Preeclampsia (PE) is a disorder affecting 2-10% of pregnancies worldwide. Clinical signs include high blood pressure (HBP) and proteinuria in the mother after the 20th week of pregnancy. Currently, the only cure for PE is delivery of the fetus, which is often necessary preterm and thus dangerous for both mother and fetus. Maternal symptoms of PE are caused by excess anti-angiogenic proteins of placental origin called soluble Flt1s (sFlt1s). sFlt1 mRNA isoforms are produced by alternative polyadenylation (APA) of full-length Flt1 (fl-Flt1) pre- mRNA. While fl-Flt1 encodes a transmembrane protein, sFlt1s encode truncated proteins that are soluble. Multiple sFlt1 isoforms exist, and their respective contribution to the pathophysiology of PE is unclear. Furthermore, it is unknown whether there is a genome-wide role for APA in PE. In my thesis research, I developed a polyadenylation site sequencing method, and used this method to simultaneously quantify transcriptome-wide polyadenylation site usage and gene expression levels in normal, early-onset PE, and late-onset PE human placentae. I observed distinct expression profiles amongst the three groups, with differential expression of genes in several functional categories, including angiogenesis. I found that three sFlt1 isoforms account for >94% of all placental FLT1 transcripts, and that increased transcription of the entire FLT1 locus drives upregulation of both fl-Flt1 and sFlt1 in PE. I found that APA does not contribute substantially to PE pathophysiology. I also identified siRNAs that knock down sFlt1 mRNA efficiently in cell lines that pave the way for further development of novel RNAi based therapeutics to alleviate PE.

Bakgrund: Av alla graviditeter är 2–3 % extrauterina och innebär i stort sett alltid en förlorad graviditet eftersom infästningen av det befruktade ägget oftast sker i äggledaren.En extrauterin graviditet kan skapa olika typer av lidande hos kvinnan som kan leda till långvariga psykologiska konsekvenser och i värsta fall kvinnans död. Det är sjuksköterskans ansvar att stödja kvinnan och lindra hennes lidande. Syfte: Att belysa kvinnors upplevelse av lidande i samband med extrauterin graviditet. Metod: En kvalitativ studie har utförts baserad på 11 bloggar som analyserats på en manifest nivå med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: En psykisk kamp, Att bli ignorerad samt En fysisk kamp. Samt sju underkategorier. En stor del av kampen var sorgen över ett förlorat barn. Konklusion: Det visade sig att en extrauterin graviditet involverade livslidande, vårdlidande och sjukdomslidande. Det var inte bara fysiskt smärtsamt att vara med om utan också psykiskt påfrestande och ledde till en stor sorg som påverkade kvinnan i flera år. För en snabbare återhämtning av sorgen var det viktigt med professionellt och socialt stöd. Det var även av stor vikt att kvinnornas sorg togs på allvar av vården för att minska risken för vårdlidande. / Background: Of all pregnancies, 2–3% are ectopic and almost always ends in a pregnancy loss because the attachment usually takes place in the fallopian tube. An ectopic pregnancy can create different types of suffering that can lead to long-term psychological consequences and in the worst case result in the death of the mother. It is the nurse's responsibility to support the woman and alleviate her suffering. Purpose: To illustrate women's experience of suffering associated with ectopic pregnancy. Method: A qualitative study has been conducted based on 11 blogs that have been analysed at a manifest level with a qualitative content analysis. Results: The analysis resulted in three categories: Amental struggle, Being ignored and A physical struggle. As well as seven subcategories. Abig part of the struggle was the grief over a lost child. Conclusion: It turned out that anectopic pregnancy involved suffering of life, suffering of care given and suffering of illness. It was not only physically painful but also psychologically stressful and led to agreat grief that affected the women for several years. For a faster recovery from grief, professional and social support was important. It was also of great importance that women's grief was taken seriously by health care professionals to reduce the risk of suffering from care.

