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Silverio SA, Memtsa M, Barrett G, Goodhart V, Stephenson J, Jurković D, Hall JA. Emotional experiences of women who access early pregnancy assessment units: a qualitative investigation. J Psychosom Obstet Gynaecol 2022; 43:574-584. [PMID: 36094423 DOI: 10.1080/0167482x.2022.2119958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Purpose: Early pregnancy complications are common and often result in pregnancy loss, which can be emotionally challenging for women. Research on the emotional experiences of those attending Early Pregnancy Assessment Units [EPAUs] is scarce. This analysis explored the emotions which women spontaneously reported when being interviewed about their experiences of using EPAU services.Materials and methods: Semi-structured telephone interviews were conducted with a purposive sample of 38 women. Using Thematic Framework Analysis, we identified six unique emotional typologies which mapped onto women's clinical journeys.Results: Women with ongoing pregnancies were characterized as having: "Anxious Presentation" or "Sustained Anxiety due to Diagnostic Uncertainty", dependent on whether their initial scan result was inconclusive. Women with pregnancy loss had one of four emotional typologies, varying by diagnostic timing and required interventions: "Anxious-Upset"; "Anxious-Upset after Diagnostic Uncertainty"; "Anxious-Upset with Procedural Uncertainty"; "Anxious with Sustained Uncertainty".Conclusions: We provide insights into the distinct emotions associated with different clinical pathways through EPAU services. Our findings could be used to facilitate wider recognition of women's emotional journeys through early pregnancy complications and stimulate research into how best to support women and their partners, in these difficult times.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, King's College London, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Maria Memtsa
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Women's Health Services, University College London Hospitals NHS Foundation Trust, London, UK
| | - Geraldine Barrett
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Venetia Goodhart
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Women's Health Services, University College London Hospitals NHS Foundation Trust, London, UK
| | - Judith Stephenson
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Davor Jurković
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Gynaecology Diagnostic and Outpatient Treatment Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jennifer A Hall
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
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Abstract
Early pregnancy complication remains a significant cause of maternal morbidity and mortality. Despite the paucity of evidence to support consultant-led early pregnancy unit over nurse- or sonographer-led services, hospitals have devoted scarce resources to appoint consultants to lead their early pregnancy units. We compared the management and outcomes of confirmed and suspected ectopic pregnancy 1 year before and one year after the transition from a nurse-led to a consultant-led early pregnancy unit in a London hospital. Our study showed improvements in the rates of negative laparoscopy, ruptured ectopic pregnancy during follow-up, need for laparotomy, ITU admission and length of stay and statistically significant reduction in operative intervention, without concomitant rise in morbidity or mortality in women with confirmed or suspected ectopic pregnancies.
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Affiliation(s)
- T L Tan
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital , Singapore
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