Effect of midwife intervention coupled with acupressure on the vaginal delivery rate and negative emotion in parturients with scarred uterus re-pregnancy.

OBJECTIVE: To investigate the effect of midwife intervention coupled with acupressure on the vaginal delivery rate and negative emotion in parturients with scarred uterus re-pregnancy. METHODS: A total of 85 parturients with scarred uterus re-pregnancy who agreed to trial-produce vaginally after assessment were analyzed retrospectively. Parturients were divided into the research group (43 parturients) who received midwife intervention coupled with acupressure and the control group (42 parturients) who received routine nursing intervention. The delivery mode, birth process time, postpartum hemorrhage, maternal and infant outcomes, negative emotion improvement, intrapartum pain score and family care satisfaction of parturients between the two groups were compared. RESULTS: Parturients in the research group had higher spontaneous vaginal delivery rate (67.44% vs. 45.24%, P<0.05), lower rates of lateral episiotomy, puerperal infection and neonatal asphyxia (all P<0.05), compared with the control group. No difference in vaginal midwifery rate was found (P>0.05). Shorter first stage of labor and second stage of labor (both P<0.001) and less postpartum 2 h and 24 h hemorrhage were found in the research group than in the control group (both P<0.05). After intervention, parturients in the research group versus those in the control group showed lower visual analogue scale scores in the incubation period and active period and negative emotion (Hamilton anxiety (HAMA) scale, and Hamilton depression (HAMD) scale) scores (all P<0.05) and greater nursing satisfaction (P<0.05). CONCLUSION: Midwife intervention coupled with acupressure can alleviate the degree of anxiety and depression in parturients with scarred uterus re-pregnancy, accelerate the progress of labor, relieve pain, increase spontaneous vaginal delivery rate, and improve maternal and infant outcomes.

Tricalysiosides P-U: Ent-kaurane glucosides and a labdane glucoside from leaves of Tricalysia dubia OHWI.

Further extensive isolation work on the 1-BuOH-soluble fraction of a MeOH extract of Tricalysia dubia afforded five new ent-kaurane glucosides (4-8) and one new labdane glucoside (9), together with a known megastigmane glucoside, sammangaoside B (1), and monoterpene glucosides (2, 3). The structures of the new compounds were elucidated by analyses of one- and two-dimensional NMR spectroscopic data. The absolute configuration of the 9-position of sammangaoside B was revised to S and its total stereochemistry was established by the modified Mosher's method.

Tricalysiosides A-G: rearranged ent-kauranoid glycosides from the leaves of Tricalysia dubia.

Seven rearranged ent-kaurane glycosides, named tricalysiosides A-G (1-7), were isolated from the leaves of Tricalysia dubia collected on Okinawa Island. Their C-18 and 19 methyls were found to have rearranged to form an alpha,beta-unsaturated gamma-lactone ring, with other functional groups remotely located only on C-15, -16, and -17 of the five-membered ring. Information available from various kinds of two-dimensional NMR spectra was limited and insufficient to allow total characterization of the structures. Finally, using X-ray crystallographic analysis, the structure of tricalysioside A (1) was determined to be 4-nor-18-homo-ent-kauran-4(18)-en-15beta,16beta,17-triol-3beta,19-olide 16-O-beta-D-glucopyranoside (1). On the basis of the crystal structure of 1, the structures of the other tricalysiosides (2-7) were also established.