Elizabeth Crang Svalenius

EXPECTANT FIRST-TIME FATHERS' EXPERIENCES OF PREGNANCY

OBJECTIVEnto describe first-time-expectant fathers experiences of pregnancy.nnnDESIGNnan inductive method using narrative interview form and qualitative content text analysis. The text of the transcripts was coded and categorised.nnnSETTINGS AND PARTICIPANTSnseven first-time-expectant fathers living in a multicultural industrial town in southern Sweden were interviewed individually when their partner was in the 38th to 39th week of pregnancy.nnnMEASUREMENTS AND FINDINGSnall the fathers-to-be experienced some psychological, social and/or physical change during the pregnancy. The main category, was time of transition. Eight categories were found under this. They were: feelings of unreality, insufficiency and inadequacy, exclusion, reality, social changes, physical changes, responsibility, and development.nnnKEY CONCLUSIONnthe fathers-to-be special needs for support and encouragement during pregnancy may be as important as those of the mothers-to-be. The caregiver needs to be as aware of and sensitive to these needs. However, before any interventions can be recommended more research is needed.

Spontaneous cephalic version of breech presentation in the last trimester

Summary. A prospective longitudinal investigation of spontaneous cephalic version from breech presentation in the last trimester is reported. All pregnancies were assessed with ultrasound in the 32nd week of gestation, and were thereafter checked weekly. Of the 310 singleton breech presentations identified at 32 weeks, spontaneous cephalic version occurred in 177 (57%) while breech presentation persisted in 133 patients (43%). Of 140 patients with a breech presentation at delivery 95% were already presenting by the breech in the 32nd week. Spontaneous cephalic version was less likely in pregnancies with extended fetal legs, low birth‐weight, short umbilical cord and primiparity.

Ultrasonography for early detection of ovarian carcinoma

Summary. Ultrasound scan for detection of ovarian enlargements was performed in a target group of out‐patients attending the clinic for various reasons in the 40–70 years range. Overall 805 women were examined, in 99% of whom the ovaries and/or their vessels could be identified. Pathological findings were suspected in 83 patients at the first scan, and were confirmed in 50 after a repeat scan, 39 of whom subsequently underwent surgery. Various ovarian lesions were found in 35 women, including five mucinous and serous cystadenomas, one carcinoma, two borderline tumours, and a cancer of the caecum. None of the borderline or malignant ovarian lesions were found by manual pelvic examination. Ultrasound screening appears to be a useful diagnostic aid, though its usefulness might be further improved if other risk factors such as heredity and period of ovulatory activity are taken into consideration.

Ultrasound measurement of the ovarian volume

The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented.

Parents' experiences of an abnormal ultrasound examination - vacillating between emotional confusion and sense of reality

BackgroundAn ultrasound examination is an important confirmation of the pregnancy and is accepted without reflection to any prenatal diagnostic aspects. An abnormal finding often comes unexpectedly and is a shock for the parents. The aim was to generate a theoretical understanding of parents experiences of the situation when their fetus is found to have an abnormality at a routine ultrasound examination.MethodsSixteen parents, mothers and fathers, whose fetus had been diagnosed with an abnormality during an ultrasound scan in the second or third trimester, were interviewed. The study employed a grounded theory approach.ResultsThe core category vacillating between the emotional confusion and sense of reality is related to the main concern assessment of the diagnosis impact on the well-being of the fetus. Two other categories Entering uncertainty and Involved in an ongoing change and adaptation have each five sub-categories.ConclusionsParents are aware of that ultrasound examination is a tool for identifying abnormalities prenatally. The information about the abnormality initially results in broken expectations and anxiety. Parents become involved in ongoing change and adaptation. They need information about the ultrasound findings and the treatment without prolonged delay and in a suitable environment. The examiner who performs the ultrasound examination must be aware of how anxiety can be intensified by environmental factors. All parents should to be offered a professional person to give them s upport as a part of the routine management of this situation.

Group antenatal care: new pedagogic method for antenatal care—a pilot study

OBJECTIVEnto investigate how women who attended group antenatal care experienced the information they received, compared with women who attended traditional antenatal care, and their satisfaction with the form of care. The aim was also to determine the effect of group antenatal care on womens social networks compared with traditional antenatal care.nnnDESIGN AND SETTINGna pilot study with an intervention group (group antenatal care) and a control group (traditional antenatal care). Both groups were selected through informed choice. A questionnaire and a follow-up telephone call, using a structured questionnaire, were used to evaluate both groups.nnnPARTICIPANTSnfor each woman who had chosen to be in the intervention group, two women who had chosen traditional antenatal care were selected from the same antenatal clinic and given the same questionnaire.nnnFINDINGSn35/45 (77%) women in the intervention group returned a completed questionnaire, compared with 40/85 (48%) women in the control group. There was little difference in satisfaction with information between the two groups, and overall satisfaction was high.nnnKEY CONCLUSIONSnat six months post partum, the women who attended group antenatal care still met others from the group more regularly than the women who attended traditional antenatal care.nnnIMPLICATIONS FOR PRACTICEngroup antenatal care is well accepted by women, and can better utilise midwives time.

