评估阴道分娩中分娩期护理的内容与质量：以一家州立医院为例。
Evaluating the content and quality of intrapartum care in vaginal births: An example of a state hospital.
作者信息
Karaçam Zekiye, Arslan Kurnaz Döndü, Güneş Gizem
机构信息
Adnan Menderes University Faculty of Health Sciences, Division of Midwifery, Aydın, Turkey.
Aydın Maternity and Children's Hospital, Clinic of Birth, Aydın, Turkey.
出版信息
Turk J Obstet Gynecol. 2017 Mar;14(1):10-17. doi: 10.4274/tjod.88123. Epub 2017 Mar 15.
OBJECTIVE
The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital.
MATERIALS AND METHODS
This cross-sectional study was conducted between January 1, 2013 and December 31, 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling. Research data were collected with a questionnaire created by the researchers and assessed using the Bologna score. Numbers and percentages were assessed in the data analysis.
RESULTS
The mean age of the women was 25.14±5.37 years and 40.5% had given one live birth. Of the women, 45.2% were admitted to hospital in the latent phase, 76.6% were administered an enema, 3.3% had epidural anesthesia, 2.6% delivered using vacuum extraction, and 54.1% underwent an episiotomy. Some 23.8% of the women experienced spontaneous laceration that needed sutures. The babies of two women exhibited an Apgar score below 7 in the fifth minute. When the quality of the intrapartum care given to the women was assessed with the Bologna score, it was found that 92.7% went into labor spontaneously, 100% of the births were supervised by midwives and doctors, 97.7% of the women had no supporting companion, and the nonsupine position was only used in 0.3% of the women. A partogram was used to follow up on the birth process in 72.6% of the women, and 82.5% achieved contact with their babies within the first hour after birth. Induction was applied in 76.6% of the women and fundal pressure in 27.4%.
CONCLUSION
The study revealed that the quality of intrapartum care in vaginal births was inadequate. Reformulating the guidelines regarding intrapartum care in accordance with World Health Organization recommendations and evidence-based practices may contribute to improving mother and infant health.
目的
本研究旨在以一家国立医院为例，评估土耳其阴道分娩中所提供的产时护理的内容和质量。
材料与方法
本横断面研究于2013年1月1日至2014年12月31日在艾登妇幼医院开展。研究样本包括303名阴道分娩的女性，采用便利抽样法纳入研究。研究数据通过研究人员编制的问卷收集，并使用博洛尼亚评分进行评估。数据分析中评估了数字和百分比。
结果
这些女性的平均年龄为25.14±5.37岁，40.5%的女性曾有过一次活产。其中，45.2%的女性在潜伏期入院，76.6%的女性接受了灌肠，3.3%的女性接受了硬膜外麻醉，2.6%的女性使用真空吸引器分娩，54.1%的女性接受了会阴切开术。约23.8%的女性发生了需要缝合的自发性裂伤。两名女性的婴儿在出生后第5分钟时阿氏评分低于7分。当用博洛尼亚评分评估给予这些女性的产时护理质量时，发现92.7%的女性自然临产，100%的分娩由助产士和医生监护，97.7%的女性没有陪护人员陪伴，仅0.3%的女性采用了非仰卧位。72.6%的女性使用产程图来监测分娩过程，82.5%的女性在产后第一小时内与婴儿进行了接触。76.6%的女性采用了引产，27.4%的女性采用了宫底加压。
结论
该研究表明，阴道分娩中产时护理的质量不足。根据世界卫生组织的建议和循证实践重新制定产时护理指南，可能有助于改善母婴健康。
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