What are Obstetrics?

Obstetrics and Gynecology is one of the four major disciplines of clinical medicine. It mainly studies the etiology, pathology, diagnosis and prevention of female reproductive organ diseases, physiological and pathological changes in pregnancy and childbirth, prevention and diagnosis of high-risk pregnancy and dystocia, female reproductive endocrinology, Family planning and women's health. Modern molecular biology, oncology, genetics, reproductive endocrinology and immunology and other medical basic theories in-depth research and clinical medical diagnosis and treatment technology advancement, broadened and deepened the development of obstetrics and gynecology, to protect women's physical and reproductive health And prevention and treatment of various obstetrics and gynecology diseases play an important role.

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Obstetrics and Gynecology is one of the four major disciplines of clinical medicine. It mainly studies the etiology, pathology, diagnosis and prevention of female reproductive organ diseases, physiological and pathological changes in pregnancy and childbirth, prevention and diagnosis of high-risk pregnancy and dystocia, female reproductive endocrinology, Family planning and women's health. modern

Obstetrics and Gynecology is not only related to surgery, internal medicine,

PhD

Should have a solid and broad basic medical theory and a certain systematic expertise in obstetrics and gynecology, through rigorous clinical practice training and research project research

Subject research scope

The scope of subject research is divided into six areas:

(l) General gynecology: research on female reproductive organ infections, trauma, prolapse, developmental deformities, and

Introduction

Postpartum depression is a type of depression. It is one of the common symptoms of pregnant women after childbirth. It belongs to emotional mental disorders, which usually occurs within 1 month to 1 year after delivery. It affects not only maternal and infant health, but also marriage, family and society. At present, the incidence of depression in China is about 17%. The clinical manifestations, causes and interventions of postpartum depression in primiparas are analyzed as follows. ^[1]

Clinical manifestation

The clinical manifestations of postpartum depression are the same as those of general depression. The salient feature is that the maternal mood is low, showing a negative emotional state with reduced psychological function or impaired social function, and lasts a long time. Its main performance is:

often feel depressed, depressed, and indifferent;

Low self-evaluation, self-violence, abandonment, self-blame, self-incrimination, or hostility, wary, and uncoordinated relationships with family members;

Impaired creative thinking;

Often lack of confidence in life, feel life is meaningless, manifested as anorexia, sleep disturbance, easy fatigue; severe cases even despair, suicidal or infanticide tendencies, and sometimes fall into disorder or lethargy.

Causes

2.1 Biological factors

2.1.1 Endocrine factors

During pregnancy and childbirth, the endocrine environment of the body has changed greatly, especially within 24 hours after the birth, the rapid change in hormone levels in the body is the biological basis of postpartum depression. The study found that the placental steroid release reached the highest value before delivery, and the patient showed emotional joy; the patient showed depression when the placental steroid secretion suddenly decreased after delivery. Moreover, the decline in postpartum progesterone increases the likelihood of postpartum depression.

2.1.2 Genetic factors

Women with a family history of mental illness, especially those with a family history of depression, have a high incidence of postpartum depression.

2.2 Psychological factors

2.2.1 Pregnancy factors

Studies have shown that the more negative life events during pregnancy, the greater the likelihood of maternal depression: negative life events, including unemployment, illness, threatened abortion, etc., are important triggers for depression. Other reports show that prenatal depression is more common in prenatal mood instability and premenstrual tension syndrome.

2.2.2 Factors during childbirth

China's primiparas lack understanding of the childbirth process, worry too much about the pain during childbirth, and have anxiety and fear about childbirth. Studies have shown that psychological stress during childbirth can cause a series of changes in the body such as neuroendocrine disorders and decreased immunity, which can cause uterine contraction weakness, pain sensitivity, prolonged labor, lead to dystocia and increased bleeding, and further increase maternal anxiety and uneasiness Emotions increase the risk of postpartum depression.

2.2.3 Fear of Motherhood

Most mothers are mothers for the first time, lacking recognition of the role of mothers, conflicts and maladaption of their own roles, and cannot overcome the pressure of motherhood.

2.3 Social factors

2.3.1 Impact of childbirth outcome

Pregnant women have different concerns about different delivery methods. Compared to natural delivery, cesarean delivery has a greater psychological impact. At the same time, adverse childbirth outcomes, such as stillbirth, stillbirth, malformed children, and maternal family dislike of infant sex, are the predisposing factors for postpartum depression. In the vast countryside of our country, traditional feudal consciousness is deeply ingrained. For the mother of a girl, the psychological pressure is greater, which is also a risk factor for postpartum depression.

