Certain dates may not provide a reliable estimate of gestational age
The estimation of a fetus's gestational age depends on accurate recall by the mother of the first day of her last menstrual period (LMP) before conception took place. However, such information is notoriously unreliable, since many women have trouble recalling exactly when their periods began. In many cases, indications of gestational age according to memory and as seen on ultrasound differ by as much as two weeks. Since accurate knowledge of fetal age is necessary for evaluating many prenatal diagnostic test results, such discrepancies are problematic. To learn more concerning the ways women record the LMP starting date, and the extent of variability between this data and ultrasound findings, 315 pregnant women in 4 prenatal clinics were interviewed. The subjects answered 14 questions concerning age, menstrual cycle, hormone use, date of LMP, and the ways they recalled that date. They then underwent ultrasound scanning; these results were compared with the gestational age according to the mother's recollection of her LMP. A total of 239 women (76 percent) said they were sure of the date of the LMP, although 14 recalled the last, not the first, day of the period. An additional 150 women had written down the date of their LMP, most in a diary. Another 56 women recalled when their periods had started in association with life events; 10 more knew the starting date because of regularity or to having stopped contraceptive pills; 8 said they had a ''good guess''; and 33 counted backwards from the date they would have expected their next period. On closer analysis, 102 women with regular cycles had very certain starting dates for their LMP. Women who were sure of their LMP date tended to be older and to have more children. The average difference between gestational age according to recall and ultrasound findings was least (2.4 days) for those with the greatest certainty about their LMP. Those who were most unsure had an average difference of 7.5 days; in all cases, gestational age was less by ultrasound than by LMP dating. These discrepancies, with their implications for determining fetal growth curves and predicting delivery problems, are important. When possible, gestational age should be determined by ultrasound evaluation. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Sleep in men and women infected with human immunodeficiency virus
Many HIV-infected patients report sleep difficulties. Interviews with 50 HIV-infected adults revealed that many or most got less sleep than normal, had difficulty falling asleep, wakened more than once per night, and rated sleep as less than satisfactory. Many sleep difficulties arose from HIV symptoms, but sleep problems were not correlated with CD4+ count. Nurses should take sleep histories with a view to ameliorating symptoms that interfere with sleep and teaching techniques for achieving more restful sleep.
Publication Name: Holistic Nursing Practice
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