RESUMO
To establish the analytic conditions for examining the aroma quality of vanilla pods, we compared different extraction methods and identified a suitable option. We utilized headspace solid-phase microextraction (HS-SPME), steam distillation (SD), simultaneous steam distillation (SDE) and alcoholic extraction combined with gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) to identify volatile components of vanilla pods. A total of 84 volatile compounds were identified in this experiment, of which SDE could identify the most volatile compounds, with a total of 51 species, followed by HS-SPME, with a total of 28 species. Ten volatile compounds were identified by extraction with a minimum of 35% alcohol. HS-SPME extraction provided the highest total aroma peak areas, and the peak areas of aldehydes, furans, alcohols, monoterpenes and phenols compounds were several times higher than those of the other extraction methods. The results showed that the two technologies, SDE and HS-SPME, could be used together to facilitate analysis of vanilla pod aroma.
Assuntos
Vanilla , Compostos Orgânicos Voláteis , Cromatografia Gasosa-Espectrometria de Massas/métodos , Odorantes/análise , Microextração em Fase Sólida/métodos , Vapor/análise , Compostos Orgânicos Voláteis/análiseRESUMO
Gastrodia elata, a fully mycoheterotrophic orchid without photosynthetic ability, only grows symbiotically with the fungus Armillaria. The mechanism of carbon distribution in this mycoheterotrophy is unknown. We detected high sucrose concentrations in all stages of Gastrodia tubers, suggesting sucrose may be the major sugar transported between fungus and orchid. Thick symplasm-isolated wall interfaces in colonized and adjacent large cells implied involvement of sucrose importers. Two sucrose transporter (SUT)-like genes, GeSUT4 and GeSUT3, were identified that were highly expressed in young Armillaria-colonized tubers. Yeast complementation and isotope tracer experiments confirmed that GeSUT4 functioned as a high-affinity sucrose-specific proton-dependent importer. Plasma-membrane/tonoplast localization of GeSUT4-GFP fusions and high RNA expression of GeSUT4 in symbiotic and large cells indicated that GeSUT4 likely functions in active sucrose transport for intercellular allocation and intracellular homeostasis. Transgenic Arabidopsis overexpressing GeSUT4 had larger leaves but were sensitive to excess sucrose and roots were colonized with fewer mutualistic Bacillus, supporting the role of GeSUT4 in regulating sugar allocation. This is not only the first documented carbon import system in a mycoheterotrophic interaction but also highlights the evolutionary importance of sucrose transporters for regulation of carbon flow in all types of plant-microbe interactions.
Assuntos
Gastrodia/metabolismo , Proteínas de Membrana Transportadoras/metabolismo , Proteínas de Plantas/metabolismo , Sacarose/metabolismo , Simbiose , Arabidopsis , Armillaria/metabolismo , Armillaria/fisiologia , Gastrodia/microbiologia , Gastrodia/fisiologia , Hibridização In Situ , Proteínas de Membrana Transportadoras/fisiologia , Microscopia Eletrônica de Transmissão , Micorrizas/metabolismo , Micorrizas/ultraestrutura , Proteínas de Plantas/fisiologia , Tubérculos/metabolismo , Tubérculos/microbiologia , Tubérculos/ultraestrutura , Plantas Geneticamente ModificadasRESUMO
Vanilla (Vanilla planifolia) is a precious natural flavoring that is commonly used throughout the world. In the past, all vanilla used in Taiwan was imported; however, recent breakthroughs in cultivation and processing technology have allowed Taiwan to produce its own supply of vanilla. In this study, headspace solid-phase microextraction (HS-SPME) combined with GC-FID and GC-MS was used to analyze the volatile components of vanilla from different origins produced in Taiwan under different cultivation and processing conditions. The results of our study revealed that when comparing different harvest maturities, the composition diversity and total volatile content were both higher when the pods were matured for more than 38 weeks. When comparing different killing conditions, we observed that the highest vanillin percentage was present after vanilla pods were killed three times in 65 °C treatments for 1 min each. From the experiment examining the addition of different strains, the PCA results revealed that the volatiles of vanilla that was processed with Dekkera bruxellensis and Bacillus subtilis was clearly distinguished from which obtained by processing with the other strains. Vanilla processed with B. subtilis contained 2-ethyl-1-hexanol, and this was not detected in other vanillas. Finally, when comparing the vanillin percentage from seven different regions in Taiwan, vanilla percentage from Taitung and Taoyuan Longtan were the highest.
