A systematic search of studies of intrapartum management of the nuchal umbilical cord at term found no published controlled studies in this area. A postal survey containing both structured and open questions and a request for local protocols and guidelines was sent to all 637 midwives in 7 maternity units in England. There were 401 (63%) responses. There appeared to be no unit guidelines for this area of practice. Midwife approaches to nuchal cord during birth varied, and included clamping and cutting of loose nuchal cords and a hands-off approach to tight nuchal cords. Reasons for specific actions included doing what had been taught during midwifery training and learning from previous personal experiences. Theories of diffusion of innovation and of planned behaviour may provide a conceptual basis for understanding the adoption of specific practices. Future qualitative and controlled studies are needed to explore the nature and consequences of varying approaches to intrapartum nuchal cord management.

译文

对足月胎儿脐带产时管理研究的系统搜索发现,该领域未发表对照研究。向英格兰7个产科单位的所有637名助产士发送了一份包含结构化和开放性问题的邮政调查,并要求提供当地协议和指南。有401 (63%) 个响应。这一实践领域似乎没有单位准则。助产士在出生时对脐带的方法各不相同,包括夹紧和切割松散的脐带,以及对紧脐带的不手方法。采取具体行动的原因包括做助产培训期间所教的事情以及从以前的个人经验中学习。创新传播和计划行为的理论可以为理解特定实践的采用提供概念基础。需要进行未来的定性和对照研究,以探索不同的产时脐带管理方法的性质和后果。

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