King Tekoa L, Pinger Whitney
J Midwifery Womens Health. 2014 Nov-Dec;59(6):572-585. doi: 10.1111/jmwh.12261.
Care for women in labor in the United States is in a period of significant transition. Many intrapartum care practices that are standard policies in hospitals today were instituted in the 20th century without strong evidence for their effect on the laboring woman, labor progress, or newborn outcomes. Contemporary research has shown that many common practices, such as routine intravenous fluids, electronic fetal monitoring, and routine episiotomies, do more harm than good. In 2010, the American College of Nurse-Midwives released a PowerPoint presentation titled Evidence-Based Practice: Pearls of Midwifery. This presentation reviews 13 intrapartum-care strategies that promote normal physiologic vaginal birth and are associated with a lower cesarean rate. They are also practices long associated with midwifery care. This article reviews the history of intrapartum practices that are now changing, the evidence that supports these changes, and the practical applications for the 13 Pearls of Midwifery.
美国对分娩期妇女的护理正处于重大转型期。如今医院里许多作为标准政策的产时护理做法是在20世纪确立的，当时并没有充分证据证明它们对分娩妇女、产程进展或新生儿结局有何影响。当代研究表明，许多常见做法，如常规静脉输液、电子胎儿监护和常规会阴切开术，弊大于利。2010年，美国助产士学院发布了一份名为《循证实践：助产精华》的幻灯片演示文稿。该演示文稿回顾了13种促进生理性阴道顺产且与较低剖宫产率相关的产时护理策略。这些也是长期以来与助产护理相关的做法。本文回顾了如今正在改变的产时做法的历史、支持这些改变的证据以及这13条助产精华的实际应用。
