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MCN. the American Journal of Maternal... 2003
Topics: Abortion, Spontaneous; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Infertility; Pregnancy; Pregnancy, Tubal
PubMed: 12675042
DOI: 10.1097/00005721-200303000-00021 -
Journal of Clinical Nursing Jun 2015To investigate women's experience of early miscarriage (the first 16 weeks of pregnancy) by reviewing the literature since 1990, identifying and exploring critical... (Review)
Review
AIMS AND OBJECTIVES
To investigate women's experience of early miscarriage (the first 16 weeks of pregnancy) by reviewing the literature since 1990, identifying and exploring critical themes.
BACKGROUND
Early miscarriage loss accounts for 50,000 inpatient admissions per year in the UK reported in 2010. It can result in anxiety, depression, guilt, emptiness and other features of bereavement.
DESIGN
A structured literature review of qualitative literature was undertaken to explore the evidence of women's experience of early miscarriage, and elicit common themes emerging.
METHODS
A systematic electronic database search was conducted using a range of search engines. Nine papers were identified; four from the UK and one paper each from the USA, Australia, Canada, Israel and Sweden.
RESULTS
Four predominant themes were identified from the experiences of 211 women in the nine studies: 'What I feel', 'Care for me and communicate with me', 'Me, my baby and others' and 'Help me to cope with the future'.
CONCLUSIONS
Early miscarriage is a potentially devastating experience, and the diversity of experiences of women must be reflected in the provision of appropriate and sensitive nursing care.
RELEVANCE TO CLINICAL PRACTICE
The study demonstrated a significant training need for nurses and midwives to provide women with individualised care.
Topics: Abortion, Spontaneous; Adaptation, Psychological; Adult; Female; Grief; Humans; Maternal-Child Nursing; Nurse's Role; Pregnancy
PubMed: 25662397
DOI: 10.1111/jocn.12781 -
European Archives of Psychiatry and... Apr 2023This case-control study was designed to examine the association between different types of miscarriage history and autism spectrum disorder (ASD), and determine whether...
This case-control study was designed to examine the association between different types of miscarriage history and autism spectrum disorder (ASD), and determine whether the number of miscarriage history affects the risk of ASD. All of 2274 children with ASD and 1086 healthy controls were recruited. Sociodemographic and prenatal, perinatal, and neonatal characteristics were compared between the two groups. Multivariable logistic regression analyses were applied to investigate association between miscarriage history and ASD. Stratified analyses based on sex and types of miscarriages were similarly performed. History of miscarriage was potential risk factors for ASD ([aOR] = 2.919; 95% [CI] = 2.327-3.517). Stratified analyses revealed that induced ([aOR] = 2.763, 95% [CI] = 2.259-3.379) and spontaneous miscarriage history ([aOR] = 3.341, 95% [CI] = 1.939-4.820) were associated with high risk of ASD, respectively. A sex-biased ratio in the risk of ASD was observed between females ([aOR] = 3.049, 95% [CI] = 2.153-4.137) and males ([aOR] = 2.538, 95% [CI] = 1.978-3.251). Stratified analysis of induced miscarriage history revealed that only iatrogenic miscarriage history was associated with an increased risk ASD ([aOR] = 2.843, 95% [CI] = 1.534-4.268). Also, multiple spontaneous miscarriage histories ([aOR] = 1.836, 95% [CI] = 1.252-2.693) were associated with higher autism risk than one spontaneous miscarriages history ([aOR] = 3.016, 95% [CI] = 1.894-4.174). In conclusion, miscarriage history is related to an increased risk for ASD in offspring, which is affected by the types of miscarriage and sex of the fetus.
Topics: Autism Spectrum Disorder; Abortion, Spontaneous; Humans; Male; Female; Pregnancy; Case-Control Studies; Logistic Models; Risk Factors; Abortion, Induced; Iatrogenic Disease; Sex Characteristics; Infant, Newborn; Adult; Sex Factors
PubMed: 36251093
DOI: 10.1007/s00406-022-01494-6 -
BMC Medicine Jan 2022Emerging evidence supports an association between vaginal microbiota composition and risk of miscarriage; however, the underlying mechanisms are poorly understood. We...
