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Biomedical subjects

R P Lederman

Publications and source records attributed to R P Lederman.

16 recordsLinked to original sources
PubMed1990

Anxiety and stress in pregnancy: significance and nursing assessment.

This article explores the significance of research on prenatal anxiety and stress for application to clinical nursing practice. The focus will be on assessment of the gravid woman's anxiety levels and coping skills. An introduction presenting a paradigm of the transitional and paradoxical changes of pregnancy precedes a discussion of the nature and sources of anxiety in pregnancy and its effects on maternal/fetal health outcomes. The cumulative effects of multiple sources of anxiety and the relevance of early state anxiety and prenatal personality dimensions, such as maternal role identification and conjugal relationships, to health outcomes also are discussed. Methods for stress reduction and recommendations for future multidisciplinary and multivariate research projects conclude the article.

Adaptation, Psychological↗
PubMed1978

The relationship of maternal anxiety, plasma catecholamines, and plasma cortisol to progress in labor.

The relationships among maternal anxiety, selected stress-related biochemical factors, and progress in three defined phases of labor were determined for 32 married, normal, primigravid women, 20 to 32 years of age. Comparisons of plasma epinephrine, norepinephrine, and cortisol in third-trimester pregnancy, during labor, and after delivery are provided. At the onset of Phase 2 of labor (3 cm. of cervical dilatation), self-reported anxiety and endogenous plasma epinephrine are significantly correlated. With the deletion of subjects to control for the effect of medications, higher epinephrine levels are significantly associated with lower uterine contractile activity at the onset of Phase 2 and with longer labor in Phase 2 (3 to 10 cm. of cervical dilatation). The relationship between epinephrine and progress in labor is explained by an adrenoreceptor theory.

Adult↗
PubMed1977

Endogenous plasma epinephrine and norepinephrine in last-trimester pregnancy and labor.

Plasma epinephrine and norepinephrine concentrations during labor and immediately after delivery were compared to those of the third trimester in 21 uncomplicated pregnancies of married primigravid women, 20 to 32 years old. Third-trimester catecholamine concentrations were similar to those of normal, nonpregnant subjects; samples were obtained under identical conditions. Compared to third-trimester levels, significant elevations of plasma epinephrine and norepinephrine were found in three phases of labor (at 3 to 5 cm. and 9 to 10 cm. of cervical dilatation and immediately after delivery). Epinephrine values returned to normal within three to 21 minutes after delivery; norepinephrine values remained high or continued to rise in this time interval. Maternal analgesia and anesthesia influenced plasma catecholamine levels.

Adult↗
PubMedDate not supplied

Professional liability and obstetrical health care delivery.

Nurse-midwives are finding liability insurance either prohibitively expensive or simply unavailable--despite the fact that, in contrast to obstetricians, they are rarely sued. As a consequence, maternal health services for rural and poor women are rapidly disappearing.

Female↗
PubMedDate not supplied

Relationship of psychological factors in pregnancy to progress in labor.

A prospective study of 32 normal, married primigravidas was conducted to determine the relationship between psychological factors in the third trimester of pregnancy and progress in two defined phases of labor. Data were analyzed for the total group and with five subjects deleted to control partially for the effect of medications. Psychological variables measured in pregnancy had significant correlations with variables measured at the onset of phase two labor. Conflict concerning the acceptance of pregnancy showed the most significant relationships to the phase two labor variables with correlations of .39 with anxiety, .59 with plasma epinephrine, -.70 and -.52 with two adjacent Montevideo units, and .58 with length of labor in phase two (3-10 cm cervical dilation). Other pregnancy variables which significantly correlated with the labor variables were identification of a motherhood role, history of psychological counseling or psychiatric treatment, the trait scale of the State-Trait Anxiety Inventory, and fears related to helplessness, pain, loss of control, and loss of self-esteem. Several psychological variables measured in pregnancy also correlated significantly with length of labor in phase three and type of delivery. The results demonstrate that specific psychological factors in pregnancy are predictive of progress in labor.

Adaptation, Psychological↗