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Although maternal depression is a common emotional disorder, assessment and intervention rates are low. Using a cross-sectional survey design, we examined attitudes, beliefs, and practices of obstetrical and neonatology nurses toward the management of symptoms of maternal depression (SMD). Nurses believed they were responsible to assess for SMD and intervene with women showing SMD. However, only 50% assessed for SMD at least once monthly. Identified barriers to care were: lack of time, training, language, and patient and family beliefs. NICU nurses reported lower confidence, knowledge, and skills, than other nurses who participated in this study. This study shows there is a need to enhance nurses? confidence in assessing and intervening with SMD, and to clarify the referral process.

Approximately one to three per cent of pregnant women undergo surgery that is unrelated to their pregnancy. In Canada this represents about 5,000 patients each year that present unique challenges to the perioperative nurse and the entire surgical team. Approximately five to ten per cent of these patients are involved in trauma, which causes 46.3% of maternal deaths. A small percentage of elective procedures are carried out in the first trimester, before the patient herself is aware of the procedure. The majority of procedures are required for urgent and emergent conditions that require surgery despite the risks to the mother and fetus. This article will discuss perioperative care of the non-obstetric pregnant patient and to introduce a nursing care guideline that can be used as a quick-reference tool. The care discussed in the appended Guideline focuses on the pregnant condition and is to be used in conjunction with routine perioperative care practices. Semi-elective and urgent surgery is not contraindicated by pregnancy, although anesthetic and surgical approaches must be modified to promote the safety of mother and her fetus. If possible, the surgery should be postponed to the second trimester. By this time major systems of the fetus are formed and the uterus does not yet infringe on abdominal structures and manipulation may be kept to a minimum. In the first trimester, spontaneous abortion is the greatest risk at 12%. This decreases to less than five per cent in the second and third trimesters. Pre-term labor presents the greatest risk in the second and third trimesters. The most common need for surgery in pregnancy is associated with appendicitis, biliary tract disease, intestinal obstruction, urinary calculi and trauma.

Purpose: To determine the impact of asthma during pregnancy from the perspective of the pregnant woman., Study Design and Methods: A descriptive survey using the Internet for subject recruitment and data collection was conducted using an adaptation of the Cancer Survivors Survey Questionnaire. Women with asthma who were pregnant or who had recently given birth (n = 166) were the sample. Women responded from the United States, Canada, Europe, and Asia. Physical symptoms, emotional responses, and coping strategies to deal with the asthma were queried., Results: Women reported a variety of respiratory difficulties including wheezing, coughing, and shortness of breath. They were concerned about avoiding triggers leading to acute asthma, the effect of the asthma medications on the fetus, and losing their jobs due to absenteeism. They wanted to know more about how to prevent an asthma attack and what effect their disease could have on their unborn infants., Clinical Implications: Women need education and support to help them deal with asthma during pregnancy. Nursing can have an important role in teaching these women and helping them monitor their asthma status during pregnancy.

Objective: To evaluate a program that provides in-home care to women with pregnancies threatened by preterm delivery (including preterm labor, preterm premature rupture of membranes, and multiple gestation) and women with pregnancy-related hypertension., Methods: Data from hospital discharge summaries were used to compare birth outcomes and cost of care for women in the in-home program and a cohort of women who received in-hospital antenatal care before the new program. Birth outcomes included data for mothers and infants. The sample included 437 women with threatened preterm delivery (n = 228 in-home, n = 209 in-hospital) and 308 with hypertension (n = 155 in-home, n = 153 in-hospital). The cost per woman included all costs of services for mothers and infants., Results: Women at risk of preterm delivery who received in-home care were half as likely to have their infants in the neonatal intensive care unit more than 48 hours (odds ratio 0.53, 95% confidence interval 0.36, 0.78). On average, their infants weighed more (2732 +/- 716 g versus 2330 +/- 749 g, P <.001) and were 2 weeks older at birth (36.1 +/- 3.1 weeks versus 34.0 +/- 4.0 weeks, P <.001). There was a wide range in the total cost per woman and no significant difference between cohorts. For women with hypertension, there were no significant differences between in-home and in-hospital cohorts in birth outcomes or costs of care per woman., Conclusion: The program with current admission criteria, staffing, and guidelines for antenatal hospital admission provides safe care to women at similar cost to that of hospitalization.