Prenatal identification of isolated bilateral radial dysplasia.

Radial aplasia or hypoplasia is characterized by complete or partial absence of the radius and/or radial ray structure occurring in 1:30,000 live births. It may be unilateral or bilateral of varying severity, and may be isolated or associated with other anomalies. We report an unusual case of isolated radial aplasia at 20 weeks' gestation with complete absence of the right radius and thumb associated with marked hypoplasia of the left radius. The intrauterine 2- and 3-dimensional findings, postnatal radiographic evaluation, and autopsy results are reported.

Emotional state and dreams in pregnant women.

The aim of this study was to investigate the frequency of recall and the content of dreams during pregnancy, as well as their correlation with socio-demographic, obstetric and physician-patients relationship variables, emotional state and duration of labour. A questionnaire, designed to analyse background characteristics, was given to 290 women in the third trimester of gestation. The psychiatric analysis of anxiety and depression was performed using the Hamilton Rating Scale for Anxiety and the Montgomery-Asberg Depression Rating Scale, while dreams were divided into masochistic and pleasant according to Beck's criteria. Oneiric activity was found to be associated with age >or= 35 years, higher family income, higher educational level, and a "satisfactory" physician-patient relationship. Masochistic content was associated with age<35 years, quality of information and frequent thoughts of delivery. Concerning the emotional state, depression levels were higher in women reporting masochistic dreams, while no difference in anxiety levels was found. Labour duration was shorter in the dreamer group and in patients with masochistic dream content. These findings may indicate that, also in pregnancy, the number and the content of dreams are influenced by women's mood and that the evaluation of the oneiric activity might represent a useful tool for clinicians either to investigate the women's emotional state or to predict its repercussions on the course of labour.

Effects of antepartum electronic fetal monitoring on maternal emotional state.

BACKGROUND: To evaluate the emotional state of pregnant women undergoing computerised cardiotocography (cCTG). METHODS: A questionnaire including questions about socio-demographic background, personal obstetric history and physician-patient relationship was given to 204 pregnant women about to undergo cCTG. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess patients' mood state before CTG, while the Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels before and after this examination. RESULTS: Mean STAI T-anxiety score did not differ before and after CTG (p=0.38), but higher levels of basal anxiety were found in women who had undergone only occasional prenatal controls (p=0.04), as well as smokers (p=0.01), and women preferring a vaginal delivery (p=0.01). The mean STAI S-anxiety score of 43.6+/-4.03 before the cardiotographic examination, increased to 45.2+/-5.4 after this test with a statistically significant difference (p=0.0001). This increase was found to be correlated with the presence of obstetric complications during the current pregnancy (p=0.036) and a lower number of fetal active movements (p=0.029). Based on the EPDS, 22 patients (14.1%) were found to be depressed, but this condition was not correlated with significant increases in anxiety levels. CONCLUSIONS: Anxiety levels in pregnant women who undergo routine CTG are increased, and this emotional reaction seems to be influenced by the perception of fetal movement during the examination, and is more evident in pregnancies affected by obstetric complications.

Cesarean section on demand: are there differences related to obstetricians' gender?

To assess possible differences related to the physicians' gender, in the motivations for a cesarean section on demand, an anonymous questionnaire was sent to 60 male and 60 female obstetricians. Maternal emotional motivations, role of relatives, influence of instrumental examinations and personal attitude towards fulfilling maternal choice were analysed. Among emotional motivations, a previous negative perinatal experience and the fear of childbirth were more frequently reported by males (96.6% vs. 46.6%, p = 0.001; 98.2% vs. 61.6%, p = 0.001), as was ultrasonography (48.2% vs. 15%, p < 0.001) among the instrumental examinations. On the contrary, no differences were evidenced for the role played by relatives and for the physician's attitude in fulfilling maternal choice.

Gender differences in dental anxiety: is the chair position important?

Dental anxiety in the general population is more prevalent in females than in males. The presence of dental anxiety was studied in a group of 189 females and 176 males using the following scales: the Dental Anxiety Scale (divided into DAS 1 containing 6 items, which explores a patient's dental anxiety and DAS 2 containing 13 items, which looks at dental anxiety concerning dentist-patient relations), the Self-Rating Depression Scale (SDS), and the Quality of Life Index (QL-Index). The results obtained showed significant differences only in relation to dental anxiety regarding the use of instruments (such as needles and handpieces) and the tilted-back position of the chair (DAS 1). No significant gender differences emerged between the two groups in relation to dental anxiety regarding dentist-patient relations (DAS 2), depression (SDS), and the quality of life (QL-Index). The results may explain why women avoid dental care and indicate new designs to make the chair position more comfortable would be useful.

Women's preference on mode of delivery in Southern Italy.

BACKGROUND: Rates of cesarean section are rising worldwide and maternal requests for this kind of delivery contribute to the increase in this trend. The purpose of this study was to analyze the factors influencing maternal demand in our region and the profile of women preferring this mode of delivery. METHODS: Six obstetricians (3 male and 3 female) were asked to give out a questionnaire to their patients with an uncomplicated pregnancy. Demographic data, obstetrical history, lifestyle, and physician-patient relationship were analyzed. Patients who would have preferred abdominal delivery were asked to report the motivations for their choice. A psychiatric evaluation, using the Hamilton Anxiety Scale and the Montgomery-Asberg Depression Rating Scale, was conducted. RESULTS: 16.9% of 390 patients enrolled preferred cesarean section. This wish was correlated with patients' age > or = 35 years (OR 2.43; p=0.0065), high level of education (OR 4.28, p=0.019), previous infertility (OR 3.91, p=0.0045), smoking (OR 4.25, p=0.0008), quality of information (OR 29.08, p=0.0013), and desire for more comprehension (OR 8.25, p=0.00001). The most frequent motivation for this choice was a safer childbirth (90.9%). No difference was found for the Hamilton scale's score, while the Montgomery-Asberg Scale showed a lower mean score for the cesarean section group (7.2+/-3.3 versus 9.4+/-7.3, p=0.0002). CONCLUSIONS: A high rate of women wish to give birth by cesarean section. This is probably an expression of the changes in society's attitudes. However, more careful attention to the psychological aspects and more personalized information about pregnancy and delivery could reduce this maternal demand.