[Difficulties facing spouses of in-patients undergoing tocolysis]

When a pregnant woman needs tocolysis to preempt the need for an abortion, there are great impacts on the daily life of her family and on the relationships between the couple and their family members, which negatively influence the balance of the family system. For a pregnant woman under tocolysis in hospital, the spouse indeed plays an important supportive role in helping her to endure many difficulties. Because men are always controllers of power and opinion, being strong and active in attitude to everything, male spouses always suppress their emotions and do not express their feelings to others. These characteristics of men, either in Eastern or Western countries, always cause nursing staff to realize the needs of the male spouse poorly during tocolysis. The current concept of nursing emphasizes family-centered nursing, so the patient's family members are also recipients of treatment, especially male spouses during the process of tocolysis. This is usually neglected, however. In this paper, the author analyzes the characteristics and the roles of male spouses in the family, and the difficulties faced by a pregnant woman during tocolysis in hospital, for the benefit of future clinical nursing practice.

[Behavioral responses of an older woman receiving tocolysis after repeated failed pregnancies]

The purpose of this study was to explore the behavioral responses to tocolysis of an older woman who has experienced two failed pregnancies. As a participant observer the primary researcher simultaneously provided care and recorded the woman's verbal and nonverbal behaviors. After repeated data analysis, it was found that the woman's stress mainly resulted from her un certainty about a safe passage through pregnancy and about the health of her fetus. In her effort to ensure a successful pregnancy and good fetal health, she exhibited the following behaviors: worrying about the status of her pregnancy, adopting effective strategies to ensure the success of the tocolysis, complying with medical procedures and nursing instructions, establishing the time marks of the pregnancy for the purpose of self-encouragement, and attaching importance to oral intake for the sake of good fetal health. The article concludes that medical personnel should actively identify the needs of pregnant women and provide family-centered nursing care to diminish the impact of preterm premature rupture of membrane and maximize the positive results of tocolysis.

[Study of stress and coping behaviors in families of hospitalized pregnant woman undergoing tocolysis]

Because of tocolysis intervention, families of pregnant woman undergoing tocolysis face stresses beyond the physical and psychological challenges of normal pregnancy. The lifestyle of the family and the relationship between family members will change significantly. The purpose of this study was to explore the stresses and coping behaviors of families of pregnant woman undergoing tocolysis in the hospital. A clinical field method was used and the subjects were recruited from one medical center in Taipei. Data, collected from participant observations and interviews, was subject to content analysis. Results showed that the family stress could be segmented into the four realms of (1) uncertainty about tocolysis; (2) worrying about infant's health; (3) role conflicts between relatives; and (4) changes in family life patterns. The study classified family coping behavior into the following four activity categories: (1) searching for information about tocolysis; (2) adjusting family member roles; (3) changing family member interactions; (4) streamlining the use of family resources. These conclusions are helpful to promote nursing quality in relation to caring for families of pregnant woman with tocolysis by fully understanding the related sources of stress and patterns of coping behaviors.

The Lived Experience of First-Time Expectant Fathers Whose Spouses Are Tocolyzed in Hospital

The purpose of this study is to explore the experiences of first-time expectant fathers whose spouses undergo tocolysis in the hospital. The study was conducted by the descriptive phenomenological method. On the basis of the qualitative method, the data were subjected to Colaizzi's content analysis by means of the constant comparison method. Data were collected through one-on-one interviews with six expectant fathers. The findings revealed that the experiences of the fathers could be summarized under the following five themes: being confused and absent-minded in an awkward situation, facing difficulty and attempting to identify solutions, breaking through the dilemma, looking forward to being a father, and looking back with complicated feelings. The findings of this study should provide nursing staff in charge of family- centered maternity care with information about how tocolysis influences the families of first-born babies. They should also contribute to improvements in nursing quality.

Maternal and fetal side effects of tocolysis using transdermal nitroglycerin or intravenous fenoterol combined with magnesium sulfate

OBJECTIVE

To compare the maternal and fetal side effects of transdermal nitroglycerin and intravenous fenoterol combined with magnesium sulfate in a prospective randomised study.

STUDY DESIGN

Fifty pregnant women between 27 and 35 weeks of gestation with preterm labour were treated with either nitroglycerin (0.4-0.8 mg/h) or fenoterol (60 - 120 microg/h). Outcome parameters were (1) the effects on fetal and maternal heart frequency (FHF/MHF) and blood pressure, and (2) subjective experiences of adverse effects assessed by utilising a questionnaire.

RESULTS

In the fenoterol group, elevated mean MHF, FHF and systolic blood pressure were recorded compared to nitroglycerin. Fewer maternal side effects were reported in the nitroglycerin group. Palpitations (82%), tremor (68%) and restlessness (64%) were most common in the fenoterol group (two drop-outs), whereas nitroglycerin caused headaches in 71% of the cases (four drop-outs).

CONCLUSION

Transdermal nitroglycerin appears to be a safe therapy for the mother and fetus and is a promising new option for the treatment of preterm labour.