Re: Omlouvám se - vkládám tento příspěvek podruhé - chtěl bych znát Váš názor, dámy - Předporodní kurzy

Mno, popravdě mě nikdy nenapadlo zjišťovat přesná čísla, protože mi to v daném případě přišlo nepodstatné. Teď jsem teda narychlo zkusila vygooglit jednu ze dvou studií, na které se odvolává WHO. Pokud dobře rozumím napsanému (jakože já anglicky neumím v případě dané studie byly dvě skupiny žen - bez klystýru a s klystýrem a ve druhé době porodní zůstalo čistých 56% žen z první skupiny a 78 % žen ze druhé skupiny. Vzhledem k tomu, že znečištění však bylo malé a vzhledem k tomu, že cca 22% (to mi opravdunepřijde, že by se blížilo nule) pravděpodonost znečištění po klystýru mi přijde docela velká, tak mně osobně přijde přijatelnější se prostě smířit s tím, že při porodu k něčemu takovému prostě dojít může


Kopíruju celý text, neb fakt neumím anglicky :o(


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Drayton, S., & Rees, C. (1984). ‘They know what they are doing". Nursing Mirror, 159(5), 4-8.

Premise: Routine enemas in labor are not supported by research.

Research Questions: Do enemas speed up labor? Do they reduce the incidence of fecal contamination? Do they decrease the risk of postpartum infections among mothers and babies? How do women in labor really feel about receiving enemas?

Background: Drayton and Rees attempted to duplicate Romney and Gordon"s (1981) research on enemas using a randomized controlled study format.

Subjects: Two hundred twenty-two women who entered the University of Wales, Cardiff, labor and delivery unit during the time of the study agreed to participate. All were at or beyond 37 weeks of gestation and carried a single fetus. Expecting mothers with conditions complicating delivery such as heart disease, diabetes, hemorrhage, or pre-eclampsia were excluded from the study.

Study Design: Subjects were randomly assigned to the experimental (no enema) or the control (enema) group. Primigravidae were studied separately from multipravidae. Low-volume phosphate enemas were used. Duration of labor was timed. Assessment of fecal contamination was divided between first and second stages of labor. Soiling was evaluated using a 0-3 point scale. A score of 0 represented no fecal soiling, while 1 represented minimal contamination, 2 represented no more than two stools, and 3 represented frequent stools. Infections found among neonates were evaluated for the presence of fecal bacteria. To assess participants" subjective feelings about being given enemas, interviews were conducted by a research midwife within 24 hours of delivery.

Findings: Length of labor was not significantly affected by the administration of an enema. For the multiparous women, the length of labor was almost identical in both groups. Thus, the hypothesis that enemas speed labor could not be supported. Minimal fecal soiling occurred in about 8% in either group and went unnoticed by the laboring woman in most cases. Six percent of the enema group and 4% of the no-enema group encountered fecal contamination at grades 2 and 3. During the second stage of labor, 56% of the experimental group and 78% of the control group remained clean. This difference was statistically significant. However, most of the recorded incidences fell into category 1 (minimal). As it was mostly formed stool, it could be easily removed. It was concluded, therefore, that enemas can reduce the incidence of fecal contamination during the second stage of labor. However, it was also noted that when contamination did occur after enema administration, it became more difficult to manage due to its consistency. In the experimental group, infection rates among neonates were similar to those found among the control group. Only one neonate in each group, however, was infected with fecal bacteria. None of the mothers in either group contracted a perineal wound infection. It was thus concluded that, while enemas can reduce the overall incidence of soiling during labor, a correlation to subsequent postpartum infections could not be established.
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