09孕产妇健康管理服务规范——黄琳推荐.pptVIP

（二）心理问题的表现特征 情绪不稳定、精神压抑或焦虑，甚至会因心理作用而自感全身无力，即使一切情况正常，也不愿活动。 * （三）心理保健指导 学习知识，增强信心 以积极的情绪，作好分娩准备： 参加母乳喂养知识讲座，增强母乳喂养的信心： 转移注意力，解除忧虑和紧张： 经常散步 * 丈夫参与和家庭社会支持 （一）孕中晚期丈夫关心和家庭社区支持很重要： 注意膳食营养，满足孕妇的特殊需求。 营造良好的家庭环境，让孕妇心情愉快。 。 * （二）分娩时的丈夫参与 研究表明，丈夫如果参加过产前培训，并全程陪伴分娩，会使妻子在产程中疼痛减轻。而自己也会体验一次全新的经历，从而感觉幸福、激动、快乐 * * * 年龄＞35岁、没有告知抽血时间 * 转诊时＞26孕周 * Goal-directed care: In many countries, the antenatal exam is divided into stations - history, blood pressure, height and weight, urine testing, abdominal palpation and fetal heart tones, etc. - with the woman moving from station to station until her antenatal exam card is filled in for the visit. When information is gathered in this way, there is a risk that the information gathered is analyzed in isolation rather than integrated. Goal-directed care, on the other hand, involves gathering information in such a way that certain complications are either detected or ruled out. The table shows how information can be gathered in a goal-directed way. Collecting information in this way forces the provider to look critically at all of the parameters that are being checked, and deciding if they mean that the woman’s pregnancy is evolving normally or that she is experiencing a complication that needs to be managed. The quality of antenatal care can be improved by having goal-directed care, not only because providers are processing the information they gather, but also because this way of gathering information facilitates clinical decision making. * 孕10周Doppler可听到胎心音 对轻度子痫前期孕妇的指导 必须及时转院处理，转出后一定要随访落实； 定期做产前检查，严密随访病情； 左侧卧位休息，每天要左侧卧位休息10-12小时； 高蛋白、低盐饮食，但不严格限盐； 如果血压进一步升高，水肿和蛋白尿加重，则需及早住院治疗。 一旦出现头痛、眼花、胸闷、视物不清，无原因的恶心，右上腹疼痛，夜间不能平卧，甚至抽搐和昏迷等危急症状，需急诊转院。 * 对早产孕妇的指导 孕妇左侧卧位休息，减少自发性宫缩，必要时给予宫缩抑制剂，如：舒喘灵2.4～4.8mg每日三次口服，必要时予安定2.5mg每日三次口服。症状不缓解者，立即落实转院。 * 对贫血孕妇的指导 孕期应多食含铁量高，富含蛋白质和维生素的食物。 药物治疗一般建议孕4个月后，每日应用100-200mg二价铁。硫酸亚铁或琥珀酸亚铁0.3g，每日3次。 中重度贫血应当及时转院。 * 对妊娠合并心脏病孕妇的指导 有心脏病史或心脏病症状的，必须立即转院，并落实诊治医院，督促其定期随访，妊娠20周前每2周一次，20周后尤其32周后每周一次