Childbirth

分娩
  • 文章类型: Journal Article
    劳动是一个复杂的,主观体验,应考虑影响疼痛的所有因素,以确保全面评估。这项研究旨在确定性别角色是否可以预测分娩疼痛。该研究具有描述性和横截面设计。它是在2019年9月至2020年9月期间在土耳其一家城市医院的产房进行的。研究样本由231名初产妇进行分娩和分娩。数据是用描述性特征表格收集的,视觉模拟量表和Bem性别角色清单。采用描述性统计和简单回归分析对所得数据进行分析。回归分析表明,性别角色是潜在分娩疼痛的预测因素,活跃,和过渡阶段,但不是在第二阶段。性别角色是潜伏期分娩疼痛的主要原因。研究结果表明,性别角色可能是预测女性分娩疼痛的有用变量,并为相关文献做出了贡献。提供分娩疼痛护理的护士和助产士应将性别角色视为影响分娩疼痛的因素。还必须个性化分娩期间给予的辅助护理。
    Labor is a complex, subjective experience, and all factors that influence pain should be considered to ensure a comprehensive evaluation. This study aimed to determine whether gender roles were predictive of labor pain. The study has a descriptive and cross-sectional design. It was carried out in a delivery room of a city hospital in Turkey between September 2019 and September 2020. The study sample consisted of 231 primiparous women presenting for labor and delivery. Data were gathered with a descriptive characteristics form, Visual Analogue Scale and The Bem Sex-Role Inventory. Descriptive statistics and simple regression analysis were employed to analyze the obtained data. Regression analysis demonstrated that gender roles were predictive of labor pain in the latent, active, and transitional stages, but not in the second stage. Gender roles were most responsible for labor pain in the latent phase. Results of the study revealed that gender roles may be useful variables to predict women\'s labor pain, and contributed to the relevant literature. Nurses and midwives offering care for labor pain should consider gender roles as a factor affecting labor pain. It is also necessary to individualize the supporting care given during labor.
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  • 文章类型: Journal Article
    背景:经医学证明,剖腹产(CS)可以挽救母亲及其新生儿的生命。这项研究评估了CS的患病率及其相关因素,关注尼日利亚农村和城市地区之间的不平等。
    方法:我们对2018年尼日利亚人口和健康调查进行了分类,并分别对尼日利亚的总体情况进行了分析。农村,和城市住宅。我们使用频率表汇总数据,并通过多变量逻辑回归分析确定与CS相关的因素。
    结果:尼日利亚的CS患病率为2.7%(总体),城市为5.2%,农村为1.2%。西北地区的患病率最低,为0.7%,整体为1.5%和0.4%,城市和农村地区,分别。受过高等教育的母亲表现出更高的CS患病率,总体为14.0%,城市住宅占15.3%,农村住宅占9.7%。频繁使用互联网增加了全国(14.3%)以及城市(15.1%)和农村(10.1%)居民的CS患病率。南部地区的CS患病率较高,西南地区总体领先(7.0%),农村地区领先(3.3%),城市地区的南南最高(8.5%)。在所有住宅中,丰富的财富指数,产妇年龄≥35岁,出生顺序较低,≥8次产前(ANC)接触增加了CS的几率。在尼日利亚农村,丈夫\'教育,配偶联合医疗决策,出生尺寸,和计划外怀孕增加CS的几率。在尼日利亚城市,多胎,基督教,经常使用互联网,并且获得访问医疗机构的许可容易与CS的可能性更高相关。
    结论:尼日利亚的CS利用率仍然很低,并且在农村和城市之间有所不同,区域,和社会经济鸿沟。对所有地区未受过教育和社会经济上处于不利地位的母亲,必须采取有针对性的干预措施,以及城市地区坚持伊斯兰教的母亲,传统,或\'其他\'宗教。综合干预措施应优先考虑教育机会和资源,尤其是农村地区,关于医学上指示的CS益处的宣传运动,并与社区和宗教领袖接触,以使用文化和宗教敏感的方法促进接受。其他实际策略包括促进最佳的ANC联系,扩大互联网接入和数字素养,特别是对于农村妇女(例如,通过社区Wi-Fi计划),改善低CS患病率地区的医疗基础设施和可及性,特别是在西北部,实施社会经济赋权计划,特别是农村地区的妇女。
    BACKGROUND: When medically indicated, caesarean section (CS) can be a life-saving intervention for mothers and their newborns. This study assesses the prevalence of CS and its associated factors, focussing on inequalities between rural and urban areas in Nigeria.
