This study reveals that the individual experience of prenatal diagnosis is not determined by the invasiveness of the procedure. Immediate visual presentation of the fetus and confirmation of a normal test result reduce stress that has previously been induced by the prenatal test itself. This contradiction should be discussed with the parents.

No abstract

Prenatal testing for fetal anomalies presents an anxiety-inducing situation for the parents-to-be. If the results are negative, anxiety is reduced. Pregnant women who are confronted with a positive malformation scan show unchanged levels of anxiety after the examination.

Infertility is a stressor that affects the infertile couple. Coping of infertile couples with the unfulfilled desire for a child is affected by numerous variables. Depending on the diagnose is the patients were assigned to four groups: Group 1: female infertility (infertile women of fertile men), Group 2: infertility of the men, Group 3: infertility of both partners, Group 4: idiopathic sterility). One hundred and ten infertile couples were investigated with the Freiburg questionnaire of Coping with Illness. Compared to their partners, the women of infertile couples report a higher feature rating in the cales "depressional coping" and "self-distraction and self-stabilisation". Women of infertile couples show lower feature ratings compared to the standardised collective of patients with chronic somatic disease only on the scale "religiousness and search for meaning". Involuntarily childless men activate all coping strategies to a smaller extent than the reference sample. The experience of infertility is greatly affected by gender and the associated role expectations.

Zusammenfassung Fragestellung: Die Endometriose ist eine häufige Erkrankung der reproduktiven Lebensphase der Frau. Die medikamentös-operative Standardtherapie führt oft nur zu vorübergehenden Therapieerfolgen mit einer hohen Rezidivrate. Dabei kann es zu einer Chronifizierung vorbestehender Schmerzen und einer gravierenden Einschränkung der Lebensqualität kommen. Material und Methode: Unter Einsatz des Deutschen Schmerzfragebogens, einem modularen Fragebogen nach dem biopsychosozialen Schmerzmodell, wurden zudem Parameter der Topografie und Intensität des Schmerzes, der Lebensqualität, die Beeinträchtigung durch den Schmerz und Depressivität erfasst. Ergebnisse: In dem dargestellten Fall ist durch die Chronifizierung endometriosebedingter Schmerzen die Lebensqualität der Patientin deutlich eingeschränkt. Mehrere operative Interventionen haben bereits zum Verlust des inneren Genitale in jungen Jahren geführt und eine weitere Chronifizierung des Schmerzes begünstigt. Der Schmerz besteht über die Elimination des auslö-senden Reizes hinaus fort. Schlussfolgerung: Die ausführliche Anamnese ist die Basis des therapeutischen Vorgehens und wird sinnvoll durch den Einsatz psychologischer Messinstrumente ergänzt. Eine Integration der so gewonnenen Erkenntnisse in ein multidisziplinäres Therapiemodell kann eine Minimierung biopsychosozialer Konsequenzen bedingen. AbstractPurpose: Endometriosis is a common finding during the reproductive phase of women. The standard therapeutic concept i.e. a combination of operative treatment with drug therapy, often fails and results in a high percentage of recurrence. Persistant pain decreases the quality of life. Materials and Methods: Using the German Pain Questionnaire, a modular questionnaire based on the model of biopsychosocial pain, parameters of pain topography and intensity, quality of life, pain-related disturbance and depression were evaluated.Results: The presented case shows the great influence of endometriosis on chronic pain and loss of quality of life. Multiple surgical interventions and the early resection of genital organs also promoted chronic pain. Pain still persists after elimination of pain stimulus. Conclusion: Based on profound anamnesis supplemented by psychological assessment further therapeutic steps can be planned. The results can be integrated into a multidisciplinary therapeutic model to minimize biopsychosocial consequences. Key wordsEndometriosis´biopsychosocial consequences´chronic pelvic pain´psychosomatic gynecology´multidisciplinary therapy´so-matoform pain disorder´fibromyalgia Originalarbeit 156 Institutsangaben