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Best Practice & Research. Clinical... Feb 2024Regardless of whether a pregnancy ends in abortion, miscarriage or ectopic pregnancy, fertility and sexual activity can resume quickly. For those who do not plan to... (Review)
Review
Regardless of whether a pregnancy ends in abortion, miscarriage or ectopic pregnancy, fertility and sexual activity can resume quickly. For those who do not plan to become pregnant again immediately, effective contraception is therefore required. Although a contraceptive discussion and the offer to provide contraception is considered an integral part of abortion care, health care providers may not always offer this same standard of care to those whose pregnancy ends in miscarriage or ectopic due to sensitivities or assumptions around this and future fertility intentions. Yet, evidence-based recommendations support the safety of initiating contraception at these times. Provision of a chosen method of contraception may be convenient for women and valued by them. As part of holistic care, healthcare professionals who care for women around these reproductive events should therefore offer quality information on contraception and help them access their chosen method to better meet their ongoing reproductive health needs.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Contraception; Abortion, Induced; Reproduction; Hydatidiform Mole
PubMed: 38142524
DOI: 10.1016/j.bpobgyn.2023.102428 -
Journal of Medicine and Life Jun 2022Miscarriage is the most common complication of pregnancy. Moreover, vitamin D deficiency is a prevalent concern among women of reproductive age, particularly in the Arab...
Miscarriage is the most common complication of pregnancy. Moreover, vitamin D deficiency is a prevalent concern among women of reproductive age, particularly in the Arab world, where the link between vitamin D deficiency and miscarriage is still unknown. This study was conducted to determine the relationship between vitamin D and miscarriage by comparing the concentration of vitamin D among women with spontaneous abortion and pregnant women. A total of 80 subjects were enrolled in this study and divided into two groups. The first group included 40 women with spontaneous abortions aged between 18 and 40 years. The second group included 40 pregnant women without previous history of miscarriages. Total 25-hydroxy vitamin D (25-OH-VD) measurement was estimated with a Dry Fluorescence Immunoassay analyzer using the Lansionbio LS-1100 instrument. The relationship between the five age groups and the vitamin D status of women with spontaneous abortion was not significant (p>0.05). There was no significant relationship between the miscarriage trimesters and vitamin D status (p>0.05) and between the five age groups (p>0.05). In our study, 95% of women with spontaneous abortion had vitamin D deficiency, compared to only 17.5% of pregnant women. A normal range of vitamin D improves the growth of the fetus and prevents pregnancy complications and miscarriage, promoting the growth of blood vessels in the placenta and improving the function of immune cells.
Topics: Abortion, Spontaneous; Adolescent; Adult; Female; Humans; Iraq; Pregnancy; Vitamin D; Vitamin D Deficiency; Vitamins; Young Adult
PubMed: 35928352
DOI: 10.25122/jml-2021-0266 -
Journal of Hazardous Materials Oct 2023Pregnancy hormones are particularly important in early miscarriage, and some evidence suggests that exposure to air pollution is associated with pregnancy hormones and...
BACKGROUND
Pregnancy hormones are particularly important in early miscarriage, and some evidence suggests that exposure to air pollution is associated with pregnancy hormones and miscarriage. However, the effects of air pollution on pregnancy hormone-mediated miscarriages have not yet been investigated.
METHODS
We collected air pollution exposure measurements and pregnancy hormone tests from the participants. Logistic regression models were used to investigate the association between air pollution and early miscarriages. A distributed lag nonlinear model (DLNM) was used to investigate non-linear and delayed associations and identify the crucial window. We performed mediation analysis to estimate the potential association that may exist between pregnancy hormone levels and early miscarriage.
RESULTS
Short-term exposure to CO and SO was associated with early miscarriage. Lag 22-28 days of exposure to both CO and SO and lag 15-21 days of exposure to CO were significantly positively associated with early miscarriage, with an obvious exposure dose response. Serum progesterone concentration explained 36.79 % of the association between lag 15-28 days of CO exposure and early miscarriage.
CONCLUSION
This study provides evidence for the association between short-term exposure to air pollution and early miscarriage, and provides clues for further exploration of biological mechanisms.
Topics: Female; Pregnancy; Humans; Abortion, Spontaneous; Air Pollution; Environmental Pollution; Progesterone
PubMed: 37666168
DOI: 10.1016/j.jhazmat.2023.132328 -
Science (New York, N.Y.) Aug 2023Temperature sensors are tracking exposure in people trying to conceive.
Temperature sensors are tracking exposure in people trying to conceive.
