Objective To provide the basis for health education by investigation of breastfeeding cognition,feeding pattern,attitude and knowledge for pregnant women with the second child.Methods Using a self-designed general information and breastfeeding knowledge questionnaire,a total of 1 98 pregnant women with second child who admitted from September 201 5 to March 201 6 and registered in-patient clinic received the investigation.Results Cognitive scores of second pregnant women with breastfeeding were in the range of 0 -20 points with average score (7.25 ±5.62)points,which was at a low level;top 3 ordinal breastfeeding knowledge sources were mother and other relatives,international circle of friends and health education from postpartum medical staff.The desired pathway to obtain knowledge in turn were health education from postpartum medical staff,hospital issued promotional text information,prenatal outpatient breast feeding counseling,and pregnant women school,etc.Different feeding ways for the first child:exclusive breastfeeding rate was 38.3%;mixed feeding rate was 48.4%;artificial feeding rate was 1 3.1 %;the breastfeeding rate was 86.8%.About 39.3%subjects experienced breastfeeding for more than 6 months with a good attitude,confidence for breastfeeding (88.3%) and willing to breastfeed (95.9%).Conclusions Second pregnant women′s perception of breastfeeding situation is not optimistic,which indicate promoting breastfeeding work is urgently needed.Medical staff should carry out a variety of forms,effective breastfeeding during pregnancy health education in timely.

Objective:To explore the cognition of medical and nursing staff on prevention and management of gestational diabetes mellitus (GDM), so as to provide reference for the construction of a standardized GDM prevention and management system.Methods:This study was a descriptive qualitative study. From June 2022 to November 2023, purposive sampling was used to select 22 clinical medical and nursing experts engaged in GDM management from ten Class Ⅲ Grade A general hospitals and six community health service centers in Beijing as the research subject. Semi-structured interviews were used to collect data, and thematic analysis was used for data analysis.Results:Through the analysis and summarization of interview data, two themes were proposed, namely the challenges faced by GDM prevention and management (lack of standardized management system, lack of quality evaluation indicators, lack of professional medical and nursing staff, weak prevention awareness of medical and nursing staff, insufficient training), and the role of the GDM prevention management system (including the leading role of the government, responsibility subject role of hospitals, outpost role of community health service institutions, auxiliary role of society, collaborative management role of families, execution subject role of individuals) .Conclusions:GDM prevention management practices face multiple challenges. China should enhance the construction of the GDM prevention and management system, establish a quality evaluation index system, strengthen education and training for medical and nursing staff, and pay attention to the role of government, hospitals, community health service institutions, families and individuals in the GDM prevention and management system.

Objective To investigate the effects of posture care on prevention of supine hypotensive syndrome during caesarean section under combined spinal and epidural anesthesia(CSEA).Methods A total of 40 healthy primiparas who were performed scheduled caesarean section under CSEA from February to August in 201 5 at Beijing Friendship Hospital were selected as study objects,which were then divided randomly into intervention group and control group with 20 cases in each.After the implementation of CSEA in intervention group,nurses turned the operation tables to the left so as to raise about 30 -45°of the right side of the primiparas,while in control group primiparas were using supine position after CSEA.Continuous electrocardio-graphic (ECG)monitoring was applied to both groups,and the blood pressures,pulses and occurrence of supine hypotensive syndrome were compared between the two groups at different time points:before CSEA, shortly after turning back of body position from CSEA procedure,5 -1 0 min after CSEA and 30 min after delivery.Results The average blood pressures were 1 28 /76 mmHg and 1 06 /70 mmHg and mean pulses were 89 times/min and 96 times/min 5 to 1 0 minute after anesthesia in intervention group and control group (P <0.05).While there was no significant difference of blood pressure and pulse between the two groups before CSEA,shortly after turning over from CSEA and 30 min after delivery (P >0.05).The incidences of supine hypotensive syndrome were 1 5% (3 /20)and 65% (1 3 /20)for intervention group and control group 5 min after CSEA (P <0.05).Conclusions The posture care by lifting 30 -45°of the right side of primiparas after CSEA can prevent about half of primiparas from supine hypotensive syndrome 5 -1 0 min after CSEA during caesarean section.

Objective To explore the effect of applying theory of planned behavior (TPB) during early pregnancy in preventing gestational diabetes mellitus (GDM) among high risk group, so as to lower incidence of GDM.Methods Patients selected were divided, according to the random number table generated by the computer, into control group and intervention group. Patients in the control group received routine pregnancy education, while patients in the intervention group were intervened by nursing measures constructed with TPB as the framework, and the incidence of GDM was analyzed byχ2test.Results Incidence of GDM in the intervention group was 14.9% (14/94), lower than that in the control group, 26.8% (26/97) (χ2=4.090, P=0.043).Conclusions Nursing intervention basing on TPB during early pregnancy can reduce the incidence of GDM.