    METHODS: We disaggregated the Nigeria Demographic and Health Survey 2018 and performed analyses separately for Nigeria\'s overall, rural, and urban residences. We summarised data using frequency tabulations and identified factors associated with CS through multivariable logistic regression analysis.
    RESULTS: CS prevalence was 2.7% in Nigeria (overall), 5.2% in urban and 1.2% in rural areas. The North-West region had the lowest prevalence of 0.7%, 1.5% and 0.4% for the overall, urban and rural areas, respectively. Mothers with higher education demonstrated a greater CS prevalence of 14.0% overall, 15.3% in urban and 9.7% in rural residences. Frequent internet use increased CS prevalence nationally (14.3%) and in urban (15.1%) and rural (10.1%) residences. The southern regions showed higher CS prevalence, with the South-West leading overall (7.0%) and in rural areas (3.3%), and the South-South highest in urban areas (8.5%). Across all residences, rich wealth index, maternal age ≥ 35, lower birth order, and ≥ eight antenatal (ANC) contacts increased the odds of a CS. In rural Nigeria, husbands\' education, spouses\' joint healthcare decisions, birth size, and unplanned pregnancy increased CS odds. In urban Nigeria, multiple births, Christianity, frequent internet use, and ease of getting permission to visit healthcare facilities were associated with higher likelihood of CS.
    CONCLUSIONS: CS utilisation remains low in Nigeria and varies across rural-urban, regional, and socioeconomic divides. Targeted interventions are imperative for uneducated and socioeconomically disadvantaged mothers across all regions, as well as for mothers in urban areas who adhere to Islam, traditional, or \'other\' religions. Comprehensive intervention measures should prioritise educational opportunities and resources, especially for rural areas, awareness campaigns on the benefits of medically indicated CS, and engagement with community and religious leaders to promote acceptance using culturally and religiously sensitive approaches. Other practical strategies include promoting optimal ANC contacts, expanding internet access and digital literacy, especially for rural women (e.g., through community Wi-Fi programs), improving healthcare infrastructure and accessibility in regions with low CS prevalence, particularly in the North-West, and implementing socioeconomic empowerment programs, especially for women in rural areas.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    丈夫和男性伴侣参与分娩不再在受孕和怀孕时停止,相反,父亲希望在分娩期间更多地参与支持他们的伴侣。这与世界卫生组织(WHO)呼吁促进男性参与分娩一致,强调支持的好处和分娩对丈夫/伴侣的积极影响,和他们的伴侣。这些知识导致了促进“人性化”出生和家庭方法的全球倡议。从父亲的角度深入了解和理解分娩出勤,提出了一种定性证据综合方法。
    要探索父亲的经历,视图,以及分娩出勤的观点。所有使用定性方法来探索感兴趣现象的研究都将包括在内。MEDLINE,CINAHL,PsycINFO,MIDIRS,WebofScience,谷歌学者将从成立日期到现在进行系统搜索,辅以灰色文献搜索和纳入研究的参考列表搜索。电子搜索策略同行评审(PRESS)将用于确保搜索策略的全面性。纳入研究的方法学质量评估,使用关键评估技能计划评估工具,并将由两名评审员独立使用标准数据提取表格从纳入的研究中提取。Thomas和Harden的三阶段方法将用于以主题方式合成数据:数据编码,发展描述性主题,以及分析主题的生成。建议评估的分级,发展,和对来自定性研究评论的证据的评估信心(对综合发现的GRADE-CERQual信心将确定对父亲分娩的观点的全面见解和理解。
    CRD42023470902。
    UNASSIGNED: The involvement of husbands and male partners in childbirth no longer ceases at conception and pregnancy, rather fathers wish to be more involved in supporting their partners during childbirth. This aligns with the World Health Organization\'s (WHO) call for promoting male participation in childbirth, emphasising the benefits of support and the positive impact attending childbirth has for husbands/partners, and their maternal partner. This knowledge has led to global initiatives promoting \"humanised\" birth and a family-approach. To gain in-depth insight and understanding of childbirth attendance from the perspectives of fathers, a qualitative evidence synthesis is proposed.
