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W356 STRIAE GRAVIDARUM AND QOL IN JAPANESE PREGNANT WOMEN
S820
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
Materials: Data from the computer system. Methods: This retrospective study reviewed maternal and fetal complications in all cases of shoulder dystocia. Cases were collected from the Operating Theatre, Special Care Baby Unit, Delivery Suite and Risk Management Registries. Results: There were 292 cases of shoulder dystocia, consisting primigravida (n = 100), and multiparous (n = 192). The overall total [Group 1] (n = 292 mean birth-weight 3.979 kg ±0.475; the instrumental delivery [Group 2] (n = 94) mean birth-weight 3.937 kg ±0.486; and the Instrumental Delivery in Theatre [Group 3] (n = 28) mean birth-weight 4.036 kg ±0.577. In group 3, a Consultant was present in theatre 19/28 = 67.86%. The Trust used the HELPERR mnemonic and the RCOG Shoulder Dystocia Proforma for standardization of documentation. Fetal complications: SCBU Admission (n = 17) – 5.82% Macrosomia >4.5 kg (n = 33) – 11.30% Erbs Palsy & Bone Fracture (n = 6) – 2.05% Stillbirth (n = 1) [Forceps delivery – 4.6 kg, delivered in 7 mins]. Maternal complications: Postpartum Haemorrhage >1000 mls (n = 20) – 6.85% 3rd Degree Tear (n = 22) – 7.53% & [4th degree Tear (n = 1)] Severe Shoulder Dystocia Delivery head-to-body interval ≥5mins (n = 12) – 4.10% Delivery Required ≥3 Manoeuvres (n = 34) – 11.64%. Conclusions: 1. Risk Management and Education Teams: The teams had a robust proforma system to identify, investigate (Serious Incident Reporting), and follow up all cases of shoulder dystocia. The trust has monthly Skills & Drills teachings. 2. Significant Maternal and Fetal Complications: 1 case stillbirth (0.34%) and Erbs palsy/fractures (2.05%) 1 case 4th degree tear (0.34%) and head-to-body-delivery ≥5mins = 4.1%. 3. High Risk Population: There were 292 cases of shoulder dystocia (~1%); about 40% of the population are high-risk. Since this audit, the trust increased the Labour ward Consultant cover to 96 hrs/week. Re-audit will be done in preparation for CNST inspection November 2012. W356 STRIAE GRAVIDARUM AND QOL IN JAPANESE PREGNANT WOMEN K. Yamaguchi1,2 , K. Ohashi1 , N. Suganuma2 . 1 Osaka University Graduate School of Medicine, Osaka, Osaka, Japan; 2 Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan Objectives: To study the prevalence of striae gravidarum and QOL of pregnant women with striae gravidarum. Setting: Three private clinics in a typical urban area in Japan. Design and Methods: We conducted the study between October 2010 and January 2011, and a cross-sectional study design using a self-administered questionnaire and evaluation for striae gravidarum. The abdominal striae gravidarum was assessed using the Davey’s scoring. The severity of striae gravidarum was divided into three categories of 0 (absent), 1 to 2 (mild), and 3 to 8 (severe). The questionnaires of WHOQOL-BREF and Skindex-29 were administrated to assess a generic QOL and a dermatologyspecific QOL, respectively. Participants: Of 447 pregnant women recruited at 36 weeks of gestation, 199 (44.5%) agreed to participate in the study and provided written informed consent. Of the 199 participants, 20 were excluded from the study (17 for incomplete questionnaire, 2 for no medical record, and 1 for no study record), resulting in a final sample of 179 pregnant women consisting of 94 primiparae and 85 multiparae. Statistical analysis: To evaluate the difference between with and without striae gravidarum in the QOL scores, we were analyzed using the Mann-Whitney U test and the KruskalWallis test followed by the Mann-Whitney U test with Bonferroni correction by SPSS version 19.0.