SAMMANFATTNING Bakgrund: Ätstörningar uppträder oftast hos kvinnor i reproduktiv ålder. Orsaker till ätstörning är svåridentifierade men sociala, psykologiska och biologiska processer verkar samverka. Ätstörningar kan vara svåra att behandla då många kvinnor är hemlighetsfulla kring sin ätstörning för att de skäms över sitt störda ätbeteende. Forskning tyder på att kvinnor med någon form av ätstörning löper risk för komplikationer under graviditeten och i samband med förlossningen samt vid övergång till moderskapet. Samtidigt som kvinnor med ätstörning ska hantera oro för fostrets/barnets välbefinnande försöker de hantera sin ätstörning, vilket kan göra dem sårbara. Det är betydelsefullt för mödravården att ha kännedom om hur ätstörningar påverkar graviditetsutfall för att kunna ge dessa kvinnor adekvat behandling och stötta dem på bästa sätt. Syfte: Att beskriva vilken effekt tidigare eller pågående ätstörning har på graviditetsutfall och övergång till moderskapet. Metod: En litteraturöversikt där sökning genomförts i databaserna Cinahl, Pubmed och PsycINFO. Tjugotvå vetenskapliga artiklar utgör resultatsammanställningen, varav sexton har kvantitativ ansats och sex kvalitativ ansats. Resultat: Pågående eller tidigare ätstörning hos gravida kvinnor påverkar kvinnans graviditet och graviditetsutfall genom ökad risk för depression och ångest under graviditeten och postnatalt samt för prematur födsel. Ätstörning ökar kvinnans sårbarhet under graviditeten och vid övergång till moderskapet på grund av hennes oro över viktuppgång och att inte bli eller vara en tillräckligt bra mamma. Pågående eller tidigare ätstörning hos mamman påverkar barnet genom ökad risk för låg födelsevikt och/eller SGA-barn. Kvinnor med ätstörning visar svårigheter i det interaktiva mönstret med barnet och har ofta svårt att känna igen barnets hunger och att kunna skilja på barnets hunger och dess behov av närhet. Kvinnor med ätstörning har ett ökat behov av stöd under graviditeten och postpartum. Motstridiga resultat framkom avseende prematur födsel, missfall, kejsarsnitt och instrumentell förlossning, inducerad förlossning, födelsevikt, SGA-barn, intrauterin tillväxthämning och Apgar-poäng. Slutsats: Denna litteraturöversikt visar att kvinnor med pågående eller tidigare ätstörning har högre risk för negativa utfall under graviditeten och perinatalt samt försämrade förutsättningar vid övergången till moderskapet. Flera studier visade på motstridiga resultat. Kliniska implikationer: Det är betydelsefullt att tidigt i graviditeten identifiera kvinnor med ätstörning för att kunna hindra eller lindra negativa utfall. Eftersom kvinnor med ätstörning ofta döljer sitt störda ätbeteende, försvåras identifieringen av dem. Ett enkelt verktyg som möjliggör screening av ätstörningar skulle möjligen underlätta upptäckten av ätstörning tidigt i en graviditet.