    UNASSIGNED: To explore fathers\' experiences, views, and perspectives of childbirth attendance. All studies that used qualitative methodologies to explore the phenomenon of interest will be included. MEDLINE, CINAHL, PsycINFO, MIDIRS, Web of Science, and Google Scholar will be systematically searched from their dates of inception to present, supplemented by a search for grey literature and a search of the reference list of included studies. Peer Review of Electronic Search Strategies (PRESS) will be used to ensure the comprehensiveness of the search strategy. Methodological quality assessment of included studies, using The Critical Appraisal Skills Programme assessment tool, and will be extracted from the included studies by two reviewers independently using a standard data extraction form. Thomas and Harden\'s three-stage approach will be used to thematically synthesise the data: coding of data, developing descriptive themes, and generation of analytical themes. The Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual confidence in the synthesised findings Comprehensive insight and understanding of fathers\' perspectives of childbirth attendance will be ascertained.
    UNASSIGNED: CRD42023470902.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:描述生活在约旦的妇女在生下第一个新生儿后重返学术岗位的经历。
    方法:定性描述性现象学设计。
    方法:约旦一所政府大学内的各种学校。这项研究描述了在约旦阿拉伯父权制社区背景下,学术界女性经历的挑战。
    方法:15名女性重返学术岗位的目的性样本。
    方法:非结构化,面对面,对女性在生下第一个新生儿后3个月内重返学术岗位的深入采访。使用Braun和Clarke的主题分析过程对记录的访谈进行了分析。
    结果:出现了三个主要主题:生活在混乱中,迫切需要过渡时间,并寻求帮助和支持。参与者将他们重返工作岗位描述为一个充满混乱和不稳定感的时期,他们感到失去了对自己生活的控制。他们表示,在恢复全职学术职位之前,迫切需要一段过渡期,强调逐步回归的重要性。最后,参与者分享了他们日常生活中额外需求的挣扎。作为职业母亲,参与者在试图履行日常职责时经历了极端的痛苦。他们强调在这个充满挑战的时期缺乏足够的支持。
    结论:生下第一个新生儿后重返学业的女性需要在身体和情感上为新生活的变化和责任做好准备。更长的产假或过渡期可以帮助在学术界工作的妇女管理多种母亲角色的需求以及她们的专业承诺。这些发现突出表明,缺乏支持学术界妇女在产假后重返工作岗位所需的正式政策。
    OBJECTIVE: To describe the experiences of women living in Jordan returning to work at their academic positions after giving birth to their first newborns.
    METHODS: Qualitative descriptive phenomenological design.
    METHODS: Various schools within a governmental university in Jordan. This study describes the challenges women in academia experience in the context of Jordan\'s Arabic patriarchal communities.
    METHODS: A purposive sample of 15 women returning to their academic positions.
    METHODS: Unstructured, face-to-face, in-depth interviews of women returning to their academic positions within 3 months after giving birth to their first newborns. The recorded interviews were analyzed using Braun and Clarke\'s thematic analysis process.
    RESULTS: Three major themes emerged: Living in Chaos, The Urgent Need for Transitional Time, and Calling for Help andSupport. Participants described their return to work as a period marked by a sense of chaos and instability, in which they felt a loss of control over their lives. They expressed a pressing need for a transitional period before resuming full-time academic roles, highlighting the importance of a gradual return. Finally, participants shared their struggles with the extra demands added to their daily routine. As working mothers, participants experienced extreme distress while attempting to fulfill their daily responsibilities. They emphasized the lack of adequate support in this challenging period.
    CONCLUSIONS: Women returning to their academic work after giving birth to their first newborns need to be prepared physically and emotionally for the changes and responsibilities of their new life. A longer period of maternity leave or a transitional period may help women working in academia to manage the demands of multiple maternal roles alongside their professional commitments. These findings highlight the absence of formal policies needed to support women in academia in their return to work after maternity leave.
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  • 文章类型: Journal Article
    目的:这项研究探讨了在马拉维的三个机构中,产妇接近失职的妇女的经历以及她们对护理质量的看法。
    方法:本研究采用定性现象学方法。使用深度访谈收集数据,并使用主题内容分析进行分析。这些数据是在2020年9月至11月期间在三家医院收集的。有目的地选择的参与者是18名符合与产科出血相关的产妇接近错过标准的女性(6),高血压疾病(7),败血症(2)和异位妊娠破裂(3)。
    结果:妇女对母亲近错过的经历分为四个主要主题;(a)近错过的认识;(b)近错过的宗教信仰和解释;(c)母亲近错过的社会和经济方面;d)对护理质量的看法。女性最初的情绪反应是恐惧和焦虑,但很快就被对婴儿幸福的恐惧所掩盖。大多数妇女认为她们得到的护理是及时的,adequate,尊重,然而,许多妇女也表示,她们的服务提供者没有提供公开讨论她们病情的机会。
    结论:差点错过的经历超越了直接的身体不适,具有心理上的,经济,以及对妇女及其家庭的社会后果。尽管女性认为护理是尊重的,与他们的服务提供商仍然存在沟通差距。在严重发病的情况下,改善提供者与患者及其家人之间沟通的运动值得考虑。
    OBJECTIVE: This study explored the experiences of women with maternal near miss and their perceptions of the quality of care they received in three facilities in Malawi.
