Dysthymic reactions of women undergoing chorionic villus sampling for prenatal diagnosis of hemoglobinopathies or karyotyping

Objectives: The aim of the study was to investigate the levels of anxiety and depression, as well as liability to depression, of women undergoing chorionic villus sampling (CVS) due to the risk of giving birth to a child suffering from hemoglobinopathy, or trisomy. Methods: The study population consisted of 309 women who attended the Fetal Medicine Unit of Alexandra Hospital, University of Athens, Athens, Greece for a first trimester chorionic villus sampling (CVS). One hundred and fifty-nine women (group A) underwent CVS due to increased possibility of carrying an embryo with beta-thalassemia, while 150 women had the procedure because of an increased nuchal translucency measurement, or a positive first trimester biochemical screening (group B). Three hundred and nine women, matched by age and gestational age with those of the study group, who were not subjected to any diagnostic intervention formed the control group. We further investigated differences of dysthymic reactions among three subgroups of women at risk for hemoglobinopathy: (a) women undergoing their first pregnancy; (b) women who had been pregnant more than once but had not any children, and ( c) women who had given birth to at least one healthy child, irrespective of previous terminations. Results: The incidence of clinically elevated levels of anxiety and depression was significantly higher in groups A and B compared to controls (p<0.001), while no significant difference was found in mean anxiety and depression, as well as the liability to depression among the three groups. Clinically elevated levels of depression were found in 10.1 and 4.7% of the women of the hemoglobinopathy and karyotyping group, respectively. Especially women who had no children, due to previous pregnancy terminations presented significantly higher incidence of elevated depression compared to women who were pregnant for the first time, or women who had given birth to at least one healthy child in their life. Conclusions: The findings of this study highlight the necessity of training medical and nursing personnel to understand and respond to the psychological and social needs of women undergoing CVS due to increased risk for hemoglobinopathy, and especially to those who have no children and who have a history of pregnancy termination due to an affected fetus. Copyright (C) 2004 S. Karger AG, Basel

Rupture of noncommunicating rudimentary uterine horn pregnancy

BACKGROUND: We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks. CASE: A 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. Hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. Hysteroscopy and laparoscopy were recommended but declined. She presented again 2 months later at 7 weeks’ gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after an emergency laparotomy at 20 weeks because of the sudden onset of abdominal pain and signs of shock. CONCLUSION: Although a rudimentary horn pregnancy had been suspected before the laparotomy, the patient presented as a clinical emergency. This report, like others, indicates that prompt diagnosis and immediate removal of the rudimentary horn is lifesaving. (C) 2002 by The American College of Obstetricians and Gynecologists

Dietary habits in adolescent girls with polycystic ovarian syndrome

The phenotype of polycystic ovarian syndrome (PCOS) is known to worsen with weight gain, increased ingestion of carbohydrates and a sedentary lifestyle. The purpose of this study was to assess the dietary habits in a group of adolescent girls with PCOS. Adolescents with PCOS were recruited and asked to complete a questionnaire on their eating habits and a recall dietary diary, from which their caloric and macronutrient intake was calculated. Results were compared with those from a group of normal controls. Thirty-five women with PCOS and 46 controls were included. Girls with PCOS were less likely to have cereals for breakfast (20.7 versus 66.7%) and as a result consumed less fibre than controls. They were more likely to eat an evening meal (97.1 versus 78.3%) and eat this over an hour later when compared to controls. Despite having comparable body mass indexes, girls with PCOS ate a daily surplus calorie average of 3% versus controls that had a negative calorie intake of 0.72% (p=0.047). Ameliorating eating habits early in adolescence in girls with PCOS may improve future metabolic concerns related to a genetic predisposition and worsened by an unhealthy lifestyle. © 2014 Informa UK Ltd

The impact of infertility diagnosis on psychological status of women undergoing fertility treatment

Despite the great number of studies conducted to examine the impact of infertility on the psychological status of women undergoing infertility treatment, little is known about the psychological impact of infertility when it is due to male or female factors and its role in the cause of higher levels of anxiety and stress. The aim of this cross-sectional study was to assess the impact of infertility diagnosis on infertile women's levels of anxiety, depression and fertility-related stress. The study involved 404 women undergoing fertility treatment in a public clinic in Athens. The research instruments were three self-administrated questionnaires. State and trait anxiety, infertility-related stress (personal, social and marital domain) and depression were measured. Most of the women in this sample had low levels of infertility-related stress and a low score for depression, but higher scores of state and trait anxiety than the published normative scores. Women with male factor infertility had higher levels of state anxiety (p = 0.007) and social stress (p = 0.007) than women with female, mixed and unknown infertility. Women with idiopathic infertility also had higher levels of trait anxiety (p = 0.001). Thus, the psychological status of women is strongly related to the aetiology of the infertility problem, and as a result it is necessary for women undergoing treatment for infertility to have an individualised psychological support, based on their infertility problem

The development and the psychometric evaluation of the Adolescents Intentions towards the Birth Options Scale in Greek

INTRODUCTION Worldwide, the rising of caesarean section rates is a major public health issue. Little is known regarding birth attitudes held by students who are the next generation of parents. The aim of this study was to develop and assess the psychometric properties of the Adolescents Intentions towards Birth Options Scale (AIBOS), a self-report and short instrument assessing intentions towards birth options in young adolescents. METHODS The AIBOS was framed by Ajzen’s theory of planned behavior and developed in a three-phase process using an integrated mixed-methods approach that included literature reviews, professional focus groups, and a psychometric survey evaluation. The psychometric evaluation was conducted by recruiting a sample of 480 high school students. Content validity, exploratory factor analysis, discriminant and construct validity, test-retest reliability and internal consistency were explored. RESULTS The expert panel determined that the content validity was satisfactory. The final 17-item scale consisted of five factors explaining 48.9% of the total variance in the data. Discriminant validity was satisfactory. Cronbach’s α coefficient was over 0.7 for each factor, indicating acceptable internal consistency of the questionnaire. There was significant agreement in all subscales as emerged from test-retest. CONCLUSIONS The AIBOS demonstrated good content validity, an easily interpretable five-factor structure, acceptable internal consistency, high test-retest reliability, and satisfactory discriminant and construct validity with sample characteristics. It is an easily comprehensible, easily completed tool, which matches the culture of young adolescents © 2022 Varnakioti D. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License. (http://creativecommons.org/licenses/by-nc/4.0

Perception of control, coping and psychological stress of infertile women undergoing IVF

The study aimed to examine: (i) the association between perception of infertility controllability and coping strategies; and (ii) the association between perception of infertility controllability and coping strategies to psychological distress, applying multivariate statistical techniques to control for the effects of demographic variables. This cross-sectional study included 137 women with fertility problems undergoing IVF in a public hospital. All participants completed questionnaires that measured fertility-related stress, state anxiety, depressive symptomatology, perception of control and coping strategies. Pearson's correlation coefficients were calculated between all study variables, followed by hierarchical multiple linear regression. Low perception of personal and treatment controllability was associated with frequent use of avoidance coping and high perception of treatment controllability was positively associated with problem-focused coping. Multivariate analysis showed that, when controlling for demographic factors, low perception of personal control and avoidance coping were positively associated with fertility-related stress and state anxiety, and problem-appraisal coping was negatively and significantly associated with fertility-related stress and depressive symptomatology scores. The findings of this study merit the understanding of the role of control perception and coping in psychological stress of infertile women to identify beforehand those women who might be at risk of experiencing high stress and in need of support. © 2012, Reproductive Healthcare Ltd