Maternal intrapartum fever during epidural labour analgesia: Incidence and influencing factors.

BACKGROUND: The management and nursing care of women's temperature during delivery is an important part of clinical obstetrics. We aimed to evaluate maternal intrapartum fever during epidural labour analgesia to provide evidence for the management and care of women in labour. METHODS: This study was conducted and reported according to the STROBE statement. Women in labour undergoing epidural labour analgesia in our hospital from 1 January 2021 to 31 August 2022 were retrospectively selected. The characteristics of women in labour with and without intrapartum fever were compared. Pearson correlation and logistic regression analysis were used to analyse the influencing factors of postpartum fever. RESULTS: A total of 196 women in labour were included, the incidence of maternal intrapartum fever in women in labour undergoing epidural analgesia was 27.5%. Pearson correlation analyses showed that BMI, oxytocin use, labour duration, number of vaginal examinations, time from rupture of the foetal membranes to the end of labour and duration of epidural analgesia were all correlated with the occurrence of intrapartum fever (all P < 0.05). Logistic regression analyses indicated that body mass index ≥28 kg/m2 (OR = 1.825), oxytocin use (OR = 2.082), labour duration ≥9.2 h (OR = 2.613), number of vaginal examinations ≥8 (OR = 2.044-3.115), the time from rupture of the foetal membranes to the end of labour ≥250 min (OR = 2.766) and duration of epidural analgesia ≥300 min (OR = 3.106) were risk factors for intrapartum fever in women in labour undergoing epidural analgesia (all P < 0.05). CONCLUSIONS: Maternal intrapartum fever in women in labour undergoing epidural analgesia is common and influenced by many factors. Nurses should take early preventive care measures according to these factors during epidural analgesia in labour.

Exploring the psychometric properties of the professional issues in maternal mental health scale (PIMMHS) in a Chinese population.

BACKGROUND: The public health and economic implications of perinatal mental health problems are well documented. Maternity clinicians are ideally placed to effectively identify women at risk and facilitate early intervention. However, in China as globally a number of issues are implicated in a failure to recognise and treat. AIM: The present study sought to develop and evaluate the Chinese version 'professional issues in maternal mental health' scale (PIMMHS), explore its psychometric properties and potential application. METHODS: A cross-sectional design and instrument translation and evaluation approach was taken to investigate the psychometric properties of the PIMMHS in a Chinese population. A total of 598 obstetricians, obstetric nurses, and midwives participated in this study from 26 hospitals across China. FINDINGS: The Chinese PIMMHS was not a good fit to the original two factor model. The emotion/communication subscale yielded an excellent fit to the data according to all fit indices, offering compelling evidence for a single factor solution. The training (PIMMHS: Training), proved problematic throughout the analysis with divergent validity for the training subscale also being poor with a concomitant impact on the total scale performance. The performance of this subscale may be related to the nature of medical training and PMH. CONCLUSION: The Chinese PIMMHS comprises a unidimensional scale of emotion/ communication, which is simple and may provide insight into the emotional burden of providing PMH care, with the potential to mitigate that burden. Further development and investigation of the training sub-scale could be of value.

Relationship between abnormal intrinsic functional connectivity of subcortices and autism symptoms in high-functioning adults with autism spectrum disorder.

PURPOSE: This study explores subcortices and their intrinsic functional connectivity (iFC) in autism spectrum disorder (ASD) adults and investigates their relationship with clinical severity. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 74 ASD patients, and 63 gender and age-matched typically developing (TD) adults. Independent component analysis (ICA) was conducted to evaluate subcortical patterns of basal ganglia (BG) and thalamus. These two brain areas were treated as regions of interest to further calculate whole-brain FC. In addition, we employed multivariate machine learning to identify subcortices-based FC brain patterns and clinical scores to classify ASD adults from those TD subjects. RESULTS: In ASD individuals, autism diagnostic observation schedule (ADOS) was negatively correlated with the BG network. Similarly, social responsiveness scale (SRS) was negatively correlated with the thalamus network. The BG-based iFC analysis revealed adults with ASD versus TD had lower FC, and its FC with the right medial temporal lobe (MTL), was positively correlated with SRS and ADOS separately. ASD could be predicted with a balanced accuracy of around 60.0 % using brain patterns and 84.7 % using clinical variables. CONCLUSION: Our results revealed the abnormal subcortical iFC may be related to autism symptoms.

