Objective To determine the effects of delayed umbilical cord clamping on the postpartum hemorrhage,instant and long-term newborn anemia,newborn jaundice.Methods In total,303 infants were selected during October 2016 to June 2017 in three hospitals in Beijing.They were randomly allocated into two groups receiving instant clamping of umbilical cord (less than 60s after delivery,n=158) and delayed clamping of umbilical cord(after cord pulsation ceased,n=145).Relevant indicators of maternal and neonatal outcomes are compared.Results There were significant differences between two groups in instant hemoglobin concentration and in 5～7 days (P＜0.05).There were no differences between two groups in transcutaneous bilirubin,the risk of anemia in three months,the risk of jaundice in 5～7 days and the need of blue-light therapy (P＞0.05).There were no differences between two groups of women in postpartum hemorrhage,the length of third stage of labor and the rate of breast feeding (P＞0.05).Conclusion Clamping the umbilical cord when cord pulsation has ceased does not have negative effects on delivery process and postpartum hemorrhage,but it increases the instant hemoglobin concentration and hemoglobin concentration after delivery in 5～7 days.Still it is unclear whether it will affect the risk of jaundice.

Objective With methods of literature review, item test, reliability and validity test, etc., to develop a fall risk assessment scale specific to the obstetrical department, which, after reliability and validity test, can be used for women health care before, at and after delivery.Methods Items in the fall risk assessment scale for pregnant and maternal women were determined and weights were assigned by reviewing relative risk factors in literature, referring to items in other fall risk assessment tools from home and aboard. After a preliminary scale was formed, 154 pregnant and maternal women hospitalized from May to December 2016 were assessed, so that reliability and validity of the scale were tested.Results In this fall risk assessment scale for the obstetrical department, test-retest reliability was 0.822, interrater reliability was 0.926, content validity of expertise was 0.927, and area under the curve (ROC) was 0.750 (P<0.05). When the dividing value was 3.5, sum of sensitivity (0.714) and specificity (0.714) reached the max.Conclusions The new fall risk scale, with favorable reliability and validity, can filter patients with high risk of fall, yet, it is still to be testified and perfected in future application.

遗传性凝血因子Ⅴ缺乏症即副血友病，是一种罕见的常染色体隐性遗传的出血性疾病。人群中纯合子发病率约为1/100万，男女均可罹患，少数患者的父母为近亲婚配[1]。对于患有纯合性凝血因子V缺乏症的患者而言，妊娠和分娩意味着危险的挑战，多数患者在分娩或产后表现出不同程度的出血，因为出血增多可能随时出现休克、多脏器功能衰竭、弥散性血管内凝血等严重情况[2]。因此，对患有凝血因子Ⅴ缺乏症的产妇一旦发生出血可能危及产妇生命。我院2012年11月收治1例凝血因子Ⅴ缺乏症的足月产妇，经过充分的评估及精心的治疗和护理，患者顺利自然分娩且未发生产后出血，现报道如下。

Objective: To explore the effect of quality control activities on decreasing urine retention rate after natural labour. Methods: The authors set up a quality control circle, followed the steps of quality control activities with professional quality management tools to solve the existing problems in preventing postpartum urine retention. Urine retention rate was compared before and after the activities. Results: The urine retention rate decreased from 18.80% to 7.29%, and the difference was statistically signiifcant (P<0.01). Conclusion: The application of the quality control circle activities could decrease the postpartum urine retention rate and improve care quality. It also could increase the quality management capacities of staff nurses.

目的调查待产孕妇家属在产房外等候期间焦虑状态及相关因素,为寻求帮助待产孕妇家属减轻焦虑的应对措施提供依据。方法应用方便取样方法,选取2010年7～9月在北京大学第一医院产科分娩的孕妇家属110名作为研究对象,使用SPielberger等人编制的状态-特质焦虑问卷(STAI)及自行设计家属焦虑相关因素问卷进行调查分析。结果 110例待产孕妇家属待产妇家属特质焦虑(T-AI)得分低于常模,在等候期间状态(S-AI)焦虑得分明显高于常模。结论待产孕妇家属在产房外等候期间存在明显的焦虑状态,产房护理人员应正确认识家属的焦虑情绪,重视家属心理需求,有针对性的给予护理干预,缓解孕妇家属焦虑状态。

本文介绍一例罕见的妊娠合并心脏病(右位心)同时合并有先天性肺缺如、单侧肺动脉缺如的剖宫产术前后的护理过程。评估患者心肺功能、心理状况,请内科医生协同会诊。术前后严格记录液体出入量,保证液体出入量平衡,注意药物反应。严密观察术后心肺功能恢复情况,术后应用物理治疗防止肺部发生感染,应用下肢血液循环驱动护理防止下肢静脉血栓形成。剖宫产后恢复顺利,无并发症发生,母婴平安。