Körperkult,Schönheitsdruck,Schlankheitswahn

Die ubiquitär durch (soziale) Medien verbreiteten unerreichbaren Schönheitsideale beeinträchtigen die psychische und körperliche Gesundheit von Frauen nachhaltig. Schönheit ist nicht mehr etwas, das man hat, sondern etwas, für das Frauen ständige Arbeit leisten müssen im Sinne von Diät, Schönheitspflege und körperlicher Betätigung und sich allenfalls kosmetisch-chirurgischen Prozeduren zur Annährung der propagierten Ideale unterziehen. Kosmetisch-chirurgische Eingriffe sind gesamtgesellschaftlich kritisch zu betrachten und insbesondere bei Störungen aus dem Spektrum der Körperdysmorphen Störungen kontraindiziert. Übermäßige sportliche Betätigung kann auch außerhalb des Hochleistungsbereichs im Sport bei restriktiver Ernährung zur Female Athlete Triad führen, insbesondere bei jungem gynäkologischem Alter einer Frau. Vorübergehende Diäten im Sinne einer restriktiven und selektiven Nahrungsaufnahme sind zur Gewichtskontrolle meist kontraproduktiv, da sie einerseits das Risiko einer mittelfristigen Gewichtszunahme, andererseits aber das Risiko des „Umkippens“ in eine Essstörung mit sich bringen. Essstörungen entstehen insbesondere bei jüngeren Frauen häufig in einem fließenden Übergang aus Diäten zum Zwecke der Körperoptimierung, wobei die Prävalenz klinischer Essstörungen in dieser Bevölkerungsgruppe zunimmt. Entscheidend für die somatische Gefährdung zu Beginn der Erkrankung sind der schnelle Gewichtsverlust und die instabile Kreislaufsituation. Früherkennung in der gynäkologischen Praxis und frühe Überweisung zur psychiatrischen Behandlung sind essenziell.     

Adolescence; Past,Present, Future

Objective.?In a cross sectional study of 89 infertile women, we explore a relationship between aspects of psycho-social stress and ovarian reserve parameters.

Methods.?Questionnaires assessed general health and mood (profile of mood state) were administered. Serum (cycle days 1–3) was collected for biomarkers of ovarian reserve (follicle stimulating hormone (FSH), Mullerian Inhibitory Substance, Inhibin B) and stress (Cortisol). Multivariable regression analyses evaluated associations between parameters of interest (dysphoric mood, morning serum cortisol levels reflecting current stress; personal history of abuse, family and/or personal history of substance abuse reflecting chronic stress), with ovarian reserve biomarkers and with the likelihood of being diagnosed with diminished ovarian reserve (DOR).

Results.?Women with DOR were almost four times more likely to acknowledge personal history of recreational substance use (0.023) and family history of early menopause (p?=?0.018). Adjusted analyses demonstrated advancing age, family history of early menopause, body mass index and chronic psycho-social stressors as independent correlates to serum FSH levels; age, family history of early menopause and chronic stress were predictive of likelihood for DOR. No demonstrable relationship was observed between ovarian reserve and current stress.

Conclusions.?Our findings identify aspects reflecting ‘chronic’ lifetime psycho-social stressors (i.e., personal history of abuse and of recreational drug use and/or family history of drug use) rather than ‘current’ stress (as reflected by dysphoric mood score and morning serum cortisol level) as detriments to ovarian reserve (i.e., were predictive of higher FSH levels and of an enhanced likelihood for DOR).     

Colecistectomía durante la resolución obstétrica,evento simultáneo

The existence of factors that influence the development of bile duct stones has been recognized for many years. These factors include multiparity, the physiology of pregnant women and hormones that contribute to the genesis of the disease.     

BIRTH CENTERS; Economy,Safety, and Empowerment

The first three-quarters of this century saw births in the United States shift dramatically from the home toward hospital-based, physician-oriented care. More recently, the establishment and proliferation of modern birth centers and the increased numbers of certified nurse-midwives in this country have expanded birth alternatives for women but not without controversy. The objectives of this article are as follows: 1) to review literature comparing modern birth centers with hospital and physician-attended births in terms of safety, rates of complications, number of invasive procedures, cost-effectiveness, and patient satisfaction, and then 2) to explicate models of empowerment as applied to birth centers and consider how they may manifest in individuals and in the community. Findings: comprehensive data have clearly demonstrated that birth centers are as safe as hospitals for low-risk births, do fewer invasive procedures and cesarean sections, are less expensive, and have high rates of patient satisfaction. Furthermore, birth centers effectively shift the locus of control of the pregnancy from physician to mother, and conform closely to ideal models of empowerment structures described in the literature. Conclusions: For low-risk pregnancies, birth centers confer many advantages over conventional hospital-based births without compromising the safety of the mother or infant and in the process can empower women to transform their lives and their community.     

The Silent Child—Mothers’ Experiences Before,During, and after Stillbirth

Abstract: Background : The quality of care received by a woman who gives birth to a dead baby is crucial for her long‐term well‐being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent. Methods : Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology. Results : Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long‐awaited but now silent baby. Conclusion : The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.