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Objective: To explore the factors influencing lateral episiotomy in vaginal deliveries of suspected macrosomia. Methods: The clinical data of 149 pregnant women with suspected macrosomia who delivered at the Obstetrics Department of the First Affiliated Hospital of Nanjing Medical University from January to July 2022 were analyzed retrospectively. According to whether the perineum was cut laterally during vaginal delivery, the perineum was divided into two groups: the episiotomy group and the natural laceration group. Risk factors for vaginal delivery in pregnant women with suspected macrosomia were analyzed. Results: Among 149 pregnant women with suspected macrosomia, lateral episiotomy was performed in 40 cases (26.85%), while 109 cases (73.15%) had vaginal deliveries accompanied by natural laceration, including 93 cases of Grade I laceration and 16 cases of Grade II laceration. The proportion of primipara and midwives with less than 5 years of experience was higher in the episiotomy group compared to the laceration group (P < 0.001, P=0.021); the proportion of the second stage of labor less than 47 min in the episiotomy group was significantly higher than that in the natural laceration group (87.5% vs. 39.4%, P < 0.001). In addition, the proportion of amniotic fluid properties (clear + I degree)in the natural laceration group was significantly higher than that in the episiotomy group (87.2% vs. 72.5%, P=0.034), while the rate of postpartum hemorrhage was significantly lower than that in natural laceration group (P=0.010). Primipara and midwives with less than 5 years of experience were independent risk factors for episiotomy in suspected macrosomia (OR=2.708, P=0.021). Conclusion: The incidence of lateral episiotomy in vaginal delivery of suspected macrosomia increases in primipara and midwives with less than 5 years of experience, at the same time, the rate of postpartum hemorrhage in the lateral episiotomy group is significantly reduced. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the effect of SLK triple therapy combined with epidural labor analgesia on pelvic floor function and perinatal outcome of primipara. Methods: 200 pregnant women who delivered singleton in Jiangyin People’s Hospital and its group hospitals from January 2022 to December 2022 were selected and randomly divided into control group, SLK triple therapy group,epidural delivery analgesia group and combined group according to random number table, with 50 cases in each group. The control group received routine training, the SLK triple therapy group received Sopfrology delivery training, Lamaze breath training and Kegel training,the epidural delivery analgesia group received patient controlled epidural analgesia, and the combined group received epidural delivery analgesia on the basis of SLK triple therapy. The pelvic floor function indexes were detected by ultrasonic diagnostic instrument(2) The pelvic floor electrophysiological indexes were detected by neuromuscular stimulation biofeedback therapeutic instrument, and the prenatal fever rate, midwifery rate, postpartum hemorrhage rate, cesarean section rate, labor process and Apgar score were recorded and compared in each group. Results: Compared with the control group, the pelvic floor ultrasonic examination △ y α, β, γ There was no significant difference among the parameters(P＞0.05); Pelvic floor ultrasonic examination △ y α, β, γ All the parameters were significantly lower than those in the control group(P＜0.05); However, there was no significant difference between SLK group and combination group in the above indicators(P＞0.05). The muscle strength of class Ⅰand class Ⅱ muscle fibers and fatigue of class Ⅰ and class Ⅱ muscle fibers in SLK group and combination group were significantly better than those in the control group(P＜0.05); However, there was no significant difference between SLK group and combination group in the above indicators(P＞0.05). The postpartum hemorrhage rate and cesarean section rate in SLK group, epidural analgesia group and combination group were significantly lower than those in the control group(P＜0.05), the first and second stages of labor in epidural analgesia group were significantly higher than those in the control group(P＜0.05), the first and second stages of labor in SLK group were significantly lower than those in the control group, and the first and second stages of labor in combination group were significantly lower than those in epidural analgesia group, Apgar score of SLK group and combined group was significantly higher than that of control group. Conclusion: SLK triple therapy combined with epidural labor analgesia can effectively improve the pelvic floor function and perinatal outcome of primipara, and make up for the shortage of epidural labor analgesia alone, which is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

