Bardzulin N T, Bochoriashvili K A, Abashidze Ts T, Konaia N A
Georgian Med News. 2006 Sep(138):45-8.
The implementation of evidence-based effective perinatal care in Georgia is very limited. This study was planned as descriptive to define the results of implementation of effective perinatal care technologies, to compare them with existed obstetric practices and reliable research summaries. We identified procedures which should be avoided as routine and practices that should be encouraged. The rate of existed practices was defined retrospectively through analyses of hospital records and interview with health care providers participating in labor and delivery process. The results of implementation of effective perinatal care technologies were determined by exit interviews with postpartum women, verified using hospital notes. The four practices widely used in obstetric care where evidence suggests that they should be avoided as routine, decreased after implementation of effective perinatal care technologies: use of pubic shaving dropped from 97% to 6%, enema from 98% to 5%, episiotomy from 82% to 21%, and lithotomic position from 100% to 30%. Social support or companionship during labor and delivery has been encouraged and used routinely. Obstetric practice must follow best available evidence. There is a need to implement widely effective perinatal care technologies and develop evidence-based clinical practice guidelines which will ensure progressive changes in clinical practice.
格鲁吉亚循证有效围产期护理的实施非常有限。本研究计划为描述性研究，旨在界定有效围产期护理技术的实施结果，将其与现有的产科实践及可靠的研究综述进行比较。我们确定了应避免作为常规操作的程序以及应鼓励的做法。通过分析医院记录以及与参与分娩过程的医疗服务提供者进行访谈，回顾性地确定现有做法的比例。通过对产后妇女进行出院访谈并利用医院记录加以核实，来确定有效围产期护理技术的实施结果。在产科护理中广泛使用的四种做法，有证据表明应避免将其作为常规操作，在实施有效围产期护理技术后有所减少：会阴备皮从97%降至6%，灌肠从98%降至5%，会阴切开术从82%降至21%，截石位从100%降至30%。分娩期间的社会支持或陪伴已得到鼓励并被常规采用。产科实践必须遵循最佳现有证据。有必要广泛实施有效的围产期护理技术，并制定循证临床实践指南，以确保临床实践的逐步改变。