Bakgrund: Ätstörning är ett tillstånd som kännetecknas av problem med ätande, aptit och vikt. Ätstörningen kan föra med sig vissa psykiatriska tillstånd och de vanligaste är ångest, depression och personlighetsstörningar. I samband med graviditet sker förändringar som kvinnor måste anpassa sig till, bland annat viktuppgång. För kvinnor som har en pågående ätstörning eller dem med tidigare ätstörning kan anpassningsprocessen bli svårare och ätstörda beteenden från tidigare år kan komma tillbaka. Forskning visar att en del kvinnor med ätstörningar upprätthåller kompensatoriska beteenden i form av intensiv träning, restriktivt matintag, bruk av laxantia samt självframkallade kräkningar för att förhindra viktuppgång under graviditeten. Mörkertalet är stort när det gäller ätstörningar och det ses en tydlig tendens i undvikande av professionell hjälp.   Syfte: Att belysa ätstörningarnas påverkan på fostret och spädbarnet samt kvinnans fysiska och psykiska hälsa under och efter graviditet.   Metod: En litteraturöversikt där sökning av artiklar genomförts i databaserna CINAHL Complete, MEDLINE, PsycINFO och PubMed. Sjutton artiklar, publicerade 2007–2017, utgör studiens resultatdel varav fem artiklar av kvalitativ design och tolv av kvantitativ design.   Resultat: Ätstörning i samband med graviditet påverkar barnet genom ökad risk för låg födelsevikt, låg Apgar-poäng och spädbarnsdöd. En ätstörning påverkar kvinnan såväl fysiskt som psykiskt både innan och under en graviditet samt postpartum. Ätstörning har visat på fertilitetsproblem och upprepade missfall hos kvinnan. Under graviditet har kvinnor med ätstörning större risk för antepartumblödning och anemi samt komplikationer i samband med förlossning så som större behov av igångsättning och kejsarsnitt än vad kvinnor utan ätstörning har. Kvinnor med ätstörningar upplever i större omfattning känslor av självkritik och otillräcklighet som förälder då fokus ligger på den egna kroppen och inte på barnet. Ångest- och depressionssyndrom har visat sig vara vanligt förekommande under och efter graviditeten hos kvinnor med ätstörningar.   Slutsats: Denna litteraturöversikt visar att kvinnans ätstörning under en graviditet kan ha negativ påverkan på fostret och spädbarnet samt risk för ogynnsamma utfall vad gäller kvinnans fysiska och psykiska hälsa. / Background: Eating disorders are a condition characterized of problems by eating, a change in appetite and weight problems. Eating disorders can cause certain psychiatric conditions and the most common are anxiety, depression and personality disorders. During pregnancy, changes that women must adapt to includes increase in body weight. For women who have an ongoing eating disorder or those with a history of eating disorder, the adaptation process may be more difficult, and disrupting behaviours from previous years may come back. Research shows that some women with eating disorders maintain their compensatory behaviours in the form of intense training, food restriction, use of laxatives and self-induced vomiting to prevent increase of body weight during pregnancy. Estimated number of unknown cases of eating disorders are high, and there is a clear tendency to avoid seeking professional help.   Aim: The aim of this study was to highlight the effects of eating disorders on the fetus and the infant as well as the physical and mental health of women during and after pregnancy.   Methods: A literature review in which searches were conducted in the databases CINAHL Complete, MEDLINE, PsycINFO and PubMed. Seventeen scientific papers, published in 2007-2017, represent the result compilation, of which five articles have a qualitative approach and twelve have a quantitative approach.   Results: Eating disorders during pregnancy affects the child through increased risk of low birth weight, low Apgar scores and infant mortality. An eating disorder affects the woman both physically and mentally, before and during pregnancy and postpartum. Eating disorders have been shown to cause fertility problems and repeated miscarriages. During pregnancy, women with eating disorders have a greater risk of antepartum bleeding, anemia and complications such as greater need of initiation of childbirth and caesarean section than women without eating disorders. These women experience feelings of self-criticism and insufficiency as a parent since focus is on their own body and not on the child. Anxiety and depression syndromes are associated with women with eating disorders during pregnancy.   Conclusion: This literature review shows that women with eating disorders during pregnancy have a negative impact on the fetus and the infant, as well as a higher risk of unfavourable outcomes in the physical and mental health of the woman.

Measurements of relaxin and acute-phase proteins have not been validated for use in canine serum as a method of pregnancy diagnosis. This means that handling and anesthesia is still necessary to check the pregnancy status of most non-domestic canines. Therefore, the intention of this study was to determine whether relaxin and/or acute-phase proteins could be detected in the urine and/or feces of the domestic dog in order to evaluate the potential for a noninvasive pregnancy test in canines. Blood, urine and feces were collected from 18 domestic dogs and assayed for the presence of relaxin, fibrinogen, alpha-1 acid glycoprotein, and ceruloplasmin. Urinary relaxin appeared to be significant for detecting pregnancy of 30 Days or more in the domestic dog. Additionally, further research might shed light on the presence of relaxin in the feces and fibrinogen and AGP in the urine of the domestic dog and their significance for pregnancy diagnosis.

