Currently, cardiac arrest has become a major public health problem, which has a high incidence rate and a high mortality rate in humans. With the continuous advancement of cardiopulmonary resuscitation techniques, the overall prognosis of cardiac arrest victims is gradually improved. However, cardiac arrest events under special circumstances are still serious threats to human health. This article reviews the progress of epidemiology, pathogenesis, treatment characteristics, and key points of cardiopulmonary resuscitation in those special cardiac arrest events associated with trauma, poisoning, drowning and pregnancy.
ObjectiveTo discuss clinical characteristics and nursing countermeasure of pregnant/delivery women with tuberculosis. MethodsFrom January 2012 to December 2013, 52 cases of pregnant women complicated with tuberculosis were included. We offered specific nursing according to the psychological counseling, reasonable administration, diet nursing, fever and prevention of hospital infection on the base of their clinical features, and then analyzed the effect. ResultsIn 52 patients who had undergone the tuberculosis and obsterrics and gynecology treatment, 4 puerperal patients died of severe pneumonia and multiple organ failure; in 48 gestational patients with tuberculosis, 23 early-middle term patients accept termination of pregnancy, and in 25 middle-late term patients, 3 had full-term natural labor, 4 underwent full-term cesarean section, 5 had premature labor, and 13 continued the pregnacy. Sixteen neonatus (including 4 given at the other hospitals) had normal results of physical examination without any deformity, in whom 5 had low body weight (body weight less than 2500 g), with negative results of tuberculin test and the result of 3-moth follow-up was normal. Three months after the anti-tuberculosis treatment, the lesion was obviously absorbed in 25 patients and in 23 patients within half of a year. No patients had hospital infection. ConclusionNursing care of pregnant patients with tuberculosis should strengthen the guidance on the patients health education, improve their compliance and self-protection knowledge. Also should strengthen the basic level medical personnel training and improve the ability of early diagnosis of tuberculosis and early treatment to reduce maternal mortality.
Objective To explore the effects of utilization of new partogram on the progress of labor and intervention in the labor. Methods We reviewed nulliparous women who had vaginal delivery at our hospital from January 1st, 2015 to December 31st, 2017. They were divided into control group (group A) (n=200; the old labor standard was used during this time) and observation group (the new labor standard was used at the same time). The observation group was sub-divided into group B (n=100, the duration of dilatation of cervix from 0 to 3 centimeters greater than or equal to 16 hours after parturition), group C1 [n=100; the second-stage duration (t) was greater than or equal to 2 hours, and less than 3 hours), and group C2 (n=100; t was greater than or equal to 3 hours). We compared the differences in intervention at the stages of labor such as using oxytocin to strengthen the contractions, artificial rupture of membranes, using phloroglucinol to soften the cervix, urinary catheterization, and manual rotation of fetal head among the groups. We also compared the differences in fetal presentation position, head tumor, fetal position, cephalopelvic disproportion and progress of the drop when the dilatation of cervix get to 10 centimeters among the groups. Results In the comparison among group A, B, C1 and C2 in rates of using oxytocin to strengthen the contractions, using phloroglucinol to soften the cervix, urinary catheterization and manual rotation of fetal head, the differences were statistically significant between group C2 and the other groups (P<0.008 5). The differences among group C1, C2 and A were statistically significant in duration of the first stage of labor (P<0.05). The same result was found between group B and A in duration of the second stage of labor (P<0.05). In the comparison of the different ratios of fetal presentation position between group A and C1, and group A and C2, when the dilatation of cervix get to 10 centimeters, the differences were significant (P<0.017), except at +1 position. The differences in whether the fetal presentation was producing head tumor and occipital anterior position among group A, C1, and C2 were statistically significant (P<0.017), but there was no difference between group A and C1 (P>0.017) in occipital anterior position. In the comparison of the different progress of the drop when the dilatation of cervix had got to 10 centimeters, 0–1 hours: the differences were statistically significant among group A, C1, and C2 (P<0.05) ; 1–2 hours: the difference was statistically significant between groups C1 and C2 (P<0.05). In group C1, there was a statistically significant difference between 0–1 hour and 1–2 hours (P<0.05). In group C2, there was no statistically significant difference among 0–1 hour, 1–2 hours and 2–3 hours (P>0.05). Conclusions According to the new labor standard, the rates of intervention in the labor would not increase, but when the second-stage duration is greater than or equal to 3 hours, the frequency would increase. We should deal with the abnormal factors affecting labor in time, and try to control the duration in 3 hours.
Objective To study the clinical significance of the microorganism culture result of amniotic fluid in cesarean section in the treatment of anti-infection after operation. Methods From August 2016 to May 2017 in Women’s and Children’s Hospital of Sichuan Province, 502 amniotic fluid samples were collected in cesarean section to carry out bacteria culture. The correlations between the amniotic fluid culture result and the preoperative and intraoperative risk factors and the correlations between postoperative infection and the preoperative and intraoperative risk factors were analyzed. Results In the 502 amniotic fluid samples, there were 131 samples culture-positive. The microbiological culture results of amniotic fluid were statistically different between the puerperae with gestational age<37 weeks and the ones with gestational age≥37 weeks (P=0.001). Postoperative infection occurred in 6 puerperae, in whom the amniotic fluid culture results were positive in 3 puerperae. There was no statistical difference in the occurrence of postoperative infection between the puerperae with amniotic fluid culture-positive results and the ones with negative results (P=0.382). The occurrence of postoperative infection was associated with preoperative infections, gestational age, using time of antimicrobial, and preoperative rupture of membranes (P<0.05). Conclusions The contamination rate of amniotic fluid specimen was high, which was of low reference value to anti-infection treatment after operation. When an extension of anti-infection treatment be carried out after cesarean section, suitable specimens should be selected according to the infection site.
