開業助産婦による経過診断の診断指標と使用状況―〈妊娠の確認〉と〈妊娠に伴う異常の可能性/CPD〉に関して

Present Situation Regarding the Usage of Defining Characteristics for Practicing Midwives to Diagnose the Pregnant Process: in Special Reference to the“Confirmation of Pregnancy”and the“Possibilitity of Abnormality Especially of CPD”

　本研究では，開業助産婦による〈妊娠の確認〉と〈妊娠に伴う異常の可能性/CPD〉の診断に対する診断指標と使用状況について明らかにし，現在開発途上にある助産診断の一助とすることを目的とし102人に調査を行った．結果，65人から回答が得られ，〈妊娠の確認〉では「月経の停止」，「つわり」，「下腹部の張り」，「乳房の張り」，「帯下の増量」，「体のだるさ」，触診による「妊娠子宮の触知」，検査方法による「免疫学的妊娠反応陽性」または「超音波診断法による胎児・心拍の確認」がいずれも8割以上あった．〈妊娠に伴う異常の可能性/CPD〉では「児頭の浮揚」，「巨大児（4,000g以上）」が8～9割と最も多く，重視する指標であることが示唆された．

　With the aim of helping complete the midwifery diagnosis that is now being developed, this study was made to clarify the present situation regarding the usage of Defining Characteristics with which practicing midwives can “confirm the pregnancy”and the “possibilitity of its abnormality especially of CPD”. Questionnaire was sent to 109 practicing midwives. Answers were obtained from 65 of them. The results revealed that the“confirmation of pregnancy”was made in 80％or above cases by following Defining Characteristics such as amenorrhea, morning sickness, distention of lower abdomen, breast engorgement, heavy vaginal discharge, general fatigue, palpabled enlarging uterus, positive pregnancy test, fetal heart beat by ultra sonic procedures. As for the“possibility of pregnant abnormality especially of CPD”, the following Defining Characteristics was considered important in 80 to 90％of the cases, such as floating head of fetus, giant baby weighed over 4,000g.