Topics: Female; Humans; Pregnancy; Abortion, Spontaneous; Hot Temperature; Climate Change
PubMed: 37535735
DOI: 10.1126/science.adk0832 -
Minerva Ginecologica Apr 2018The aim of this paper was to estimate the risk of miscarriage after amniocentesis or chorionic villus sampling (CVS) based on a systematic review of the literature. (Comparative Study)
Comparative Study Review
INTRODUCTION
The aim of this paper was to estimate the risk of miscarriage after amniocentesis or chorionic villus sampling (CVS) based on a systematic review of the literature.
EVIDENCE ACQUISITION
A search of Medline, Embase, and The Cochrane Library (2000-2017) was carried out to identify studies reporting complications following CVS or amniocentesis. The inclusion criteria for the systematic review were studies reporting results from large controlled studies (N.≥1000 invasive procedures) and those reporting data for pregnancy loss prior to 24 weeks' gestation. Data for cases that had invasive procedure and controls were inputted in contingency tables and risk of miscarriage was estimated for each study. Summary statistics were calculated after taking into account the weighting for each study included in the systematic review. Procedure-related risk of miscarriage was estimated as a weighted risk difference from the summary statistics for cases and controls.
EVIDENCE SNTHESIS
The electronic search from the databases yielded 2465 potential citations of which 2431 were excluded, leaving 34 studies for full-text review. The final review included 10 studies for amniocentesis and 6 studies for CVS, which were used to estimate risk of miscarriage in pregnancies that had an invasive procedure and the control pregnancies that did not. The procedure-related risk of miscarriage following amniocentesis was 0.35% (95% confidence interval [CI]: 0.07 to 0.63) and that following CVS was 0.35% (95% CI: -0.31 to 1.00).
CONCLUSIONS
The procedure-related risks of miscarriage following amniocentesis and CVS are lower than currently quoted to women.
Topics: Abortion, Spontaneous; Amniocentesis; Chorionic Villi Sampling; Female; Gestational Age; Humans; Pregnancy; Risk
PubMed: 29161799
DOI: 10.23736/S0026-4784.17.04178-8 -
BMC Pregnancy and Childbirth Oct 2023Miscarriages account for 20% of clinically confirmed pregnancies and up to 50% of all pregnancies and is considered one of the most heartbreaking events experienced by...
BACKGROUND
Miscarriages account for 20% of clinically confirmed pregnancies and up to 50% of all pregnancies and is considered one of the most heartbreaking events experienced by women. The current study aimed to explore participants' perceptions and practices and how they link with the negative emotions of miscarriage.
METHODS
In this cross-sectional study a web-based questionnaire was used to gather data from 355 women living in Jordan who had experienced a previous miscarriage. The questionnaire consisted of four sections, including socio-demographic information, experience with miscarriage, emotions after the experience, and self-care practices. Participants were recruited through social media platforms from April to August 2022. Data were analyzed using SPSS, and descriptive statistics, chi-square test, and binomial regression were performed to examine the results.
RESULTS
The results show that the majority of participants were in the age group of 22-34 years and a larger percentage of participants hold a Bachelor's degree and were employed. All participants had experienced a previous miscarriage with 53.8% having one, 27.0% having two, and 19.2% having three or more miscarriages. In addition, most miscarriages did not have an explanation for their cause (77.5%), but vaginal bleeding was the most reported symptom (55.2%) and surgical management was predominant (48.7%). Most participants reported adequate emotional support from partners and family (63.7% and 62.3%, respectively). Almost half (48.7%) of the respondents felt like they had lost a child and those who did not receive any social support had a higher association with the same feeling (p = 0.005). Of the participating women, 40.3% decided to postpone another pregnancy while 20.0% planned for a subsequent pregnancy. The feeling of shame regarding the miscarriage was the main driver for women to get pregnant again (Odd ration [OR] 2.98; 95% confidence interval (CI) 1.31-6.82; p = 0.01).
CONCLUSIONS
The findings highlight the emotional impact of miscarriage on women and the need for proper support and self-care practices.
Topics: Adult; Female; Humans; Pregnancy; Young Adult; Abortion, Spontaneous; Adaptation, Psychological; Cross-Sectional Studies; Emotions; Jordan
PubMed: 37884884
DOI: 10.1186/s12884-023-06075-6 -
MCN. the American Journal of Maternal... 2018It is estimated that 750,000 to 1,000,000 miscarriages occur every year in the United States. Women experiencing a miscarriage enter the healthcare system in a variety...
It is estimated that 750,000 to 1,000,000 miscarriages occur every year in the United States. Women experiencing a miscarriage enter the healthcare system in a variety of ways. A family may be seen for a miscarriage in the prenatal clinic, the emergency department, same-day surgical department, or perhaps the labor and birth unit. Nurses must be prepared to guide and support these families. Understanding the clinical aspects of miscarriage as well as the emotional care of families experiencing early pregnancy loss is important to nurses in all areas of the medical center. Clinical aspects of miscarriage are reviewed along with the needed emotional care for families experiencing the most common cause of early pregnancy loss.