Results: The prevalence of striae gravidarum was 39.1% (27.7% in primiparae, and 51.8% in multiparae). Although there were no differences in WHOQOL-BREF scores between the presence and absence of striae gravidarum and with its severity, the whole group of pregnant women and the multiparae group showed significant differences in scores on emotion of Skindex-29 between the presence and absence of striae gravidarum. Pregnant women with severe striae gravidarum showed significantly higher scores on emotion of Skindex-29 compared with those with the absent and mild striae gravidarum. Conclusions: There was no difference in generic QOL of pregnant women between the presence and absence of striae gravidarum, although the occurrence and severity of striae gravidarum influenced their dermatology-specific QOL. Especially, multiparae women were impaired by striae gravidarum and it is considered important to prevent striae gravidarum of the multiparae group. Prevalence of striae gravidarum in area out of Japan. W357 RELATIONSHIP BETWEEN DEPRESSION IN PRIMIGRAVIDAS AND THEIR MOTHERS – COMPARISON BY SEVERE AND MILD DEPRESSION GROUPS H. Okayama1 , K. Masaki1 , Y. Saito1 , S. Tsuchikawa2 , T. Terasaka1 , M. Mori1 , Y. Arai3 , H. Kuwata1 . 1 Clinical Nursing, Shiga University of Medical Science, Otsu, Japan; 2 Shiga University of Medical Science Hospital, Otu, Japan; 3 Kitasato University School of Nursing, Sagamihara, Japan Objectives: This study was conducted to examine the relationship between primigravidas with depression and their mothers by comparing severe and mild depression groups. Materials: The self-reported questionnaires used in this study were the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS, Okano et al, 1996) and Primigravida-Mother Relationship Scale (PMRS, Okayama, 2011). The PMRS consists of seven subscales: “Support by Mother (Support),” “Closeness to Mother (Closeness),” “Affirmative Feeling toward Mother (Affirmative),” “Independence from Mother (Independence),” “Exploration of Mother Image Model through Mother (Image Model),” “Preparations for Pregnancy, Delivery, and Childcare Using Mother as a Model (Preparation),” and “Adaptation to Pregnancy Period (Adaptation)”. The level of depression was determined using the cut-off score adopted in Japan (8/9): primigravidas with a score of eight or less and nine or more were categorized into mild and severe depression groups, respectively. Methods: A cross-sectional study was conducted for 605 Japanese primigravidas: 131 in the first (15 weeks or earlier), 134 in the second (16–27 weeks), and 340 were in the last (28–40 weeks) stage of pregnancy. Results: Regarding EPDS scores, the number of primigravidas included in the severe group in the first, second, and last stages of pregnancy was 19 (14.5%), 22 (16.4%), and 56 (16.5%), respectively. As a result of comparing scores of PMRS subscales for the severe and mild groups, the severe group showed significantly lower scores in the subscale “Adaptation” (p < 0.001) at the first and last stages. At the second stage, scores for the severe group were significantly lower in “Adaptation” (p < 0.001) and “Preparation” (p < 0.05). Conclusions: The results suggest that primigravidas with severe depression were unable to appropriately adapt themselves to pregnancy throughout its course, and, at the second stage of pregnancy, the ability to prepare themselves (Preparations for Pregnancy, Delivery, and Childcare Using Mother as a Model) was low as well. Therefore, it is necessary to provide severely depressed primigravidas with mental health care from the first stage of pregnancy to help them adapt to it. It is also important for their mothers to provide support for them or become a role model in order to encourage them to prepare for delivery and childcare.
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
Materials: Data from the computer system. Methods: This retrospective study reviewed maternal and fetal complications in all cases of shoulder dystocia. Cases were collected from the Operating Theatre, Special Care Baby Unit, Delivery Suite and Risk Management Registries. Results: There were 292 cases of shoulder dystocia, consisting primigravida (n = 100), and multiparous (n = 192). The overall total [Group 1] (n = 292 mean birth-weight 3.979 kg ±0.475; the instrumental delivery [Group 2] (n = 94) mean birth-weight 3.937 kg ±0.486; and the Instrumental Delivery in Theatre [Group 3] (n = 28) mean birth-weight 4.036 kg ±0.577. In group 3, a Consultant was present in theatre 19/28 = 67.86%. The Trust used the HELPERR mnemonic and the RCOG Shoulder Dystocia Proforma for standardization of documentation. Fetal complications: SCBU Admission (n = 17) – 5.82% Macrosomia >4.5 kg (n = 33) – 11.30% Erbs Palsy & Bone Fracture (n = 6) – 2.05% Stillbirth (n = 1) [Forceps delivery – 4.6 kg, delivered in 7 mins]. Maternal complications: Postpartum Haemorrhage >1000 mls (n = 20) – 6.85% 3rd Degree Tear (n = 22) – 7.53% & [4th degree Tear (n = 1)] Severe Shoulder Dystocia Delivery head-to-body interval ≥5mins (n = 12) – 4.10% Delivery Required ≥3 Manoeuvres (n = 34) – 11.64%. Conclusions: 1. Risk Management and Education Teams: The teams had a robust proforma system to identify, investigate (Serious Incident Reporting), and follow up all cases of shoulder dystocia. The trust has monthly Skills & Drills teachings. 2. Significant Maternal and Fetal Complications: 1 case stillbirth (0.34%) and Erbs palsy/fractures (2.05%) 1 case 4th degree tear (0.34%) and head-to-body-delivery ≥5mins = 4.1%. 3. High Risk Population: There were 292 cases of shoulder dystocia (~1%); about 40% of the population are high-risk. Since this audit, the trust increased the Labour ward Consultant cover to 96 hrs/week. Re-audit will be done in preparation for CNST inspection November 2012. W356 STRIAE GRAVIDARUM AND QOL IN JAPANESE PREGNANT WOMEN K. Yamaguchi1,2 , K. Ohashi1 , N. Suganuma2 . 1 Osaka University Graduate School of Medicine, Osaka, Osaka, Japan; 2 Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan Objectives: To study the prevalence of striae gravidarum and QOL of pregnant women with striae gravidarum. Setting: Three private clinics in a typical urban area in Japan. Design and Methods: We conducted the study between October 2010 and January 2011, and a cross-sectional study design using a self-administered questionnaire and evaluation for striae gravidarum. The abdominal striae gravidarum was assessed using the Davey’s scoring. The severity of striae gravidarum was divided into three categories of 0 (absent), 1 to 2 (mild), and 3 to 8 (severe). The questionnaires of WHOQOL-BREF and Skindex-29 were administrated to assess a generic QOL and a dermatologyspecific QOL, respectively. Participants: Of 447 pregnant women recruited at 36 weeks of gestation, 199 (44.5%) agreed to participate in the study and provided written informed consent. Of the 199 participants, 20 were excluded from the study (17 for incomplete questionnaire, 2 for no medical record, and 1 for no study record), resulting in a final sample of 179 pregnant women consisting of 94 primiparae and 85 multiparae. Statistical analysis: To evaluate the difference between with and without striae gravidarum in the QOL scores, we were analyzed using the Mann-Whitney U test and the KruskalWallis test followed by the Mann-Whitney U test with Bonferroni correction by SPSS version 19.0.
