Objective To explore the effect of different pre-labor position for premature rupture of membrane (PROM) after 37 weeks with vertex and engaged presentation on the maternal and neonatal outcomes. Methods A total of 120 women over 37 weeks PROM with single fetus in vertex presentation and engaged head were randomly allocated into two groups. The trial group (60 women) received no limit of movement after hospitalization and before labor while the control group (60 women) adapted lateral and supine position alternatively with hip-up. Labor process and neonatal outcomes were observed and recorded. SPSS 13.0 software was adopted to analyze the data. Results Compared with the control group, the trial group had higher rate of normal birth (70% vs. 46.7%, χ2=6.72, P=0.01), shorter first and second stage of labor (t=2.11, P=0.039; t=2.75, P=0.007), fewer incidence of dysuria during labor (χ2=8.11, P=0.0041), and less amount of amniotic fluid (107±55 mL vs. 248±42 mL, t=4.188, P=0.000 1). Conclusion For PROM over 37 weeks pregnancy with single vertex presentation and engaged head, no limit on the position before labor is safe and feasible, and it can improvie spontaneous delivery rate, shorten labor process, decrease amount of amniotic fluid, and eliminate the incidence of dysuria. It is worth to be popularized in the clinic.
Objective To evaluate the effect of maternal and child health care training at the primary levelin Chongqing, and to detect and solve the existing problems so as to provide evidence for the further training andmonitoring. Methods The rural maternal and children health staff of Rongchang County, Chongqing were trained. A test and, in-depth interviews and field observation wereused to evaluate the training process and results. Results Seventynine members of the Clinical Skill Group (CS) and 73 members of Health Education Group (HE) have taken the test. The median score of CS before training was 11 while it was 23 after training (Plt;0.01); the median score of HE was 18 before training while it was 25 after training (Plt;0.01). The scores change of thetest before and after training showed that the training had a good result. Conclusion Primary level health staff members had poor knowledge of maternal and children health care. This training enhanced their knowledge of maternal and child health care improved their skill. Organizers should ensure that the training contents are rich,novel, and varied. Maternal and child health staff should be willing to join the training.
Objective To explore maternal health services utilization in rural areas in Rongchang County, and to analyze the influencing factors. Methods Seven hundred pregnant women were enrolled by stratified cluster sampling. The data was analyzed in SAS 8.2. Results Ninety-five percent of pregnant women had an antenatal examination, 69.3% had it for 5 times or more, and 75.4% received checking in the earlier stage of pregnancy; 98.3% were delivered in hospital, 26.3% had postpartum visit 3 times or more, and 16.7% had been systematically managed. The main influencing factors of systematic management rate were family yearly income before pregnancy whether or not the patient participated in the new rural cooperative medical scheme, and the number of pregnancies. Conclusion The maternal systematic management rate in the county has yet to be improved. Health education to improve prenatal care and postnatal visit status should be strengthened, and women should be guided to participate in the new rural cooperative medical scheme.
ObjectiveTo explore the corresponding intervention measures to reduce maternal mortality rate by analyzing the causes and problems of maternal deaths. MethodsA retrospective analysis was conducted to analyze all cases of maternal mortality from January 2005 to June 2013 in West China Second University Hospital. ResultsAmong the 14 cases of maternal deaths, the main diseases of the patients were pregnancy complicated with heart disease, hypertensive disorders, obstetric hemorrhage, amniotic fluid embolism and ectopic pregnancy. Four cases got prescriptive prenatal care during pregnancy, accounting for 28.6% (4/14), while 10 cases did not, accounting for 71.4% (10/14). Six patients died in prenatal period which accounted for 42.9% (6/14), while 8 died in postnatal period which accounted for 57.1% (6/14) and 5 died within 24 hours which accounted for 62.5% (5/8). Seven underwent cesarean section and 6 fetuses survived. Two went through trial of labor and no fetus survived. There was no ordered postmortem. ConclusionIntensifying education of prenatal care during pregnancy, improving quality of obstetrical service and diathesis of healthcare professionals, strengthening the supervision of high-risk pregnancy and timely choosing the time and manner of delivery are the main measures to decrease the maternal mortality.