In view of the huge size of China' s rural migrant population and the gradual slowdown of its transfer, it is necessary to ex⁃ plore whether the transfer potential of rural labor is exhausted from the perspective of the confirmation of rural land rights. Based on the institutional practice of rural land right confirmation, we deconstructed the particularity of rural-urban transfer in China and regarded it as a three-stage transfer process (rural separation, urban entry, and urban integration) involving four types of subjects (farmers, migrant workers, new urban citizens, and urban citizens). We used the China Labor Dynamics Survey data of 2014 and 2016 to empirically test the stage effect and lag effect of rural land right conformation on labor transfer and further discuss its impact on labor family migration. We found that: ① The effects of rural land right conformation on labor transfer had stage heterogeneity, which promoted the second stage of labor identity transformation and hindered the first stage of industrial transfer and the third stage of social security transforma⁃ tion. However, rural land right conformation had a lag effect on promoting laborers' rural-urban transfer: the probability of labor force participation in non-agricultural employment and basic pension insurance for urban enterprise employees who had been confirmed for two years increased by 16.9% and 1.9%, respectively. ② Rural land right conformation had quantile heterogeneity in affecting the fami⁃ ly migration of laborers, particularly for low-quantile labor families, which could significantly increase family migration and decrease the migration of the new generation of migrant workers. Based on these, we suggest that: ① Policy design should focus on the promotion of the laborers' rural-urban transfer according to their transfer stages and types. On the one hand, policymakers should strengthen the driving force of rural land right conformation from the rural side and continuously improve the mechanisms of land transfer, land trustee⁃ ship, and land withdrawal in the first and second transfer stages in order to provide transfer power to farmers, migrant workers, and new urban citizens. On the other hand, policymakers should strengthen the pulling force from the urban side, reduce the resistance to urban transfer in the second and third transfer stages, and create an urban working and living environment friendly for migrant workers and new citizens. ② Policymakers should classify and implement policies according to different confirmation times, give priority to solving the problems left over by the confirmation from the low-quantile 'amphibious' labor families, and allow the new generation of migrant workers to 'bring soil into the city.' These measures can rely on the results of rural land right conformation to promote transfer and ur⁃ ban citizenship for rural laborers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the effects of patient-controlled intravenous analgesia ( PCIA) versus programmed intermittent epidural bolus (PIEB) administration in nalbuphine patients on labour analgesia. METHODS: A total of 68 full-term, singleton, and cephalic pregnant women admitted into the hospital from Nov. 2020 to Aug. 2021 were extracted to be divided into the PCIA group and PIEB group according to different analgesic method, with 34 cases in each group. The visual analogue score of pain (VAS), heart rate ( HR) and mean arterial pressure (MAP) at the time of admission to the delivery room, at 2 cm opening, at 3 cm opening, at 4 cm opening, at full opening and at the time of delivery were compared between two groups. The dosage of analgesic pump liquid and the duration of labor were compared between two groups. The neonatal Apgar score, neonatal behavioral neurological assessment ( NBNA) score, and the incidence of adverse drug reactions were compared between two groups. RESULTS: There was no statistically significant difference between two groups in the VAS scores at the time of admission to the delivery room, at 2 cm opening, at 3 cm opening, at 4 cm opening, at full opening and at the time of delivery (P>0. 05). There was no statistically significant difference between groups, between time points and between groups·time points in the comparison of HR and MAP levels at different moments in both groups (P>0. 05). The dosage of analgesic pump in the PIEB group was lower than that in PCIA group, and the duration of the second stage of labor was shorter than that in PCIA group, the differences were statistically significant (P<0. 05). There was no significant difference in the duration of the first stage of labor and the third stage of labor between two groups (P> 0. 05). There was no statistically significant difference in the 1 min Apgar score, 5 min Apgar score and 24 h NBNA score between two groups of neonates (P>0. 05). The incidence of urinary retention in the PIEB group was lower than that in PCIA group, with statistically significant differences ( P < 0. 05). CONCLUSIONS: The administration of nalbuphine PIEB for labor analgesia can obtain similar analgesic effect and hemodynamic stabilization effect as PCIA, reduce the dosage of analgesic pump liquid and urinary retention, and shorten the duration of the second stage of labor without affecting maternal and neonatal conditions, and has clinical application advantages. [ABSTRACT FROM AUTHOR]

