Effect analysis of the cesarean scar pregnancy with intervention treatment and expectant treatment / 中国实用妇科与产科杂志

OBJECTIVE: To discuss the clinical significance of cesarean scar pregnancy with expectatant treatment.METHODS: Collect 21 cases of CSP between 2012 and 2017 in the Third Affiliated Hospital of Guangzhou Medical University.Group A had 8 cases who were pregnant again after intervention treatment,and group B had 13 cases who insisted on expecting treatment.We summarized clinical indexes of both groups,such as preserving uterus,bladder rupture,admission to ICU,blood transfusion,placenta implantation,etc. in order to further study the significance of expecting treatment for CSP.RESULTS: All of group A were pregnant again after intervention treatment,of whom 1 was CSP again and hysterectomy was performed at 15 weeks due to placenta implantation,while another 7 were uterine pregnancy,of whom 3 were term birth and had no placenta implantation,and another 4 were terminated in response to the requirements of patients,of whom 1 was treated with drug abortion and 3 underwent dilatation and curettage.Uterus was preserved in the 7 women,and there was no bladder rupture,no admission to ICU,no blood transfusion,and no placenta implantation.Among the 13 cases in group B, 6 cases underwent cesarean section during third trimester,including 3 cases of premature delivery and 3 cases of delivery at 37 weeks.5 cases were pregnant to second trimester,containing 4 cases received hysterectomy and 1 case suffered subtotal hysterectomy.2 cases were pregnant to first pregnancy, including 1 case of abdominal nidus resection, 1 case of ultrasound-guided dilation and curettage;Among the13 patients, 4 cases underwent bladder rupture, 4 cases lost uterus, 5 cases were admitted to the ICU, and 10 cases required blood transfusion.Placental implantation occurred in 11 cases who were pregnant to second and third trimester.CONCLUSION: Most of CSP with expecting treatment will develop into placenta implantation inevitably in the late stage of pregnancy.The patients with CSP can be pregnant again after early intervention and have extremely low possibility of a second CSP.

Effect of swimming and caressing on neonatal jaundice and weight / 现代临床护理

Objective To explore the effect of swimming and caressing on neonatal jaundice and weight.Methods Two hundred and forty newborns were divided equally into control and observation group with random digits table.The former received care with caressing and the latter with swimming and caressing.The two groups were compared in terms of weights and jaundice indices at birth and 7d after birth.Results Seven days after birth,the jaundice index in the observation group were lower than that of the control group and the weights of the observation group were larger(P<0.05).Conclusion Swimming and caressing are helpful for the development of neonates by C-sect and the reduction of jaundice duration.

Outcome analysis of capitation payment as used in hospital delivery / 中华医院管理杂志

Objective To study the impact of capitation payment on obstetric indicators for the maternity insurance of urban workers in Yinchuan city.Methods Collection of indicators on lying-in women hospitalized at the obstetrics departments of designated hospitals in Yinchuan,in the period of 2011 to 2012 when the capitation payment was put in place.Such indicators include the percentage of uterine-incision delivery,diagnostics and therapeutic expenses,drug expenses,and average days of stay,along with mortality of pregnant and lying-in women and that of newborns,which are used as indicators to measure quality of care.Results The capitation payment policy has witnessed drops in the percentage of uterine-incision delivery,cost per inpatient,drug expenses per inpatient and average days of stay among urban workers covered by the insurance.The drops amount to 10％ for cost per inpatient and 45％ for drug expenses per inpatient.The differences found in pregnant and lying-in women are not statistically significant.Conclusion Capitation payment is conducive to dropping the percentage of uterine-incision delivery and medical expenses,and saving medical insurance payment,for the sake of optimal use of healthcare resources.

Post-operative Preventive Medication of Antibacterials for Patients with Uterine-incision Delivery:Cost-effectiveness Analysis / 中国药房

OBJECTIVE:To compare the cost-effectiveness of4antibacterials in the prevention of post-operative in-fection in patients with uterine-incision delivery(UID).METHODS:A total of1066cases with UID were ascribed to receive cefoperazone sodium/sulbactam sodium+arilin(therapy A),ampicillin sodium/sulbactam sodium+arilin(B),cefradine+ar-ilin(C)and cefoperazone sodium/sulbactam sodium(D),respectively for the prevention of infection.The cost-effectiveness of the4groups was analyzed retrospectively.RESULTS:The costs of the4schemes were4954.13yuan,4752.77yuan,3870.16yuan and3988.22yuan,respectively;The effective rates were98.5%,87.4%,84.6%and96.8%,respectively;The cost-effectiveness ratios were50.30,54.38,45.75and41.20,respectively;The incremental cost-effectiveness ratios of scheme A,B and D were77.98,315.22and9.68,respectively as against scheme C.CONCLUSIONS:Scheme D is more economical and reasonable in the prevention of post-operative infection in patients with UID.

Acid-Base and Blood-Gas Status of Newborn Umbilical Blood according to Induction-Delivery and Uterine Incision-Delivery Intervals under General Anesthesia for Cesaeran Section / 대한마취과학회지

In cesarean section under general anesthesia, inhalation anesthetics may compound fetal acidosis brought by maternal hypoxia or uteroplacental insufficiency. The chance af fetal distress may be increased with prolonged induction-delivery (ID) and uterine incision-delivery (UD) intervals in such cases. These studies were undertaken to evaluate the changes of fetal acid-base and blood-gas status according to these intervals in 58 parturients given cesarean section under general anesthesia. 58 neonates were divided into three groups according to their ID interval [group 1 (N=26): less than 6 minutes, group 2 (N=25): 6 to 10 minutes, group 3 (N=7): 10 to 15 minutes] and four groups according to their UD interval[group A (N=25): less than 60 seconds, group B (N=22): 60 to 90 seconds, group C (N=9): 90 to 120 seconds, group D (N=2): 120 to 180 seconds]. The pH, PCO2, PO2 and HCO3 values of the umbilical vein blood at delivery in the groups 1, 2, 3 divided according to ID intervals were 7.37+/-0.03, 7.36+/-0.04, 7.36+/-0.03; 39.75+/-4.83, 41.76+/- 4.03, 38.81+/-2.31; 34.35+/-745, 32.65+/-9.63, 30.89+/-11.28 (in mmHg); and 23.21+/-0.33, 23.30+/-0.26, 22.15+/-0.52 (in mEq/L), respectively, and in groups A, B, C, D divided according to UD intervals, they were 7.37+/-0.02, 7.37+/-0.02, 7.37+/-0.03, 7.36+/-0.06; 40.30+/-5.20, 40,63+/-3.11, 39.96+/-4.42, 40.03 +/-5.09; 32.35+/-8.23, 31.82+/-0.17, 35.67+/-8.35, 33.53+/-10.53 (in mmHg); and 23.14+0.26, 23.60+/-0.36, 22.88+/-0.67, 23.35+/-0.35 (in mEq/L), respectively. No significant differences in these values were present between these ID- or UD- based groups.

Drugs Utilization Review of 513 Patients Undergoing Uterine-incision Delivery / 中国药房

1 were also high in DDDs(i.e.high dosage).CONCLUSION: The patients undergoing uterine-incision delivery had a high proportion in using antimicrobial drugs yet the choice of drug kinds was reasonable.However,great attention should be paid to the high dosage of some of the antimicrobial drugs.