ABSTRACT
Nulliparous women with singleton gestation were assessed prospectively for anxiety levels with the State-Trait Anxiety Inventory, which measured state (situational and transitional) and trait (dispositional and stable) anxiety, with high scores indicating high anxiety. Bivariate and multivariate methods were used for data analysis. Anxiety assessments (n = 239) were obtained in 88 women at different stages of gestation. Mean anxiety scores were lowest at 22 to 26 weeks. A woman's successive scores were highly correlated. The trait anxiety (A-T) scores were higher for married women. A positive correlation was present between anxiety scores and gestational age at delivery. Low A-T scores correlated with low birthweight, preterm delivery, and chorioamnionitis. High state anxiety (A-S) levels correlated with the presence of meconium in the amniotic fluid and neonatal congenital abnormalities. Postdate delivery also was associated with higher although statistically insignificant anxiety scores. Women who presented to the labor and delivery room for various complaints had higher A-S and A-T levels. Maternal anxiety level was associated with adverse perinatal outcome; specifically, prematurity and low birthweight correlated with low A-T levels.
Subject(s)
Anxiety , Pregnancy Outcome , Pregnancy/psychology , Adult , Female , Humans , Parity , Prenatal Care , Prospective Studies , Psychiatric Status Rating ScalesABSTRACT
Renal transplantation has been very effective in the treatment of end-stage renal disease. Over 750 cases of successful pregnancies in these patients have been reported, and only 15 patients with sickle cell disease (homozygous hemoglobin S) have had renal allografts. The present study documents the first case of a successful pregnancy in a patient with sickle cell disease and renal transplantation. The combined complications increase the risks in view of the susceptibility of certain vital organs in pregnancy. Careful multidisciplinary management enhances successful outcome.
Subject(s)
Anemia, Sickle Cell/therapy , Kidney Transplantation , Pregnancy Complications, Hematologic/therapy , Adult , Anemia, Sickle Cell/physiopathology , Female , Humans , Kidney Failure, Chronic/surgery , Pregnancy , Pregnancy Complications, Hematologic/physiopathologyABSTRACT
A simple test for surfactant, utilizing bubble stability in ethanol, was performed in 106 samples of amniotic fluid obtained from 94 patients. Of these patients 80 delivered within 48 hours of the collection of the sample. The results were compared with the lecithin concentration in the same amniotic fluid samples and with the quality of respiration in the neonate. The test was "positive," indicating fetal pulmonary maturity, in 37 cases and none of these infants developed respiratory distress syndrome (R.D.S.). In only one of these cases, however, was gestation less than 37 weeks. The test was "intermediate" or "negative" in 43 cases but in 35 of these infants respiration at birth was perfectly normal.Performed by the method described by its originators, this simple test gives too many false negative results to be of value in routine clinical practice, although a positive result is helpful. The concept of the test is ingenious, however, and further developments may be expected.