Assuntos
Vanilla/química , Vanilla/metabolismo , Compostos Orgânicos Voláteis/química , Agricultura/métodos , Benzaldeídos/química , Benzaldeídos/isolamento & purificação , Cromatografia Gasosa/métodos , Aromatizantes/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Extratos Vegetais/análise , Microextração em Fase Sólida/métodos , Taiwan , Compostos Orgânicos Voláteis/análiseRESUMO
BACKGROUND: Bronchiectasis is a chronic infectious respiratory disease with diverse causes and ethnic or geographic differences. However, few large-scale studies of its etiology have been conducted in Asia. This study aimed to determine the etiology and clinical features of bronchiectasis in Taiwan. METHODS: This longitudinal cohort study investigated the etiology and clinical features of newly diagnosed non-cystic fibrosis bronchiectasis patients from January 2002 to December 2016. The clinical, functional and microbiological data of patients were retrieved from the Chang Gung Research Database, which includes seven medical facilities throughout Taiwan. The index date was the date of the first bronchiectasis diagnosis. Known diseases that were diagnosed before the index date were regarded as etiologies of bronchiectasis. RESULTS: The cohort comprised 15,729 adult patients with bronchiectasis. Idiopathic (32%) was the most common cause, followed by post-pneumonia (24%). Other causes included post-tuberculosis (12%), chronic obstructive pulmonary disease (14%), asthma (10%), gastroesophageal reflux disease (2%) and rheumatic diseases (2%). At diagnosis, 8487 patients had sputum culture. Pseudomonas aeruginosa (5.3%) was the most common bacteria, followed by non-tuberculosis mycobacteria (3.6%), Haemophilus influenzae (3.4%) and Klebsiella pneumoniae (3.1%), but 6155 (72.1%) had negative sputum cultures. Patients with post-tuberculosis had a higher sputum isolation rate of non-tuberculosis mycobacteria than P. aeruginosa. Patients with post-tuberculosis and post-pneumonia bronchiectasis had a higher frequency of chronic lung infection than other groups (p < 0.05). Clinical characteristics, such as gender, lung function, comorbidities and microbiology, were significantly different between idiopathic and known etiologies. CONCLUSIONS: Idiopathic, post-infection and tuberculosis constitute major bronchiectasis etiologies in Taiwan. Clinical characteristics and sputum microbiology were distinct among separate etiology phenotypes.
Assuntos
Bronquiectasia/etiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Asma/complicações , Bronquiectasia/epidemiologia , Comorbidade , Bases de Dados Factuais , Feminino , Previsões , Infecções por Haemophilus/complicações , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/isolamento & purificação , Humanos , Infecções por Klebsiella/complicações , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Doença Pulmonar Obstrutiva Crônica/complicações , Infecções Respiratórias/complicações , Escarro/microbiologia , Taiwan/epidemiologiaRESUMO
The Orchidaceae is a diverse and ecologically important plant family. Approximately 69% of all orchid species are epiphytes, which provide diverse microhabitats for many small animals and fungi in the canopy of tropical rainforests. Moreover, many orchids are of economic importance as food flavourings or ornamental plants. Phalaenopsis aphrodite, an epiphytic orchid, is a major breeding parent of many commercial orchid hybrids. We provide a high-quality chromosome-scale assembly of the P. aphrodite genome. The total length of all scaffolds is 1025.1 Mb, with N50 scaffold size of 19.7 Mb. A total of 28 902 protein-coding genes were identified. We constructed an orchid genetic linkage map, and then anchored and ordered the genomic scaffolds along the linkage groups. We also established a high-resolution pachytene karyotype of P. aphrodite and completed the assignment of linkage groups to the 19 chromosomes using fluorescence in situ hybridization. We identified an expansion in the epiphytic orchid lineage of FRS5-like subclade associated with adaptations to the life in the canopy. Phylogenetic analysis further provides new insights into the orchid lineage-specific duplications of MADS-box genes, which might have contributed to the variation in labellum and pollinium morphology and its accessory structure. To our knowledge, this is the first orchid genome to be integrated with a SNP-based genetic linkage map and validated by physical mapping. The genome and genetic map not only offer unprecedented resources for increasing breeding efficiency in horticultural orchids but also provide an important foundation for future studies in adaptation genomics of epiphytes.
