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Nursing care of women after abortion performed for a genetic indication in II. trimester
FAJMANOVÁ, Dita
The finding congenital defect or chromosomal aberration by child puts a woman to big medical, ethical but also social problem, when she is forced to decide, if she should interrupt the pregnancy or to continue. By searching for abnormalities and pathologies in pregnancy is held by prenatal diagnostics. This involves cooperation of many medical fields such as obstetrics, ultrasonography, specialized laboratory and clinical genetics. The task of prenatal diagnostics is to reveal abnormalities in development of the child and to be able to interrupt the pregnancy, give information about following approach, to give possibility of choice, decrease fear and worries, and be able to cure the child in prenatal stage. Interruption is an action by which another development of the child is terminated. It brings many complicated situations, in which it is necessary to deal with them individually and in correlation with legislation. According to law it is possible to interrupt pregnancy after 12th week only in that case, when a life of the woman is threaten, or serious damage of child is proven or the child is not able to survive. If there are some genetic reasons for interruption, it is possible to interrupt pregnancy till 24th week and furthermore this possibility is valid when risk of damage of the child is more than 10% based on genetic examination. For interruption in second trimester it is necessary to choose sufficient method of interruption and provide a woman traumatic treatment to minimize the trauma. In this case the assistance of birth assistant is essential.This bachelor thesis is focused on problematic of interruption of pregnancy in second trimester based on genetic indication from decision of a woman if continue or interrupt the pregnancy all the way to nursery care during hospitalization. The aim of the thesis is to find out the factors, which influenced women in making their decision about interruption of pregnancy in second trimester a to find out their satisfaction with nursery care and attitude of birth assistants during hospitalization.In theoretical part the findings obtained from bibliographic sources were generalized. In practical part was done research for which was used qualitative method in form of questioning. For data collection technique was chosen structured interview. Interviews were done in department of conservative gynecology of Gynecological- obstetric clinic of Faculty Hospital in Pilsen in January, February and March of 2013. The focus group were five women, which were hospitalized here in that time with diagnosis of interruption in second trimester based on genetic indication. Obtained data were then categorized and for its interpretation some respondents´ citation were used.With research was found, that the decision making about interruption is influenced mainly by results of prenatal examination, standpoint of the partner and family and also suggestion of gynecologist. The decision is indirectly influenced by moral principles and conscience and also personal experience with damaged child. Satisfaction with nursery care and approach of birth assistants was expressed by all questioned women. They had some comments regarding organizational possibilities of medical facility. Two out of five respondents expressed need of more privacy, to be alone in the room. In their case it was impossible due to occupied single rooms. For three respondents it was unpleasant to go through interruption in delivery room. The research also revealed lack in satisfaction of psychical needs of respondents. The possibility of intervention with psychologist was offered only to two of them and all questioned women would appreciate intervention with psychologist already during decision making process.
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