Caring as perceived during the birth experience.
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Female↗
Biomedical subjects
M G Propst
Publications and source records attributed to M G Propst.
Vaginal delivery following previous cesarean birth.
Because of the rising cesarean birth rate in the United States, renewed interest in vaginal delivery after prior abdominal operation has been evident. In a prospective collaborative study 789 patients were evaluated for inclusion into this investigation. Of the 717 subjects who entered the study 162 chose to attempt vaginal birth and 101 were successful. Desire for tubal sterilization and the lack of prior vaginal delivery were significant correlates of the group selecting repeat abdominal birth and of those who were unsuccessful when vaginal delivery was attempted. There were eight dehiscences and three uterine ruptures among the 717 patients and none was related to catastrophic outcome for the mother or neonate. Perinatal losses (12) were not related to uterine rupture or method of delivery. There were no significant differences in uterine disruption between patients selecting either route of delivery. Likewise ancillary factors such as a prior febrile puerperium (endometritis), number of prior cesarean births, low-vertical uterine incisions, recurrent operative indications, the use of epidural anesthesia, or oxytocin administration were not discriminating factors in whether women chose to attempt or were successful in completing vaginal delivery after prior abdominal birth. From our data vaginal birth after cesarean section appears to be safe if conducted in a carefully selected population that is closely monitored in a prospective manner.
Cesarean Section↗
The use of medroxyprogesterone acetate for relief of climacteric symptoms.
Climacteric symptoms in the menopausal woman are perplexing to the physician. Recent literature concerning the relationship of estrogen to carcinogenesis has caused many women to discontinue this medication; thus, there is a need for an alternative therapy for the relief of these symptoms. The drug medroxyprogesterone acetate (Depo-Provera) was assessed in a double-blind, randomized, placebo-controlled study involving 48 subjects. Only one of the placebo-treated patients claimed any relief from climacteric symptoms while only two of the patients who received the study drug noted little or no relief (P < 0.0001). Relief from climacteric symptoms began at 4 to 7 days after entry into the study and extended for 8 to 20 weeks. The only side effects were withdrawal bleeding and a slight, transient weight gain. Depo-Provera appears to be a reliable substitute for estrogen in the treatment of climacteric symptoms. Further investigations with this medication seem indicated.
Adult↗
Sickle hemoglobin and the gravid patient: a management controversy.
It is evident that patients with sickle cell disease are now in an era when they can safely complete a pregnancy with a reasonable expectation of a good outcome for both the mother and baby. Although there are vast disagreements as to which techniques (both diagnostic and therapeutic) to employ, the use of individualized methods in various geographic areas will yield the best result. To conclusively answer the questions raised in this article, a large multi-center collaborative study must be performed. If randomized treatment regimens of "transfusion versus no transfusion" were carried out in such a study, the true risk of both approaches could be assessed. Moreover, with adequate follow-up studies many of the risks of each type of treatment could be evaluated. Only through such a large study will these controversies be resolved.
Adult↗
Addressing sexuality-related needs in practice: perspectives of maternal/child and women's health nurses.
A quantitative, descriptive survey was conducted using Waterhouse's instrument, Survey of Sexuality-Related Nursing Practice. The purpose of this study was to examine the extent to which maternal/child and women's health nurses address sexuality in their practice and to assess the influence of select variables on that practice. A sample of maternal/child and women's health registered nurses (n = 130) was systematically selected from the 1995 Association of Women's Health, Obstetric and Neonatal Nurses' (AWHONN) District VII mailing list. Findings reveal incongruities in maternal/child and women's health nurses' perspectives and the incorporation of sexuality-related nursing interventions into practice.
Adult↗