Application of breast milk smears in umbilical care of full-term newborn.

With the continuous innovation of digital technology in my country at this stage and the design of medical imaging technology systems, the depth and breadth of the development of digital medical imaging technology have been greatly expanded. This paper focus on application of medical images in breast milk smearing of the umbilical nursing for full-term newborns. OBJECTIVE: To explore the effect of breast milk application in umbilical nursing of full-term newborns. METHODS: 596 full-term newborns were divided into three groups: Experimental Group, Control Group A and Control Group B, Experimental Group A treated with breast milk, control group a treated with 75% alcohol, and control group B treated with 37 ~ 42°C warm boiled water, the time of umbilical cord abscission, infection and other complications were compared among the three groups. The process was recorded by images. RESULTS: According to the images, compared with the Control Group A and B, the experimental group significantly shortened the time of umbilical cord shedding, the difference was statistically significant (p < 0.001). CONCLUSION: The application of breast milk in umbilical region of full-term neonates can reduce the time of umbilical cord abscission without increasing the incidence of Omphalitis.

Effects of social support, anxiety, and hope levels on cognitive bias in patients with nasogastric/nasoenteric tubes.

BACKGROUND: Unplanned extubation is a common adverse event and an important indicator of quality and safety of care. It is well recognized that the incidence of unplanned extubation of nasogastric/nasoenteric tubes is higher than that of other devices. Theory and previous research have suggested that cognitive bias in conscious patients with nasogastric/nasoenteric tubes may lead to unplanned extubation, and that social support, anxiety, and hope are influencing factors of cognitive bias. Therefore, the objective of this study was to investigate the effects of social support, anxiety, and hope levels on cognitive bias in patients with nasogastric/nasoenteric tubes. METHODS: In this cross-sectional study, 438 patients with nasogastric/nasoenteric tubes were selected from 16 hospitals in Suzhou from December 2019 to March 2022 by convenience sampling method. The participants were assessed using the General Information Questionnaire, Perceived Social Support Scale, Generalized Anxiety Disorder-7, Herth Hope Index, and Cognitive Bias Questionnaire for patients with nasogastric/nasoenteric tubes. The structural equation model was established with AMOS 22.0 software. RESULTS: The cognitive bias score of patients with nasogastric/nasoenteric tubes was 2.82±0.61. Patients' perceived levels of social support and hope were negatively correlated with their cognitive bias (r=-0.395 and -0.427, respectively, P<0.05), and anxiety was positively correlated with cognitive bias (r=0.446, P<0.05). Structural equation model analysis showed that anxiety had a direct positive effect on cognitive bias, with an effect value of 0.35 (P<0.001), and hope level had a direct negative effect on cognitive bias with an effect value of -0.33 (P<0.001). Social support had a direct negative effect on cognitive bias and was also shown to indirectly affect cognitive bias through anxiety and hope levels. The effect values were -0.22, -0.12, and -0.19 (P<0.001), for social support, anxiety, and hope, respectively. Social support, anxiety, and hope explained 46.2% of the total variation in cognitive bias. CONCLUSIONS: Moderate cognitive bias is noted in patients with nasogastric/nasoenteric tubes, and social support significantly affects cognitive bias. Anxiety and hope level play a mediating role in social support and cognitive bias. Positive psychological intervention and the obtention of positive support could improve the cognitive bias of patients with nasogastric/nasoenteric tubes.

Effect of Music Therapy Combined with Free Position Delivery on Labor Pain and Birth Outcomes.

Objective: At present, the clinical effect of music therapy combined with free position to assist delivery is rarely reported. Based on evidence-based nursing, this study is aimed at exploring the effect of the combination of music therapy and free position delivery on labor pain and maternal and fetal outcomes. Methods: A total of 440 primiparas with vaginal delivery in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Soochow University between July 2018 and July 2019 were selected. They were divided into music therapy, free position delivery group (n = 201) and traditional delivery group (n = 239). Subsequently, the two groups were compared in terms of the Chinese Perception of Labor Pain Questionnaire (PLPQ) score, bleeding amount at 2 hours after birth, perineal injury, labor stage duration, and 1 minute Apgar score. Results: The combination group had better results of the Chinese PLPQ score, postpartum hemorrhage, and perineum condition. However, compared with traditional delivery, a longer duration of the first stage and total stage of labor was found in the combination group. Music therapy combined with free position delivery required less medical intervention during delivery, and there was no significant difference in 1 minute Apgar score between the two groups. Conclusions: Music therapy combined with free position delivery, an intervention based on evidence-based nursing, can effectively reduce maternal labor pain, postpartum hemorrhage, soft birth canal injury, and medical intervention during labor. It is, therefore, a safe intervention to assist delivery.

