ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90119-2

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTSeveral techniques of measuring fundal height have been described in the literature. Differences between the measurement techniques include the following: whether a tape measure or caliper is used to obtain the measurement; whether the uppermost border of the uterine fundus or the fetal pole in the fundus should be used as the superior landmark; which point on the symphysis pubis should be used as the inferior landmark; whether the tape measure should be held in contact with the skin of the maternal abdomen throughout the length of the measurement; and whether the measurement is obtained in the midline of the maternal abdomen or at the highest point of the uterine fundus or fetal pole. Preliminary studies indicate that the various measurement techniques yield different results. However, the differences between the measurement techniques have not been studied adequately and the superiority of one measurement technique has not been demonstrated. Because the various measurement techniques yield different results, it is important that clinicians be consistent in their measurement technique. Future studies should evaluate and compare the various measurement techniques to determine if one technique yields measurements that are more reliable and valid than other techniques.

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90120-6

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe intra‐ and interexaminer reliability of three fundal height measurement techniques (two tape measure and one caliper) was studied in a convenience sample of 60 pregnant women. The three measurements were obtained twice by two examiners. Four examiners with varying levels of clinical experience participated in the study; one examiner obtained measurements in all 60 cases and the other three examiners each obtained measurements in approximately one‐third of the cases. Examiners were blinded to their own and to other examiners' measurements. The mean absolute differences between individual examiner's first and second measurements varied from 0.68 to 1.74 cm, the percentage of differences ≤ 1.0 cm varied from 45% to 77.8%, and the maximal differences varied from 1.6 to 7.5 cm. The caliper technique consistently demonstrated the smallest mean absolute intraexaminer differences (0.68 to 1.39 cm) and the highest percentage of intraexaminer differences ≤ 1.0 cm (55% to 77.8%). The differences between pairs of examiners' measurements were consistently greater than the differences between individual examiner's measurements: Mean absolute differences varied from 1.36 to 3.60 cm, the percentage of differences ≤ 1.0 cm varied from 9.1% to 55.6%, and the maximal differences varied from 3.1 to 11.5 cm. Interexaminer differences were smallest for the tape “over‐the‐curve” measurements and the caliper measurements. These findings indicate that, to ensure maximal reliability, fundal height measurements should be obtained by the same clinician throughout pregnancy. Additionally, these findings indicate that calipers may be the most reliable method of obtaining fundal height measurements and that the accuracy of caliper measurements in identifying fetal growth disturbances and other pregnancy complications merits furt

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90121-V

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe effect of maternal position on fundal height measurements was studied in 192 nonobese women between 21 and 36 weeks of gestation. Four clinicians participated in the study and each clinician obtained measurements on 48 women. Fundal height measurements were obtained in each of four positions: supine; trunk elevation; knee flexion; and trunk elevation with knee flexion. The sequence in which measurements were obtained was assigned randomly. Clinicians were blinded to the results of their measurements. Measurements obtained in the supine position were largest, and measurements obtained in the trunk elevation with knee flexion position were smallest. Repeated measures analysis of variance demonstrated that measurements obtained in the four positions were significantly different (F = 87.71,df= 3,573,P<.001). A posteriori comparisons demonstrated that measurements obtained in each position were significantly different except for measurements obtained in the trunk elevation and knee flexion positions. These findings indicate that clinicians should be consistent when they position patients to obtain fundal height measurements.

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90122-W

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTA survey of certified nurse‐midwives (CNMs) in Arizona was carried out in 1990 to provide data for maternity service planning in the state. Information was gathered on location and scope of CNM practice, barriers to practice, and the contribution of CNMs to maternity care. Demographic and clinical practice characteristics of urban and rural CNMs were also compared. Urban and rural CNMs are significantly different in terms of education (urban CNMs are much more likely to have master's degrees) and number of years since first certification (urban CNMs have been certified significantly longer). Rural midwives are more likely to be under the age of 40. Health services provided by urban and rural CNMs were compared with each other and with national data. Midwives in rural areas of Arizona are more likely to provide comprehensive nurse‐midwifery services than are either urban Arizona midwives or U.S. midwives as a whole. Urban and rural CNMs described lack of physician backup as a major barrier to nurse‐midwifery practice in rural areas. Lack of hospital privileges was another major obstacle noted by rural nurse‐midwives. Arizona CNMs felt they could provide comprehensive, cost‐effective maternity services in rural areas that would improve access to care, patient satisfaction, and maternal and child health

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90123-X

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90124-Y

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTDuring pregnancy, stress and vigorous exercise often result in pronounced tachycardia. Generally, a vagal stimulatory effort will interrupt the episode; however, intrapartum supraventricular tachycardia may not respond to vagal stimulation, necessitating drug therapy.This article is a case report of idiosyncratic supraventricular tachycardia following initiation of epidural analgesia; use of epinephrine was part of the test dose protocol. Adenosine, chosen for the lack of hypotensive effect associated with verapamil, was administered intravenously with immediate results. Fetal monitoring via scalp electrode provided evidence of fetal well‐being during and after the episod

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90125-Z

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe health of populations residing on either side of the United States–Mexican border has public policy implications for both border communities. A study of barriers to prenatal care for residents of the San Diego, California–Tijuana. Mexico region was conducted. The study was designed specifically to address the availability of health services for women who crossed the border in either direction. This article reports the methodology used in the construction and validation of a dual‐language (as opposed to a Spanish language form) survey instrument that was developed for the study. Particular attention is given to the methodology used for language translation to ensure that it would reflect the idiomatic diversity of the multicultural popul

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90126-2

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTReading and interpreting research studies is an important and necessary activity of clinical practitioners. Correct evaluation of research findings requires appreciation of certain fundamentals of research methodology and statistics. This article, the third of the series, will review issues pertinent to statistical significance testing.

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90127-3

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90129-5

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY