<p>Abstract Delivering a preterm baby who is admitted to a neonatal intensive care unit can be an enormous hardship for parents and families, and especially for mothers. The consequences of prematurity alter the parental role, affect their confidence in caring for the baby, and subsequently may impact infant outcomes. Adequately educating mothers of premature babies using an evidence-based practice approach may help them gain the confidence and skills needed to care for their infants. The purpose of this project was to create a tool kit to educate mothers of premature babies about the essential components of caring for their babies, establish content validity of the tool kit among clinical experts, and make recommendations about the use of the tool kit in the neonatal intensive care unit. Polit, Beck, and Owen?s framework was used to establish content validity. Neonatal intensive care nurses who were considered ?experts? using Benner?s novice-to-expert theory (n = 7 reviewed the tools which were quantitatively computed and yielded an Item Content Validity Index value range of 0.86 to 1.00, and a Scale Content Validity Index of 0.97, reflecting that the content met the objectives of the toolbox. Positive social change can be realized through use of the tool kit in the neonatal intensive care unit to educate mothers in the care of their preterm babies, thus improving both maternal and infant outcomes.

Three experiments investigated the effects of tactile stimulation on a large sample of infants (N = 115). The pilot experiment used full-term babies (n = 13). It compared the effects of Rice Infant Sensorimotor Stimulation (which involves stroking together with other kinds of stimulation) with various controls. At three months the R.I.S.S. babies had higher scores on the Bayley Developmental Scale. In the main experiment, only stroking (no handling) was used as stimulation for 10-15 minutes, twice daily for 14-21 days employed by the investigator. Birthweight was in the range 760g to 2,200 kg. Three hospitals were used. In the first one, experimental babies (n = 6) gained more weight (by day 21) and were bottle fed and moved to the cot earlier than controls (n = 6). In hospitals 2 and 3, fifty-four babies were treated as coming from the same population (justified by statistical analysis). Some of the findings are that, as compared with controls, treated babies had less weight loss in the first week and higher gain at day 21, and scored higher on sucking and hand grasp. There was some evidence that the gains were greatest if stimulation was started before day 3. At 40 weeks the treated babies scored higher on general measures, but particularly several items of the Dubowitz Assessment Scale. Compared with full-term untreated infants of the same age (n = 10), at 40 weeks the pre-term treated infants had poorer posture, but better auditory orientation and alertness and fewer startles. At 12 months, treated AGA infants scored higher on the Bayley Development Scale (MDI) than untreated AGA infants (blind). Compared with full-term (n = 6) untreated infants of the same age, the preterm AGA untreated and the preterm SGA treated infants had a poorer MDI score (adjusted aged). A final complementary study used a modified stroking technique (n = 20). 'Blind' assessments showed that treated infants had less weight loss in the first week and higher gain at day-21, and scored higher on sucking and hand grasp. They also showed significantly higher scores on posture, leg traction, body movement, rooting, walking, auditory orientation and less irritability. At 6 months, follow-up treated infants scored higher on the Bayley Development Scale (MDI).Concurrent and immediately subsequent reactions to the stimulation showed that treated infants changed their state and showed signs of pleasure (main and complementary studies). The two experiments together provide some evidence that tactile stimulation on its own has beneficial physical, neurological, neuro-behavioural effects.

Rhesus isoimmunisation very rarely causes any upset in the pregnant woman but may have a profound and serious effect on her child. For this reason, the condition is of considerable importance to the obstetrician, especially as its presence is likely to be detected during the time that he is responsible for the patient's care and well-being.

Aim: To develop an intervention that could be facilitated by midwives to improve symptoms of mild to moderate anxiety in pregnant women Background: Many women experience symptoms of anxiety during pregnancy. Severe anxiety is associated with negative health outcomes for women and babies. Psychological interventions may be beneficial for pregnant women with mild to moderate symptoms of anxiety. Interventions require evaluation in pregnant populations to strengthen the evidence base. Methods: An intervention was developed according to the Medical Research Council theoretical and modelling phases for developing complex interventions. The study comprised three phases: 1. systematic reviews exploring the effectiveness and acceptability of interventions for pregnant women with anxiety; 2. development of an intervention which comprised individual support from midwives, peer group discussion and self-help resources; 3. a feasibility study of the intervention. Data collection comprised baseline and post-intervention self-report anxiety measures and semi-structured interviews conducted post-intervention. Data analysis used descriptive statistics for the quantitative data and template analysis for the qualitative data. Findings: Ten women participated in the feasibility study. Two midwife facilitators and two midwifery support worker co-facilitators were recruited and trained to facilitate the intervention. Women reported that the intervention was acceptable and beneficial. The findings highlighted how the intervention could be improved to maximise participant recruitment and improve the benefit derived by pregnant women with symptoms of anxiety. Facilitators provided positive comments about their involvement and said they felt prepared to deliver the intervention. Areas were identified where the training of intervention facilitators, study manuals and use of self-help resources could be enhanced to improve performance and fidelity of the intervention. Conclusions: Midwives have the potential to facilitate supportive interventions to enhance the current provision of emotional support in pregnancy. Minor refinements to the intervention are recommended prior to further testing. The next stage of development should be to conduct a randomised pilot trial. This should determine robust research methods and procedures for conducting a main trial to assess the effectiveness of the intervention on self-report symptoms of anxiety in pregnant women.

