K M Behrenz | PubMed Health

PubMed1999

Fatigue in pregnancy: a comparative study.

The objective of this study was to use validated scales to determine if fatigue is increased during the first trimester of pregnancy compared to nonpregnant women with similar demographic characteristics. Women between 6 and 12 weeks' gestation were invited to complete a demographics questionnaire and the Numerical Rating Scale for Fatigue (NRS-F), State Trait Anxiety Inventory (STAI), and Beck Depression Index (BDI-II). Nonpregnant women were also invited to participate. Statistical analysis was performed using Mann-Whitney U, Fisher's exact, Spearman correlation, and Monte Carlo tests where appropriate; significance was assumed at p <0.05. Twenty pregnant and 15 nonpregnant patients were enrolled. There was no difference in age, parity, BMI, race, marital status, education, income or hours worked outside the home between pregnant and nonpregnant subjects. Pregnant women reported greater number of hours spent sleeping each day (8 [7-10] vs. 7 [6-9], p = 0.03). There was no significant difference in BDI-II, STAI-S, or STAI-T scores, but pregnant women had significantly higher scores on the NRS-F test (72.5 [20-88] vs. 36 [18-94], p <0.05). Women in the first trimester of pregnancy experience significantly greater fatigue compared to a similar group of nonpregnant women.

Adolescent↗

PubMed1998

Maternal-fetal transfers: indications, appropriateness, and cost.

The objective of this study was to assess the indications, appropriateness, and cost of maternal-fetal transfers to a tertiary care facility in an era of managed care. Our perinatal database was reviewed from January 1, 1996 through June 30, 1997 to determine maternal and fetal indications for transfer, referring institution characteristics, utilization of tertiary level services, and cost of transfer. There were 273 transfers from 53 referring hospitals ranging in distance from <20 miles (n = 102) to >100 miles (n = 41). Thirty-one patients were transferred by air (average cost $7656), 238 by ground (average cost $920), 4 by private car. The referring diagnosis was preterm premature rupture of membranes (PPROM) (n = 80), preterm labor (n = 76), preeclampsia (n = 42), medical complications (n = 25), or other (n = 50). Mean gestational age (GA) at transfer was 28.5+/-5.5 weeks. Patients were referred from hospitals with a self-designated nursery level I (n = 115), II (n = 111), III (n = 45), or none (n = 2). In 42 patients, (15%) no maternal or fetal indication for hospital transfer was identified after evaluation at the tertiary center. The most common referring misdiagnoses were preterm labor (n = 25), PPROM (n = 10) and preeclampsia (n = 3). One hundred and sixty-five patients delivered during transfer admission (mean GA = 29.6+/-4.8 weeks); 79 infants (48%) required admission to a level III, and 52 (31%) to a level II nursery. Most patients require the services of a tertiary facility after maternal fetal transfer. If delivered during transfer admission, the majority of neonates require care in an intermediate or intensive care nursery.

Costs and Cost Analysis↗