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Reakcje kobiet po stracie ciąży oraz zachowania partnerów

100%

SIKORA K.

Ginekologia i Położnictwo

2014

vol. 9

issue 3

40-55

Introduction. The experince of loosing a child while a woman is pregnant with it concerns a significant number of couples. The chock following the loss of a child before its birth may lead to incorrect ways of communication with the medical staff. This is a situation that burdens emotionally both sides. The aim of the work. The evaluation of the type of feelings the women and men are going through after the loss of a child before its birth. The understanding of this experience may lead to ensuring tothe parents after a miscarriage a care responding to their needs, including the appropriate medical staff support and access to professional psychological help. Materials and methods. We applied a hermeneutic dialogue and thematic studies on the life of the human being. We analysed 26 interviews with pregnant women who underwent miscarriage in the past. Results. The result of our work is the ‘Pattern of experience after the loss of a child before its birth’. They focus on the feelings of a woman after miscarriage. We determined modelling factors that is circumstances acompanying the miscarriage, the attitude towards pregnancy and ways of coping with this problem, including the social support obtained after the loss. An important element of the pattern are also the partners’ behaviours described by the examined women, including the support given to the wife and the woman’s own feelings. We also discovered distant consequences of the miscarriage, that is the feelings of the woman in the following pregnancy. The process of accepting the fact of having lost a child before its birth is facilitated by: the presence of the husband; the hope of having a child in the future; the information on the circumstances of miscarriage transmitted by the doctor; a conversation with a person showing understanding. Conclusions. The reaction following a miscarriage reminds the grief after the loss of a close person. The experience of the loss of a child before its birth can be differentiated on an individual basis and is of a procesual nature, without distinguishing phases. The situations that may intensify the sorrow and grief are encounters with a small child or a pregnant woman and problems in relation with the husband. The behaviour of the medical staff adjusted to the needs of the patient constitute a significant source of support, and the inadequate behaviours lead to the intensification of the reaction after miscarriage. A remote consequence of the loss of a child before its birth is the miscarriage-related anxiety, appearing in every other pregnancy. There is a need of psychological assistance as early as in the hospital in order to obtain further professional support.

Częstość zakażeń typem 16. wirusa brodawczaka ludzkiego w przebiegu ciąży

84%

Skrajna A., Maździarz A., Śpiewankiewicz B.

Current Gynecologic Oncology

2012

vol. 10

issue 2

109-115

Introduction: Among the HPV infection risk factors one can list: age, early sexual activity, frequent change of sexual partners, multiparity, low socioeconomical status, coexistence of Chlamydia trachomatis, HSV type 2, HIV infections, vitamin deficiencies, smoking cigarettes, using hormonal contraceptives, immune system disorders and also pregnancy. The aim of the study is the assessment of human papillomavirus infection frequency in the course of pregnancy, particularly with attention to HPV type 16 infection. Material and methods: The study included 242 pregnant women who in the years 2004-2008 were treated in the Pathology of the Pregnancy Ward and Gynecologic-Obstetric Outpatient Clinic in the Voivodal Brodnowski Hospital. The patients included to the study had had cervical smear test performed by PCR method for HPV. Results: In the examined group of 242 pregnant patients human papillomavirus was isolated from 150 (62%) patients. Type 16 was statedin 87 (58%) patients. In case of normal pregnancy the presence of HPV virus was stated in 70.8% of cases (51 out of 72 women). In this group HPV type 16 comprised 61.6%. In pregnancies complicated with the symptoms of early termination the infections were stated in 99 out of 170 patients (58.2%). HPV type 16 infection was stated in 92.9% of cases. Conclusions: 1) In the analyzed material the frequency of human papillomavirus infection equaled 62%. Type 16 of virus caused 58% of these infections. 2) Regardless of the age of pregnancy and its course the percentage of cervix infections by HPV type 16 was quite significant and oscillated from 36% to 65%. 3) In patients who lost their pregnancies before 22 week of gestation, HPV type 16 was significantly more frequently isolated from miscarried tissues in comparison to its presence in cervical canal smear.

Wstęp: Wśród czynników ryzyka infekcji HPV wymienia się: wiek, wczesne rozpoczęcie współżycia płciowego, częstą zmianę partnerów seksualnych, wielorodność, niski status socjoekonomiczny, współistnienie zakażeń Chlamydia trachomatis, HSV typu 2., HIV, niedobory witaminowe, palenie papierosów, stosowanie antykoncepcji hormonalnej, zaburzenia odporności, a także ciążę. Celem pracy jest ocena częstości występowania zakażeń wirusem brodawczaka ludzkiego w przebiegu ciąży, ze szczególnym uwzględnieniem infekcji typem 16. HPV. Materiał i metody: Badaniem objęto 242 kobiety w ciąży, które w latach 2004-2008 były leczone na Oddziale Patologii Ciąży oraz w Poradni Ginekologiczno-Położniczej w Wojewódzkim Szpitalu Bródnowskim. Włączone do badania pacjentki miały wykonane badania wymazów z szyjki macicy metodą PCR w kierunku HPV. Wyniki: W badanej grupie 242 ciężarnych wirusa brodawczaka ludzkiego wyizolowano od 150 (62%) kobiet. Typ 16. rozpoznano u 87 (58%) pacjentek. W przypadku ciąży przebiegającej prawidłowo obecność wirusa stwierdzono w 70,8% przypadków (51 spośród 72 kobiet). W tej grupie HPV 16 stanowił 61,6%. W ciąży powikłanej wystąpieniem objawów przedwczesnego jej ukończenia infekcje rozpoznano u 99 spośród 170 pacjentek (58,2%). Zakażenie typem 16. stwierdzono w 92,2% przypadków. Wnioski: 1) W analizowanym materiale częstość zakażeń wirusem brodawczaka ludzkiego wynosiła 62%. Typ 16. wirusa wywołał 58% z tych infekcji. 2) Niezależnie od wielkości ciąży i jej przebiegu odsetek zakażeń szyjki macicy typem 16. HPV był dość znaczny i wahał się od 36% do 65%. 3) U pacjentek, które utraciły ciążę przed 22. tygodniem, znamiennie częściej w poronionych tkankach izolowano typ 16. wirusa HPV w porównaniu z jego obecnością w wymazach z kanału szyjki macicy.

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Częstość zakażeń typem 16. wirusa brodawczaka ludzkiego w przebiegu ciąży