Anxiety associated with diagnostic uncertainty in early pregnancy
| Autor: | Kavita Vedhara, Alison Richardson, Shilpa Deb, Nick Raine-Fenning, Bruce K. Campbell |
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| Rok vydání: | 2017 |
| Předmět: |
Gynecology
medicine.medical_specialty Abdominal pain Pregnancy 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology Ectopic pregnancy business.industry Obstetrics Obstetrics and Gynecology General Medicine medicine.disease 03 medical and health sciences 0302 clinical medicine Reproductive Medicine medicine Anxiety Gestation Radiology Nuclear Medicine and imaging Vaginal bleeding 030212 general & internal medicine medicine.symptom Medical diagnosis business Prospective cohort study |
| Zdroj: | Ultrasound in Obstetrics & Gynecology. 50:247-254 |
| ISSN: | 0960-7692 |
| Popis: | Objectives To determine anxiety levels of women presenting to Early Pregnancy Assessment Units (EPAU) with abdominal pain and/or vaginal bleeding and assess how these change over time and according to ultrasonographic diagnosis. Methods We undertook a prospective cohort study in a EPAU in a large UK teaching hospital. Women with abdominal pain and/or vaginal bleeding in early pregnancy (less than 12 weeks gestation) presenting for the first time were eligible for inclusion in the study. State anxiety levels were assessed using the standardised short form of Spielberger's state-trait anxiety inventory on three occasions (before, immediately after and 48–72 hours after an ultrasound scan). Scores were correlated with ultrasonographic diagnosis. The diagnosis was either certain or uncertain. Certain diagnoses were either positive i.e. a viable intrauterine pregnancy (IUP), or negative i.e. a non-viable IUP or ectopic pregnancy (EP). Uncertain diagnoses included pregnancies of unknown location (PUL) and uncertain viability (PUV). Statistical analysis involved mixed ANOVAs and the post-hoc Tukey-Kramer test. Results 160 women were included in the study. Anxiety levels decreased over time for women with certain diagnoses (n = 128), even when negative (n = 64), and increased over time for women with uncertain diagnoses (n = 32). Before the ultrasound, anxiety levels were high (21.96 ± 1.11) and there was no significant difference between the five groups. Immediately after the ultrasound, anxiety levels were lower in the viable IUP group (n = 64; 7.75 ± 1.13) than any other group. The difference between the five groups was significant (p |
| Databáze: | OpenAIRE |
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