Assuntos
Mapeamento Cromossômico , Cromossomos de Plantas/genética , Genoma de Planta/genética , Orchidaceae/genética , Melhoramento Vegetal/métodos , Adaptação Fisiológica/genética , Genoma de Planta/fisiologia , CariotipagemRESUMO
Phalaenopsis is the most important economic crop in the Orchidaceae family. There are currently numerous beautiful and colorful Phalaenopsis flowers, but only a few species of Phalaenopsis have an aroma. This study reports the analysis volatile components present in P. Nobby's Pacific Sunset by solid-phase microextraction (SPME) coupled with gas chromatography (GC) and gas chromatography/mass spectrometry (GC-MS). The results show that the optimal extraction conditions were obtained by using a DVB/CAR/PDMS fiber. A total of 31 compounds were identified, with the major compounds being geraniol, linalool and α-farnesene. P. Nobby's Pacific Sunset had the highest odor concentration from 09:00 to 13:00 on the eighth day of storage. It was also found that in P. Nobby's Pacific Sunset orchids the dorsal sepals and petals had the highest odor concentrations, whereas the column had the lowest.
Assuntos
Flores/química , Orchidaceae/química , Extratos Vegetais/isolamento & purificação , Adsorção , Microextração em Fase Sólida , Compostos Orgânicos Voláteis/isolamento & purificaçãoRESUMO
This study investigated the effects of different storage times (0-24 months) and temperatures (-20 °C, 4 °C, 25 °C, and 35 °C) on the volatile compounds and color of vanilla beans from Taiwan using ISO 5565-1:1999 as the commercial quality indicators. The vanillin level was highest at -20 °C for 6 months (p < 0.05) and no color-perceived differences (ΔE < 1). At 35 °C, lipid metabolism, enzymatic oxidation, and Maillard reaction products, such as 2-acetylpyrrole and 5-hydroxymethylfurfural, were detected after 18 months of storage, leading to significant color-perceived differences (ΔE > 5) and changes in the odor profile, which did not meet ISO standards. To sum up, as the storage temperature and duration increased, oxidative metabolites increased. Furthermore, storage at -20 °C or 4 °C is stable, but considering vanillin quality, the storage temperature of -20 °C can extend the storage period by 12 months.
RESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Excessive UV irradiation and ROS exposure are the main contributors of ocular pathologies. Pseudobulb of Dendrobium nobile Lindl. is one of the sources of Shihu and has long been used in traditional Chinese medicine as a tonic to nourish stomach, replenish body fluid, antipyretic and anti-inflammation. AIM OF STUDY: This study aimed to investigate whether D. nobile could protect ocular cells against oxidative stress damage. MATERIALS AND METHODS: Retinal-related cell lines, ARPE-19 and RGC-5 cells, were pretreated with D. nobile extracts before H2O2- and UV-treatment. Cell viability and the oxidative stress were monitored by sulforhodamine B (SRB) and SOD1 and CAT assay kits, respectively. The oxidative stress related proteins were measured by Western blotting. RESULTS: Under activity-guided fractionation, a sesquiterpene-enriched fraction (DN-2) and a major component (1) could ameliorate H2O2- and UV-induced cytotoxicity and SOD1 and CAT activity, but not dendrobine, the chemical marker of D. nobile. Western blotting showed both DN-2 and compound 1 protected ARPE-19 cells against UV-induced oxidative stress damage by regulating MAPK and Nrf2/HO-1 signaling. CONCLUSION: Our results suggest D. nobile extract protects retinal pigment epithelia cells from UV- and oxidative stress-damage, which may have a beneficial effect on eye diseases.
Assuntos
Dendrobium/química , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Epitélio Pigmentado da Retina/efeitos dos fármacos , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Células Epiteliais/efeitos dos fármacos , Heme Oxigenase-1/metabolismo , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Camundongos , Fator 2 Relacionado a NF-E2/metabolismo , Epitélio Pigmentado da Retina/citologia , Transdução de Sinais/efeitos dos fármacos , Raios Ultravioleta/efeitos adversosRESUMO
Background: The prevalence of nontuberculous mycobacteria (NTM) in patients with chronic respiratory disease has increased. The implication of NTM in non-CF bronchiectasis remained controversial. This study investigated the impact of NTM in non-CF bronchiectasis in Taiwan. Methods: Clinical manifestation, imaging, and microbiological data were retrieved from the Chang Gung Research Database, the largest electronic medical record-based database in Taiwan. Patients with bronchiectasis during 2001-2016 were included. Cox proportional hazard model was employed to compare outcomes between patients with negative and positive NTM isolates after 1:1 propensity score matching. Results: A total of 19,647 non-CF bronchiectasis patients were enrolled and 11,492 patients were eligible for analysis after exclusion screening. Finally, patients with negative and positive NTM isolates-650 each-were analyzed after propensity score matching. The patients with negative NTM isolates were divided into three groups: Pseudomonas aeruginosa isolates (n = 53); fungus isolates (n = 26); and concomitant P. aeruginosa and fungus isolates (n = 8). The patients with positive NTM isolates were divided into five groups: single NTM isolate (n = 458); multiple NTM isolates (n = 60); concomitant NTM and P. aeruginosa isolates (n = 89); concomitant NTM and fungus isolates (n = 33); and concomitant NTM, P. aeruginosa, and fungus isolates (n = 10). Patients with P. aeruginosa isolates; concomitant NTM and P. aeruginosa isolates; concomitant NTM, P. aeruginosa, and fungus isolates had independently associated with respiratory failure and death. Patients with single or multiple NTM isolates were not related to ventilator use, but both were independent risk factor for mortality. Conclusion: NTM, either combined with P. aeruginosa or fungus, exhibited more frequent exacerbations in non-CF bronchiectasis patients. Moreover, NTM predicted mortality in non-CF bronchiectasis patients and were also correlated to respiratory failure while concomitantly isolated with P. aeruginosa and fungus.
RESUMO
BACKGROUND: Vanilla planifolia is an important tropical orchid for production of natural vanilla flavor. Traditionally, V. planifolia is propagated by stem cuttings, which produces identical genotype that are sensitive to virulent pathogens. However, propagation with seed germination of V. planifolia is intricate and unstable because the seed coat is extremely hard with strong hydrophobic nature. A better understanding of seed development, especially the formation of impermeable seed coat would provide insights into seed propagation and conservation of genetic resources of Vanilla. RESULTS: We found that soaking mature seeds in 4% sodium hypochlorite solution from 75 to 90 min significantly increased germination. For the culture of immature seeds, the seed collection at 45 days after pollination (DAP) had the highest germination percentage. We then investigated the anatomical features during seed development that associated with the effect of seed pretreatment on raising seed germination percentage. The 45-DAP immature seeds have developed globular embryos and the thickened non-lignified cell wall at the outermost layer of the outer seed coat. Seeds at 60 DAP and subsequent stages germinated poorly. As the seed approached maturity, the cell wall of the outermost layer of the outer seed coat became lignified and finally compressed into a thick envelope at maturity. On toluidine blue O staining, the wall of outer seed coat stained greenish blue, indicating the presence of phenolic compounds. As well, on Nile red staining, a cuticular substance was detected in the surface wall of the embryo proper and the innermost wall of the inner seed coat. CONCLUSION: We report a reliable protocol for seed pretreatment of mature seeds and for immature seeds culture based on a defined time schedule of V. plantifolia seed development. The window for successful germination of culturing immature seed was short. The quick accumulation of lignin, phenolics and/or phytomelanins in the seed coat may seriously inhibit seed germination after 45 DAP. As seeds matured, the thickened and lignified seed coat formed an impermeable envelope surrounding the embryo, which may play an important role in inducing dormancy. Further studies covering different maturity of green capsules are required to understand the optimal seed maturity and germination of seeds.
RESUMO
BACKGROUND: Gastrodiae Rhizoma (Tianma), the dried tuber of Gastrodia elata Bl. (Orchidaceae), is listed as a top-grade herbal medicine in Shen-nong Ben-ts'ao Jing and has been used for treating headaches, dizziness, vertigo and convulsion. It has a neuroprotective effect and extends the lifespan in mouse models of Huntington's disease and Niemann-Pick type C disease. However, its effect on senescence remains unknown. PURPOSE: This study aimed to investigate the anti-aging effects and the underlying mechanism of Gastrodiae Rhizoma. METHODS: D-galactose (D-gal)- and BeSO4-induced cellular senescence and senescence-associated ß-galactosidase (SA-ß-gal) activity were evaluated in SH-SY5Y and PC12 cells. D-gal-induced aging mice were used as an in vivo model. Animal behaviors including nesting and burrowing and Morris water maze were conducted. Neurogenesis in the hippocampus was assessed by immunohistochemistry and confocal microscopy, and the aging-related proteins were assessed by Western blot analysis. The potential neuritogenesis activity of the partially purified fraction of Gastrodiae Rhizoma (TM-2) and its major ingredients were investigated in PC12 cells. RESULTS: TM-2 could improve D-gal-induced learning and memory impairement by inhibiting oxidative stress, increasing hippocampal neurogenesis and regulating the SH2B1-Akt pathway. Moreover, N6-(4-hydroxybenzyl)adenine riboside (T1-11) and parishins A and B, three constituents of TM-2, had anti-aging activity, as did T1-11 and parishin A induced neuritogenesis. CONCLUSION: Our data suggested that TM-2 slowed down D-gal-induced cellular and mouse brain aging. These results indicate that Gastrodiae Rhizoma has a beneficial effect on senescence. It may be used for neuroprotection and promoting neurogenesis.
