产后护理:产后护理:指南比较评论》。

IF 4.3 4区 医学 Q1 OBSTETRICS & GYNECOLOGY Obstetrical & Gynecological Survey Pub Date : 2024-02-01 DOI:10.1097/OGX.0000000000001224
Sonia Giouleka, Ioannis Tsakiridis, Nikolaos Kostakis, Eirini Boureka, Apostolos Mamopoulos, Ioannis Kalogiannidis, Apostolos Athanasiadis, Themistoklis Dagklis
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引用次数: 0

摘要

重要性:产后护理是指为母亲及其后代提供的持续保健服务,有助于及时发现和有效处理产后并发症,以确保母婴短期和长期的健康:本研究旨在回顾和比较最近出版的具有影响力的产后护理实践指南:证据获取:对美国妇产科医师学会、世界卫生组织、美国国家健康与护理卓越研究所和加拿大公共卫生局有关产后护理的指南进行了比较审查:结果:在产后提供医疗保健服务的重要性方面,包括家访和助产服务、使用远程医疗促进与病人的沟通、为出院做好适当的准备以及出院标准等方面,所审查的指南达成了共识。所有医学会还就每次产后访视时应评估的临床方面达成一致,但在联系时间安排上存在差异。此外,关于产后感染、会阴疼痛、大小便失禁和体育锻炼指导的管理也是一致的。根据所有指南,产后每次就诊时都应处理心理健康问题,但对于抑郁症的常规筛查存在分歧。至于最佳的产后间隔,美国妇产科医师学会建议至少在产后 6 个月内避免怀孕,而美国国家健康与卓越护理研究所则建议间隔 12 个月。关于推荐的避孕方法、营养指导和产后妊娠并发症的处理,目前还没有统一的途径。值得注意的是,只有世界卫生组织提供了关于产后预防特定感染的建议:产后护理仍然是孕产妇护理中相对欠缺的一个方面,尽管产褥期是建立母性和过渡到初级护理的关键时期。因此,为产后妇女提供最佳护理和支持而制定一致的国际协议,对于安全地指导临床实践,进而降低孕产妇和新生儿发病率似乎具有不可逾越的重要意义。
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Postnatal Care: A Comparative Review of Guidelines.

Importance: Postnatal care refers to the ongoing health care provision of both the mother and her offspring and contributes to the timely identification and effective management of complications in the postpartum period, to secure maternal and infant short- and long-term well-being.

Objective: The aim of this study was to review and compare the most recently published influential guidelines on postnatal care practices.

Evidence acquisition: A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the World Health Organization, the National Institute for Health and Care Excellence, and the Public Health Agency of Canada regarding postnatal care was conducted.

Results: There is a consensus among the reviewed guidelines regarding the importance of health care provision in the postpartum period, including home visits and midwifery services, the use of telemedicine for the facilitation of communication with the patient, and the appropriate preparation for discharge, as well as the discharge criteria. All medical societies also agree on the clinical aspects that should be evaluated at each postnatal visit, although discrepancies exist with regard to the contact schedule. In addition, there is consistency regarding the management of postpartum infections, perineal pain, fecal and urinary incontinence, and physical activity guidance. Mental health issues should be addressed at each postnatal visit, according to all guidelines, but there is disagreement regarding routine screening for depression. As for the optimal interpregnancy interval, the American College of Obstetricians and Gynecologists recommends avoiding pregnancy for at least 6 months postpartum, whereas the National Institute for Health and Care Excellence recommends a 12-month interval. There is no common pathway regarding the recommended contraceptive methods, the nutrition guidance, and the postpartum management of pregnancy complications. Of note, the World Health Organization alone provides recommendations concerning the prevention of specific infections during the postnatal period.

Conclusions: Postnatal care remains a relatively underserved aspect of maternity care, although the puerperium is a critical period for the establishment of motherhood and the transition to primary care. Thus, the development of consistent international protocols for the optimal care and support of women during the postnatal period seems of insurmountable importance to safely guide clinical practice and subsequently reduce maternal and neonatal morbidity.

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来源期刊
CiteScore
2.70
自引率
3.20%
发文量
245
审稿时长
>12 weeks
期刊介绍: ​Each monthly issue of Obstetrical & Gynecological Survey presents summaries of the most timely and clinically relevant research being published worldwide. These concise, easy-to-read summaries provide expert insight into how to apply the latest research to patient care. The accompanying editorial commentary puts the studies into perspective and supplies authoritative guidance. The result is a valuable, time-saving resource for busy clinicians.
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