BACKGROUND
Emerging evidence supports an association between vaginal microbiota composition and risk of miscarriage; however, the underlying mechanisms are poorly understood. We aim to investigate the vaginal microbial composition and the local immune response in chromosomally normal and abnormal miscarriages and compare this to uncomplicated pregnancies delivering at term.
METHODS
We used 16S rRNA gene based metataxonomics to interrogate the vaginal microbiota in a cohort of 167 women, 93 miscarriages (54 euploid and 39 aneuploid using molecular cytogenetics) and 74 women who delivered at term and correlate this with the aneuploidy status of the miscarriages. We also measured the concentrations of IL-2, IL-4, IL-6, IL-8, TNF-α, IFN-γ, IL-1β, IL-18 and IL-10 in cervical vaginal fluid.
RESULTS
We show that euploid miscarriage is associated with a significantly higher prevalence of Lactobacillus spp. deplete vaginal microbial communities compared to aneuploid miscarriage (P = 0.01). Integration of matched cervicovaginal fluid immune-profiles showed that Lactobacillus spp. depleted vaginal microbiota associated with pro-inflammatory cytokine levels most strongly in euploid miscarriage compared to viable term pregnancy (IL-1β; P < 0.001, IL-8; P = 0.01, IL-6; P < 0.001).
CONCLUSIONS
Our data suggest the vaginal microbiota plays an important aetiological role in euploid miscarriage and may represent a target to modify risk of pregnancy loss.
Topics: Abortion, Spontaneous; Dysbiosis; Female; Humans; Inflammation; Pregnancy; RNA, Ribosomal, 16S; Vagina
PubMed: 35090453
DOI: 10.1186/s12916-021-02227-7 -
Acta Obstetricia Et Gynecologica... Mar 2024Women with a prior stillbirth or a history of recurrent first trimester miscarriages are at increased risk of adverse pregnancy outcomes. However, little is known about... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Women with a prior stillbirth or a history of recurrent first trimester miscarriages are at increased risk of adverse pregnancy outcomes. However, little is known about the impact of a second trimester pregnancy loss on subsequent pregnancy outcome. This review investigated if second trimester miscarriage or termination for medical reason or fetal anomaly (TFMR/TOPFA) is associated with future adverse pregnancy outcomes.
MATERIAL AND METHODS
A systematic review of observational studies was conducted. Eligible studies included women with a history of a second trimester miscarriage or termination for medical reasons and their pregnancy outcomes in the subsequent pregnancy. Where comparative studies were identified, studies which compared subsequent pregnancy outcomes for women with and without a history of second trimester loss or TFMR/TOPFA were included. The primary outcome was livebirth, and secondary outcomes included: miscarriage (first and second trimester), termination of pregnancy, fetal growth restriction, cesarean section, preterm birth, pre-eclampsia, antepartum hemorrhage, stillbirth and neonatal death. Studies were excluded if exposure was nonmedical termination or if related to twins or higher multiple pregnancies. Electronic searches were conducted using the online databases (MEDLINE, Embase, PubMed and The Cochrane Library) and searches were last updated on June 16, 2023. Risk of bias was assessed using the Newcastle-Ottawa scale. Where possible, meta-analysis was undertaken. PROSPERO registration: CRD42023375033.
RESULTS
Ten studies were included, reporting on 12 004 subsequent pregnancies after a second trimester pregnancy miscarriage. No studies were found on outcomes after second trimester TFMR/TOPFA. Overall, available data were of "very low quality" using GRADE assessment. Meta-analysis of cohort studies generated estimated outcome frequencies for women with a previous second trimester loss as follows: live birth 81% (95% CI: 64-94), miscarriage 15% (95% CI: 4-30, preterm birth 13% [95% CI: 6-23]).The pooled odds ratio for preterm birth in subsequent pregnancy after second trimester loss in case-control studies was OR 4.52 (95% CI: 3.03-6.74).
