控制性脐带牵引对防止产后大出血起效甚微

    This is the VOA Special English Health Report.
    这里是美国之音慢速英语健康报道。

    Severe bleeding, also called hemorrhage, causes one-third of pregnancy-related deaths in Asia and Africa.
    大出血导致的死亡人数占到了亚洲和非洲与妊娠有关死亡人数的三分之一。

    The World Health Organization has been recommending several ways to reduce the risk of hemorrhage immediately after birth. These include giving the mother a hormone called oxytocin. It helps the uterus expel the placenta, or afterbirth. Another recommendation to help expel the placenta has been to use what is called controlled-cord traction. In this procedure, the birth attendant gently pulls on the umbilical cord while pushing upwards on the mother's stomach.
    世卫组织已经提出了几种降低产后大出血风险的办法。其中包括注射一种名为催产素的荷尔蒙,它可以帮助子宫排出胎盘或胎衣。另一项一直采用的帮助排出胎盘的建议被称为控制性脐带牵引。在这个过程中, 接生员轻轻拉扯脐带,同时在妈妈的肚子上向上推(此举意在固定子宫)。

    Dr. Metin Gulmezoglu of the World Health Organization led a study on the effectiveness of controlled-cord traction. He says it is not easy to perform and, if it is not done correctly, it can harm the mother.
    世卫组织的梅滕·古梅泽格鲁(Metin Gulmezoglu)博士领导了一项有关控制性脐带牵引有效性的研究。他表示,这一方法不容易执行。如果执行有误会伤害到母亲。

    METIN GULMEZOGLU: "If it's not applied by people who are skilled in doing it, then it may cause more problems."
    古梅泽格鲁:“如果不是由经验丰富的人来实施,那么可能会导致更多问题。”

    The study involved more than twenty-three thousand pregnant women who had vaginal births. The births happened in sixteen hospitals and two primary health-care centers in eight countries. These were Argentina, Egypt, India, Kenya, the Philippines, South Africa, Thailand and Uganda.
    这项研究涉及了超过2.3万名自然分娩的孕妇。这些分娩发生在8个国家的16个医院和2个初级卫生保健中心。这8个国家是阿根廷,埃及,印度,肯尼亚,菲律宾,南非,泰国和乌干达。

    About half of the mothers received a so-called full package of measures including controlled-cord traction. The other women gave birth helped only by gravity and pushing by the mother. Both groups of women received injections of oxytocin immediately after giving birth.
    大约有一半的妈妈接受了所谓的全套措施,包括控制性脐带牵引。其他女性只经由重力和母亲推动分娩。两组女性分娩后都立即注射了催产素。

    The study showed that, on average, both groups had about the same amount of blood loss. The study found that controlled-cord traction had very little effect in reducing the risk of serious blood loss -- defined as a liter or more. There was serious blood loss in 1.9 percent of the women who received the procedure, compared to 2.1 percent of those in the simplified group.
    研究表明,平均而言两组失血量几乎相同。研究发现控制性脐带牵引在降低严重失血风险上起效甚微。严重失血是指失血1升或更多。接受了控制性脐带牵引的女性中严重失血的比例为1.9%,相比而言,另一组只接受了简单措施的女性中严重失血比例为2.1%。

    Dr. Gulmezoglu says using oxytocin was much more important than pulling on the umbilical cord to reduce blood loss.
    古梅泽格鲁博士表示,从减少失血上来说,使用催产素比牵引脐带更为重要。


    METIN GULMEZOGLU: "The main factor that helps to reduce blood loss after birth is the oxytocin, the medication that helps the uterus to contract. And the procedure itself, in our study, adds a minute amount."
    古梅泽格鲁:“减少分娩后失血的主要因素是帮助子宫收缩的药物催产素。在我们的研究中,牵引过程本身增加了一分钟的失血量。”

    Oxytocin is injected, but only into the muscle. This makes it easier to administer for birth attendants with little training. Also, the hormone does not cost very much. But it can lose its effectiveness if stored at high temperatures. The WHO may recommend single-use syringes with sensors to warn of exposure to high temperature.
    催产素只是被注射到肌肉中。这使得助产士稍加培训便能更容易管理。此外,这种激素花销不大。但如果将它存放在高温下就会失效。世卫组织可能会建议使用带有传感器的一次性注射器对暴露于高温提出警示。

    The WHO is expected to changes its guidelines based on the new findings. The study is in the Lancet medical journal.
    基于这项新的发现,世卫组织预计将改变其指导条例。这项研究发表在柳叶刀医学期刊上。

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