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Erschienen in: Irish Journal of Medical Science (1971 -) 2/2017

09.02.2016 | Brief Report

An exploration of the prevalence and patterns of care for women presenting with mid-trimester loss

verfasst von: S. Cullen, S. Power, B. Coughlan, J. Chaney, M. Butler, M. Brosnan

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2017

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Abstract

Background

Mid-trimester loss (MTL) is an area that is poorly defined in the literature and often under reported in clinical practice. The prevalence of MTL in Ireland is uncertain and has a huge impact on the woman, her family and maternity care services.

Aims

To explore the prevalence and patterns of care for women with MTL in a large Maternity hospital in Ireland.

Methods

A descriptive, exploratory study was used involving a retrospective chart audit.

Results

220 women presented with MTL over the 3 year data collection period (January 2011–December 2013), giving a rate of 0.8 % of all deliveries. The majority of women had no previous pregnancy losses and were multiparous (i.e., had a previous pregnancy >500 g). The mean gestational age was 17.69 weeks (SD = 2.73). The mean length of hospital stay was 1.89 days. Intra muscular (IM) analgesia was the most commonly (58.5 %) used medication. Follow up hospital care was received in over 78 % of cases. The majority of women were referred the CMS Bereavement and Chaplain services, with a small number (approx. 5 %) referred to the social worker. Over 46.4 % of families availed of the hospital burial service.