Assuntos
Envelhecimento/efeitos dos fármacos , Senescência Celular/efeitos dos fármacos , Gastrodia/química , Hipocampo/efeitos dos fármacos , Rizoma/química , Animais , Comportamento Animal/efeitos dos fármacos , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/farmacologia , Galactose , Hipocampo/citologia , Hipocampo/fisiologia , Masculino , Camundongos , Neurogênese/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Células PC12 , RatosRESUMO
Background The ROCKET AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) evaluated rivaroxaban (20/15 mg/d) versus warfarin in patients with atrial fibrillation. A separate trial, J-ROCKET AF (Japanese ROCKET AF), compared rivaroxaban (15/10 mg/d) and warfarin in Japanese patients with atrial fibrillation. Data about rivaroxaban following J-ROCKET AF criteria compared with warfarin and ROCKET AF dosage were limited. Methods and Results This retrospective study used medical data from a multicenter healthcare provider in Taiwan that included 3162 patients taking rivaroxaban. Among 2320 patients with an estimated glomerular filtration rate (eGFR) ≥50 mL/min per 1.73 m2, 384 and 1936 patients followed the ROCKET AF (20 mg/d) and J-ROCKET AF (15 mg/d) recommendation, respectively. Among 842 patients with an eGFR <50 mL/min per 1.73 m2, 422 and 420 patients followed the ROCKET AF (15 mg/d) and J-ROCKET AF (10 mg/d) recommendation, respectively. A total of 2053 patients with atrial fibrillation receiving warfarin were identified. Rivaroxaban following either ROCKET AF or J-ROCKET AF dosage criteria was associated with a comparable risk of thromboembolism but a lower risk of bleeding than warfarin. For patients with an eGFR ≥50 mL/min per 1.73 m2, risks of clinical events did not differ significantly between the 2 dosage criteria of rivaroxaban. For patients with an eGFR <50 mL/min per 1.73 m2, the ROCKET AF dosage was associated with a higher risk of major bleeding compared with the J-ROCKET AF dosage (hazard ratio, 2.70; P=0.0445) without significant differences regarding the risk of ischemic events. Conclusions In Asian patients with atrial fibrillation, the J-ROCKET AF dosage was as effective as the ROCKET AF dosage irrespective of renal function. The risk of major bleeding was lower with the J-ROCKET AF dosage in patients with an eGFR <50 mL/min per 1.73 m2. Compared with warfarin, rivaroxaban following either dosage criteria was effective and even safer.
Assuntos
Fibrilação Atrial/tratamento farmacológico , Inibidores do Fator Xa/administração & dosagem , Rivaroxabana/administração & dosagem , Idoso , Anticoagulantes/administração & dosagem , Povo Asiático , Estudos de Coortes , Relação Dose-Resposta a Droga , Feminino , Taxa de Filtração Glomerular , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Masculino , Estudos Retrospectivos , Acidente Vascular Cerebral/prevenção & controle , Taiwan/epidemiologia , Tromboembolia/epidemiologia , Varfarina/administração & dosagemRESUMO
BACKGROUND: Preparation of good chromosome spreads without cytoplasmic contamination is the crucial step in cytogenetic mapping. To date, cytogenetic research in the Orchidaceae family has been carried out solely on mitotic metaphase chromosomes. Well-spread meiotic pachytene chromosomes can provide higher resolution and fine detail for analysis of chromosomal structure and are also beneficial for chromosomal FISH (fluorescence in situ hybridization) mapping. However, an adequate method for the preparation of meiotic pachytene chromosomes in orchid species has not yet been reported. RESULTS: Two Taiwanese native Phalaenopsis species were selected to test the modified drop method for preparation of meiotic pachytene chromosomes from pollinia. In this modified method, pollinia were ground and treated with an enzyme mixture to completely remove cell walls. Protoplasts were resuspended in ethanol/glacial acetic acid and dropped onto a wet inclined slide of 30° from a height of 0.5 m. The sample was then flowed down the inclined plane to spread the chromosomes. Hundreds of pachytene chromosomes with little to no cytoplasmic contamination were well spread on each slide. We also showed that the resolution of 45S rDNA-containing chromosomes at the pachytene stage was up to 20 times higher than that at metaphase. Slides prepared following this modified drop method were amenable to FISH mapping of both 45S and 5S rDNA on pachytene chromosomes and, after FISH, the chromosomal structure remained intact for further analysis. CONCLUSION: This modified drop method is suitable for pachytene spreads from pollinia of Phalaenopsis orchids. The large number and high-resolution pachytene spreads, with little or no cytoplasmic contamination, prepared by the modified drop method could be used for FISH mapping of DNA fragments to accelerate the integration of cytogenetic and molecular research in Phalaenopsis orchids.
