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顺产好还是剖宫产好?

2017-09-08 04:01:54   中国青年网

长沙晚报记者 杨蔚然 唐江澎 通讯员 阳成英 黄配

这两天,一则新闻引起社会广泛关注:8月31日,陕西榆林市第一医院待产妇马某,在即将分娩前,从医院的产房跳楼自杀,这一惨痛悲剧在网上掀起轩然大波。

孕产妇到底该不该做剖宫产?顺产还是剖宫产好?记者昨日采访了湖南省妇幼保健院和长沙市第一医院有关专家。

什么情况下适合剖宫产或顺产?

省妇幼保健院产科副主任医师田辉介绍,每个人的身体状况不同,合并症、并发症不同,所以需医生进行综合评估。

“一般会通过副主任医师以上级别的医生进行评估,看孕妇能不能试产,在试产过程中检测她的各项指征。”田辉介绍,根据新的产程标准,医护人员会根据产妇发作的潜伏期、活跃期以及第二产程等综合评估。“不管是剖宫产还是顺产,都具有一定风险:剖宫产导致身体有创伤,容易引发并发症。在再次妊娠时间上来说,剖宫产是2年,顺产是半年。大多数产妇都愿意顺产。”

孕妇分娩到底承受多大的痛感?

省妇幼保健院麻醉科副主任陈亮介绍,与手指头垫在桌子上,锤子一锤砸下去的痛感一样。

而麻醉科医生黄洁去年采取无痛分娩,她说:“就像从地狱到了天堂,没有多大痛感,只有发胀的感觉了。”

“目前湖南省妇幼保健院的无痛分娩率达到50%以上,每个月都有400多位产妇无痛分娩。”陈亮介绍。

怎么认识分娩这个疼痛的过程?

“分娩的疼痛程度,是所有疼痛中排名仅次于烧伤,排在第二位的。”市第一医院妇产科主任、主任医师杨静表示,生过孩子的人都知道孕妇痛起来会失去理智,咬老公、掐自己、下跪、求医生做手术的情况时有发生。如果给予正确的引导、安慰、鼓励,大部分人是可以坚持顺产的。

如果个别孕产妇实在接受不了,家属也强烈要求剖宫产,医生会采纳孕产妇及家属的意见。

孕产妇分娩前与家属需做哪些方面的准备?

杨静认为,在分娩前,选择何种分娩方式,除了征求专业医生的意见外,孕产妇和家人也需达成一致意见。

家人应给孕产妇一些正面的、积极的意见。在面对分娩的疼痛时,家人应给予其帮助和鼓励,积极的陪伴;指导其深呼吸、按摩、听音乐,陪其下床活动,以减轻痛苦。而孕产妇本人在孕期应对分娩的过程有所了解,如果对痛非常敏感,可以选择无痛分娩等方法。

如何对待孕产妇的抑郁情绪?

“这需要高度关注孕产妇的心理状态。”杨静指出,产后抑郁症现象比较普遍,而抑郁症不单在产后出现,在孕期和分娩时也常出现。大概有三分之一的孕产妇都出现过情绪低落、易哭、烦躁、焦虑等,极个别的出现与家人吵架、离家出走、伤害孩子、自杀的情况。

“在孕期和产后,女性的激素水平都会发生很大变化,需要家人多陪伴、多鼓励,帮其及时疏导,防止意外事故的发生。”杨静强调,孕产妇自身也需高度重视,要放松情绪,尽量保持乐观心态,积极的情绪在一定程度上可抑制疼痛。当孕产妇出现问题时,要及时与医生沟通。

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