一位雙胞胎孕婦行子宮頸環紮術後面臨早產之護理經驗

The Nursing Experience of caring A Women with Twins facing Preterm Labor after Cervical Cerclage Procedure

本文為描述一位雙胞胎孕婦行子宮頸環紮術之安胎照護經驗，住院期間因擔心破水增加胎兒感染機率，因而自行選擇停止安胎之照護經驗。筆者照護期間為2021年10月18日至11月2日，運用Gordon十一項健康功能性型態評估，透過直接照護、會談、觀察及身體評估方式，蒐集個案生理、心理等資料，進行整體性的分析，確立個案健康問題為：1.焦慮、2.舒適型態改變、3.高危險傷害。筆者以維護病人及胎兒安全為優先考量，除了給予身體上的照護外，指導於安胎期間製作胎兒超音波心情日誌等護理措施，幫助個案於安胎期間增加自信心。雖然個案30+2週時因擔心破水增加感染機會而決定停止安胎，但於出院後電訪得知，安胎期間給予的照護及措施讓個案留下了美好的回憶。建議針對此類個案，可發揮跨團隊的照護、鼓勵個案及案夫與胎兒多對話、共同討論安胎目標，並主動介紹早產兒支持團體，以提供完整的照護。

This report presents the tocolysis care of a twin-pregnant woman who underwent a cervical cerclage procedure. During hospitalization, she decided to stop tocolysis due to concerns about premature rupture of membranes and the subsequent risk of infection. My nursing care period lasted from October 18 to November 2, 2021. The author used the ''Gordon’s 11 Functional Health Patterns'' to assess the nursing process. Through caregiving, communication, and observation, the author collected and analyzed data to identify the primary issues of anxiety, changes in comfort patterns, and a high risk of injury. The top priority was to ensure the safety of both the patient and the fetuses. In addition to providing physical care, a fetal diary was created during the tocolysis period to help the patient build self-confidence. Although the tocolysis was eventually stopped, the patient reported positive memories from this period during a telephone interview. For twin-pregnant women undergoing cervical cerclage, it is recommended to provide interdisciplinary care, encourage the parents to communicate with their fetuses, set goals together, and attend support groups for premature birth.