Thesis (MPH.) -- University of Limpopo, 2021 / Pregnancy and childbearing are most of the crucial milestones in women’s lives as they look forward to becoming mothers. During this time, they have positive expectations while pregnant, however, the physical, hormonal, neurotransmitters and psychosocial changes that occur can make pregnancy to be stressful and overwhelming. The disability associated with depression and its impact on maternal and child health has important implications for public health policy. While the prevalence of postnatal depression is high, there are no prevalence data and associated risk factors on antenatal depression in Helen Franz Hospital of Limpopo Province, South Africa. The purpose of this study was to determine the prevalence and factors associated with depression amongst pregnant women at Helene Franz Hospital. Methodology: A quantitative retrospective design was used in the study and a sample size of 336 was required which was calculated based on the 95% confidence interval, 5% sampling error and 38.5% prevalence of depression amongst pregnant women in KZN. A self-administered questionnaire with close-ended questions which was adopted from the Edinburgh postnatal depression scale was given to the participants to complete. The scoring of the questionnaire was that the maximum score was 30 and the persons who scored 10 or greater were considered depressed according to the Edinburg scale for assessing depression. Data were analysed using SPSS V.21.0 and a p-value of less than 0.05 was considered statistically significant. Results: The participants ranged from 18 to 47 years with the mean age of 27.8±6.9 years. The majority of the pregnant women were in the age groups 20-24 years and 25-29 years. The mean depression score for pregnant women was 7.87±5.2 and ranged from 0 to 23. The prevalence rate of depression symptoms was 31%. Maternal age was not significantly associated with depression and a significantly higher proportion of married pregnant women were depressed as compared to unmarried women at p=0.017. Pregnant women who smoke were significantly more likely to be depressed than those who do not smoke at p=0.002. Pregnant women without financial support from partnerwere significantly likely to be depressed than those who receive financial support at p-=0.002. A significantly greater proportion of pregnant women with partner violent were likely to be depressed than those with non-violent partner at p <0.001. Pregnant women in relationships with unemployed spouses were significantly likely to experience depression than the employed spouse at p=0.035. lastly, pregnant women in relationship with a spouse with lower educational level were significantly likely to be depressed than the other groups at p-.006. Conclusion: The prevalence of depression among pregnant women was high and the main risk factors involved in the onset of antenatal depression have highlighted a complex multifactorial aetiology. These are related to different sources of chronic diseases, psychosocial, environmental, obstetric and pregnancy- related risk factors have been highlighted. Correctly identifying women at risk of suffering from depression would provide an opportunity to target those women who would benefit from preventive and supportive interventions. Therefore, a psychosocial assessment, in the sense of a comprehensive and multidimensional evaluation of a woman's psychosocial circumstances should be common practice for all women during the antenatal period. Key concepts Antenatal care; Pregnancy; Childbearing; Depression; Psychosocial

Discriminant function analysis was performed on data from 87 female volunteers who were between the ages of 21 and 53 years old and who had been married at least one time. Sixty-two of the subjects had no history of premarital pregnancy; 18 subjects had been pregnant when they married; and seven subjects had an induced abortion before marriage. All groups were discriminated (p < .05) by the variables of marital adjustment, lack of emotional vulnerability, masculinity, chance locus of control, powerful others locus of control, and number of marriages. Women with a history of premarital pregnancy were less satisfied with their present or most recent marriage and tended to have had more marriages; they also were higher on belief in chance, lower on belief in powerful others, lower on instrumentality and more lacking in emotional vulnerability than were women without history of premarital pregnancy. The two groups with history of premarital pregnancy were discriminated (p < .05) by marital adjustment and lack of emotional vulnerability. Women who married when pregnant were less satisfied with their present or most recent marriage and were more emotionally vulnerable than were women who had abortions prior to marriage.

No description available.