Objective: To explore the influencing factors and preventive measures of fever during painless delivery. Methods: 60 cases of parturients with fever during painless childbirth in our hospital from January 2020 to December 2020 were selected as the research objects, and they were divided into the observation group, and another 60 cases of parturients without fever during painless childbirth in the same period were selected as the control group. Clinical data analysis was carried out for all the puerpera. The demographic characteristics, basic diseases of pregnancy and different conditions during labor of the two groups were compared, and all the related factors were analyzed by multivariate logistic regression. Finally, summarize and analyze, and put forward the prevention measures of painless childbirth maternal fever during production. Results: There was no significant difference in age, gestational weeks, times of pregnancy and stillbirth history between the two groups (P>0.05). The number of cases with history of fetal protection in the observation group was significantly higher than that in the control group, and the times of labor in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in anemia, thyroid gland dysfunction, hypertension, diabetes mellitus and premature delivery between the two groups (P>0.05), the number of pregnant women with premature rupture of membranes in the observation group was significantly higher than that in the control group (P<0.05); the time of the first stage of labor, the second stage of labor and the delivery time of premature rupture of membranes in the observation group were significantly higher than those in the control group (P<0.05); the number of pregnant women in the observation group with routine dose of ropivacaine anesthesia, artificial rupture of membranes, use of oxytocin and amniotic fluid pollution were significantly higher than those in the control group All factors were assigned values, in which "yes" was 1, and "no" was 0. Logistic regression analysis showed that only the history of fetal protection, times of labor, time of the first stage of labor, time of the second stage of labor, delivery time of premature rupture of membranes, epidural anesthetics, use of oxytocin and amniotic fluid pollution were the independent risk factors of maternal fever during painless delivery (P<0.05). Conclusion: The situation of premature rupture of membranes and the way of rupture of membranes may be related to the occurrence of fever, but only the history of fetal protection, the number of labor, the time of the first stage of labor, the time of the second stage of labor, the delivery time of premature rupture of membranes, epidural anesthetics, the use of oxytocin and amniotic fluid pollution are the independent risk factors of fever on the primipara, have a history of fetal protection, long duration of labor, premature rupture of membranes, long delivery time, amniotic fluid pollution and other painless childbirth maternal give certain preventive measures, and adjust the use of epidural anesthesia, reduce the use of oxytocin, to avoid painless childbirth maternal fever during production. [ABSTRACT FROM AUTHOR]

To evaluate the effect of low-dose ropivacaine combined with sufentanil epidural anesthesia on labor analgesia in elderly women. 80 elderly painless parturients admitted to our hospital from January 2019 to December 2020 were selected as the study objects. The control group was given ropivacaine for epidural anesthesia; the observation group was given low-dose ropivacaine combined with sufentanil for epidural anesthesia. The analgesic effect, VAS score, Bromage score, additional times of PCEA, duration of labor, the asphyxia and 24-hour lactation score of the newborn at 4 hours were compared between the two groups. The analgesic effect of the observation group was significantly better than that of the control group, the difference was not significant (P>0.05), the Bromage score of the third labor process was different in the two groups (P>0.05); the Bromage scores of the first and second stages of labor in the observation group were slightly lower than those in the control group, but the difference was not significant (P>0.05). the additional times of PCEA in the observation group was significantly lower than that of the control group (P<0.05); the time of the first labor process and the second labor process was different in the two groups (P<0.05). The score of 24 h postpartum lactation in the observation group was compared with the control group(P<0.05). The proportion was slightly lower than that of the control group, but there was no significant difference(P>0.05). Low dose ropivacaine combined with sufentanil is effective in epidural analgesia for the elderly parturient. It is safe and effective for the parturient to secrete breast milk after childbirth. It is worthy of clinical application. [ABSTRACT FROM AUTHOR]

To explore the value of different doses of ropivacaine combined with dezocine in patient-controlled epidural analgesia (PCEA) in the application for painless labor. 180 primiparas who planned to give birth naturally in Peking Union Medical College Hospital from January to December in 2019 were selected. According to the method of random remainder, they were divided into group A, B and C, with 60 cases in each group. 