Topics: Abortion, Spontaneous; Adult; Chorionic Gonadotropin; Decision Making; Emergency Service, Hospital; Female; Humans; Middle Aged; Mothers; Pregnancy
PubMed: 29049054
DOI: 10.1097/NMC.0000000000000390 -
Bipolar Disorders Feb 2015To compare rates of bipolar episodes following miscarriage and termination with those occurring in the postpartum period.
OBJECTIVES
To compare rates of bipolar episodes following miscarriage and termination with those occurring in the postpartum period.
METHODS
Information in relation to pregnancy and childbirth was gathered retrospectively for 1,283 women with broadly defined bipolar disorder by interview and case-notes review.
RESULTS
Rates of mania or affective psychosis were significantly higher after full-term delivery than after termination (p < 0.001) or miscarriage (p < 0.001). Rates of non-psychotic major depression were similar following full-term deliveries, miscarriages (p = 0.362), and terminations (p = 0.301).
CONCLUSIONS
While women with bipolar disorder and their clinicians should be aware of the possible onset of depression in the weeks following miscarriage or termination, episodes of mania or affective psychosis are less common in comparison with the high rates observed in the postpartum period.
Topics: Abortion, Legal; Abortion, Spontaneous; Adult; Bipolar Disorder; Depression; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Middle Aged; Postpartum Period; Pregnancy; Puerperal Disorders; Recurrence; Retrospective Studies
PubMed: 24912983
DOI: 10.1111/bdi.12217 -
Journal de Gynecologie, Obstetrique Et... Dec 2014To define guidelines for the management of women diagnosed with threatened late miscarriage (TLM). (Review)
Review
OBJECTIVES
To define guidelines for the management of women diagnosed with threatened late miscarriage (TLM).
MATERIALS AND METHODS
A systematic review of the literature was performed using Pubmed and the Cochrane library databases and the guidelines from main international societies.
RESULTS
Management of women diagnosed with threatened LM requires a complete history-taking searching for a previous history of LM and/or of premature delivery (Grade B). Speculum examination is required to diagnose membrane prolapse (Grade B) and vaginal ultrasound scan is recommended to measure the cervical length (Grade B). Finally, initial management should allow to rule out chorioamniotitis (Grade B). Vaginal progesterone therapy (90-200mg daily) is recommended for women diagnosed with a sole shortened cervix (<25mm) in mid-pregnancy (Grade A). Cerclage is only recommended in women with both history of previous premature delivery and/or previous LM and shortened cervical length diagnosed before 24 weeks of gestation (Grade A). Finally, cervical cerclage (Mc Donald technique) associated with systematic tocolytic therapy (indometacine) and antibiotics are to be recommended in women diagnosed with TLM with dilated cervical os eventually associated with membrane prolapse (GradeC).
Topics: Abortion, Spontaneous; Female; France; Humans; Practice Guidelines as Topic; Pregnancy; Pregnancy Trimester, Second
PubMed: 25447364
DOI: 10.1016/j.jgyn.2014.09.015 -
Reviews on Environmental Health Sep 2018The developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes.... (Review)
Review
The developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes. Pregnancy loss, including spontaneous abortion (miscarriage) and stillbirth, is the most severe adverse pregnancy outcome. This review focuses on air pollution exposure during pregnancy in relation to spontaneous abortion and stillbirth. A total of 43 studies are included in this review, including 35 human studies and eight animal studies. Overall, these studies suggest that exposure to air pollutants such as particulate matter (PM), carbon monoxide (CO) and cooking smoke may be associated with higher risk for stillbirth and spontaneous abortion. PM exposure during an entire pregnancy was associated with increased risk of spontaneous abortion, and exposure to PM and PM in the third trimester might increase the risk of stillbirth. CO exposure during the first trimester of pregnancy was associated with an increased risk of spontaneous abortion and exposure during the third trimester was associated with an increased risk of stillbirth. Cooking smoke was found to increase the risk of stillbirths, and the evidence was consistent. Insufficient and conflicting evidence was found for various other pollutants, such as NO and SO. Studies did not show clear evidence for associations between pregnancy loss and others pollutants such as heavy metals, organochlorine compounds, PAH and total dust count. Further research is warranted to better understand the relationship between air pollution exposure and pregnancy loss.
Topics: Abortion, Spontaneous; Air Pollution; Female; Humans; Incidence; Pregnancy; Stillbirth
PubMed: 29975668
DOI: 10.1515/reveh-2017-0033