Objective: Rates of pregnancy smoking in the rural South are twice national averages and contribute to poor birth and long term outcomes for affected women and children. Efforts to intervene during prenatal care with pregnant women have been hampered by lack of knowledge, skill, comfort, and commitment from prenatal providers and their nursing staff. Regional community providers and staff have been reluctant to participate in available trainings, and even those who do seldom exhibit attitude and practice change long term. Therefore, efforts to educate health care professionals on the dangers of pregnancy smoking, and to provide necessary skills for intervention efforts, may need to occur before they ever enter practice. Thus, the goal of the current project was to implement and evaluate a pregnancy smoking-related training session for baccalaureate nursing students in rural Southern Appalachia. Design: Nursing students attended training on pregnancy smoking dangers/intervention techniques. Sample: Third year students beginning clinical rotations in obstetrics. Methods: 1.5-hour training including pre- and post-tests. Implementation Strategies: Four months later, follow-up survey assessed gains in knowledge, skill, comfort, and willingness to address smoking. Results: Over seven semesters, 659 nursing students were trained. Substantial gains in knowledge of pregnancy smoking issues were seen from pre- to post-testing, with knowledge retained at four- month follow-up. The percentage of students who felt they lacked skills to intervene with pregnant smokers dropped from 39% at pre-test to 6% at same day post-test. In addition, the percentage who reported they would be uncomfortable talking with pregnant women about smoking dropped from 10% to 1%, while the percentage who indicated they would always make time to address smoking with pregnant women increased from 54% to 87%. While most students did address smoking with multiple pregnant patients encountered during clinicals, and over half felt the patients benefited from their actions, only 58% were confident in their intervention skills at four month follow-up. Finally, 83% felt the training had been beneficial, and over 90% committed to addressing smoking with pregnant patients once they graduated. Conclusion/Implications for nursing practice: Training can increase nursing student knowledge, skill, comfort, and willingness to address smoking with pregnant women. However, it appears ongoing education may be needed to promote skills and confidence long term. In the rural South, where smoking rates are high and provider efforts to address pregnancy smoking are inconsistent, educating future nurses could have substantial impact on pregnancy smoking rates and birth outcomes into the future.

Graviditetsförlust i form av tidiga missfall är en vanlig diagnos i sjukvården. En mer sällsynt diagnos är utomkvedshavandeskap som kan ha ett dramatiskt förlopp och vara direkt livshotande. Sjuksköterskan kan inom flera olika områden i sjuk-vården träffa på kvinnor som har råkat ut för någon av dessa förluster och behöver omvårdnad. Syftet med litteraturöversikten var att ta reda på vad eventuell forsk-ning visade angående kvinnors känslomässiga upplevelser vid graviditetsförlust samt att ur ett omvårdnadsperspektiv belysa kvinnors reaktioner på vården. För att uppnå syftet gjordes en litteraturöversikt enligt Friberg (2006). Resultatet ledde fram till tre teman; Känslomässiga upplevelser, Hur dessa hanterades och Reak-tioner på omvårdnaden. Kvinnorna upplevde graviditetsförlusten olika men gemensamt för dem var att bemötandet från vårdpersonalen hade betydelse för hur de känslomässigt hanterade situationen. Om vårdpersonalen var sympatisk, enga-gerad och hade tid för dem klarade de av att hantera situationen på ett bättre sätt än när personalens bemötande upplevdes känslokallt och rutinmässigt. Resultatet diskuterades i förhållande till Travelbees omvårdnadsfilosofi. Kvinnorna behöver ges omvårdnad utgående från varje enskild individs unika situation. Det är en patientkategori som oftast har kort vårdtid vilket gör det till en utmaning för sjuk-sköterskor att i omvårdnaden hinna bemöta dem individuellt och uppfatta deras behov. / Pregnancy loss and early miscarriage are common adverse outcome in pregnancy. A more rare diagnosis is ectopic pregnancy that can be very dramatic and life-threatening. Nurses from different areas in hospitals meet women in need of care after such a loss. The purpose of this literature review was to find out what the research show about women’s emotional experience of pregnancy loss and from a nursing view find out how the women experienced the care they received. To reach the purpose, a literature review was done according to Friberg (2006). The results showed three different themes; Emotional experiences, How the women coped with the emotional experiences and How the women reacted to the care given. The women experienced the pregnancy loss differently but they had one thing in common: The way they handled the situation depended on how the health professional treated them. If the caregivers were sympathetic, compassionate and gave time to the women they coped a lot better than if the caregivers were insensi-tive, callous and showed a matter of fact attitude. The result is discussed in rela-tion to Travelbees nursing philosophy. The women need to be provided with targeted care. The care must be based on every woman’s individual needs. These patients often spend a very short time at the hospital with short time for treatment witch leads the nurses to a challenge of how to get the time to treat every woman individually. This would lead to a better understanding for the women’s needs