Objective To guide blood glucose management during pregnancy and reduce the incidence of long-term complications of the fetus by exploring the long-term growth condition of offspring of pregnant women with gestational diabetes mellitus. Methods A total of 180 cases full-term newborns of pregnant women with gestational diabetes mellitus from December 25th, 2011 to December 25th, 2012 were selected as the diabetes group. Another 200 newborns of pregnant women without any complications were randomly collected as the control group. Birth weight, gestational age, sex, blood glucose, and 24-, 48-, 72- and 120-hour transcutaneous bilirubin value after the birth of the newborns were recorded; weight, height, body mass index (BMI), triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein, blood pressure and fasting plasma glucose quota between the two groups were contrasted when the children were three years old. Results There were no significant difference in the birth weight, gestational age and sex between the diabetic and the control group. The blood glucose levels of the newborns in the diabetic group was significantly lower than that in the control group (P<0.05). The 24-, 48-, 72- and 120-hour transcutaneous bilirubin values of the newborns in the diabetic group were significantly higher than those of the control group (P<0.05). The weight, height and BMI of the three years old offspring in the diabetic group were significantly higher than those in the control group (P<0.05). There were no significant difference in triglycerides, total cholesterol, HDL, Low density lipoprotein, fasting plasma glucose quota, and systolic blood pressure between the diabetic group and the control group (P>0.05), but the diastolic blood pressure in the diabetic group was much higher than that in the control group (P<0.05). Conclusion The impact of gestational diabetes mellitus on offspring of pregnant women was not only in the fetus and newborn period, but also in the future, which should be timely intervened.
ObjectiveTo systematically evaluate the detection rate of postpartum depression in Chinese maternal population and to provide a scientific basis for the prevention and treatment of postpartum depression.MethodsWe searched CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library databases to collect studies on the detection rate of postpartum depression in Chinese maternal population from January, 2001 to August, 2019. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was performed using Stata15.0 software.ResultsA total of 24 studies involving 38 357 cases were included. Meta-analysis results showed that the total detection of postpartum depression in Chinese females was 15% (95% CI 12% to 17%). Subgroup analysis showed that the detection of postpartum depression was 12.3% (95% CI 9.3% to 15.2%) in the south and 17.3% (95%CI 12.1% to 22.5%) in the north. According to the Edinburgh postpartum depression scale, the rate was 14.5% (95%CI 11.4% to 17.5%); and for other scales, the rate was 15.0% (95% CI 8.9% to 21.2%); simple random sampling method was 14.8% (95%CI 11.0% to 18.7%), and cluster sampling was 16.3% (95%CI 12.0% to 20.5%). The rate was 15.8% (95%CI 9.3% to 22.3%) from 2001 to 2010, 13.5% (95%CI 7.7% to 19.2%) from 2011 to 2014, and 14.8% (95%CI 10.9% to 18.6%) from 2015 to 2019. Sensitivity analysis showed that the combined results were stable.ConclusionsThe detection rate of postpartum depression in Chinese maternal population is high, and early screening and related intervention should be paid more attention to these population.
ObjectivesTo understand the current situation of the nosocomial infection management system in maternal and child health care institutions at all levels in Sichuan province, and provide a feasible policy basis for strengthening the nosocomial infection management.MethodsThe expert group members of Sichuan Maternal and Child Health Association Academy Association designed a unified questionnaire, and distributed the questionnaire through “Questionnaire Star” to carry out on-site online survey.ResultsA total of 159 maternal and child health care institutions participated in the survey. Most secondary and below maternal and child health care institutions had not set up professional hospital infection monitoring system. A few secondary and below maternal and child health care institutions did not independently set up a hospital infection management committee, hospital infection management department, full-time hospital infection department head, the inspection team of infection control, monitoring system, and nosocomial infection management system and special supervision had not been established in special departments. There were statistical differences in some jobs in the construction of nosocomial infection management system in different levels of maternal and child health care institutions (P<0.05).ConclusionsThe organizational system construction of hospital infection managemen are at a low level in the second level and below maternal and child health care institutions in Sichuan province. The tertiary maternal and child health care institutions should give full play to the leading role in promoting the standard construction of nosocomial infection management system of maternal and child health care institutions in Sichuan province, and carry out nosocomial infection management of maternal and child health care institutions orderly.
