{"created":"2023-06-19T13:30:38.365600+00:00","id":569,"links":{},"metadata":{"_buckets":{"deposit":"3faf7634-b9b0-477d-a7c6-8d98134e1ae1"},"_deposit":{"created_by":14,"id":"569","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"569"},"status":"published"},"_oai":{"id":"oai:jrckicn.repo.nii.ac.jp:00000569","sets":["2"]},"author_link":["1313","1312"],"item_10001_alternative_title_1":{"attribute_name":"タイトルのヨミ","attribute_value_mlt":[{"subitem_alternative_title":"セイジョウブンベン ニ オケル ジョサンシ ガ オコナッタ ジンコウ ハマク ノ ジッタイ ト ソノゴ ノ テンキ"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2012","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"82","bibliographicPageStart":"72","bibliographicVolumeNumber":"26","bibliographic_titles":[{"bibliographic_title":"日本助産学会誌 = Journal of Japan Academy of Midwifery"},{"bibliographic_title":"日本助産学会誌 = Journal of Japan Academy of Midwifery","bibliographic_titleLang":"en"}]}]},"item_10001_creator_3":{"attribute_name":"著者別名","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"SONODA, Nozomi","creatorNameLang":"en"},{"creatorName":"園田, 希","creatorNameLang":"ja"},{"creatorName":"ソノダ, ノゾミ","creatorNameLang":"ja-Kana"}],"familyNames":[{"familyName":"SONODA","familyNameLang":"en"},{"familyName":"園田","familyNameLang":"ja"},{"familyName":"ソノダ","familyNameLang":"ja-Kana"}],"givenNames":[{"givenName":"Nozomi","givenNameLang":"en"},{"givenName":"希","givenNameLang":"ja"},{"givenName":"ノゾミ","givenNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"1312","nameIdentifierScheme":"WEKO"},{"nameIdentifier":"70826362","nameIdentifierScheme":"e-Rad","nameIdentifierURI":"https://kaken.nii.ac.jp/ja/search/?qm=70826362"}]}]},"item_10001_description_12":{"attribute_name":"論文ID（NAID）","attribute_value_mlt":[{"subitem_description":"http://ci.nii.ac.jp/naid/130004845839","subitem_description_type":"Other"}]},"item_10001_description_19":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_10001_description_6":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"　本研究は，正常分娩において人工破膜が実施された状況を振り返ることで，正常分娩における人工破膜の実態を明らかにすること，そして人工破膜と分娩経過，児の娩出方法，児に与える影響を明らかにすることを目的とした。なかでも，児の娩出方法に関しては検証されておらず，明らかになっていない。そのため，これらを明らかにすることは，長年伝統的に行われていた人工破膜を，根拠に基づき実施するための一助となると考える。\n　調査対象は，助産所，病院で正常妊娠経過を辿った初産婦326名，経産婦435名の計761名とした。過去の診療録や助産録などより情報を収集し，自然破水群，人工破水群に分類した。分娩経過として，分娩第 I 期，第II期，分娩所要時間，促進剤の使用の有無，を比較した。分娩第 I 期，第II期，分娩所要時間，については，Mann-Whitney U検定を，促進剤の使用の有無に関しては，χ2検定を実施した。また，児の娩出方法として，医療介入の有無，新生児の予後について比較した。医療介入の有無，新生児の予後についてはχ2検定を，度数が5以下の場合は，フィッシャーの直接確率検定を採用した。\n　その結果，破水から児娩出までの所要時間に関して，初産婦においてのみ，自然破水群は中央値74分，人工破膜群では中央値58分で人工破膜群が有意に短かった（p=.029）。\n　分娩第II期の所要時間は，経産婦でのみ，自然破水群は中央値18分，人工破膜群では中央値16分で，人工破膜群が有意に短かった（p=.002）。\n　児の娩出方法は，自然破水群の初産婦と比較すると，人工破膜群の初産婦で【圧出分娩】【圧出分娩および器械分娩の併用】が有意に高率であった（χ2=5.420, p=.020, χ2=7.071, p=.001）。\n　初産婦において，破水から児娩出までの所要時間の平均は，人工破膜群が有意に短かったが，初産婦の人工破膜群において【促進剤の使用】が有意に高率であったこと，促進剤の使用時期は人工破膜後からが最も多かったことが，破水から児娩出までの所要時間の平均が有意に短いという結果をもたらしたと考えられる。\n　そのため，人工破膜による分娩促進の効果は，初産婦・経産婦とも必ずしも効果があるとは言い難く，分娩促進目的での人工破膜の実施は，頸管開大度から判断するだけでなく，産婦の身体的，精神的状態，産婦の希望を考慮し，慎重に判断していく必要がある。\n　なかでも，初産婦では，人工破膜後に圧出分娩や促進剤の使用などの医療介入を必要とする可能性が示唆された。そのため，初産婦に対して人工破膜を実施する際には，人工破膜後に生じる可能性のある弊害を考慮し，その必要性を慎重に判断していく必要がある。","subitem_description_type":"Other"},{"subitem_description":"A total of 326 primiparous (164 amniotomy group and 162 no-amniotomy group; and 435 multiparous (273\namniotomy group and 162 no-amniotomy group) yielded a total sample of 761 subjects. There was a statistically\nsignificant reduction in the length of the second stage of labour in the multiparous amniotomy group compared to\nthe multiparous no-amniotomy group. The time from rupture to delivery was shorter in the primiparous amniotomy\ngroup and the multiparous amniotomy group compared with the no-amniotomy groups. Compared to the primiparous\nno-amniotomy group to the primiparous amniotomy group, there was a statistically significant difference for:\noxytocin requirement (χ2=11.227, p=.001); Kristeller's expression (χ2=5.420, p=.020) and both Kristeller's expression\nand vaginal birth instrumentation (χ2=7.071, p=.001).