The objective of the study was to compare psychological responses of women following a pregnancy termination due to ultrasound-detected fetal anomalies (ultrasound group) with the psychological responses of women following a late spontaneous abortion or a perinatal death (perinatal loss group). The assessments, which were performed on four occasions in the year after the life event, included Montgomery and Asberg Depression Rating Scale, Goldberg General Health Questionnaire, Impact of Event Scale, State-Trait Anxiety Inventory and Schedule for Recent Life Events. In the acute phase, a few days after the life event, the women in the ultrasound group reported statistically significantly less depressive symptoms and less intrusion and avoidance symptoms than the perinatal loss group. No differences in psychological responses in the two groups were found at the examinations at approximately 7 weeks, 5 months or 1 year. A statistically significantly higher proportion of women in the ultrasound group reported that they had tried to become pregnant in the following year. A few subjects in each group reported persisting high psychological distress throughout the year, but only one woman fulfilled the criteria of a post-traumatic stress disorder. It is concluded that the long-term psychological stress response in women to pregnancy termination following ultrasonographic detection of fetal anomalies does not differ from the stress responses seen in women experiencing a perinatal loss.
Objective Despite the relatively common occurrence of imperforate anus, prenatal diagnosis is rarely reported. In this study, we investigated the presence and diagnosis of imperforate anus along with strategies for improving prenatal diagnosis of the condition.
Patients and methods Fetuses and infants with imper
The accordance between ultrasound diagnoses and postmortem examinations proved to be satisfactory. The close co-operation between ultrasonographers and perinatal pathologists is mutually beneficial. In addition to complementing prenatal diagnosis, postmortem examination is of vital importance for the quality control of ultrasonography in fetal diagnosis and plays an important role in genetic counseling.
A prospective evaluation of the therapeutic effect of neuromuscular electrical pelvic floor stimulation was performed in 55 women with urinary stress incontinence awaiting surgical repair. Chronic stimulation was applied anally or vaginally by an integrated plug electrode for a median of 5.4 months. After therapy, 68% of the patients were continent or had improved so such that the planned operation was cancelled. At 2-year follow-up, the persisting success rate after electrostimulation was reduced to 56%, 31% had undergone surgical repair or were awaiting colposuspension, 9% were still incontinent, but refused surgery, and 4% were deceased. However, in the high-compliance group of 45 patients who had used the device regularly for at least 3 months, the success rate of pelvic floor stimulation was 72% at 2-year follow-up. The therapeutic effect could be verified objectively by positive changes in clinical stress test and dynamic urethral pressure profile. Approximately E 2,300 were saved for each patient avoiding surgery. A 40% reduction of the total cost of stress incontinence therapy was attained by the presented model.
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