Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Jan 2012
The relation of psychological distress to salivary and serum cortisol levels in pregnant women shortly after the diagnosis of a structural fetal anomaly.
To examine the association between psychological distress and levels of salivary cortisol (SalC) and the ratio of serum cortisol to cortisol-binding globulin (SC/CBG) in pregnant women shortly after the diagnosis of a structural fetal anomaly. DESIGN. A prospective, observational study. ⋯ Median (range) GA at assessment was 19 (12-38) and 19 (13-22)weeks in the study and the comparison group, respectively. The study group had significantly higher psychological distress levels (p≤0.001) than the comparison group in all outcome measures. Salivary cortisol correlated with GA in both groups (p<0.004). In subanalyses including only women with GA 18-22 weeks, and excluding smokers or women with chronic diseases or medication which might interfere with cortisol levels, there were no relations of SalC or SC/CBG with the psychometric variables in the study group. CONCLUSIONS. Women with detected fetal malformation had high psychological distress scores. The lack of association between psychological distress and SalC or SC/CBG suggests a blunted response of the hypothalamic-pituitary-adrenal axis following recent psychological stress activation in the second trimester of pregnancy.
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Acta Obstet Gynecol Scand · Jan 2012
Clinical TrialApplication of uterine compression suture in association with intrauterine balloon tamponade ('uterine sandwich') for postpartum hemorrhage.
We evaluated in a prospective observational study the use of a 'uterine sandwich' technique (uterine compression sutures in association with intrauterine tamponade) in women who had had unsuccessful medical treatment for postpartum hemorrhage. Ten of the 11 patients had cesarean sections (complicated by placenta previa and uterine atony) and one had a normal delivery. The median estimated blood loss and units of blood transfused were 1500ml (range 750-4000ml) and two units (range 0-9), respectively. ⋯ Bakri balloon tamponade was in place for a median of 22 hours (range 17-27 hours), while the median volume infused in the balloon was 300ml (range 150-350ml). The combined technique was successful in avoiding hysterectomy in all cases, and there was no documented postpartum morbidity. This is a simple and quick surgical technique that can be used to treat atonic postpartum hemorrhage, particularly in conjunction with placenta previa.
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Acta Obstet Gynecol Scand · Jan 2012
Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size.
To examine the effects of maternal prenatal smokeless tobacco use on infant birth size. ⋯ We found a modest but non-significant reduction in the birthweight of infants of smokeless tobacco users compared with infants of tobacco non-users. Because smokeless tobacco contains many toxic compounds that could affect other pregnancy outcomes, results of this study should not be construed to mean that smokeless tobacco use is safe during pregnancy.
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Acta Obstet Gynecol Scand · Jan 2012
Comparative StudyObstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy.
To compare obstetric outcomes for women with fear of childbirth who received counseling during pregnancy with women without fear of childbirth. ⋯ Fear of childbirth is a predisposing factor for emergency and elective CS even after psychological counseling. Maximal effort is necessary to avoid traumatizing deliveries and negative experiences, especially for nulliparous women.
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Acta Obstet Gynecol Scand · Jan 2012
Clinical skills training in obstetrics - a descriptive survey of current practice in Denmark.
The Danish National Board of Health has recommended that labor wards establish regular obstetric emergency skills training programs. The aim of this study was to describe current practice in Denmark. A questionnaire was sent to all obstetric departments in Denmark in 2008. ⋯ Obstetric emergency skills training is being actively conducted in the majority of the Danish labor wards. However, it still remains a challenge to ensure the uniform organization and evaluation of the current training programs. Development of validated national or international standards for an obstetric training program should be a future aim.