Conclusions

Results suggest the incidence of mid-trimester loss may be slightly lower than the 1 or 2 % of pregnancies reported in the literature. The incidence of mid-trimester loss in multiparous women is approximately twice that of nulliparous women. The referral services offered in the study were utilised by most of the women, as were follow-up clinic appointments.
Literatur
1.
Zurück zum Zitat Health Service Executive (HSE) (2014) Clinical practice guideline no. 29; The management of second trimester miscarriage. Dublin: Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive Health Service Executive (HSE) (2014) Clinical practice guideline no. 29; The management of second trimester miscarriage. Dublin: Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive
2.
Zurück zum Zitat Health Service Executive (HSE) (2012) Clinical practice guideline no. 10; The management of early pregnancy miscarriage. Dublin: Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive Health Service Executive (HSE) (2012) Clinical practice guideline no. 10; The management of early pregnancy miscarriage. Dublin: Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive
3.
Zurück zum Zitat Serrano F, Lima ML (2006) Recurrent miscarriage: psychological and relational consequences for couples. Psychol Psychother: Theory, Res Pract 79(4):585–594CrossRef Serrano F, Lima ML (2006) Recurrent miscarriage: psychological and relational consequences for couples. Psychol Psychother: Theory, Res Pract 79(4):585–594CrossRef
5.
Zurück zum Zitat Edlow AG, Srinivas SK, Elovitz MA (2007) Second trimester loss and subsequent pregnancy outcomes: what is the real risk? Am J Obstet Gynecol 197(6):581, e1–e6 Edlow AG, Srinivas SK, Elovitz MA (2007) Second trimester loss and subsequent pregnancy outcomes: what is the real risk? Am J Obstet Gynecol 197(6):581, e1–e6
6.
Zurück zum Zitat Wyatt PR, Owolabi T, Meier C et al (2005) Age-specific risk of fetal loss observed in a second trimester serum screening population. Am J Obstet Gynecol 192:240–246CrossRefPubMed Wyatt PR, Owolabi T, Meier C et al (2005) Age-specific risk of fetal loss observed in a second trimester serum screening population. Am J Obstet Gynecol 192:240–246CrossRefPubMed
7.
Zurück zum Zitat Westin M, Kallen K, Saltvedt S, Amstrom M, Grunewald C, Valentin L (2007) Miscarriage after a normal scan at 12–14 gestational weeks in women at low risk of carrying a fetus with chromosomal abnormalities according to nuchal translucency screening. Ultrasound Obstet Gynecol 30(5):720–736CrossRef Westin M, Kallen K, Saltvedt S, Amstrom M, Grunewald C, Valentin L (2007) Miscarriage after a normal scan at 12–14 gestational weeks in women at low risk of carrying a fetus with chromosomal abnormalities according to nuchal translucency screening. Ultrasound Obstet Gynecol 30(5):720–736CrossRef
8.
Zurück zum Zitat Morris A, Meaney S, Spillane N et al (2014) A retrospective observational study of second-trimester miscarriage. Arch Dis Child Fetal Neonatal Ed 99(Suppl 1):168 Morris A, Meaney S, Spillane N et al (2014) A retrospective observational study of second-trimester miscarriage. Arch Dis Child Fetal Neonatal Ed 99(Suppl 1):168
9.
Zurück zum Zitat Maconochie N, Doyle P, Prior S et al (2006) Risk factors for first trimester miscarriage- results from a UK- population-based case-control study. Br J Obstet Gynaecol 114:170–186CrossRef Maconochie N, Doyle P, Prior S et al (2006) Risk factors for first trimester miscarriage- results from a UK- population-based case-control study. Br J Obstet Gynaecol 114:170–186CrossRef
10.
Zurück zum Zitat Arck P, Rucke M, Mathias R et al (2008) Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reprod BioMed 17(1):101–113CrossRef Arck P, Rucke M, Mathias R et al (2008) Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reprod BioMed 17(1):101–113CrossRef
11.
Zurück zum Zitat Royal College of Obstetricians and Gynaecologists (RCOG) (2011) The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. RCOG, London Royal College of Obstetricians and Gynaecologists (RCOG) (2011) The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. RCOG, London
12.
Zurück zum Zitat Nilsson F, Anderson P, Strandberg-Larsen K et al (2014) Risk factors for miscarriage from a prevention perspective: a national follow up study. Br J Obstet Gyneacol 121:1375–1385CrossRef Nilsson F, Anderson P, Strandberg-Larsen K et al (2014) Risk factors for miscarriage from a prevention perspective: a national follow up study. Br J Obstet Gyneacol 121:1375–1385CrossRef
13.
Zurück zum Zitat Lasher H, Fear K, Sturdee DW (2004) Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study. Hum Reprod 19(7):1644–1646CrossRef Lasher H, Fear K, Sturdee DW (2004) Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study. Hum Reprod 19(7):1644–1646CrossRef
14.