ObjectiveTo systematically review the association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect case-control and cohort studies on the association between maternal folate supplementation during pregnancy and the risk of ASD in the offspring from inception to December 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software.ResultsA total of 17 studies involving 10 812 cases and 876 241 controls were included. The results of meta-analysis showed that there was no significant association between maternal folate supplementation during pregnancy and the risk of ASD in the offspring in the total population. The subgroup analysis revealed that maternal folate supplementation during pregnancy was statistically associated with a reduced risk of ASD in the offspring in the Asian population (OR=0.71, 95%CI 0.53 to 0.96, P=0.03). However, there were no statistical correlations in European and American populations.ConclusionsCurrent evidence shows that maternal folate supplementation during pregnancy may reduce the risk of ASD in the offspring in the Asian population. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the protective effect of serum maternal respiratory syncytial virus (RSV) antibodies on infants with RSV infection. MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data databases were electronically searched to collect observational studies on the correlation between serum maternal RSV antibodies and infants with RSV infection from inception to July 18, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies, then, qualitative analysis was performed. ResultsA total of 19 studies were included, and 60% of those studies suggested that a higher level of maternal antibodies could prevent RSV infection. However, the remaining 40% of them showed that there was no significant difference in the level of RSV maternal antibodies between the infected group and the non-infected group. Further more, in the studies of the correlation between maternal antibody level and disease severity after RSV infection, 55% of those showed that maternal antibody level was negatively correlated with disease severity. ConclusionThe protective effect of serum maternal RSV antibodies on infants reported in different studies varies. Whether it can prevent RSV infection and affect the severity of RSV infected children still needs to be explored.
Objective To investigate the organizational structure, routine management, emergency response, and material reserves related to the prevention and control of infectious diseases in maternal and child health institutions at all levels in Sichuan, and to understand the construction of emerging infectious diseases prevention and control system in maternal and child health institutions throughout the province. Methods We conducted a survey on the current situation of the epidemic prevention and control system in maternal and child health institutions using a self-developed questionnaire, which was conducted in October 2020 and July 2021, respectively. We conducted comparative analysis on the basic situation, the construction of emerging infectious disease prevention and control systems, and the setting and management of fever clinics/rooms of maternal and child health institutions at all levels in Sichuan in 2020 and 2021. Results In 2020, a total of 166 maternal and child health institutions participated in the survey, and 166 questionnaires were collected, including 17 at the provincial and municipal levels and 149 at the county level. In 2021, a total of 182 maternal and child health institutions participated in the survey, and 182 questionnaires were collected, including 17 at the provincial and municipal levels and 165 at the county level. In 2021, all levels of maternal and child health institutions in Sichuan had established epidemic prevention and control leadership groups. Compared with 2020, the construction of the emerging infectious disease prevention and control system in maternal and child health institutions at all levels in Sichuan in 2021 had improved to a certain extent in terms of establishing epidemic prevention and control leadership groups, hospital area three channel management, three-level pre-examination triage, inpatient area allocation, staff management, and patient management (P<0.05). Compared with 2020, fever clinics that met the requirements of three zones and two channels management, fever clinics that met the requirements of closed-loop management, and management of fever clinics/rooms in maternal and child health institutions at all levels in Sichuan in 2021 had improved to a certain extent (P<0.05). Conclusion Through strengthened construction during the epidemic prevention and control period, the construction of the emerging infectious disease prevention and control system in maternal and child health institutions in Sichuan has improved, but still faces continuous challenges in normalized prevention and control.