\nConclusions\nIt is necessary to keep in mind that amniotomy had occurred with oxytocin, Kristeller's expression and both\nKristeller's expression and vaginal birth instrumentation. A critical area to explore is the necessity of medical interventions\npost-amniotomy.","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本助産学会"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"info:doi/10.3418/jjam.26.72","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"一般社団法人 日本助産学会"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://square.umin.ac.jp/jam/","subitem_relation_type_select":"URI"}}]},"item_10001_rights_15":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"©2012 日本助産学会"},{"subitem_rights":"本文データは学協会の許諾に基づきJ-STAGEから複製したものである"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN10216477","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"09176357","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"SONODA, Nozomi","creatorNameLang":"en"},{"creatorName":"園田, 希","creatorNameLang":"ja"},{"creatorName":"ソノダ, ノゾミ","creatorNameLang":"ja-Kana"}],"familyNames":[{"familyName":"SONODA","familyNameLang":"en"},{"familyName":"園田","familyNameLang":"ja"},{"familyName":"ソノダ","familyNameLang":"ja-Kana"}],"givenNames":[{"givenName":"Nozomi","givenNameLang":"en"},{"givenName":"希","givenNameLang":"ja"},{"givenName":"ノゾミ","givenNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"1312","nameIdentifierScheme":"WEKO"},{"nameIdentifier":"70826362","nameIdentifierScheme":"e-Rad","nameIdentifierURI":"https://kaken.nii.ac.jp/ja/search/?qm=70826362"}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"堀内, 成子","creatorNameLang":"ja"},{"creatorName":"HORIUCHI, Shigeko","creatorNameLang":"en"},{"creatorName":"ホリウチ, シゲコ","creatorNameLang":"ja-Kana"}],"familyNames":[{"familyName":"堀内","familyNameLang":"ja"},{"familyName":"HORIUCHI","familyNameLang":"en"},{"familyName":"ホリウチ","familyNameLang":"ja-Kana"}],"givenNames":[{"givenName":"成子","givenNameLang":"ja"},{"givenName":"Shigeko","givenNameLang":"en"},{"givenName":"シゲコ","givenNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"1313","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-12-25"}],"displaytype":"detail","filename":"正常分娩における助産師が行った人工破膜の実態とその後の転帰.pdf","filesize":[{"value":"838.4 kB"}],"format":"application/pdf","license_note":"１．コンテンツの著作権は、日本助産学会が有します。\n２．機関リポジトリに登録されているコンテンツの利用は、著作権法に規定されている私的使用や引用などの範囲内で行って下さい。\n３．著作権法に規定されている私的使用や引用などの範囲を超える利用を行う場合には、日本助産学会の許諾を得て下さい。","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","url":"https://jrckicn.repo.nii.ac.jp/record/569/files/正常分娩における助産師が行った人工破膜の実態とその後の転帰.pdf"},"version_id":"1a834290-2a55-45cd-a1ab-b3553a630f58"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"人工破膜","subitem_subject_scheme":"Other"},{"subitem_subject":"分娩所要時間","subitem_subject_scheme":"Other"},{"subitem_subject":"初産婦","subitem_subject_scheme":"Other"},{"subitem_subject":"促進剤の使用","subitem_subject_scheme":"Other"},{"subitem_subject":"圧出分娩","subitem_subject_scheme":"Other"},{"subitem_subject":"器械分娩","subitem_subject_scheme":"Other"},{"subitem_subject":"amniotomy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"primiparous","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"oxytocin requirement","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Kristeller's expression","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"vaginal birth instrumentation","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"正常分娩における助産師が行った人工破膜の実態とその後の転帰","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"正常分娩における助産師が行った人工破膜の実態とその後の転帰"},{"subitem_title":"Current status of amniotomy in relationship to labor progress and delivery outcomes; A retrospective study","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["2"],"pubdate":{"attribute_name":"公開日","attribute_value":"2018-12-26"},"publish_date":"2018-12-26","publish_status":"0","recid":"569","relation_version_is_last":true,"title":["正常分娩における助産師が行った人工破膜の実態とその後の転帰"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-12-19T07:02:26.786710+00:00"}