2.3.2 Impact of traditional habits

The traditional habit of our country is to take a rest at home for one month after giving birth. During this month, you are not allowed to read books, newspapers, or watch TV. You are not allowed to go out or even get out of bed. In this way, the opportunity for the mother to communicate with others is reduced, and the scope of life is suddenly reduced, as if confined, which will cause the mother to have an irritable, irritable, and irritable adverse emotional response, and also easily induce postpartum depression.

2.3.3 Impact of family atmosphere

Lack of family and social support and help, especially from husbands and elders, is a risk factor for postpartum depression. The study found that there is less action and mental support from partners, parents and colleagues, and more negative life events are encountered after childbirth, which is prone to postpartum depression.

Nursing measures

3.1 Strengthening health care during pregnancy and delivery so that it can safely pass through the perinatal period

Studies have shown that maternal awareness of their own health status and knowledge of childbirth are related to the occurrence of postpartum depression. In the early stages of pregnancy, the nursing staff can provide pregnant women with the current changes in the physiology, growth and development of the mother and child and corresponding health care measures; in the third trimester, they can provide the mother with knowledge about childbirth, help the mother to understand the childbirth process, and teach the mother Some relaxation techniques during childbirth to reduce their nervousness and fear of childbirth; during childbirth, medical staff should closely observe the progress of labor, give encouragement and help in a timely manner, actively deal with abnormal situations, and distract maternal attention, Try to reduce the pain of childbirth and eliminate bad physical and mental stimuli.

3.2 Implement psychological care in a timely manner to ensure a good family and social atmosphere

Actively carry out mental health care for pregnant women, understand their psychological status, personality characteristics, past medical history, especially changes in mental status before and after childbirth, and use medical psychological and sociological knowledge to take different intervention measures according to different situations Relieve the psychological factors that cause disease, reduce the psychological burden, and enhance self-confidence. For pregnant women with a bad psychological personality, give corresponding psychological guidance to reduce or avoid mental stimulation; for pregnant women with a history of mental disorders or family history of depression, regularly ask a mental health professional to observe and guide them to rest adequately and avoid fatigue Excessive and prolonged psychological burden; Provide more help to pregnant women who have symptoms of anxiety, easy tension and high risk factors for depression, use relaxation therapy, establish a correct attitude to understand things and deal with problems, and improve psychological quality; For families with more traditional feudal ideas that prioritize patriarchs, actively promote the meaning of gender equality, so that propaganda and education can reach families. At the same time, using language communication skills to give full play to the role of the social support system, you can use hints, guidance, and create a warm atmosphere to enhance the relationship between husband and wife, mother-in-law, and promote family members, especially husbands, to often care for and soothe pregnant women, so that pregnant women always feel at home The warmth eliminates anxiety and depression, and reduces the incidence of postpartum depression.

3.3 Pay attention to the physical and mental changes of early parturients and deal with the aura symptoms in time

One week postpartum is a high incidence of postpartum depression, and six weeks postpartum is a high incidence of postpartum depression. Therefore, we should create a relaxed, harmonious and warm post-natal rest environment. In view of the characteristics of postpartum psychological fragility, susceptibility to implication and strong dependence, medical staff should respect the mother, attitude and enthusiasm, take care of it, improve the self-confidence of feeding and caring for the baby, and reduce the psychological burden of the mother. Before the mother is discharged from the hospital, grasp the mother's physical and physiological recovery, and understand the psychological changes of the mother. Get understanding and help from family members. At the same time, do necessary health education work, such as letting them understand the changes in reproductive organ recovery and possible abnormalities, the time and place of postpartum maternal and child examinations, possible problems for infants and young children, and methods and countermeasures for help. Possibly reduce the pressure of caring for children, avoid the factors that induce postpartum depression, and protect the physical and mental health of the mother.

to sum up

In short, postpartum depression not only affects the physical and mental health of mothers and babies, but also affects marriage, family, and society. Therefore, it is necessary to give full attention and intervention to postpartum depression, and mobilize attention to changes in the physical and psychological status of pregnant women To reduce the incidence of postpartum depression.