PubMed Health⌕ Search

Biomedical subjects

V C Nikodem

Publications and source records attributed to V C Nikodem.

9 recordsLinked to original sources
PubMed1994

Selective birth in twins with discordant chromosomal abnormality.

Selective termination in twin pregnancies with a chromosomal abnormality in one twin may be offered to prevent long-term suffering for the infant and/or the family. The procedure poses considerable risks to the remaining fetus and also to the mother, and these, together with the ethical aspects, should be discussed thoroughly with the couple. We report 2 successful cases of selective midtrimester termination by intracardiac potassium chloride injection, and recommend a management protocol for selective birth in twins with discordant chromosomal abnormalities.

Abortion, Therapeutic↗
PubMed1993

Postpartum depression and companionship in the clinical birth environment: a randomized, controlled study.

OBJECTIVE: Postpartum depression is a common feature of childbearing and is the cause of considerable morbidity. We have explored the possibility that clinically oriented care during labor may contribute to its occurrence. STUDY DESIGN: Of 189 nulliparous women laboring in a familiar community hospital, 92 were allocated by randomized, sealed envelopes to receive additional companionship from one of three volunteer labor companions recruited from the community. RESULTS: The group receiving support attained higher self-esteem scores and lower postpartum depression and anxiety ratings 6 weeks after delivery. CONCLUSION: In the clinical labor environment companionship modifies factors that contribute to the development of postnatal depression. We emphasize the importance of paying attention to the psychosocial environment in which labor takes place, to facilitate adaptation to parenthood.

Depression↗
PubMed1993

A nonpenetrating fetal scalp electrode.

OBJECTIVE: To develop a nonpenetrating scalp electrode for intrapartum fetal monitoring. DESIGN: Preliminary observational evaluation of the device. SETTING: An urban academic hospital in Johannesburg, South Africa. SUBJECTS: Fifteen women in labour. INTERVENTION: Application of the electrode for intrapartum monitoring. OUTCOME MEASURES: Quality of tracings, duration of application, disconnection of the electrode, marking of the scalp. RESULTS: Application was successful in 13 of 15 women, and high quality tracings obtained in 12. CONCLUSIONS: The design of scalp electrode tested is effective and produces high quality tracings in most cases.

Adult↗
PubMed1993

Do cabbage leaves prevent breast engorgement? A randomized, controlled study.

A randomized, controlled trial was conducted to evaluate the effect of cabbage leaves on mothers' perceptions of breast engorgement and the influence of this treatment on breastfeeding practices. The subjects, 120 breastfeeding women 72 hours postpartum, were randomly allocated to an experimental group who received application of cabbage leaves to their breasts, or to a control group who received routine care. The experimental group tended to report less breast engorgement, but this trend was not statistically significant. At six weeks, women who received the cabbage leaf application were more likely to be breastfeeding exclusively, 76 and 58 percent (35/46 vs 29/50; P = 0.09), and their mean duration of exclusive breastfeeding was longer (36 vs 30 days; P = 0.04). The greater breastfeeding success in the experimental group may have been due to some beneficial effect of cabbage leaf application, or may have been secondary to reassurance and improved confidence and self-esteem in these mothers.

Attitude to Health↗
PubMed1993

Do high fetal catecholamine levels affect heart rate variability and meconium passage during labour?

OBJECTIVES: To determine the relationship between umbilical arterial catecholamine levels and fetal heart rate variability and meconium passage. STUDY DESIGN: A prospective descriptive study was performed. Umbilical artery catecholamine levels were measured in 55 newborns and correlated with fetal heart rate before delivery, umbilical arterial pH, base excess and the presence of meconium-stained liquor. RESULTS AND CONCLUSION: The range of catecholamine levels was enormous, with very high epinephrine or norepinephrine levels in several fetuses. We were unable to demonstrate an association between high catecholamine levels and the presence of normal fetal heart rate variability despite acidaemia. We postulate that high catecholamine levels may inhibit fetal meconium passage.

Adolescent↗
PubMed1991

Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding.

OBJECTIVE: To measure the effects of supportive companionship on labour and various aspects of adaptation to parenthood, and thus by inference the adverse effects of a clinically orientated labour environment on these processes. DESIGN: Randomized controlled trial. SETTING: A community hospital familiar to most of the participants, with a conventional, clinically-orientated labour ward. SUBJECTS: Nulliparous women in uncomplicated labour. INTERVENTION: Supportive companionship from volunteers from the community with no medical nor nursing experience, concentrating on comfort, reassurance and praise. MAIN OUTCOME MEASURES: Duration of labour, use of analgesia, perceptions of labour and breastfeeding success. RESULTS: Companionship had no measurable effect on the progress of labour. Diastolic blood pressure and use of analgesia were modestly but significantly reduced. The support group were more likely to report that they felt that they had coped well during labour (60 vs 24%, P less than 0.00001). Their mean labour pain scores (26.0 vs 44.2, P less than 0.00001) and state anxiety scores (28.2 vs 37.8, P less than 0.00001) were lower than those of the control group. Compared with the control group (n = 75), at 6 weeks women in the support group (n = 74) were more likely to be breastfeeding exclusively (51 vs 29%, P less than 0.01); and to be feeding at flexible intervals (81 vs 47%, P less than 0.0001). CONCLUSIONS: Labour in a clinical environment may undermine women's feelings of competence, perceptions of labour, confidence in adapting to parenthood and initiation of successful breastfeeding. These effects may be reduced by the provision of additional companionship during labour aimed to promote self-esteem.

Analgesia, Obstetrical↗