Factors Influencing Informed Choice of Prenatal Diagnosis: Women’s Feelings and Attitudes

Objective: To obtain knowledge about factors that could influence women’s informed choice and extent of prenatal diagnosis, her feelings when implementing it, and her satisfaction. Method: A questionnaire including Visual Analogue Scale was given to 823 women and replies received from 662 (80.4%). Ease of choice was the basis for the statistical analysis. Results: The factors that most often influenced choice were the fetus health, maternal age, and knowledge of the consequences. The choice was easy to make, only 2% finding it very difficult. The time period from the amniocentesis until the results were available was the most difficult time reported. Conclusions: The choice of method for prenatal diagnosis was very easy for most women. Satisfaction with choice was high (98%). Extra support can be needed while awaiting results of invasive prenatal diagnosis.

Parents' worried state of mind when fetal ultrasound shows an unexpected finding: a comparative study.

Objective. Most parents yearn for a second‐trimester ultrasound examination and feel excitement about it, but some also worry about what the examination will show. According to prior research, using only generic instruments or specific questionnaires, anxiety decreases when the ultrasound findings are normal. The aim of this study was to compare parents worry (Parents Expectations, Experiences, and Reactions to Ultrasound [PEER‐U] State of Mind Index) and sense of coherence before and after a routine second‐trimester ultrasound examination when it showed normal or abnormal findings. Methods. A 1‐year cohort study was performed at a Swedish university hospital. A total of 2049 parents who had their second‐trimester ultrasound examinations there filled in a questionnaire consisting of 2 parts before and after the examinations. Results. Parents with normal ultrasound findings were less worried than parents with abnormal findings. The group with normal findings also showed less worry after the examination than before. A sex analysis showed similar patterns. Conclusions. Parents with abnormal ultrasound findings are more worried and anxious. The new instrument, the PEER‐U State of Mind Index, not only measures parents worry but can also expose what influences their ultrasound examination experience.

Parental level of anxiety, sense of coherence and state of mind when choroid plexus cysts have been identified at a routine ultrasound examination in the second trimester of pregnancy: a case control study.

The aim of the study was to compare parents experience of a routine ultrasound examination in the second trimester, when a choroid plexus cyst/cysts (CPC) were found (Study group; n = 22), with matched controls where no fetal deviations were identified (Control group, n = 66). All the parents had participated in a larger cohort study. The instruments used for measuring anxiety were STAI-state/trait, sense of coherence (SOC) and Parents Expectations, Experiences, Reactions to an Ultrasound examination during pregnancy (PEER-U, State of Mind Index). Regarding the SOC and STAI-state/trait no significant differences were found between the cases and controls or within the respective group before and after the ultrasound examination. The cases had an increase in anxiety (more anxious) as measured by the instrument PEER-U after the examination, while the controls showed a significant better level of State of Mind Index (less anxious) after the examination, compared to before. Therefore PEER-U can be a more reliable instrument when studying state of mind (anxiety) in connection with ultrasound examinations, and as it is specific for this situation it does not appear to be time dependent.

Developing the PEER‐U scale to measure parents' expectations, experiences and reactions to routine ultrasound examinations during pregnancy

The aim of this study was to develop and test a specific questionnaire to measure parents expectations, experiences and reactions in connection with routine ultrasound examinations during pregnancy. A questionnaire consisting of ultrasound specific questions was constructed in two parts, one to be used before and one after the examination. It was examined for face validity and a pilot study was then conducted with women and their partners (n = 156). Explorative factor analysis and Cronbachs alpha were used to test validity and reliability. Factor analysis gave a solution where part one measures seven dimensions of expectations before the ultrasound examination and part two five dimensions of experiences and reactions. The dimensions that measured the parents state of mind were used to calculate an index. The index was also compared to the results of State and Trait Anxiety Inventory (STAI) and Sense of Coherence Scale (SOC). The PEER‐U questionnaire was tested and showed satisfactory validity and reliability. The ultrasound state of mind index can be used to measure the impact of an ultrasound examination on the parents, before and after this takes place.