Background: Women with communicating double uterine anomalies are at increased risk for obstetric complications, including early pregnancy loss, preterm delivery, and breech presentation. We present the pregnancy of a woman with a previously diagnosed communicating double uterine anomaly. Case: An 18-yr-old white female with a previous diagnosis at age 11 of a communicating double uterus, double cervix, and obstructed left hemivagina was followed during the course of her pregnancy. She experienced no complications until 36 6/7 weeks, when she was found to have signs and symptoms of mild preeclampsia. The fetus was in a breech presentation and a cesarean section was performed. Two hemiuteri were identified intraoperatively. The communication was not visualized. A viable male infant was delivered without complications. Conclusion: This patient represents only the sixth report of successful pregnancy in a woman with a Toaff type 5A communicating uterine anomaly.

Objectives This study is a follow-up to previous research regarding buprenorphine medication-assisted therapy (MAT) in Johnson City, Tennessee. For-profit MAT clinics were surveyed to determine changes in tapering practice patterns and insurance coverage during the last 3 years. Methods Johnson City for-profit MAT clinics; also called office based opioid treatment centers, were surveyed by telephone. Clinic representatives were asked questions regarding patient costs for therapy, insurance coverage, counseling offered onsite, and opportunities for tapering while pregnant. Results All of the MAT clinics representatives indicated that tapering in pregnancy could be considered even though tapering in pregnancy is contrary to current national guidelines. Forty-three percent of the clinics now accept insurance as compared with 0% in the 2016 study. The average weekly cost per visit remained consistent. Conclusions The concept of tapering buprenorphine during pregnancy appears to have become a standard of care for this community, as representatives state it is offered at all of the clinics that were contacted. Representatives from three clinics stated the clinics require tapering, even though national organizations such as the American College of Obstetricians and Gynecologists and the American Society of Addiction Medicine do not recommend this approach. Although patients who have government or other insurance are now able to obtain buprenorphine with no expense at numerous clinics, the high cost for uninsured patients continues to create an environment conducive to buprenorphine diversion.

With this thesis, I have been looking at opportunities for improvement of childbirth in Scandinavia with a focus on prevention of perineal tears and levator injuries during labor. I have aimed to help couples during their pregnancy by giving them a more active role to avoid tears during childbirth. I have strived to help pregnant mothers to improve their well-being as well as improve cooperation between pregnant couples for them to have a better birthing experience. My goal has been to develop a concept that could improve today’s situation and that in theory could be implemented today in Scandinavia. Another goal was to create a discursive design topic, to question childbirth as it is today and show a new vision for how it could look like in the future. I wanted to show the importance of quality of life and that childbirth both could and should be questioned and looked into more to improve it.

The first objective of this study was to investigate the adjustment of women during pregnancy through various indices, namely: level of anxiety, attitudes to pregnancy, and perception of body-image boundaries, and to investigate the relationship among these indices. A second objective was to determine if a significant rank order of values inferred through clothing exists among pregnant women, and to relate these values to the measures of adjustment. The comparison of women by trimester and gravidity on the measures of adjustment and the inferred values, was a third objective. The theoretical framework proposed that adjustment to the stress of pregnancy has important implications for the mental health and welfare of mother and child. It was also based on research findings that the subconscious evaluation of body boundaries is an index of adjustment, as is level of anxiety and attitudes to pregnancy_ The interdisciplinary approach to the study of clothing postulates that clothing can facilitate adjustment by serving as an extension of self, as reinforcement of boundaries, and as a communicative factor. Value analysis is central to understanding and predicting behavior, therefore, the values pregnant women seek to reinforce through clothing should provide insight into the function of clothing in adjustive behavior. The sample of 56 pregnant women was selected on a non-random basis from prenatal clinics in southwest. Saskatchewan. The instruments administered were: Cattell's IPAT Anxiety Scale, Grimm's Hel.P. pregnancy Questionnaire, Holtzman Inkblot Protocols, Kernaleguen's Inferred Values of Clothing Inventory, and a General Information Questionnaire. The analyses revealed: (1) significant association among anxiety and factors in attitudes and adjustment to pregnancy, and some of the inferred values of clothing; (2) relationships among factors in attitudes and adjustment to pregnancy and the four inferred values of clothing; (3) positive correlation between Barrier and Penetration, but no significant relationships among Barrier or Penetration and the other indices of adjustment or the inferred values; (4) significant difference in Penetration among subjects in each trimester of pregnancy; (5) no significant difference between primigravidae and multigravidae on any of the variables; (6) significant rank order of inferred values among all subjects, by trimester and gravidity, with value for physical comfort ranked highest. and the social values ranked loweste The theoretical framework received some support. High level of anxiety was related to negative attitudes to pregnancy. The relationship of the measures of adjustment with the more subconscious concept of body-image was not clearly establishede A number of recommendations are included.

