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Objective: Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT., Methods: Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses., Results: Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did., Conclusions: This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction., (Copyright © 2014 John Wiley & Sons, Ltd.)

Background: This is a descriptive study of the management and outcome of 18 cases of fetomaternal alloimmune thrombocytopenia (FMAIT) treated from 1991 to 2001., Material and Methods: Management of the disease changed over the years from cordocentesis in the 20-24th week of gestation, platelet transfusions and immunoglobulin to a less invasive management consisting of only blind administration of immunoglobulin and predelivery cordocentesis., Results: Three of the fetuses were treated with intrauterine platelet transfusions. Two of these were delivered by emergency cesarean section due to failed transfusions and the third fetus died as a result of the procedure. Nine mothers were treated with immunoglobulin intravenously. Four of these delivered thrombocytopenic children. Three women did not want to undergo any treatment, and all newborns had low platelet counts. Two fetuses died, one in conjunction with a platelet transfusion and the other in utero before treatment was commenced. All the other children did well despite the fact that some of them were severely thrombocytopenic at birth., Conclusions: Due to the limited number of patients, the present material does not allow any far reaching conclusions. Our experience is that a non-invasive management can be practiced in cases of FMAIT. The value of performing cordocentesis and platelet transfusions in the second trimester is doubtful in view of the risk for the fetus and the limited amount of information it provides for management of the individual case.

The etiology of premature rupture of the membranes (PROM) has been investigated in 30 consecutive cases and 30 matched controls. The significance of several possible factors predisposing to this condition is discussed and the obstetric and pediatric outcome reviewed. Significantly increased frequencies of previous genital operations, cervical operations and lacerations were found in the PROM group, which also contained significantly more heavy smokers. The relation between the length of the PROM delivery time interval and the risks of prematurity and infection are discussed. Patients delivered > 24 hours after PROM had significantly more puerperal infections than those with a latent period of < 24 hours. Maternal fever was found to be an unreliable prognostic indicator. The incidence of puerperal infection amounted to 27 per cent in the PROM group. A 12 per cent incidence of proven neonatal septicaemia contributed to a high perinatal mortality rate (17.6 per cent).