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产妇保健专业人员对脐带夹闭时机、脐血库和脐血捐赠的看法:一项定性研究。

Maternity health professionals' perspectives of cord clamp timing, cord blood banking and cord blood donation: a qualitative study.

机构信息

Clinical Nursing - Maternal, Child and Family Health, The University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia.

The University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia.

出版信息

BMC Pregnancy Childbirth. 2020 Jul 16;20(1):410. doi: 10.1186/s12884-020-03102-8.

Abstract

BACKGROUND

Parents today have several options for the management of their infant's cord blood during the third stage of labour. Parents can choose to have their infant's cord clamped early or to have deferred cord clamping. If the cord is clamped early, cord blood can be collected for private cord blood banking or public cord blood donation for use later if needed. If cord clamping is deferred, the placental blood physiologically transfuses to the neonate and there are physiological advantages to this. These benefits include a smoother cardiovascular transition and increased haemoglobin levels while not interfering with the practice of collecting cord blood for gases if needed. The aim of this study is to explore Australian maternity health professionals' perspectives towards cord clamp timing, cord blood banking and cord blood donation.

METHODS

Fourteen maternity health professionals (midwives and obstetricians) from both private and public practice settings in Australia participated in semi-structured interviews either in person or by telephone. Interviews were transcribed and data analysed using thematic analysis.

RESULTS

Overall there was strong support for deferred cord clamping, and this was seen as important and routinely discussed with parents as part of antenatal care. However, support did not extend to the options of cord blood banking and donation and to routinely informing parents of these options even when these were available at their birthing location.

CONCLUSION

Formalised education for maternity health professionals is needed about the benefits and implications of cord blood banking and cord blood donation so that they have the confidence to openly discuss all options of cord clamp timing, cord blood banking and cord blood donation to facilitate informed decision-making by parents.

摘要

背景

如今,父母在分娩第三阶段有几种选择来处理婴儿脐带血。父母可以选择尽早夹住婴儿的脐带,也可以选择延迟夹住脐带。如果尽早夹住脐带,可以收集脐带血用于私人脐带血库存储或公共脐带血捐赠,以备将来需要时使用。如果延迟夹住脐带,胎盘血会生理性地输送给新生儿,这具有生理优势。这些益处包括更平稳的心血管过渡和血红蛋白水平升高,同时不会干扰在需要时采集脐带血进行血气分析的操作。本研究旨在探讨澳大利亚产妇保健专业人员对脐带夹闭时机、脐带血库存储和脐带血捐赠的看法。

方法

来自澳大利亚私人和公共医疗机构的 14 名产妇保健专业人员(助产士和产科医生)参与了面对面或电话形式的半结构化访谈。访谈记录被转录,数据采用主题分析方法进行分析。

结果

总体而言,延迟夹住脐带得到了强烈支持,这被认为很重要,并作为产前护理的一部分与父母进行了常规讨论。然而,这种支持并不延伸到脐带血库存储和捐赠的选择,也不会向父母常规告知这些选择,即使在他们分娩的地方可以提供这些选择。

结论

需要为产妇保健专业人员提供有关脐带血库存储和捐赠的益处和影响的规范化教育,以便他们有信心公开讨论脐带夹闭时机、脐带血库存储和脐带血捐赠的所有选择,从而促进父母知情决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ef9/7364524/0d2042d1fa88/12884_2020_3102_Fig1_HTML.jpg

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