ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00715.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:In a prospective longitudinal study, 202 primigravidas were assessed for depression using the National Institute of Mental Health's (NIMH) standardized clinical interview, the Schedule for Affective Disorders and Schizophrenia (SADS), and Research Diagnostic Criteria (RDC) at four periods: 10 to 14 weeks of pregnancy, 30 to 32 weeks of pregnancy, 1 to 2 weeks postpartum, and 14 weeks postpartum. Women's responses did not fit the SADS standardized questions and prescribed ratings because pregnancy and postpartum symptoms often mimicked depression symptoms. This was addressed by adding questions and scoring criteria to separate out pregnancy and postpartum symptoms from depression symptoms. Results showed that, after accounting for pregnancy‐postpartum symptoms, women consistently claimed eight symptoms with high frequency and higher mean ratings: dysphoric mood, worrying, somatic and psychic anxiety, insomnia, fatigue, anger, and irritability. The findings suggest that 1) depression in pregnant and newly delivered women may be underdiagnosed if caregivers attribute their complaints or symptoms to time‐limited somatic conditions; 2) depression may be overdiagnosed if clinicians use self‐report measures solely, or without carefully interviewing women to separate the symptoms of depression from symptoms of pregnancy and postpartum; and 3) women's reactions to perinatal symptoms may have some bearing on the development of depression then or later. Simple clinical and social amelioration of the symptoms of distress might reduce their effect and diminish the rate of mistaken diagnoses of depre

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00716.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:For centuries, there has been speculation regarding the etiology of postpartum depression. An improved diagnostic classification has emerged, however, as the universality of the syndrome has been recognized and the role of hormonal, genetic, and obstetric variables considered. In addition, different cultures have different perceptions of the needs of the new mother. The emphasis in investigative work now appears to be in the psychosocial and psychodynamic areas. Our recent research focused on identification of risk factors early in pregnancy, including a history of depression, separation from one or both parents in childhood or adolescence, poor parental emotional support in childhood and adulthood, poor relationship with husband or partner, economic problems, and dissatisfaction with amount of education. We suggest that physicians, nurses, and mental health professionals be aware of the emotional status of their patients, familiarize themselves with the risk factors, and initiate a program of careful postpartum follow‐up. These measures will help to improve recognition and management of the woman at risk for postpartum depressio

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00717.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00718.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:Maternity care for women in Ontario is provided almost exclusively by physicians, the majority of whom are obstetricians. Using a self‐administered questionnaire, pregnant women in one Ontario city were surveyed about their interest in midwifery care as an alternative to physician care. Although 3 percent of the women surveyed had used a midwife, 60 percent expressed an interest in midwifery care, particularly the counseling and support aspects. Over 11 percent showed an interest in complete primary midwifery car

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00719.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00720.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00721.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:Allowing a trial of labor in patients who have had a single low transverse cesarean section has become increasingly accepted and widespread in the United States. Evidence with regard to the safety of this practice in patients with two or more prior cesarean births has, however, been sparse. We performed a retrospective review of the charts of 170 patients who had undergone two or more low transverse cesarean deliveries and subsequently delivered at Wishard Memorial Hospital between January 1, 1983, and December 31, 1987. Of 35 of these women who underwent a trial of labor, 27 (77%) had a successful vaginal delivery. No increase in maternal or fetal morbidity or mortality was associated with labor. The women who underwent trial of labor had fewer postpartum complications and shorter hospital stays. Although the number of patients in this study was small, growing evidence appears to support a trial of labor in patients with two or more prior cesarean sections as a safe and successful alternative to elective repeat cesarean section.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00722.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00723.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT:Prenatal caregivers often note that the behavior of pregnant patients creates the risk of fetal harm. Three such cases are reviewed, together with care providers' responses and relevant law. Pregnant womens' rights to disregard medical advice are increasingly being overridden in courtrooms and bedside hearings. To preserve the patient‐provider relationship, and to avoid coercive actions that may have little legal basis, emphasis should be on helping the woman act in her own best interest and that of her fetus, rather than on the law or the courts as a means of directly or indirectly controlling her behavio

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1990.tb00724.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY