Psychological adaptation after peripartum cardiomyopathy: A qualitative study.

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening condition of heart failure affecting women with no previous heart disease in the last months of pregnancy and up to six months after childbirth. OBJECTIVE: To explore women's experiences of the process of regaining psychological balance and wellbeing (i.e. psychological adaptation) after having experienced severe peripartum morbidity. DESIGN: A qualitative exploratory research design was applied to guide the study. Data was collected through in-depth, semi-structured, face-toface telephone and e-mail interviews. Thematic analysis was applied in the data analysis. SETTING: The study was a sub-study of a larger nationwide research study investigating the incidence and clinical outcome of peripartum cardiomyopathy in Denmark during a ten-year period of 2005-2014. PARTICIPANTS: Through a criterion-based sampling strategy, 14 Danish women with peripartum cardiomyopathy were recruited for participation in the study. In relation to severity of disease, demographics and pregnancy related characteristic, the sample showed a wide range of diversity. FINDINGS: The overarching theme of the thematic analysis was identified to be Recovering to a new normal after peripartum cardiomyopathy. The overarching theme was comprised by five main themes: Losing trust, Silence after chaos, Disrupted early mothering, Choices made for me and not by me, and Ability to mobilize inner resources. CONCLUSIONS: Findings from this study suggest that women are vulnerable in the time after PPCM diagnosis and struggle to find psychological balance in their life. The need for professional psychological support was often unmet and the physical symptoms were foregrounded in the recovery period. After PPCM, follow-up on psychological wellbeing and morbidity should be offered to women routinely.

[Report: complicated influenza A(H1N1) in a second-trimester pregnancy]. / Kompliceret influenza A (H1N1) hos gravid i andet trimester.

A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded and an emergency caesarean was performed at 26 weeks + 2 days of gestation. The neonatal period was uncomplicated. Influenza A (H1N1) is especially dangerous in pregnant women and vaccination is important.