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Labour and birth care
Published in Helen Baston, Midwifery, 2020
When a woman is in labour the midwife needs to use a range of skills that have taken time to learn and develop. She will be able to use her hands to assess the strength and frequency of contractions, whilst, at the same time, reading the woman’s facial expressions and demeanour to detect how the woman is responding to the pain. However, the midwife must also be able to work with the available technology, where appropriate, to monitor and detect when additional medical input might be required. For example, if a woman has a high-risk pregnancy, perhaps because she has developed a condition such as pre-eclampsia, or if she has an underlying medical diagnosis such as diabetes, the midwife must be able to use electronic monitoring equipment, manage a range of intravenous lines, observe urine output and detect deterioration of the fetal heart. Of course, this is possible, but the real test is whether it can be done whilst also remaining calm and adopting a reassuring demeanour.
Adherence in Pregnancy
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
A high risk pregnancy may result in an infant with medical problems, usually due to prematurity. It is routine in America for preterm infants to be discharged home on cardio-respiratory monitors to “prevent” sudden infant death syndrome. Silvestri et al. (1995) used an automatic recording system to document the level of parental adherence and factors that might affect such adherence. Of the 67 study infants, parents used the monitors for an average of 15.5 hours with 75% monitored for more than 10.5 hours and 25% for more than 21 hours. However, since previous studies indicate that 57–80% of infant deaths are associated with non-adherence to proper technique (Meny, 1988; Kelly, 1988), instruction and discussion of potential problems as well as continued support for families may boost effective surveillance even higher.
Effects on Female Offspring and Mothers After Exposure to Diethylstilbestrol
Published in Takao Mori, Hiroshi Nagasawa, Toxicity of Hormones in Perinatal Life, 2020
J. Rotmensch, K. Frey, A. L. Herbst
Although exposure to DES in utero is associated with unfavorable pregnancy outcome, over 80% of DES-exposed women who achieved pregnancy have delivered at least one live-born infant.37,40 Due to the increased risk during pregnancy, careful prenatal care is mandatory and the patients should be managed as having a high-risk pregnancy.
High/severe fear of childbirth and related risk factors among pregnant women: is vaginismus a risk factor?
Published in Journal of Obstetrics and Gynaecology, 2022
Elçin Özçelik Eroğlu, M. İrem Yıldız, Özge Türkoğlu, Esra Tanrıöver, Ayşe Evran, Sevilay Karahan, Dilek Şahin
Depression and anxiety symptoms that existed in the pre-pregnancy period and persisted or emerged during pregnancy have also been reported to be among the reported risk factors for FOC (Storksen et al. 2012). In this study, depression and anxiety scores were higher in those who had high/severe FOC. Following up with high-risk pregnancy is another FOC risk factor; such cases are expected to have higher FOC due to their medical conditions (Wigert et al. 2020). In our study, the rate of high-risk pregnancy was higher in pregnant women with high/severe FOC. Depression and anxiety scores have been reported to be higher in high-risk pregnancies (Lee et al. 2019). However, in this study, the lack of a difference between the low- and high-risk pregnancy groups in terms of anxiety and depression scores suggests that FOC in high-risk pregnant women is associated with different causes other than anxiety and depressive symptoms. Therefore, high-risk pregnancy cases should be further investigated.
The effect of motivational video and nutrition on the non-stress test: a randomised controlled clinical trial
Published in Journal of Obstetrics and Gynaecology, 2022
Sermin Timur Taşhan, Ebru İnci Coşkun, Gülçin Nacar, Behice Erci
The non-stress test (NST) is one of the most common tests that are used to assess foetal well-being. It is frequently preferred as it is an easily applicable, inexpensive and reliable test that can be interpreted quickly (Şirin and Kavlak 2015; Aktaş and Osmanağaoğlu 2017). The NST is a written document trace of electrical data produced by transducers, one of them named a cardiotocograph that transmits foetal heart rates and the other transmits uterine contractions (Aktaş and Osmanağaoğlu 2017). The NST that monitors the relationship between foetal movement and heart rates is a test that reveals the relationship between foetal neurological condition and cardiovascular reflexes. It is a non-invasive method to detect the diversion of the foetus from a healthy state in normal pregnancies and high-risk pregnancy cases such as gestational diabetes, preeclampsia and foetal hypoxia issues (Umana and Siccardi 2021). However, the false positivity rate of the NST is 27% (Ivanov and Malinova 2011). These false-positive rates of the NST lead to many obstetric complications, in addition to increasing cesarean-section rates (Walton and Peaceman 2012; Bal et al. 2013). Recent studies have shown that there are methods and factors that increase foetal movements and shorten the NST’s application period. It was identified that food intake, music therapy, foetal vibroacoustic and halogen light stimulation before the NST increases foetal movements and shortens the NST period (Kafali et al. 2011; Buscicchio et al. 2012, 2013; Hasanpour et al. 2013; Esin 2014).
Pregnancy outcome in women with different rheumatic diseases: a retrospective analysis
Published in Scandinavian Journal of Rheumatology, 2021
H Eisfeld, AM Glimm, GR Burmester, S Ohrndorf, M Backhaus
The search of the medical records identified 95 patients with the diagnosis of high-risk pregnancy. Fifty-seven were diagnosed with RMDs and judged eligible for inclusion in this retrospective analysis (Figure 1). Nine participants had been managed during two pregnancies, yielding a total of 66 high-risk pregnancies. In brief, 48 of the 66 pregnancies occurred in patients with a connective tissue disease (CTD group): SLE (n = 29), CLE (n = 7), pSS (n = 6), SSc (n = 3), undifferentiated CTD (n = 2), and mixed CTD (n = 1). The remaining 18 occurred in women with an inflammatory joint disease (IJD group): RA (n = 8), JIA (n = 3), PsA (n = 2), AS (n = 4), and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome (n = 1). Overall, the mean age at conception was 30.1 ± 4.2 years (range 18–42 years), and the mean interval from RMD diagnosis to pregnancy was 6.2 ± 6.1 years (range 0–30 years). Five women were first diagnosed with an RMD after becoming pregnant: SLE (n = 1), CLE (n = 1), and pSS (n = 3). Thirty-eight (57.6%) of the pregnancies were the mother’s first pregnancy, 25 the second pregnancy, and three the third pregnancy. Fifty-seven (86.4%) pregnancies occurred in women with no history of miscarriage, eight (12.1%) in women with one previous miscarriage, and one (1.5%) in a woman with two previous miscarriages. None of the nine women with a history of miscarriage at baseline had anti-phospholipid syndrome (APS).