Abdominal Decompression during Pregnancy

Abstract

BmTmIS 317 absence among the refinery population: those who had frequent absences, those who had long absences, and those who had no absences.A major difference between the groups was the attitude of the men towards themselves and their work. A memory of unhappy childhood was commoner in the " frequently " and " long " sick than in a group of matched controls, while dislike of the job or frustrated ambition was common in the " frequently " sick. The " never " sick denied such personal problems with the same firmness as they denied all illness, even though one-quarter of them had organic disease on physical examination. Eysenck's personality inventory showed that the " frequently" sick had a higher extraversion and neuroticism score than the controls. The " never sick were characterized by introversion and stability and the "long " sick by introversion and neuroticism. However, some of these conclusions need confirmation, because the control group can be validly compared only with the "frequently " sick group.These careful studies, though on a small working group, suggest that younger men who have developed the habit of having frequent short spells of sickness absence are likely to take this experience with them into middle and older age, with an inevitable rise in overall sickness rates over the years. In addition it may be possible to identify men who are liable to have unfavourable sickness experience for a number of years at a time, if not all their working lives. If the findings are confirmed, it will be possible to concentrate attempts to alter the atitudes which lead to sickness absence which has a flimsy clinical basis where they will have most effect. Abdominal Decompression During PregnancyIn 1954 Professor 0. S. Heyns, of the University of Witwatersrand, found that curarization of women during labour made it less painful. But the method was potentially dangerous, so he experimented with the idea of reducing the pressure of the abdominal walls on the uterus during its contractions. This led to the development of his decompression suit, which surrounds the patient from the axillae to the feet. Beneath the suit is a rigid " spacer " overlying the lower part of the chest and abdomen. When air is mechanically sucked out of the suit the pressure on the abdominal walls is reduced by 50 to 150 mm. Hg. The abdomen swells outwards and the diaphragm descends. The effect is to alter the shape of the abdominal cavity, and the uterus, from being ellipsoidal, becomes more spherical. The uterus is therefore contracting isotonically, rather than isometrically. Heyns argues that the isotonic contraction is more efficient and so shortens labour and reduces pain." He claims that 98% of patients decompressed during the first stage of labour are helped. From these beginnings the work has been extended especially to the giving of oxygen together with decompression during the last weeks of pregnancy. In 1965 Heyns' recommended decompression once or twice daily from the 28th week of pregnancy. Such treatment was claimed to imp...