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Vuthiwong C.,Maternal Fetal Medicine Unit
Journal of the Medical Association of Thailand = Chotmaihet thangphaet

To assess the attitude of husbands toward the thalassemic carrier screening test and to explore the causes of non-participation of having a blood test. Descriptive study. During 2007-2008, 100 husbands of pregnant women with screening-positive test for thalassemia who refused to have blood test were enrolled by voluntariness. They would fill out a structured questionnaire designed for the present study which was divided into 3 parts; (1) participant's personal characteristics (2) their attitudes toward thalassemic carrier screening test with the score ranging from 1-5, and (3) reasons for their refusal of having a blood test. The husbands had a favorable attitude toward testing for thalassemia, with overall mean score and standard deviation of 3.57 and 0.38. Commonly expressed reasons against testing were the self-belief of having a non-affected child and the inconvenience of coming to the hospital. Husbands had a favorable attitude toward test for thalassemia. Source

Carlin A.J.,Maternal Fetal Medicine Unit
Cochrane database of systematic reviews (Online)

BACKGROUND: Peripartum cardiomyopathy (PPCM or PCMO) is a rare disease of unknown etiology, characterised by an acute onset of heart failure in women in the late stage of pregnancy or in the early months postpartum. OBJECTIVES: To assess the effectiveness and safety of any intervention for the care of women and/or their babies with a diagnosis of peripartum cardiomyopathy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 July 2010) and the reference lists of identified studies. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials of any intervention for treating peripartum cardiomyopathy. Such interventions include: drugs; cardiac monitoring and treatment; haemodynamic monitoring and treatments; supportive therapies and heart transplant. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. MAIN RESULTS: We identified and included one pilot study, involving 20 women, undertaken in South Africa. Women were diagnosed postnatally and included in the study within 24 hours of diagnosis. AUTHORS' CONCLUSIONS: There are insufficient data to draw any firm conclusions. Treatment with bromocriptine appears promising, although women would be unable to breastfeed due to suppression of lactation. Source

Madden K.L.,University of Adelaide | Turnbull D.,University of Adelaide | Cyna A.M.,Womens and Childrens Hospital | Adelson P.,University of Adelaide | Wilkinson C.,Maternal Fetal Medicine Unit
Women and Birth

Objective: To compare the personal preferences of pregnant women, midwives and obstetricians regarding a range of physical, psychosocial and pharmacological methods of pain relief for childbirth. Method: Self-completed questionnaires were posted to a consecutive sample of 400 pregnant women booked-in to a large tertiary referral centre for maternity care in South Australia. A similar questionnaire was distributed to a national sample of 500 obstetricians as well as 425 midwives at: (1) the same hospital as the pregnant women, (2) an outer-metropolitan teaching hospital and (3) a district hospital. Eligible response rates were: pregnant women 31% (n=123), obstetricians 50% (n=242) and midwives 49% (n=210). Findings: Overall, midwives had a greater personal preference for most of the physical pain relief methods and obstetricians a greater personal preference for pharmacological methods than the other groups. Pregnant women's preferences were generally located between the two care provider groups, though somewhat closer to the midwives. All groups had the greatest preference for having a support person for labour with more than 90% of all participants wanting such support. The least preferred method for pregnant women was pethidine/morphine (14%). Conclusion: There are differences in the personal preferences of pregnant women, midwives and obstetricians regarding pain relief for childbirth. It is important that the pain relief methods available in maternity care settings reflect the informed preferences of pregnant women. © 2011 Australian College of Midwives. Source

Papanna R.,Baylor College of Medicine | Mann L.K.,Baylor College of Medicine | Molina S.,Maternal Fetal Medicine Unit | Johnson A.,Baylor College of Medicine | Moise K.J.,Baylor College of Medicine
Prenatal Diagnosis

Objective: To assess serial changes in the Tei index of the recipient fetus secondary to fetoscopic laser photocoagulation of placental anastomoses (FLP) for twin-twin transfusion syndrome (TTTS) during the peri-operative period. +Study design: A prospective study of cases that underwent FLP at the Texas Children's Fetal Center was performed. Mean and individual changes in the Tei index measurements were obtained during the pre-operative, intra-operative and the post-operative (12-h and 24-h) periods after surgery and were compared using paired t-test. A p-value of < 0.05 was considered as significant. Results: A total of 20 patients were included in the study. In both the right and the left side, the mean Tei indices appeared to be increased from baseline during the intra-operative period, with a subsequent decrease to pre-operative values within 24 h of laser surgery. These changes were also noted when individualized patient results were analyzed in a serial fashion. Conclusion: FLP results in a transient increase in the intra-operative myocardial performance index in the recipient fetus. These changes appear to resolve in the post-operative period. Copyright © 2011 John Wiley & Sons, Ltd. Source

Turnbull D.,University of Adelaide | Adelson P.,University of Adelaide | Oster C.,Flinders Medical Center | Bryce R.,Flinders University | And 2 more authors.

Background: Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to "prime" or "ripen" the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. Methods: Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). Results: Of 1,004 eligible women, 85 percent consented (n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. Conclusion: Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety. © 2013, Wiley Periodicals, Inc. Source

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