    METHODS: This study employed a qualitative phenomenological approach. Data were collected using in depth interviews and analysed using thematic content analysis. The data were collected in three hospitals between September and November 2020. The purposively selected participants were 18 women meeting criteria for maternal near miss related to obstetric haemorrhage (6), hypertensive disorders (7), sepsis (2) and ruptured ectopic pregnancy (3).
    RESULTS: Women\'s experiences of maternal near miss fell under four broad themes; (a) realisation of the near miss; (b) religious beliefs and interpretation of near miss; (c) social and economic aspects of maternal near miss; and d) perceptions of quality of care. Women\'s initial emotional responses were fear and anxiety but were soon overshadowed by the fear for their babies\' wellbeing. Most women perceived the care they received as timely, adequate, and respectful, yet many women also expressed that their service providers did not provide an opportunity to openly discuss their condition.
    CONCLUSIONS: The experience of near miss goes beyond the immediate physical discomforts and has psychological, economic, and social consequences for women and their families. Despite women\'s perception of care as respectful, there are still communication gaps with their service providers. Campaigns to improve the communication between providers and patients and their families in situation of severe morbidity warrant consideration.
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  • 文章类型: Journal Article
    目的:本研究旨在确定匈牙利罗姆妇女在产妇护理方面的歧视,由于种族和社会经济因素。
    方法:我们使用了18匈牙利出生队列研究的数据,涵盖2018-2019年的出生人数(n=7805)。健康访客在怀孕期间和产后六个月进行了面对面的访谈。使用Welch的方差分析测试了产科护理的差异。Logistic回归模型估计了罗姆人对出生位置的影响,调整社会经济变量。计算具有95%置信区间的赔率比和调整后的预测。
    结果:由于计划干预措施较少,罗姆母亲的剖腹产率较低(13.3%vs.非罗姆母亲的19.1%)。罗姆妇女与非罗姆妇女相比,由私人产科医生分娩的可能性较小(15%vs.52.6%),并且在出生时有家庭成员在场的可能性较小(40%与65.5%)。对于阴道分娩,61.3%的罗姆妇女的出生位置由医院工作人员决定,非罗姆妇女的比例为40.6%。种族背景显著影响出生位置的选择,但这些关联在调整社会经济和地域因素后减弱。变量,如私人产科医生的存在,家庭支持,和居住在匈牙利中部减少了在固定位置分娩的可能性。
    结论:在匈牙利,罗姆妇女在产妇保健方面面临着明显的劣势。民族背景对护理质量有负面影响,但它也受到不利的社会经济和区域因素的显著影响。
    OBJECTIVE: This study aims to identify discrimination in maternity care experienced by Roma women in Hungary, due to ethnic and socio-economic factors.
    METHODS: We used data from the Cohort\'18 Hungarian Birth Cohort Study, covering births in 2018-2019 (n = 7805). Face-to-face interviews were conducted by health visitors during pregnancy and six months postpartum. Differences in obstetric care were tested using Welch\'s ANOVA. Logistic regression models estimated the influence of Roma ethnicity on birth position, adjusting for socio-economic variables. Odds ratios with 95 % confidence intervals and adjusted predictions were calculated.
    RESULTS: Roma mothers had a lower rate of caesarean section due to fewer planned interventions (13.3% vs. 19.1% for non-Roma mothers). Roma women were less likely than non-Roma women to have a birth attended by a private obstetrician (15% vs. 52.6%) and less likely to have a family member present at the birth (40% vs. 65.5%). For vaginal births, 61.3% of Roma women had their birth position dictated by hospital staff, compared with 40.6% of non-Roma women. Ethnic background significantly influenced the choice of birth position, but these associations were attenuated after adjustment for socio-economic and territorial factors. Variables such as the presence of a private obstetrician, family support, and residence in Central Hungary reduced the likelihood of giving birth in a fixed position.
