Women’s Health

Nurses Lead Improved Care For Miscarriage Patients
Breast Reduction Surgery A Weighty Issue

Pre-Eclampsia In The Sights Of Flinders’ Researchers

Nurses Lead Improved Care For Miscarriage Patients
First Published: Investigator - September 2008
Updated:

A project led by Emergency Department nurses is improving the hospital journey for women who experience bleeding in the first 12 weeks of pregnancy.

There is a possibility that women who experience bleeding in the first 12 weeks (first trimester) will have a miscarriage.

One in five pregnancies will end in miscarriage in the first 12 weeks of pregnancy, but unfortunately there is no medical intervention which can prevent a miscarriage from occurring.

Reasons for miscarriage include a malfunction of the early development of the fertilised egg, or development of pregnancy in the wrong part of the uterus.

‘We identified that it was important to consider the psychological, spiritual and emotional aspects of women as well as their medical needs,’ Acting Clinical Services Coordinator Jacki McDonald said.

Education sessions have been held for Emergency Department staff to gain a better understanding of miscarriage and the psychological needs of women.

‘Women experiencing miscarriage are going through a traumatic experience, and it can be difficult for some women to retain information, or be in the right frame of mind to ask questions,’ she said.

‘Some women are so distraught it is hard for them to understand what is happening, or why it has happened; other women get home and realise they didn’t ask enough questions.’

Detailed patient information brochures have been developed for women which provide information about miscarriage, medical advice and contact details to support groups and other resources.

All women experiencing miscarriage are now referred to FMC-based social workers, who offer counselling services and make follow up calls with patients.

‘Threatened miscarriage or miscarriage is something we really care about as nurses, and we decided that we wanted to do something about it,’ Jacki said.

Breast Reduction Surgery A Weighty Issue
First Published: Investigator - July 2008
Updated:

A new study at Flinders Medical Centre is assessing physical and psychological outcomes following breast reduction surgery.

The aim of the study is to determine which women benefit most from surgery – and whether that correlates with their original breast size.

‘We’re hypothesising that the bigger the bust, the better the outcome in terms of less pain, headaches, rashes and lowered self esteem,’ said research coordinator and Flinders Medical Centre occupational therapist Karen Burford.

Around 30 women - with cup sizes generally EE upwards - have breast reduction surgery at Flinders Medical Centre and Flinders Private Hospital each year.

Lead investigator and head of the General and Plastics Unit at FMC, Mr Phil Griffin, said while some people believed breast reduction surgery was a cosmetic procedure, for many women it was a medical necessity.

‘Having oversized breasts can be very debilitating and lead to a poorer quality of life. Many women can’t even exercise, let alone run or jump, and most experience constant backache, neck pain, headaches and rashes.’

He said the ‘embarrassment’ factor was also a key issue for women, with many suffering lowered self esteem due to stares or comments from people. ‘Some women won’t even get undressed in front of their partners.’

Phil said while previous studies had measured functional improvement following breast reduction surgery, this was believed to be the first time researchers had used an exact method to measure breast volume before and after surgery.

Central to the study is a $221,000 three-dimensional body scanner, which can scan a woman’s exact breast volume in 17 seconds.

Assistant researcher and FMC registrar Alexa Potter said while it was too early to make any conclusions, very early verbal feedback from women involved in the study had been positive.

The scanner was purchased with the assistance of funding from the SA Department of Health and will be used for other research projects at Flinders.

‘Almost all patients have reported immediate relief from back and neck pain and that they are more active and happier. They are also motivated to get back to improving their fitness levels and self esteem.’

The five-year study aims to recruit around 200 women. Women involved in the study will be followed up over a 12-month period. It is hoped the research will help to prioritise the waiting list for breast reduction surgery at Flinders.

Pre-Eclampsia In The Sights Of Flinders’ Researchers
First Published: Investigator - July 2008
Updated:

Reducing the incidence of potentially life-threatening pre-eclampsia in pregnancy is the aim of research being conducted at Flinders Medical Centre.

Pre-eclampsia is a condition of pregnancy characterised by high blood pressure and protein in the urine. It can lead to heart and liver damage in the mother and low-weight babies. Research suggests that small babies are predisposed to a wide range of diseases as adults.

The condition is cured only once the baby is born.

While pre-eclampsia is generally picked up and treated in pregnant women in developed countries, the incidence of the condition is on the rise – most likely because of the trend towards women having babies later in life and a greater likelihood of having multiple births.

In developing countries, between 1.5 and 8 million women develop pre-eclampsia every year and around 40,000 women and 20 percent of babies die from the condition. In industrialised nations, it affects between 50,000 and 370,000 women annually.

Dr Ida Llewellyn-Smith, a National Health and Medical Research Council Principal Research Fellow and Associate Professor in Cardiology from the Department of Medicine at Flinders, said researchers were still unsure why pre-eclampsia developed in some women but not others.

‘One school of thought is that pre-eclampsia is caused by problems with the blood vessels that supply blood to the uterus. Certainly, there has been some scientific data suggesting that the nerves to these blood vessels are different in women with pre-eclampsia.’

Ida said an increase in the density of the nerves around blood vessels in women who would develop pre-eclampsia could reduce the flow of blood to the uterus, thus triggering the condition.

‘That’s what we’re investigating – whether the nerves to blood vessels that supply the uterus are different in pregnant females.’

‘Once we have determined what is going on with the blood vessels that supply the entire uterus during pregnancy, we can look towards reducing the incidence of pre-eclampsia in the future. That’s the ultimate aim of the research.’