[关于在分娩期间驱逐努力的管理方式的更新]
Ninon Dupuis1, Camille Le Ray2
1Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, université de Paris, Inserm, INRA, Paris, France; Pôle de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 31059 Toulouse, France.
Gynecologie, obstetrique, fertilite & senologie
|April 14, 2024
概括
优化分娩的第二阶段包括管理驱逐力度,以尽量减少母亲和新生儿的并发症. 一个个性化的方法,以女性为中心.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 围产期护理 围产期护理
背景情况:
- 劳动的第二阶段,包括被动和活跃的阶段与驱逐力度,需要谨慎管理,以防止孕产妇和新生儿并发症.
- 长时间的驱逐力度与产后出血,围外伤和母亲长期失禁等风险增加有关.
- 与驱逐努力相关的新生儿风险包括酸化,窒息,新生儿重症监护室入院和出生创伤.
研究的目的:
- 审查和分析当前的策略,在劳动的第二阶段管理驱逐力度.
- 确定最优的方法,尽量减少孕产妇/新生儿并发症和医疗干预.
- 评估各种管理方面,包括时间,持续时间,推动技术和母亲的定位.
主要方法:
- 关于劳动第二阶段管理的当前研究的文献综述.
- 对比立即推与延迟推的研究的分析.
- 检查不同的推力方式 (强度,大脑的使用) 和母亲的位置.
主要成果:
- 目前的文献不支持驱逐努力的特定技术或持续时间,以普遍减少母亲或新生儿并发症.
- 有证据表明需要考虑各种因素,如推进时间,持续时间,技术和母亲的位置.
- 没有一个单一的方法在预防不良结果方面被最终证明是优越的.
结论:
- 劳动的第二阶段的最佳管理需要一个个性化的方法,根据每个妇女的情况量身定制.
- 将照顾的重点放在女性身上,将她的偏好纳入决策,对于有效的管理至关重要.
- 个性化策略尊重母亲的自主权,并可能改善分娩经验和结果.
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