RESUMO
OBJECTIVE: Pleasant and humane childbirth is every mother's wish. The objective of this study was to propose a practicable mother-friendly childbirth model tailored to Taiwanese women in order to improve the quality of perinatal care and maternal satisfaction. MATERIAL AND METHODS: In this study, the guidelines of several countries were systematically reviewed, and a standard set of clinical guidelines were established by a focus group. In addition, a total of 172 Taiwanese obstetricians were visited, and a cross-sectional study of these obstetricians' attitudes toward the practicality and effectiveness of the model was performed using questionnaires. RESULTS: A total of 10 suggestions were developed for this woman-friendly childbirth model, including: (1) intermittent fetal monitoring for low-risk pregnancy, (2) no routine enema, (3) no routine perineal shaving, (4) no routine restricted oral intake, (5) no routine parenteral fluid support, (6) no routine elective amniotomy, (7) nonpharmacological pain management, (8) upright position during childbirth, (9) delayed pushing, and (10) restrictive episiotomy. Taiwanese obstetricians approved of no routine oral intake restriction and providing nonmedical pain relief. The majority of obstetricians disagreed that perineal shaving and routine elective amniotomy were necessary, and agreed to modify their practice according to the suggestions. Suggestions were still being debated, such as no routine parenteral fluid support, using an upright position for childbirth, and delayed pushing. Intermittent fetal monitoring for low-risk pregnancy, no routine enema, and restrictive episiotomy were questioned by many Taiwanese obstetricians. CONCLUSION: Several suggestions were made in this model. However, there was still no consensus of Taiwanese obstetricians. More evidence for the advantages and disadvantages of the various suggestions was needed to convince Taiwanese obstetrician to modify their routine practice.
Assuntos
Atitude do Pessoal de Saúde , Parto Obstétrico/métodos , Obstetrícia , Padrões de Prática Médica , Adulto , Estudos Transversais , Enema , Episiotomia , Feminino , Monitorização Fetal , Grupos Focais , Humanos , Manejo da Dor , Posicionamento do Paciente , Gravidez , TaiwanRESUMO
OBJECTIVES: Pleasant and humane childbirth is every mother's wish. We established one practicable and tailored Taiwanese mother-friendly childbirth model, and the objective of this study was to investigate the implementation, pregnancy outcomes, and women's satisfaction. MATERIALS AND METHODS: We used the Taiwanese mother-friendly childbirth model. Women from eight hospitals were divided into an experimental group and control group. The experimental group received prenatal care modified by the Taiwanese mother-friendly childbirth model and the control group received routine prenatal care according to their hospital. We performed a quasi-experimental study of women's satisfaction toward this mother-friendly childbirth model by questionnaires and surveyed the practicality and effectiveness of this model. RESULTS: Seven hundred and fifty-one women from eight hospitals, including three medical centers and five regional hospitals were included. There was significantly different practices between the two groups, such as: (1) intermittent fetal monitoring for low-risk pregnancy; (2) no routine enema; (3) no perineal shaving; (4) less routine parenteral fluid support; (5) using an upright position; and (6) restrictive episiotomy. The mean maternal height, body weight gain, gestational age, birth weight, and episiotomy wound infection rate were indifferent. The epidural anesthesia rate and induction medication use were significantly lower in the experimental group. The self-reported pain score was higher in the experimental group and the self-reported satisfactory score was also higher in the experimental group, without statistical significance. CONCLUSION: Women receiving standardized prenatal care modified by the woman-friendly childbirth model of prenatal care had less epidural anesthesia, less induction medication, higher self-reported satisfaction score, and indifferent pregnancy outcomes such as gestational age, birth weight, and wound infection rate.