Conclusion:In the advanced maternal age women, primiparas have a higher risk of adverse perinatal outcomes than multiparas, such as premature rupture of membranes, preeclampsia/eclampsia, gestational diabetes mellitus, small-for-gestation age and cesarean section.
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This study evaluated the effect of birth weight and weight gain during the suckling phase on the piglet daily weight gain during the nursery phase (21-61 days of age). Piglets (n= 534) derived from 55 first-parity sows were weighed at birth, weaning, and end of the nursery phase. The data were analyzed according to a completely randomized experimental design, with three classes of birth weight (BW) and two classes of weight gain during the suckling phase (SDWG). High BW and low SDWG piglets were 0.2kg lighter at weaning than low BW and high SDWG animals (P< 0.05). However, at the end of the nursery phase, this situation was inverted, with high BW and low SDWG piglets 2.20kg heavier (P< 0.05). Low BW and high SDWG piglets were heavier at weaning and at the end of the nursery phase than low BW and low SDWG piglets (P< 0.05). At the same time, intermediate and high BW and low and high SDWG piglets presented body weight differences at weaning (P< 0.05), but not at the end of the nursery phase (P< 0.05). Piglets with 1.25 to 2.30kg BW and low weight gain during suckling presented a partial compensatory growth during the nursery phase.(AU)
Objetivou-se avaliar o efeito do peso dos leitões ao nascimento e do seu ganho de peso na maternidade sobre seu desempenho na fase de creche (21-61 dias de idade). Quinhentos e trinta e quatro leitões, provenientes de 55 primíparas, foram pesados ao nascimento, no desmame e na saída da creche. Os animais foram distribuídos em um delineamento inteiramente ao acaso, em três classes de peso ao nascimento (PN) e duas classes de ganho de peso diário (GPD) na maternidade. Os animais com alto PN e baixo GPD na maternidade desmamaram 0,2kg mais leves que os animais com baixo PN e alto GPD na maternidade (P<0,05). Porém, os animais com alto PN e baixo GPD na maternidade saíram da creche 2,10kg mais pesados (P<0,05). A diferença aos 21 dias entre os dois tratamentos (alto e baixo GPD) com animais de baixo PN foi de 1,18kg e passou para 2,20kg ao final da creche (P<0,05). No caso dos animais com médio e alto PN, a diferença ao desmame era de 1,14 e 1,26kg e passou para 0,90 e 0,70kg na saída da creche (P<0,05), respectivamente. Leitões com peso ao nascimento entre 1,25 e 2,30kg, com baixo ganho de peso diário na maternidade, apresentaram efeito compensatório parcial no ganho de peso diário durante a creche.(AU)
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Animales , Porcinos , Peso al Nacer , Aumento de Peso , Animales Recién Nacidos/crecimiento & desarrolloRESUMEN
Background: Breast milk is first, natural and nutritious food for newborn that promote sensory and cognitive development as well as protect against infectious and chronic diseases. The aim and objective of the study was to estimate the prevalence and to point out determinants of cessation of exclusive breastfeeding among rural primi-para mothers.Methods: This is a hospital based cross sectional study conducted at rural tertiary health centre located Western Maharashtra, India in the month of November-December 2017. A total of 140 breastfeeding primi-para mothers were enrolled and interviewed by utilizing pretested questionnaire include socio-demographic data, obstetric and breastfeeding history after written consent. Data were analyzed for inferential statistics using SPSS Version 21.Results: Among 140 eligible mothers, max. 84.2% were in age group 18-24 years with high proportions, 72.8% housewives, 90% literate and 75.7% with joint family structure. Max. 92.1% mothers were institutionally delivered. The overall prevalence of cessation of exclusive breastfeeding was 22.85% with gradual and sudden cessation was 20% and 2.85% respectively. Maternal determinants like insufficient breast milk secretion (37.5%), maternal sickness (12.5%) were highly contributed for cessation of breastfeeding whereas, infant illness, 12.5% respectively. The nuclear family structure, caesarean delivery and low birth weight baby were significantly associated with cessation of exclusive breastfeeding. The risk of cessation of exclusive breastfeeding is of 4.5 and 2.5 times higher with maternal nuclear family structure and infant with low birth weight.Conclusions: Prevalence of cessation of exclusive breastfeeding was low among primi-para mothers residing in rural area of western Maharashtra, India. The nuclear family structure, low birth weight baby have had significant effect on cessation of exclusive breastfeeding.