CONCLUSIONS
Very low certainty evidence suggests there may be an increased risk of preterm birth in a subsequent pregnancy after a late miscarriage. However, evidence is limited. Larger, higher quality cohort studies are needed to investigate this potential association.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Pregnancy Outcome; Abortion, Spontaneous; Pregnancy Trimester, Second; Stillbirth; Premature Birth; Cesarean Section; Abortion, Habitual
PubMed: 38037500
DOI: 10.1111/aogs.14731 -
European Journal of Obstetrics,... May 2002Miscarriage is one of the most frequent problems in human pregnancy. The most widely accepted definition is that proposed by the World Health Organization (WHO) in 1977.... (Review)
Review
Miscarriage is one of the most frequent problems in human pregnancy. The most widely accepted definition is that proposed by the World Health Organization (WHO) in 1977. The incidence among clinical pregnancies is about 12-15% but including early pregnancy losses it is 17-22%. The only two etiologic factors recognized by all authors are uterine malformations and parental balanced chromosomal rearrangements. There have been many other suggested risk factors. In this revision we discuss these.
Topics: Abortion, Spontaneous; Autoantibodies; Chromosome Aberrations; Female; Humans; Isoantibodies; Pregnancy; Risk Factors; Uterus
PubMed: 11950476
DOI: 10.1016/s0301-2115(01)00613-3 -
Birth Defects Research. Part A,... Jun 2012The objectives of the current study were to calculate: (1) the expected rates of miscarriage by gestational week; (2) the cumulative risk of miscarriage; and (3) the... (Review)
Review
The objectives of the current study were to calculate: (1) the expected rates of miscarriage by gestational week; (2) the cumulative risk of miscarriage; and (3) the remaining risk of miscarriage for gestational weeks five through 20, through a systematic review of the literature. We searched MEDLINE for articles published in English through the end of 2009. References of articles were also searched. Four studies were identified to have the three necessary pieces of information for the proposed calculations: (1) gestational age at study entry, (2) pregnancy outcome; and (3) the gestational age at which the pregnancy outcome occurred. Data were extracted from each study and Life Table Analysis Methods were conducted. Weekly miscarriage rates varied in the early gestational weeks with the highest rate documented at >20 miscarriages per 1000 women-weeks at each week of gestation prior to week 13. By week 14, the rate for all studies became relatively comparable and fell below 10 miscarriages per 1000 woman-weeks at risk and fell even lower through week 20. The cumulative risk of miscarriage for weeks 5 through 20 of gestation ranged from 11 miscarriages per 100 women to 22 miscarriages per 100 women (11-22%). Based on data from comparable study populations, a range of background miscarriage rates by week of gestation for weeks 5 through 20, the cumulative risk of miscarriage, and the remaining risk of miscarriage are presented. Wider variation of miscarriage rates and risks occurred early in gestation (<14 weeks).
Topics: Abortion, Spontaneous; Adult; Databases, Bibliographic; Female; Gestational Age; Humans; Life Tables; Pregnancy; Pregnancy Outcome; Risk Factors; Time Factors; United States
PubMed: 22511535
DOI: 10.1002/bdra.23014 -
Ultrasound in Obstetrics & Gynecology :... Mar 1998
Review
Topics: Abortifacient Agents, Nonsteroidal; Abortifacient Agents, Steroidal; Abortion, Incomplete; Abortion, Missed; Abortion, Spontaneous; Dilatation and Curettage; Female; Humans; Mifepristone; Misoprostol; Pregnancy
PubMed: 9589136
DOI: 10.1046/j.1469-0705.1998.11030161.x -
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 -
The Practitioner Apr 1992
Review
Topics: Abortion, Spontaneous; Counseling; Female; Humans; Pregnancy; Recurrence; Risk Factors
PubMed: 1454699
DOI: No ID Found