<p> Postpartum hemorrhage is the leading cause of maternal mortality and morbidity globally and affects women with a gestational age of 20 weeks and above. To determine whether the utilization of synthetic Pitocin in the intra-partum period has any association to postpartum hemorrhage, the primary investigator encouraged clinicians to continuously utilize the Triton OR to quantify the blood loss for 24 hours after vaginal delivery. The project also entailed chart review of 30 women who labored and delivered at a local hospital in the State of Georgia. One group was given synthetic Pitocin to induce and or augment their labor while the other group did not. Two clinical questions guided the project. What is the difference in the amount of blood loss within 24 hours of vaginal delivery between women who had their labor induced and or augmented with synthetic Pitocin compared to those who spontaneously labored and delivered? Is there any association between the utilization of synthetic Pitocin for the induction and or augmentation of labor, and post-partum hemorrhage within 24 hours of vaginal delivery? Jean Watson theory of human caring guided guide the project. A quantitative comparative design was utilized for the project. The mean blood loss for those women who received synthetic Pitocin was 279.20 milliliters, while that of women who did not receive synthetic Pitocin was 293.67 milliliters; hence there was no association between the utilization of synthetic Pitocin in the intra-partum period and postpartum hemorrhage (<i>p</i> >.05). Conducting the project on a larger scale is paramount in determining whether there is any association between synthetic Pitocin utilization in the intra-partum period and postpartum hemorrhage.</p><p>

Thesis (M Med(Obstetrics and gynaecology))--University of Limpopo (Medunsa Campus), 2011. / BACKGROUND: Parasuicide is defined as an act with non-fatal outcome, in which an individual deliberately initiates a non-habitual behaviour that without intervention from others will cause self-harm, or when an individual deliberately ingests a substance in excess of the prescribed or generally recognized therapeutic dosage. Pregnant women experience higher rates of depression, anxiety, psychosomatic symptoms and lower level of social adjustments than nonpregnant women. Cases of parasuicide among pregnant women have been seen and treated at Dr George Mukhari Hospital over the years without any systematic assessment of the extent of the problem. OBJECTIVE: The aim of the study was to evaluate the impact of cases of parasuicide on the eventual maternal and foetal outcomes. 10 MATERIALS AND METHODS: The study was conducted retrospectively using the hospital files of those pregnant women who had been diagnosed at Dr George Mukhari Hospital. The medical records of all such cases were retrieved from the filling room for assessment. The review period covered 1st January 2004 to 31st December 2006. Analysis was predominantly descriptive in which rates of incidences as well as proportion of occurrence of variables were calculated. Evaluation was for demographics, social status, intents and methods of parasuicide. In addition, the outcome of treatment for the mothers and their babies were evaluated. All the patients had been treated with gastric lavage and ingestion of activated charcoal from their referring centres regardless of the material used. The patients were stabilized and then referred for psychological counselling. RESULTS: During the three-year review period, 54 cases of parasuicide were recorded, with files for 42 (77.7%) patients found and evaluated. The ages of the women ranged from 16 to 35 years (median=21 years). Majority of women (57.1%) were parous while 42.9% were nulliparous. Socio-economic status of the women revealed that most patients were unemployed (95%), most were living with parents (90%), pregnancy was planned by 62%, 10% reported history of 11 physical abuse and only one of the women (2%) had a problem of alcohol abuse. Materials used for parasuicide included ingestion of tablets (23; 54.8%), organophosphates (7; 16.7%), herbal potions (6; 14.3%), rat poison (2; 4.8%) and other things such as paraffin, detergent (Jik) and laxatives. Thirty five of the 42 patients (83.3%) had reasons documented for parasuicide, of which the majority had relationship difficulties with their partners (22; 62.8%), (8; 22.9%) had relationship problems with family members and (5; 14.3%) wanted to terminate the pregnancy. The gestation at admission for treatment for parasuicide ranged between 16 and 40 weeks and at delivery pregnancy ended as: abortion (6; 14.3%), preterm delivery (13; 36.1%) and term delivery (23; 63.9%). The rate of abortion (14.3%) was significantly higher in these patients (ρ-value = 0.0001) compared to non-parasuicide patients (1.2%). Most of them delivered vaginally (95%), only one patient needed ICU admission for 6 days and there was no case of maternal death. Out of the 36 women who delivered viable babies, there were 33 (91.7%) who had live births, three other women had IUFDs (8.3%) and no neonatal death was recorded. 12 CONCLUSION Although parasuicide in pregnancy occurs infrequently at DGMH, the most striking factor which could have led to attempts at parasuicide was the socioeconomic situation of the women. A scenario in which 95% of these pregnant women were unemployed, 90% were unmarried and for most of the women the reasons for parasuicide were related to relationship difficulties, provide an effective recipe for parasuicide.

Thesis--New York University. / Includes bibliographical references (leaves 58-61).

Thesis--Columbia University. / Includes bibliographical references (leaves 141-153).

Thesis (MTech (Radiography))--Peninsula Technikon, 2000. / Word processed copy. Summary in English. Includes bibliographical references (leaves 51-61). Also available online.

Thesis (M.A.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains iv, 52 p. Includes bibliographical references (p. 49-51).