Results: The prevalence of striae gravidarum was 39.1% (27.7% in primiparae, and 51.8% in multiparae). Although there were no differences in WHOQOL-BREF scores between the presence and absence of striae gravidarum and with its severity, the whole group of pregnant women and the multiparae group showed significant differences in scores on emotion of Skindex-29 between the presence and absence of striae gravidarum. Pregnant women with severe striae gravidarum showed significantly higher scores on emotion of Skindex-29 compared with those with the absent and mild striae gravidarum. Conclusions: There was no difference in generic QOL of pregnant women between the presence and absence of striae gravidarum, although the occurrence and severity of striae gravidarum influenced their dermatology-specific QOL. Especially, multiparae women were impaired by striae gravidarum and it is considered important to prevent striae gravidarum of the multiparae group. Prevalence of striae gravidarum in area out of Japan. W357 RELATIONSHIP BETWEEN DEPRESSION IN PRIMIGRAVIDAS AND THEIR MOTHERS – COMPARISON BY SEVERE AND MILD DEPRESSION GROUPS H. Okayama1 , K. Masaki1 , Y. Saito1 , S. Tsuchikawa2 , T. Terasaka1 , M. Mori1 , Y. Arai3 , H. Kuwata1 . 1 Clinical Nursing, Shiga University of Medical Science, Otsu, Japan; 2 Shiga University of Medical Science Hospital, Otu, Japan; 3 Kitasato University School of Nursing, Sagamihara, Japan Objectives: This study was conducted to examine the relationship between primigravidas with depression and their mothers by comparing severe and mild depression groups. Materials: The self-reported questionnaires used in this study were the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS, Okano et al, 1996) and Primigravida-Mother Relationship Scale (PMRS, Okayama, 2011). The PMRS consists of seven subscales: “Support by Mother (Support),” “Closeness to Mother (Closeness),” “Affirmative Feeling toward Mother (Affirmative),” “Independence from Mother (Independence),” “Exploration of Mother Image Model through Mother (Image Model),” “Preparations for Pregnancy, Delivery, and Childcare Using Mother as a Model (Preparation),” and “Adaptation to Pregnancy Period (Adaptation)”. The level of depression was determined using the cut-off score adopted in Japan (8/9): primigravidas with a score of eight or less and nine or more were categorized into mild and severe depression groups, respectively. Methods: A cross-sectional study was conducted for 605 Japanese primigravidas: 131 in the first (15 weeks or earlier), 134 in the second (16–27 weeks), and 340 were in the last (28–40 weeks) stage of pregnancy. Results: Regarding EPDS scores, the number of primigravidas included in the severe group in the first, second, and last stages of pregnancy was 19 (14.5%), 22 (16.4%), and 56 (16.5%), respectively. As a result of comparing scores of PMRS subscales for the severe and mild groups, the severe group showed significantly lower scores in the subscale “Adaptation” (p < 0.001) at the first and last stages. At the second stage, scores for the severe group were significantly lower in “Adaptation” (p < 0.001) and “Preparation” (p < 0.05). Conclusions: The results suggest that primigravidas with severe depression were unable to appropriately adapt themselves to pregnancy throughout its course, and, at the second stage of pregnancy, the ability to prepare themselves (Preparations for Pregnancy, Delivery, and Childcare Using Mother as a Model) was low as well. Therefore, it is necessary to provide severely depressed primigravidas with mental health care from the first stage of pregnancy to help them adapt to it. It is also important for their mothers to provide support for them or become a role model in order to encourage them to prepare for delivery and childcare.