From the other side …

A nurse recounts her experience as a hysterectomy patient, an experience which gave her a different view of the nurses and doctors, the patients' problems, and the atmosphere of the hospital in which she works.     

Amnioscopy … Is It Worthwhile?

Summary: Amnioscopy has been used in late pregnancy to monitor the amniotic fluid of the fetus at risk of intra-uterine hypoxia. The test has been performed on more than 3,000 patients over a 7-year period. Properly performed it is a worthwhile clinical procedure since it can improve the quality of antenatal care for the fetus who is at risk. Apart from this it has been of assistance in the induction of labour, the early detection of unsuspected abnormalities and research on membrane cytology.     

The Humidicrib … A Model of Isolation?

Summary: The premature infant, whose physical well-being often depends on his remaining in an incubator for a variable period, is in a particularly vulnerable psychological situation, being separated from his parents and cut off from the world outside the "humidicrib" or "isolette". The name itself highlights the isolation experienced by parent and child; the mother feeling cut off from her baby, inadequate in not being able to produce a healthy, term infant and incompetent to care for him or her. The infant, on the other hand, is robbed of many of the normal opportunities for contact and stimulation, while being exposed to multiple noxious stimuli essential for survival.     

Sipple''s Syndrome (Multiple Endocrine Neoplasia) in Pregnancy … Case Report

Summary: A case of Sipple's syndrome (multiple endocrine neoplasia) in a 24-year-old pregnant Hindu patient is described. Classical features included multiple carcinoma of the thyroid and adrenal glands. The patient died shortly after admission with hypertensive encephalopathy/preeclampsia.     

Life Course Pathways to Prenatal Maternal Stress

ObjectiveTo evaluate the impact of childhood stressors, recalled childhood stress, and stressors in adulthood on perceived stress in pregnancy.DesignProspective cohort study.SettingPregnant women were recruited from pre‐birth clinics in two communities.ParticipantsFour‐hundred and twenty‐one pregnant women.ResultsPerceived prenatal maternal stress was the main outcome measure. Recalled childhood stress was positively associated with prenatal stress (β = .54) after adjusting for other child and adult factors. Low family cohesion during childhood was indirectly associated with prenatal stress through its effects on recalled childhood stress, current family cohesion, and current subjective socioeconomic position (SEP). Low levels of adult subjective SEP (β = −.44) and family cohesion (β = −.25) were directly associated with prenatal stress. Perceived social support during childhood was indirectly associated with prenatal stress through its effect on recalled childhood stress and perceived social support in adulthood. Childhood subjective SEP indirectly influenced prenatal stress through its effect on adult subjective SEP and recalled childhood stress.ConclusionsPrenatal stress is a result of the interplay between factors from childhood and adulthood. The study findings can be used to inform psychosocial risk assessment and interventions across the lifespan to decrease prenatal stress and its adverse outcomes.     

Poor Health‐related Quality of Life After Severe Preeclampsia

Abstract: Background: Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality, and adverse birth outcomes. The objective of this study was to describe changes in all domains of health‐related quality of life between 6 and 12 weeks postpartum after mild and severe preeclampsia; to assess the extent to which it differs after mild and severe preeclampsia; and to assess which factors contribute to such differences. Methods: We conducted a prospective multicenter cohort study of 174 postpartum women who experienced preeclampsia, and who gave birth between February 2007 and June 2009. Health‐related quality of life was measured at 6 and 12 weeks postpartum by the RAND 36‐item Short‐Form Health Survey (SF‐36). The population for analysis comprised women (74%) who obtained scores on the questionnaire at both time points. Results: Women who experienced severe preeclampsia had a lower postpartum health‐related quality of life than those who had mild preeclampsia (all p < 0.05 at 6 wk postpartum). Quality of life improved on almost all SF‐36 scales from 6 to 12 weeks postpartum (p < 0.05). Compared with women who had mild preeclampsia, those who experienced severe preeclampsia had a poorer mental quality of life at 12 weeks postpartum (p < 0.05). Neonatal intensive care unit admission and perinatal death were contributing factors to this poorer mental quality of life. Conclusions: Obstetric caregivers should be aware of poor health‐related quality of life, particularly mental health quality of life in women who have experienced severe preeclampsia (especially those confronted with perinatal death or their child’s admission to a neonatal intensive care unit), and should consider referral for postpartum psychological care. (BIRTH 38:3 September 2011)