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Goal-directed Fluid Therapy May Improve Hemodynamic Stability of parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

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Chinese Medical Journal 2015年第14期128卷 1922-1931页

作者： Wei Xiao Qing-Fang Duan Wen-Ya Fu Xin-Zuo Chi Feng-Ying Wang Da-Qing Ma Tian-Long Wang Lei Zhao Department of Anesthesiology Xuan Wu Hospital Capital Medical University Beijing 100053 China Department of Obstetrics and Gynecology Xuan Wu Hospital Capital Medical University Beijing 100053 China Department of Surgery and Cancer Pain Medicine and Intensive Care Faculty of Medicine Chelsea and Westminster Hospital Imperial College London United Kingdom

Background： Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy （HDP） can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy （GDFT） with LiDCOrapid system can improve well-being of both HDP parturient and their babies. Methods： Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer＇s solution （LR）, parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume （ASV） provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. Results： The severity of HDP was similar between two groups. The total LR infusion （P 〈 0.01） and urine output （P 〈 0.05） were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group （P 〈 0.01）. There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased （P 〈 0.05）, and the incidences of neonatal hypercapnia and hypoxemia were statistically increased （P 〈 0.05） than in the GDFT group. Conclusions： Dynamic responsiveness guided fluid therapy with the LiDCOrapid system may provide po

关键词： Cesarean Delivery Fluid Therapy Hypertensive Disorders of Pregnancy LiDCOrapid System parturient

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Effect of Resistance Training,Aerobic Exercise Before Doula-Assisted Delivery on the Psychological Well-Being and Labor Duration of parturients

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Journal of Clinical and Nursing Research 2023年第6期7卷 118-123页

作者： Jing Zhou Sha Tang Li Zhou Cong Jiang Wenjian Fan Department of Obstetrics and Gynecology Second People’s Hospital of Banan DistrictChongqing 400054China

Objective:To investigate the impact of resistance training and aerobic exercise before doula-assisted delivery on the psychological well-being and labor duration of ***:105 cases of parturients who gave birth in our hospital from February 2021 to April 2023 were included in this *** patients were divided into a control group of 52 cases and an observation group of 53 *** patients in the control group received no particular intervention before delivery and only received doula *** patients in the observation group received resistance training,aerobic exercise,and doula assistance prior to giving *** delivery,the mothers were observed for 2 hours in the delivery room and then returned to the maternal and infant *** observation indicators of the two groups were ***:In comparison to the control group,the observation group exhibited shorter durations in the first,second,and third stages of labor,as well as the total delivery ***,the amount of postpartum blood loss at 2 hours was smaller in the observation *** rate of cesarean section was lower,and the rate of vaginal natural delivery was higher in the observation *** the intervention,both groups of postpartum women showed decreased SAS and SDS scores compared to before the ***,the observation group had lower scores than the control *** differences were all statistically significant(Pparturients,shorten labor duration,increase the rate of natural vaginal delivery,and reduce pain and postpartum hemorrhage.

关键词： Doula assistance Resistance training Aerobic exercise parturient Psychological state Labor duration

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Determinants of Home Birth in the Community of Dagbati in Togo

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Open Journal of Obstetrics and Gynecology 2022年第6期12卷 520-527页

作者： Améyo Ayoko Ketevi Akila Bassowa Bidilukinu Katende Dédé Régine Diane Ajavon Adjo Sylvie Biwuh Alessi Andele Abdoul-Samadou Aboubakari Koffi Akpadza Department of Gynecology-Obstetrics Sylvanus Olympio Teaching Hospital Lome Togo Department of Gynecology-Obstetrics Campus Teaching Hospital Lome Togo Department of Gynecology-Obstetrics Regional Hospital Center Kara Togo Department of Gynecology-Obstetrics Kara Teaching Hospital Lome Togo

Introduction: Home birth or unassisted birth means for a woman to make the decision to give birth at home, not alone in absolute terms, but without professional assistance, be it that of a midwife, a doctor or any other person with midwifery qualifications. Methods: This was a descriptive cross-sectional study conducted from November 04th to December 21st, 2019 and from August 17th to August 21st, 2020, in the community of Dagbati, in 33 women who gave birth at home, received at the USP of Dagbati and during advanced strategies;who were registered or not in the delivery register of USP Dagbati and who agreed to participate in the survey freely and in an informed manner. Results: Of the 48 deliveries that took place in the locality during our study period, 33 took place at home, with a rate of 68.7%. The average age of the women giving birth was 26.33 years with extremes of 15 and 47 years. In 42.4% of cases, they were farmers. Twenty-seven women who gave birth had farmer spouses (81.9%). The distance between their house and the health center was greater than 2 km in 78.8% of cases. Among the reasons for giving birth at home, the lack of financial means was mentioned in 60.6%. In 63.6%, the family had assisted the women in giving birth. Conclusion: Home birth is still a reality in our communities, despite the increased number of health facilities. The sensitization of the population, the improvement of the conditions of accessibility to the health center, the quality of obstetric care, and also, the improvement of the living conditions of women will surely allow a total abandonment of home births.

关键词： Home Births Dagbati Determinants parturient Togo

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Uneventful Spinal Anesthesia in a Patient with Precipitous Drop of Platelet Secondary to HELLP Syndrome: A Case Report and Review of Literatures

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Open Journal of Anesthesiology 2012年第4期2卷 138-141页

作者： Joe Z Liu Chunhua Li Hong Wang Department of Anesthesiology Detroit Medical Center Detroit Michigan USA

Thrombocytopenia caused by Hemolysis, Elevated Liver enzymes and Low Platelet count (HELLP) syndrome in pre-eclampsia parturients can be associated with substantial maternal and neonatal morbidity. Data on the issue of the safety of neuraxial anesthesia with thrombocytopenia in HELLP syndrome is limited. A lower limit of 100,000 per microliter for platelet count was suggested as “safe” for performing neuraxial anesthesia, however there is no supporting data. This lower limit is challenged lately. We present a case of uneventful spinal anesthesia for urgent Cesarean section in a patient with severe pre-eclamsia, HELLP syndrome and precipitous platelet drop from 230,000 to 42,000 per microliter.

关键词： Thrombocytopenia Pre-eclampsia HELLP Syndrome parturient Cesarean Section Platelet Neuraxial Anesthesia Neuraxial Hematoma

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Application Effect of Midwifery Nursing in the Prevention of Neonatal Asphyxia

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Journal of Clinical and Nursing Research 2022年第1期6卷 51-54页

作者： Tiantian Zhu Nan Hao Yan Qiao Rongrong Ma Yan’An People’s Hospital Yan’An 716000China

Objective:To explore the role of midwifery care in the prevention of neonatal ***:The 100 cases of parturient received in our hospital from January 2018 to January 2021 were divided into two groups,respectively,the control group and the experimental group with 50 cases in each *** control group received routine care,and the experimental group received midwifery *** psychological status of the mothers and the occurrence of neonatal asphyxia were compared between the two ***:Before nursing,there was no significant difference in the mental state of the two groups of parturient(P>0.05).After the nursing,the mental state of the parturient in the experimental group was significantly better than that of the control group(Pparturient can improve the mental state of the parturient and help reduce the incidence of neonatal *** is worthy of clinical attention and promotion.

关键词： Midwifery care parturient Neonatal asphyxia

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