    CONCLUSIONS: Roma women face significant disadvantages in maternity care in Hungary. Ethnic background has a negative impact on the quality of care, but it is also significantly influenced by adverse socio-economic and regional factors.
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  • 文章类型: Journal Article
    这项试点横断面研究旨在确定厄瓜多尔近年来产科暴力的概况。在2022年3月至2022年4月之间进行了一项在线调查,其中包括18岁以上知情同意参加的女性(n=1598)。我们使用非概率抽样来获得我们的样本。费舍尔的精确检验是为了评估暴力和出生类型之间的关联,医疗机构,和教育水平。在参与这项研究的妇女中,89.2%(n=1426)认为自己是梅斯蒂扎。此外,88.3%(n=1411)完成了大学教育。大多数参与者,具体为63.6%(n=1017),在公共机构接受了他们的照顾,98.2%(n=1569)报告结构性疏忽,74.5%(n=1190)的人报告侵犯了他们的知情权。整个样本肯定经历了对在场权的侵犯。该报告显示,厄瓜多尔以不同的方式存在产科暴力,妇女在分娩期间遭受疏忽和侵犯其接受道德保健的权利。
    This pilot cross-sectional study was designed to determine the profile of obstetric violence in Ecuador in recent years. An online survey was conducted between March 2022 and April 2022, including women over 18 years who granted their informed consent to participate (n = 1598). We used non-probabilistic sampling to obtain our sample. Fisher\'s exact test was performed to assess the association between violence and type of birth, healthcare facility, and education level. Out of the women who participated in the study, 89.2% (n = 1426) identified themselves as Mestiza. Additionally, 88.3% (n = 1411) had completed university-level education. The majority of the participants, specifically 63.6% (n = 1017), received their care in public institutions, and 98.2% (n = 1569) reported structural negligence, while 74.5% (n = 1190) reported violation of their right to information. The entire sample affirmed to have experienced violation of the right of presence. This report shows that obstetric violence is present in Ecuador in different ways and that women experience negligence and violation of their right to receive ethical healthcare during childbirth.
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  • 文章类型: Journal Article
    目的:本研究旨在了解大动脉炎(TAK)患者原发疾病的药物治疗现状及妊娠结局,以及儿童的出生结局。
    方法:本研究回顾性招募了TAK患者,这些患者在疾病发作后受孕,并在参加卫生部日本研究委员会的医疗机构进行管理,劳工,以及顽固性血管炎的福利。
    结果:本研究纳入了51例病例和68例2019-2021年怀孕。其中,48例和65例怀孕(95.6%)导致分娩和活产婴儿。诊断和分娩的中位年龄分别为22岁和31岁。孕前治疗包括泼尼松龙(PSL)51(78.5%,中位数7.5毫克/天),18例免疫抑制剂(27.7%),和生物制剂在12(18.5%)怀孕。6例妊娠前行手术治疗。怀孕期间的药物包括48例PSL(73.8%,中位数:9毫克/天),免疫抑制剂13例(20.0%),9例(13.8%)怀孕中的生物制剂。据报道,在一次怀孕中动脉瘤增大,这可能与循环血浆体积增加有关。TAK在怀孕期间和分娩后的4例(6.2%)和8例(12.3%)妊娠中复发,分别。此外,观察到13/62(20.9%)早产儿和17/59(28.8%)低出生体重儿,没有人出现严重的产后异常。在51名确诊的婴儿中,42(82.4%)是纯母乳喂养或与配方混合。
    结论:大多数TAK患者的妊娠在PSL≤10mg/天的情况下是可以控制的。怀孕期间和产后复发发生在<20%的怀孕中。
    OBJECTIVE: This study aimed to understand the status quo of medical treatments of the primary disease and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children\'s birth outcomes.
    METHODS: This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Intractable Vasculitis.
    RESULTS: This study enrolled 51 cases and 68 pregnancies 2019-2021. Of these, 48 cases and 65 pregnancies (95.6%) resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. Enlargement of an aneurysm was reported in one pregnancy, which might be associated with increased circulating plasma volume. TAK relapsed in 4 (6.2%) and 8 (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low birth weight infants were observed, and none had serious postnatal abnormalities. Of the 51 confirmed infants, 42 (82.4%) were exclusively breastfed or mixed with formula.
    CONCLUSIONS: Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.
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