Zurück zum Zitat Tennant P, Rankin J, Bell R (2011) Maternal body mass index and the risk of fetal and infant death: a cohort study from the north of England. Hum Reprod 26(6):1501–1511CrossRefPubMedPubMedCentral Tennant P, Rankin J, Bell R (2011) Maternal body mass index and the risk of fetal and infant death: a cohort study from the north of England. Hum Reprod 26(6):1501–1511CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Rittenberg V, Sobaleva S, Ahmad A et al (2011) Influence of BMI on risk of miscarriage after Single blastocyst transfer. Hum Reprod 26(10):2642–2650CrossRefPubMed Rittenberg V, Sobaleva S, Ahmad A et al (2011) Influence of BMI on risk of miscarriage after Single blastocyst transfer. Hum Reprod 26(10):2642–2650CrossRefPubMed
16.
Zurück zum Zitat Simpson JL (2007) Causes of fetal wastage. Clin Obstet Gynaecol 50:10–30CrossRef Simpson JL (2007) Causes of fetal wastage. Clin Obstet Gynaecol 50:10–30CrossRef
17.
Zurück zum Zitat Schott J, Henley A (2007) Pregnancy loss and death of a baby: the New Sands Guidelines 2007. Br J Midwifery 15(4):195–198CrossRef Schott J, Henley A (2007) Pregnancy loss and death of a baby: the New Sands Guidelines 2007. Br J Midwifery 15(4):195–198CrossRef
18.
Zurück zum Zitat Bryant AG, Grimes DA, Garrett JM et al (2011) Second-trimester abortion for fetal anomalies or fetal death. Obstet Gynecol 117(4):775–776CrossRef Bryant AG, Grimes DA, Garrett JM et al (2011) Second-trimester abortion for fetal anomalies or fetal death. Obstet Gynecol 117(4):775–776CrossRef
19.
Zurück zum Zitat Gold K, Dalton VK, Schwenk TL (2007) Hospital care for parents after perinatal death. Obstet Gynecol 109(5):1156–1166CrossRefPubMed Gold K, Dalton VK, Schwenk TL (2007) Hospital care for parents after perinatal death. Obstet Gynecol 109(5):1156–1166CrossRefPubMed
20.
Zurück zum Zitat Griebel C, Halvorsen J, Golemon T et al (2005) Management of spontaneous abortion. Am Fam Physician 72(7):1243–1250PubMed Griebel C, Halvorsen J, Golemon T et al (2005) Management of spontaneous abortion. Am Fam Physician 72(7):1243–1250PubMed
21.
Zurück zum Zitat Kong GWS, Lok IH, Lam PM et al (2010) Conflicting perceptions between healthcare professionals and patients on the psychological morbidity following miscarriage. Aust N Z J Obstet Gynaecol 50:562–567CrossRefPubMed Kong GWS, Lok IH, Lam PM et al (2010) Conflicting perceptions between healthcare professionals and patients on the psychological morbidity following miscarriage. Aust N Z J Obstet Gynaecol 50:562–567CrossRefPubMed
22.
Zurück zum Zitat Regan L, Rai R (2000) Epidemiology and the medical causes of miscarriage. Best Pract Res Clin Obstet Gynaecol 14(5):839–854CrossRef Regan L, Rai R (2000) Epidemiology and the medical causes of miscarriage. Best Pract Res Clin Obstet Gynaecol 14(5):839–854CrossRef
23.
Zurück zum Zitat Lasker JN, Toedter LJ (1994) Satisfaction with hospital care and interventions after pregnancy loss. Death Stud 18(1):46–64CrossRef Lasker JN, Toedter LJ (1994) Satisfaction with hospital care and interventions after pregnancy loss. Death Stud 18(1):46–64CrossRef
24.
Zurück zum Zitat Simmons RK, Singh G, Maconochie N et al (2006) Experience of miscarriage in the UK: qualitative findings from the National Women’s Health Study. Soc Sci Med 63(7):1934–1946CrossRefPubMed Simmons RK, Singh G, Maconochie N et al (2006) Experience of miscarriage in the UK: qualitative findings from the National Women’s Health Study. Soc Sci Med 63(7):1934–1946CrossRefPubMed
25.
Zurück zum Zitat Hughes P, Turton P, Hopper E et al (2002) Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. Lancet 13(36):114–118CrossRef Hughes P, Turton P, Hopper E et al (2002) Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. Lancet 13(36):114–118CrossRef
26.
Zurück zum Zitat ESRI (2013) Perinatal statistics report, 2012. ESRI, Dublin ESRI (2013) Perinatal statistics report, 2012. ESRI, Dublin
27.
Zurück zum Zitat Lasker JN, Toedter LJ (1991) Acute versus chronic grief: the case of pregnancy loss. Am J Orthopsychaitr 61(4):510–522CrossRef Lasker JN, Toedter LJ (1991) Acute versus chronic grief: the case of pregnancy loss. Am J Orthopsychaitr 61(4):510–522CrossRef
28.
Zurück zum Zitat Lovell A (2001) The changing identities of miscarriage and stillbirth. Bereave Care 20(3):37–40CrossRef Lovell A (2001) The changing identities of miscarriage and stillbirth. Bereave Care 20(3):37–40CrossRef
29.
Zurück zum Zitat Moulder C (1999) Late pregnancy loss: issues in hospital care. Br J Midwifery 7:244–247CrossRef Moulder C (1999) Late pregnancy loss: issues in hospital care. Br J Midwifery 7:244–247CrossRef
30.
Zurück zum Zitat Nikcevic AV, Tunkel SA, Nicolaides KH (1998) Psychological outcomes following missed abortions and provision of follow-up care. Ultrasound Obstet Gynaecol 11(2):123–128CrossRef Nikcevic AV, Tunkel SA, Nicolaides KH (1998) Psychological outcomes following missed abortions and provision of follow-up care. Ultrasound Obstet Gynaecol 11(2):123–128CrossRef
Metadaten
Titel
An exploration of the prevalence and patterns of care for women presenting with mid-trimester loss
verfasst von
S. Cullen
S. Power
B. Coughlan
J. Chaney
M. Butler
M. Brosnan
Publikationsdatum
09.02.2016
Verlag
Springer London
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2017
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1413-y

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