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Fetal Heart Monitoring, Nursing Surveillance, and Cesarean Birth.

机译：胎儿心脏监测，护理监测和剖宫产。

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摘要

Purpose: Birth by cesarean delivery is a major public health issue with nearly one in three births delivered by cesarean section. Cesarean birth may be necessary to save mother or baby, but the rapid rise since 1996 without concomitant reduction in maternal and neonatal morbidity and mortality may indicate this mode of delivery may be over utilized. Cesarean births pose significant maternal and newborn health risks. Identification of factors that may contribute to reduction in the first cesarean birth in low-risk women who are nulliparous, term gestation, with single fetus in head down position (NTSV) is a health priority. The purpose of this study was two-fold: (1) to examine nursing assessment of fetal heart rate (FHR) tracing and their interventions (nursing surveillance) in response to identification of an FHR tracing consistent with category IT pattern and (2) to identify whether nursing surveillance and frequency of category II patterns contribute to the risk of cesarean birth in NTSV women.;Methodology: A descriptive, cross-sectional, correlational research design with purposive sample was used. Retrospective review of patient's electronic medical record was conducted for NTSV women who delivered at a large tertiary women's hospital between May and June 2013.;Results: Statistically significant relationships were found between maternal age, admission BMI, induced labor, and cesarean birth. The odds of having a cesarean delivery was 12% (OR = 1.12) higher among women who had an increased number of nursing interventions within four hours prior to delivery. However, when examining the type of nursing intervention, none of the nursing interventions entered into the model were statistically significant as predictors of cesarean delivery. There was statistical significance between women who delivered vaginally and those who delivered by cesarean when examining nursing documentation of frequency of category II FHR tracing and nursing interventions.;Conclusions: The primary aims of this research study were to examine if nursing identification of a category II FHR pattern and nursing interventions were predictors of cesarean birth. The presence of category II FHR pattern was not a predictor but frequency of nursing interventions was a statistically significant predictor when entered into a logistic regression model.
机译：目的：剖宫产分娩是一个重大的公共卫生问题，剖宫产分娩的比例接近三分之一。剖腹产可能是挽救母亲或婴儿所必需的，但自1996年以来的迅速增长并未伴随母婴发病率和死亡率的降低，可能表明这种分娩方式可能被过度利用。剖宫产会给母亲和新生儿带来重大健康风险。确定可能导致未生育，足月妊娠且头朝下的单胎胎儿（NTSV）的低危妇女首次剖腹产减少的因素是健康的重点。这项研究的目的是双重的：（1）检查胎儿心率（FHR）追踪的护理评估及其干预措施（护理监测），以响应与类别IT模式一致的FHR追踪的识别；以及（2）鉴定护理监视和II类模式的频率是否对NTSV女性剖宫产风险有影响。方法：采用描述性，横断面，相关研究设计和目的性样本。回顾性审查了2013年5月至2013年6月在大型三级妇产医院分娩的NTSV妇女的电子病历。结果：发现孕产妇年龄，入院BMI，引产和剖宫产之间存在统计学上的显着关系。在分娩前四个小时内增加护理干预措施的妇女中，剖宫产的几率高出12％（OR = 1.12）。但是，在检查护理干预措施的类型时，没有任何模型进入护理模型作为剖宫产预测指标具有统计学意义。在检查II类FHR追踪频率和护理干预措施的护理文档时，阴道分娩的妇女和剖宫产的妇女之间具有统计学意义。结论：本研究的主要目的是检查是否可以识别II类的护理FHR模式和护理干预是剖宫产的预测指标。当进入逻辑回归模型时，II类FHR模式的存在不是预测因素，但护理干预的频率是统计学上显着的预测因素。

著录项

  • 作者

    Colombo, Maria del Carmen.;

  • 作者单位

    University of San Diego.;

  • 授予单位 University of San Diego.;
  • 学科 Nursing.;Obstetrics.
  • 学位 Ph.D.
  • 年度 2014
  • 页码 87 p.
  • 总页数 87
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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