Pregnant adolescents and adolescent mothers are a population at risk to a variety of negative social, economic, and psychological consequences. Numerous group interventions have been designed to improve the psychological adjustment of pregnant adolescents and adolescent mothers. However, there has been a paucity of research evaluating the efficacy of these interventions. This research was designed to evaluate the efficacy of the development group intervention. The primary objective of this research was to evaluate the effects of this intervention upon the psychological adjustment of the participants. Thirty-two subjects (16 experimental and 16 comparison) enrolled in two alternative public high schools in Ogden, Utah, participated in the study. Demographic data were obtained for all subjects prior to the initiation of the study. All subjects completed a battery of self-report questionnaires prior to the development group intervention. This battery was comprised of the following assessment instruments: Revised Kaplan Scale, Adolescent Life Change Event Scale, State-Trait Anxiety Inventory (STAI), Rathus Assertiveness Schedule, Center for Epidemiological Studies Depression Scale, Rosenberg Self-Esteem Scale, and Wazlavek Support Scale. At the end of the 14-week intervention period, all participants again completed the self-report assessment battery. No statistically significant differences were found between the experimental group and the comparison group. However, development group attendance was significantly positively correlated with posttest levels of perceived social support. There is indication that married adolescents may benefit more from the development group experience than single adolescents.

The purpose of this study was to compare couples who experienced a pregnancy early in their courtship, late in their courtship, or not pregnant at all on their development of behavioral interdependence across three levels of involvement; regularly dating , a couple, and committed to marriage, and into marriage. Data were collected by means of a semi-structured interview schedule which permitted couples to retrospectively graph their courtship from the first time they met until marriage. Partners divided their courtship into the three levels of involvement and then completed questionnaires which ascertained the activities they performed and with whom they performed them for each of the three levels of involvement and once for marriage. Analyses of variance were performed on properties derived from the graphs and the behavioral variables obtained from the activities questionnaires. Partners in the early pregnant group spent more time in the couple 1evel of involvement than in the regularly dating and committed 1evel s and partners in the late pregnant group spent more time in the committed level of involvement than the other levels. Partners in the early and late pregnancy groups performed fewer female activities alone than did the partners in the nonpregnant group; an indication that partners in the two pregnancy groups are less traditional than partners in the nonpregnant group. Partners in the early and late pregnancy groups also reported performing more affectionate activities early in their courtship than did the partners in the nonpregnant group, but the performance of affectionate activities by the early pregnant partners was lower than the late and nonpregnant pairs at marriage. Partners in the early pregnant group seemed to be more isolated in their performance of leisure activities. They performed proportionately fewer leisure activities with family members or friends only than did partners in the late and nonpregnant groups.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21457号 / 人健博第64号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 古田 真里枝, 教授 若村 智子, 教授 万代 昌紀 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Pregnancy induced hypertension (PIH) occurring during pregnancy, labour and puerperium is a major contributor to the high percentage of maternal morbidity and mortality in the Eastern Cape Province, and worldwide. In South Africa (SA), PIH is the second most common of all primary causes of maternal mortality reported in the triennium from 1999 to 2001. From 1999 to 2001, PIH was the cause of 20,7 % (n = 507) of all maternal mortalities in SA (Department of Health (DOH), 2001:38). In the light of these statistics and other statistics related to other causes of MMR, the National Confidential Committee on Enquiries into Maternal Deaths (NCCEMD) developed the National Guidelines for Maternity Care in South Africa, a Manual for Clinics, Community Health Centres and District Hospitals. The guidelines related to PIH were of particular interest in this study. A quantitative, descriptive and contextual survey was conducted to determine the implementation of the National Guidelines for Maternity Care for the management of PIH by the midwife at level-1 clinics in the Eastern Cape, and to make recommendations for the management of PIH by midwives at level-1 clinics with the intention of reducing maternal mortality and morbidity due to PIH. The research method comprised a retrospective record review of the records of all patients admitted with PIH at a level-3 hospital who were referred by a midwife from a level-1 clinic. Data were collected by means of a researcher-administered data collection tool based on the iii National Guidelines for Maternity Care in SA for the management of PIH. The researcher wished to determine whether the National Guidelines for Maternity Care in SA was being implemented for the management of PIH by midwives at level-1 clinics in East London. A purposive sample of 290 maternal records of mothers who had been admitted for PIH at level 3 after being referred from level-1 clinics from May 1999 to June 2003 were used. Data were analysed using descriptive statistics. Ethical issues were taken into consideration. Validity and reliability were ensured. In conclusion, given the study findings, the researcher has made recommendations with the intention of reducing mortality due to PHI in the Eastern Cape.