Maternal circulating levels of transforming growth factor-ß superfamily and its soluble receptors in hypertensive disorders of pregnancy.

OBJECTIVE: To assess circulating levels of transforming growth factor (TGF)-ß superfamily members and their soluble receptors in hypertensive disorders of pregnancy, and to investigate associations with clinical manifestations. METHODS: A retrospective study was conducted using data for women admitted to a center in China for delivery between May 2011 and April 2013. Women with severe pre-eclampsia, mild pre-eclampsia, and gestational hypertension were included, along with a control group. Serum levels of activin A, inhibin A, TGF-ß1, soluble endoglin (sEng), and soluble betaglycan (sBG) were measured. RESULTS: Women with severe pre-eclampsia (n = 17) had higher mean levels of activin A (23.5±2.1 µg/L), inhibin A (1.7±0.2 µg/L), sEng (32.1±3.2 µg/L), and sBG (84.1±9.4 µg/L) than did normotensive controls (n = 18), women with gestational hypertension (n = 15), and those with mild pre-eclampsia (n = 14; all P<0.05). Women with early-onset pre-eclampsia (n = 13) had higher levels of these serum markers than did preterm normotensive controls (n = 8; all P<0.001). Women with severe or early-onset pre-eclampsia had the lowest TGF-ß1 levels. Activin A, inhibin A, sEng, and sBG levels were positively correlated with mean arterial pressure and proteinuria (all P<0.01). CONCLUSION: Pre-eclampsia is associated with an imbalance of members of the TGF-ß superfamily and their soluble receptors, which might contribute to the development of pre-eclampsia and help to predict onset and severity.

[Comparative studies on pharmacological effects of angong niuhuang pill with its simplified prescicription].

OBJECTIVE: Based on the therapeutic claims of Angong Niuhuang pill, a series of pharmacodynamic experiments were designed, where pharmacological effects were investigated comparatively with its simplified prescription(realgar and cinnabar are removed from the original pill) as a parallel control in order to explore possible contribution of cinnabar and realgar to pharmacodynamic activities of the pill as a whole. METHOD: Anti-pyretic, sedative, anti-convulsive, and mice-protected effects of the pill and its simplified prescription as a control were observed, respectively, in rabbits with fever induced by typhoid bacillus, in pentobarbital sodium-induced sleeping mice, in mice with convulsion induced by strychnine, or pentylenetetrazole, and in mice with anoxia induced by NaNO2. RESULT: Both the pill and its simplified prescription were found to have Anti-pyretic action and protective effect against the mouse death induced by anoxia, and synergistic interaction with pentobarbital sodium in sedative activity, although neither of them was found to have any effects on the convulsion of mice. CONCLUSION: No significant difference between Angong Niuhuang pill and its simplified prescription was found in the above pharmacodynamic experiments.

[Absorption and distribution of mercury and arsenic from realgar and cinnabar of angong niuhuang pill in normal rats and rats with cerebral ischemia].

OBJECTIVE: To study comparatively the characteristics of absorption and distribution of mercury and arsenic from realgar and cinnabar of Angong Niuhuang Pill in normal rats and the rats with cerebral ischemia after oral administration. METHOD: The blood samples and homogenates of liver, kidney and brain were prepared at various intervals after the animals were treated with Angong Niuhuang pill ig. The levels of total mercury and total arsenic in the blood and the organ homogenates were measured with Microwava Accelerated Reaction System and AAs, respectively. RESULT: The blood concentrations of mercury and arseic reached the highest point in normal rats at one hour following single oral dosing of Angong Niuhuang pill. In normal rats, the mercury distribution was characterized by its higher level in blood and kidneys than in other organs, while a higher distribution of arsenic was found in blood than in organs. No difference in the distribution of mercury or arsenic was found between normal rats and rats with cerebral ischemia after the treatment with the pill. CONCLUSION: The highest level of mercury or arsenic in blood occurs at one hour after oral administration of the pill in normal rats. There is a higher distribution of mercury in blood and kidneys, while a higher distribution of the arsenic only in blood. There is no significant difference in the distribution of mercury or arsenic between the normal rats and the ischemic rats.