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.
ObjectivesTo systematically review the clinical characteristics of pregnant females, newborns, children and adolescents with SARS infection.MethodsThe clinical characteristics of patients with SARS infection were searched using PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases. Descriptive analysis was performed to analyze the clinical characteristics of the patients, clinical manifestations, treatment and prognosis.ResultsA total of 13 studies including 19 pregnant females, 14 newborns, and 81 children and adolescents were identified. The ratio of male to female was 1 to 1.2 in children and adolescents patients aged 56 days to 17.5 years. Children under 12 years old accounted for 58.3% (28/48). Of the child patients, 34.0% (16/47) had close contact with patients with SARS. Fever (93.8%, 76/81) and cough (49.4%, 40/81) were the most common symptoms in children and adolescents with SARS infection, and 17.5% (11/63) occurred with shortness of breath or dyspnea. The positive ratio of nucleic acid detection for SARS-CoV was 9.2% (14/48), and the positive ratio of serum antibody was 92.9% (13/14). Peripheral blood lymphocyte reduction was approximately 65.7% (44/67). Approximately 70.8% (51/72) unilateral and 29.2% (21/72) bilateral lesions were found by thoracic X-ray or CT scan. No child fatalities were reported. As of maternal patients, aged 23 to 44 years, 10 cases (52.6%) were infected during early and middle pregnancy, and 9 cases (47.4%) during late pregnancy. Fever (100.0%, 19/19) and cough (78.9%, 15/19) were the main clinical symptoms, and shortness of breath/dyspnea occurred in 36.8% (7/19) of infected pregnant females. The positive ratio of nucleic acid detection for SARS-CoV was 50.0% (8/16), whereas the positive ratio of serum antibody was 93.3% (14/15). The ratios of thrombocytopenia, lymphopenia, and liver enzymes abnormalities were 38.9% (7/18), 61.1% (11/18) and 50.0% (3/6). All patients were identified for lesions by thoracic X-ray or CT scan examination. Seven cases were severe (36.8%). Five patients were treated with mechanical ventilation (26.3%). Three patients died (15.8%). Four patients were spontaneous abortion (40.0%, 4/10). Nine patients were cesarean sectioned (75.0%, 9/12). Six fetuses (46.2%, 6/13) with fetal distress, 7 cases (53.8%, 7/13) with premature delivery were identified. Three fetuses (23.1%) had intrauterine growth retardation. None of the fourteen newborns was diagnosed as SARS infection.ConclusionsThe clinical symptoms such as fever and cough in children and adolescents with SARS infection are similar to that of adult patients. However, children and adolescents are usually manifested as mild infection without reported death. There is no evidence to support that SARS-CoV could transmit vertically from infected mother to their fetuses.
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.
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.
ObjectiveTo analyze the clinical data of pregnant females and children infected with H1N1 during the global pandemic in 2009, and summarize the epidemiological characteristics.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were searched to collect studies on H1N1 infection in pregnant females and children during the 2009 pandemic from January 1st, 2009 to February 17th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, epidemiological characteristics were descriptively analyzed.ResultsA total of 33 studies involving 939 children, 5 newborns and 2 416 maternal infections were included. The results showed that the age span of children was 0 to 18, the male-to-female ratio was 1.2:1, and the history of close contact accounts was 18.8% (80/425). The primary symptoms were fever, cough, headache, vomiting and other symptoms in some children. More than half of the children received oseltamivir antiviral treatment (545/807, 67.5%), and 6 died (6/861, 0.7%). The primary symptoms of pregnant females were fever, cough, sore throat, muscle pain, fatigue, headache, diarrhea, and so on. The majority of patients received antiviral therapy (1 571 to 1 783, 88.1%). A total of 178 mortalities (178/2 335, 7.6%), 48 stillbirths (48/966, 5.0%), and 9 live birth mortalities (9/494, 1.8%) were reported. All 5 newborns were positive for RT-PCR detection, including 4 premature infants. The mode of transmission was close contact in 3 cases (including 1 case in contact with sick medical staff), 1 case of vertical transmission from mother to child, and 1 case of unknown. The primary clinical manifestation of newborns was dyspnea. After treatment with oseltamivir, 4 cases were cured and 1 case deceased.ConclusionsPregnant females and children are at high risk of serious complications of H1N1 influenza. H1N1 infection in pregnancy is associated with an increased risk of adverse pregnancy outcomes. The symptoms of H1N1 infection in children and pregnant females are similar to those in adults, primarily respiratory and systemic symptoms. Oseltamivir and zanamivir are effective antiviral drugs.