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OBJECTIVE@#To explore the effect of auricula-point pressure combined with personalized music therapy on perioperative stress response in primipara.@*METHODS@#A total of 1000 primiparas who were elective for cesarean section were randomly divided into an observation group and a control group, 500 cases in each one. 1 h before surgery and 3 h, 6 h, 12 h and 24 h after surgery, individualized music relaxation intervention was given for 1 h in the two groups. On the basis of the treatment, auricular-point pressure was added at Pizhixia (AT), Shenmen (TF), Xin (CO), Zigong (uterus), Luanchao (ovary), Neishengzhiqi (TF) in the observation group. Each point was pressed for 1 min each time, repeated once every 15 min, the force is from light to heavy, and it is better to have a feeling of distension, sourness and radiation in the auricle. The scores of anxiety self-rating scale, visual analog scale (VAS), heart rate, systolic blood pressure, thyroid stimulating hormone, cortisol and blood glucose levels were observed in the two groups.@*RESULTS@#A total of 973 primiparas completed the clinical study in the end, including 488 patients in the observation group and 485 patients in the control group. Compared to enrollment, the scores of anxiety self-rating scale before entering the operating room in the two groups were significantly improved (<0.05), and the observation group was superior to the control group (<0.05). Entering the operating room and tracheal extubation, the heart rate and systolic blood pressure of the primiparas in the observation group were more stable than those in the control group, and the differences were statistically significant (<0.05). Entering the operating room, 1 h into the surgery and 3 h after surgery, the thyroid stimulating hormone, cortisol and blood glucose levels of the primiparas in the observation group were significantly better than those in the control group (<0.05). The VAS scores in the observation group at 6 h, 12 h and 24 h after surgery were lower than those in the control group (<0.05).@*CONCLUSION@#Auricular-point pressure combined with personalized music therapy can reduce the perioperative stress response in primipara and promote the improvement of psychological, physiological and emotional.
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Femenino , Humanos , Embarazo , Puntos de Acupuntura , Terapia por Acupuntura , Acupuntura Auricular , Cesárea , Música , Musicoterapia , Paridad , Atención PerioperativaRESUMEN
OBJECTIVE@#To explore the postoperative effect of auricular acupuncture on primipara with cesarean in order to promote postpartum rehabilitation.@*METHODS@#A total of 120 primiparas with cesarean were randomly divided into an observation group and a control group, 60 cases in each group. The routine treatment and care after surgery were given in the two groups. On the basis treatment, auricular acupuncture was applied at penqiang (TF), shenmen (TF), jiaogan (AH), pizhixia (AT), neishengzhiqi(TF), pi(CO), wei(CO) in the observation group, even-needling technique at all points. The needles were retained for 30 min, 3 times a day, the acupuncture was alternately every other day for 5 days continuously. The postpartum pain, anus exhaust time, incidence of postpartum hemorrhage, urinary retention and constipation, and postpartum average hospitalization day were recorded and compared between the two groups.@*RESULTS@#Twenty-seven cases of postpartum uterine contraction pain (45.0%), 25 cases of wound pain (41.7%), 19 cases of breast distending pain (31.7%) and 11 cases of muscle soreness (18.3%) in the observation group, which was significantly lower than 38 cases (63.3%), 36 cases (60.0%), 30 cases (50.0%) and 21 cases (35.0%) respectively in the control group (<0.05). The anus exhaust time in the observation group was earlier than that in the control group (<0.05), and the average hospitalization time was shorter than that in the control group (<0.05). The incidence of postpartum hemorrhage, urinary retention and constipation in the observation group was lower than that in the control group (<0.05).@*CONCLUSION@#Auricular acupuncture can effectively relieve postpartum pain in primipara with cesarean, promote postpartum exhaust and shorten hospitalization days, and reduce the incidence of postpartum complications such as postpartum hemorrhage, urinary retention and constipation, it is conducive to postpartum rehabilitation.