Tonja R Nansel1, Faith Doyle, Margaret M Frederick, Jun Zhang. 1. Investigator, Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, 6100 Executive Blvd., Rm. 7B13, MSC 7510, Bethesda, MD 20892-7510, USA. nanselt@mail.nih.gov
Abstract
OBJECTIVES: To examine predictors of quality of life, depression, and stress in women undergoing medical management of early pregnancy failure with misoprostal and to assess the relationship of quality of life, depression, and stress to treatment acceptability. DESIGN: Descriptive observational study of women undergoing medical management of early pregnancy failure with misoprostol conducted as part of a multicenter pilot study testing the efficacy of saline-moistened versus dry application of vaginal misoprostol. Data were collected prior to treatment through 15 days posttreatment. SETTING: Four university-based hospitals. PARTICIPANTS: Women (n = 80) < or = 1 weeks pregnant diagnosed with anembryonic gestation or fetal demise. INTERVENTION: Vaginal misoprostol for medical evacuation. MAIN OUTCOME MEASURES: Quality of life (physical role functioning, emotional role functioning, social functioning, vitality, and bodily pain), depression, stress, and treatment acceptability. RESULTS: Women who received medical evacuation demonstrated poorer quality of life than same-age published population norms, scoring 0.25 to 0.78 of a standard deviation below the population mean for four of the five subscales. CONCLUSIONS: Nurses should assist patients to minimize and manage physical symptoms during treatment for early pregnancy failure. Women with higher external demands and lower social/tangible support may need greater assistance.
OBJECTIVES: To examine predictors of quality of life, depression, and stress in women undergoing medical management of early pregnancy failure with misoprostal and to assess the relationship of quality of life, depression, and stress to treatment acceptability. DESIGN: Descriptive observational study of women undergoing medical management of early pregnancy failure with misoprostol conducted as part of a multicenter pilot study testing the efficacy of saline-moistened versus dry application of vaginal misoprostol. Data were collected prior to treatment through 15 days posttreatment. SETTING: Four university-based hospitals. PARTICIPANTS: Women (n = 80) < or = 1 weeks pregnant diagnosed with anembryonic gestation or fetal demise. INTERVENTION: Vaginal misoprostol for medical evacuation. MAIN OUTCOME MEASURES: Quality of life (physical role functioning, emotional role functioning, social functioning, vitality, and bodily pain), depression, stress, and treatment acceptability. RESULTS:Women who received medical evacuation demonstrated poorer quality of life than same-age published population norms, scoring 0.25 to 0.78 of a standard deviation below the population mean for four of the five subscales. CONCLUSIONS: Nurses should assist patients to minimize and manage physical symptoms during treatment for early pregnancy failure. Women with higher external demands and lower social/tangible support may need greater assistance.