Clinical experience of unexpected findings in prenatal array testing.

AIM: The aim of this study was to evaluate whether unexpected diagnoses (UD) made by prenatal array testing contribute to pregnancy management. PATIENTS & METHODS: In 2010-2015 in 19/4043 (0.5%) pregnancies an UD was made. The clinical usefulness of UDs was assessed based on the couple's responses during post-test counseling and their decisions. RESULTS: In 16/19 cases, the UD was helpful either for the couples in making a decision about the course of their pregnancy, for perinatal management or family genetic counseling. CONCLUSION: The majority of the pregnant couples found the UDs relevant for pregnancy management and genetic counseling. This adds another motive for offering whole genome array during pregnancy in patients who wish broad testing of their fetus.

Who's that girl? A qualitative analysis of adolescent girls' views on factors associated with teenage pregnancies in Bolgatanga, Ghana.

BACKGROUND: Adolescent pregnancy remains a public health concern, with diverse serious consequences, including increased health risk for mother and child, lost opportunities for personal development, social exclusion, and low socioeconomic attainments. Especially in Africa, teenage pregnancy rates are high. It is important to find out how girls without pregnancy experience differ in their contraceptive decision-making processes as compared with their previously studied peers with pregnancy experience to address the high rate of teenage pregnancies. METHODS: We conducted semi-structured in-depth interviews with never been pregnant girls (N = 20) in Bolgatanga, Ghana, to explore the psychosocial and environmental factors influencing the sexual decision making of adolescents. Themes such as relationships, sex, pregnancy, family planning and psychosocial determinants (knowledge, attitudes, self-efficacy, norms, risk perceptions) derived from empirical studies and theories related to sexuality behavior guided the development of the interview protocol. RESULTS: Results showed that the girls did talk about sexuality with their mothers at home and did receive some form of sexual and reproductive health education, including the use of condoms discussions in school. Participants reported high awareness of pregnancy risk related to unprotected sex, were positive about using condoms and indicated strong self-efficacy beliefs towards negotiating condom use. The girls also formulated clear future goals, including coping plans such as ways to prevent unwanted pregnancies to reach these targets. On the other hand, their attitudes towards family planning (i.e., contraceptives other than condoms) were negative, and they hold boys responsible for buying condoms. CONCLUSION: An open parental communication on sexuality issues at home, comprehensive sex education in school and attitude, self-efficacy, risk perception towards contraception, alongside with goal-setting, seem to be protective factors in adolescent girls' pregnancy prevention efforts. These factors should be targets in future intervention programs at the individual, interpersonal, and school and community levels.

[Radioiodine therapy for women with Graves' disease and the risk of foetal hypothyroidism if they are later found to be pregnant]. / Behandeling van een vrouw met de ziekte van graves door middel van radioactief jodium en het risico op foetale hypothyreoïdie als zij later zwanger blijkt te zijn.

Three fertile female patients aged 33, 29 and 38 years, respectively, were treated with radioiodine 1-131 for Graves' disease. In retrospect, the first woman was 14 weeks pregnant at the time of treatment, and the other 2 women were treated around the time of conception. All 3 women decided to continue their pregnancies after being counselled about the potential adverse health risks of radioiodine therapy for the infant. The first woman was delivered at term of an infant diagnosed with hypothyroidism that was ascribed to radioiodine. The other 2 women delivered euthyroid infants. According to international standards, radioiodine should not be given during pregnancy because of its toxic effects. An interval of at least 4 months is advised between maternal radioiodine therapy and conception. This should be discussed with the patient. Prior to the initiation of radioiodine therapy, menstrual and contraceptive history should be ascertained in fertile female patients. Pregnancy testing should be performed where indicated, and the result should be verified before radioiodine therapy is initiated.

[Results from laparoscopically assisted vaginal hysterectomy in the Ikazia Hospital, Rotterdam, 1993-1997]. / Resultaten van laparoscopisch geassisteerde vaginale hysterectomie in het Ikazia Ziekenhuis te Rotterdam, 1993-1997.

OBJECTIVE: Evaluation of experience with laparoscopy-assisted vaginal hysterectomy (LAVH). DESIGN: Retrospective review. SETTING: Dept. of Gynaecology, Ikazia Hospital, Rotterdam, the Netherlands. PATIENTS AND METHODS: Of 84 patients undergoing a LAVH instead of an abdominal hysterectomy in the period 1993-1997, data on indications for surgery, hospital stay and complications were analysed from the medical records. RESULTS: Mean age was 45 years (range: 30-62). The most frequent indication was hypermenorrhoea (75; 89%). The mean duration of the operation was 87 min (range: 45-130). There was one conversion to laparotomy. Three times a major complication was seen: twice a bladder injury and once a major haemorrhage for which laparotomy was performed. Mean hospital stay was 6 days, in accordance with protocol. CONCLUSION: LAVH offers a safe technique to convert some of the abdominal hysterectomies into vaginal ones. The higher costs of disposable equipment and increased operation time must be overcome by a shorter time in hospital and shorter convalescence time.

Full versus divided attention and implicit memory performance.

Effects of full and divided attention during study on explicit and implicit memory performance were investigated in two experiments. Study time was manipulated in a third experiment. Experiment 1 showed that both similar and dissociative effects can be found in the two kinds of memory test, depending on the difficulty of the concurrent tasks used in the divided-attention condition. In this experiment, however, standard implicit memory tests were used and contamination by explicit memory influences cannot be ruled out. Therefore, in Experiments 2 and 3 the process dissociation procedure was applied. Manipulations of attention during study and of study time clearly affected the controlled (explicit) memory component, but had no effect on the automatic (implicit) memory component. Theoretical implications of these findings are discussed.