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分娩第三阶段即刻实施袋鼠式护理对产后失血及子宫复旧的影响:一项半实验性比较研究。

The Effect of Immediate Kangaroo Mother Care During Third Stage of Labor on Postpartum Blood Loss and Uterine Involution: A Quasi-Experimental Comparative Study.

作者信息

Almutairi Wedad M, Raidi Dareen K

机构信息

Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah 22254, Saudi Arabia.

Nursing College, Bisha University, Bisha 67714, Saudi Arabia.

出版信息

Healthcare (Basel). 2024 Dec 17;12(24):2548. doi: 10.3390/healthcare12242548.

Abstract

BACKGROUND

Obstetric hemorrhage is the leading cause of maternal death worldwide. Obstetric hemorrhage accounts for 27.1% of all maternal death worldwide. Of all obstetric hemorrhages, postpartum hemorrhage (PPH) accounts for 72%. The physiological management of the third stage of labor is a growing area as a preventive measure to control postpartum blood loss. Immediate kangaroo mother care (KMC) is suggested as one of the physiological management methods of the third stage of labor to reduce postpartum blood loss. The duration of the third stage of labor, uterine involution, and amount of postpartum blood loss are the physiological parameters of effective management of the third stage of labor. Examining the absolute effects of immediate KMC on maternal physiological parameters is needed in different populations with different settings. Thus, this study aimed to examine the effects of immediate KMC on uterine involution and postpartum blood loss.

METHODS

A quasi-experimental comparative design was conducted in the labor and delivery room at Maternity and Children Hospital, Makkah, Saudi Arabia. A sample of 80 women was divided into two equal groups: a treatment group that underwent immediate KMC and a control group that received routine care.

INSTRUMENT

A questionnaire developed by the researchers was used to collect the data.

RESULTS

The effects of immediate KMC were significant concerning uterine involution and regarding the uterine position immediately after placenta separation (70% at umbilicus, χ = 8.5, < 0.01), postpartum blood loss (χ = 76.098, < 0.00), the heaviness of lochia (χ = 44.679, = 0.00), and the number of pads used in the first 24 h ( < 0.001).

摘要

背景

产科出血是全球孕产妇死亡的主要原因。产科出血占全球所有孕产妇死亡的27.1%。在所有产科出血中,产后出血(PPH)占72%。作为控制产后失血的预防措施,产程第三阶段的生理管理是一个不断发展的领域。即时袋鼠式护理(KMC)被建议作为产程第三阶段减少产后失血的生理管理方法之一。产程第三阶段的持续时间、子宫复旧和产后失血量是产程第三阶段有效管理的生理参数。需要在不同环境下的不同人群中研究即时KMC对孕产妇生理参数的绝对影响。因此,本研究旨在探讨即时KMC对子宫复旧和产后失血的影响。

方法

在沙特阿拉伯麦加市妇幼医院的产房进行了一项准实验性对照设计。80名妇女的样本被平均分为两组:接受即时KMC的治疗组和接受常规护理的对照组。

工具

使用研究人员编制的问卷收集数据。

结果

即时KMC对子宫复旧、胎盘娩出后即刻子宫位置(70%位于脐部,χ = 8.5,P < 0.01)、产后失血量(χ = 76.098,P < 0.00)、恶露量(χ = 44.679,P = 0.00)以及24小时内使用卫生巾的数量(P < 0.001)的影响显著。

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本文引用的文献

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Epidemiology and definition of PPH worldwide.全球产后出血的流行病学及定义
Best Pract Res Clin Anaesthesiol. 2022 Dec;36(3-4):325-339. doi: 10.1016/j.bpa.2022.11.001. Epub 2022 Nov 13.
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Effect of Maternal Body Mass Index on Postpartum Hemorrhage.母亲体重指数对产后出血的影响。
Anesthesiology. 2018 Apr;128(4):774-783. doi: 10.1097/ALN.0000000000002082.

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