0.75% ropivacaine 0.33 mL (2.50 mg), 0.50 mL (3.75 mg), 0.67 mL (5.0 mg) combined with dezocine PCEA for labor analgesia were used respectively. Painless labor was performed when the uterine orifice was opened to 2~3 cm, L2~L3 interstitial puncture, a cephalic tube was placed on the PCEA, PCEA was stopped at the full time of uterine opening. The visual analogue scale (VAS) scores before analgesia (T0), analgesia 15 minutes (T1), full opening (T2), fetal delivery (T3), placental delivery (T4) and sutures Perineum (T5) were compared in the three groups. The modified Bromage score was used to evaluate the effect of lower extremity motor nerve block. The analgesic onset time, the time from the beginning of analgesia to the full opening of the uterine orifice, the first stage of labor, the second stage of labor, and the third stage of labor were counted, and the amount of analgesic drugs used when each group reached the target anesthesia level and the times of pressing the analgesic pump were counted. The amount of postpartum hemorrhage and final delivery methods in each group were recorded, and the neonatal Apgar score method (Apgar) was used to evaluate the neonatal asphyxia, cord blood gas analysis was performed, and the incidence of adverse reactions during delivery of each group was counted. VAS scores of the three groups at T1~T5 time points decreased compared with those of T0 time points (P<0.05), and VAS scores at T1~T5 time points in groups B and C were all lower than those in group A (P<0.05). There was statistical significance in the modified Bromage grading distribution among the three groups (P<0.05). The onset time of analgesia in group B, C was faster than that in group A and the time of the second stage of labor and the third stage of labor in group B, C was shorter than that in group A, the amount of analgesic drugs used when each group reached the target anesthesia level, the times of pressing the analgesic pump and the times of effective pressing were all reduced compared with those of group A (P<0.05), and there were no statistically significant difference in the above indicators between group B and group C (P>0.05). There were no statistically significant differences in the amount of postpartum hemorrhage, final delivery methods, Apgar scores at 1min and 5min after birth, pH value, blood oxygen partial pressure (PO2), carbon dioxide partial pressure (PCO2) and the incidence rate of adverse reactions in the three groups (P>0.05). 0.75% ropivacaine 0.50 mL (3.75 mg) combined with dezocine PCEA has satisfactory analgesic effect in painless labor, little effect on labor process, uterine contraction, mother and child, has the advantages of separation of motor nerve block and sensory nerve block, with less adverse reactions and has a high safety. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the influence of labor process time and intervention on postpartum hemorrhage caused by uterine atony in singleton full-term primipara. Methods: Singleton full-term primipara were chosen in the period from January 2017 to December 2020 in our hospital and were grouped according to the first stage time of labor and matched by PSM method included ＜8 h group and ≥ 8 h group each with 771 cases. The general information, duration of labor and uterine atony postpartum hemorrhage were analyzed and the relationship between the time and intervention of labor process and the occurrence of postpartum hemorrhage due to uterine inertia were evaluated. Results: There was no significant difference in age, gestational times and gestational weeks between 2 groups P>0.05 . The second stage time of labor and the first stage + second stage of labor in gestational weeks between 2 groups inertia were evaluated. relations P<0.05 . The postpartum hemorrhage rate of tage + second stage of labor in gestational weeks between 2 groups inertia h group P<0.05 . The second stage of labor and the first stage + second stage of labor in ional weeks between 2 groups inertia were evaluated. relationship between intervention P<0.05 . The first, second and first stage + second stages of labor of f laboroup and < 8 h group with labor intervention were significantly longer than without labor intervention P<0.05 . The postpartum hemorrhage rate of rvention were significantly longer than without laborhigher than without labor intervention P<0.05 . Conclusion: The incidence of postpartum hemorrhage due to uterine atony in singleton term primipara increased with the increased of the first stage time of labor, while the second stage time of labor often increased with the increased of the first stage time of labor. [ABSTRACT FROM AUTHOR]

Objective: To observe the effect of phloroglucinol on postpartum psychological status, serum stress response index and maternal and infant outcomes of primiparas with cervical opening 2-3 cm. Methods: 200 cases of primiparas who were admitted to the First Affiliated Hospital of Hunan College of traditional Chinese medicine from January 2019 to December 2019 were studied, they were randomly divided into control group and study group by the random number table method, 100 cases in each group. The control group was given routine treatment during delivery, while the study group was injected with phloroglucinol on the basis of the control group. The first stage of labor, the second stage of labor and the total stage of labor were observed in the two groups. The psychological status, maternal and infant outcomes and the incidence rate of adverse reactions after delivery in the two groups were recorded. The stress reaction indexes in the two groups were compared when the cervix opening 2 ~ 3 cm larger and after delivery. Results: The first stage of labor and the second stage of labor in the study group were shorter than those in the control group, which significantly shortened the total stage of labor, and the difference between the two groups was statistically significant (P<0.05). The scores of self rating Anxiety Scale (SAS) and self rating Depression Scale (SDS) in the study group after delivery were lower than those in the control group, and the difference was statistically significant (P<0.05). The levels of insulin, cortisol and blood glucose in the two groups after delivery were higher than those before delivery (P<0.05), but the levels of insulin, cortisol and blood glucose in the study group were lower than those in the control group (P<0.05). There were no significant differences in postpartum hemorrhage rate and neonatal asphyxia rate between the two groups (P>0.05). The perineal laceration (Ⅱ) rate and midwifery delivery rate in the study group were lower than those in the control group, and the normal delivery rate was higher than that in the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Phloroglucinol should be used when the cervix opening 2 ~ 3 cm larger, which can reduce the stress reaction during delivery, improve the maternal and infant outcomes, and reduce postpartum depression and anxiety, and with good safety. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To study the effect of epidural anesthesia on pelvic floor function during painless delivery, cesarean section and natural delivery. Methods: Selected 80 cases of delivery woman from October 2019 to November 2020, there were 15 parturients in natural delivery group, 26 parturients in painless delivery group and 39 parturients in planned cesarean section group. The pain degree of the first and second stages of labor, the time required for the first and second stages of labor, the maternal and infant outcomes of macrosomia, neonatal jaundice, low birth weight infants and neonatal asphyxia, Apgar score, intrapartum blood loss and fetal weight were recorded in the natural delivery group and painless delivery group; the pelvic floor muscle strength of the puerpera was examined, and the occurrence of urinary incontinence in the natural delivery group, painless delivery group and cesarean section group was recorded rate. Results: The VAS score and time required for the first and second stages of labor in painless delivery group were lower than natural delivery group (P<0.05). There was no significant difference in adverse maternal and infant outcomes, Apgar score, intrapartum hemorrhage and fetal weight between natural delivery group and painless delivery group (P>0.05), pelvic floor muscle strength of natural delivery group was higher than natural delivery group (P<0.05). There was no significant difference in the incidence of urinary incontinence among the three groups (P>0.05). Conclusion: Painless delivery can not only reduce the degree of labor pain, but also reduce the damage to pelvic floor tissue function. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical efficacy of double-cavity water sac combined with abdominal aortic interventional obstruction compared with oxytocin combined with conventional cesarean section for induction of labor in late gestational diabetes. Methods: A total of 146 patients with late gestational diabetes who were expecting labor in our hospital from September 2019 to April 2020 were collected and randomly divided into a study group (73 cases) and a control group (73 cases). In the study group, a double-chamber water sac was placed on the cervix to induce labor. For patients who failed to induce labor, a cesarean section was performed with abdominal aortic interventional obstruction; the control group was induced by a simple intravenous drip of low-dose oxytocin. Patients who fail to induce labor with oxytocin undergo routine cesarean section. Collect data on the general condition of pregnant women, cervical Bishop scores before and after induction of labor, various stages of labor, and adverse reactions by asking about medical history, physical examination, laboratory examinations, etc.; for some patients who fail to induce labor, collecting operation time, blood transfusion volume, blood loss, hysterectomy rate, etc. Apgar score of newborns. The results of promoting cervical maturity, various stages of labor, pregnancy outcome, adverse reactions and other results of the two groups of patients were compared and analyzed. Results: The cervical Bishop score of the pregnant women in the study group was higher than that of the control group after treatment (P<0.05); there was a statistically significant difference in the improvement of the cervical Bishop score between the study group and the control group (P<0.05). The success rate of induction of labor in the study group was higher than that in the control group, and the rate of cesarean section in the control group was higher than that in the study group. There was a statistically significant difference in the outcomes of the two components (P<0.05). The time from induction of labor to labor, the first stage of labor, the second stage of labor, and the total duration of labor in the study group were shorter than those in the control group (P<0.05). The amount of intraoperative blood loss, blood transfusion, hysterectomy rate and Apgar score of newborns in the study group were lower than those in the control group (P<0.05). The number of adverse reactions in the study group was lower than that in the control group (P<0.05). Conclusion: Both double-cavity water sac and oxytocin can promote cervical ripening, but the former is better than the latter and can increase the success rate of labor induction; the application of abdominal aortic interventional obstruction has more obvious advantages than conventional cesarean section, and it is for late gestational diabetes. The use of double-cavity water balloon combined with abdominal aortic interventional obstruction for pregnant women to induce labor has higher safety and is worthy of clinical reference. [ABSTRACT FROM AUTHOR]