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Nursing Times
Topics: Abortion, Spontaneous; Dilatation and Curettage; Female; Home Nursing; Humans; Pregnancy; United Kingdom
PubMed: 11963142
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jan 2020
Topics: Abortion, Incomplete; Abortion, Spontaneous; Adult; Conservative Treatment; Female; Gynecologic Surgical Procedures; Humans; Mental Health; Patient Preference; Patient Selection; Practice Guidelines as Topic; Pregnancy; Risk Assessment; Ultrasonography; United Kingdom
PubMed: 31959625
DOI: 10.1136/bmj.l6438 -
The Journal of Family Practice Oct 2005More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that... (Review)
Review
More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that from surgical intervention (strength of recommendation [SOR]: A, based on multiple randomized controlled trials [RCTs] and cohort studies). Expectant management is successful within 2 to 6 weeks without increased complications in 80% to 90% of women with first-trimester incomplete spontaneous abortion and 65% to 75% of women with first-trimester missed abortion or anembryonic gestation (presenting with spotting or bleeding and ultrasound evidence of fetal demise) (SOR: B, based on multiple cohort studies). There is no difference in short-term psychological outcomes between expectant and surgical management (SOR: B, based on RCT). Women experiencing spontaneous abortion with unstable vital signs, uncontrolled bleeding, or evidence of infection should be considered for surgical evacuation (SOR: C, expert opinion).
Topics: Abortion, Spontaneous; Clinical Trials as Topic; Evidence-Based Medicine; Female; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, First
PubMed: 16202377
DOI: No ID Found -
Reproductive Biomedicine Online Jun 2021Which parameters affect the likelihood of miscarriage after single euploid frozen-thawed blastocyst transfer (FBT)?
RESEARCH QUESTION
Which parameters affect the likelihood of miscarriage after single euploid frozen-thawed blastocyst transfer (FBT)?
DESIGN
In this retrospective study, clinical and laboratory data from 1051 single euploid FBTs were evaluated. Exclusion criteria were endocrine or systemic pathologies, uterine anomalies or pathologies, unilateral or bilateral hydrosalpinx, karyotypic abnormalities (either maternal or paternal) or thrombophilia. Patients were divided into two groups according to pregnancy outcome: live birth and miscarriage.
RESULTS
Body mass index (BMI) (25.98 ± 0.5 versus 24.36 ± 0.21, P = 0.019), duration of infertility (6.62 ± 0.54 versus 4.92 ± 0.18, P = 0.006) and number of previous miscarriages (1.36 ± 0.13 versus 0.79 ± 0.05, P < 0.001) were significantly higher in the miscarriage group (n = 100) than in the live birth group (n = 589). Although the trophectoderm and inner cell mass (ICM) percentage scores were not statistically different among the miscarriage and live birth groups, the percentage of day-6 biopsied embryos was significantly higher in the miscarriage group. Binary logistic regression analysis revealed that BMI (OR 1.083, 95% CI 1.013 to 1.158, P = 0.02) and number of previous miscarriages (OR 1.279, 95% CI 1.013 to 1.158, P = 0.038) were independent factors for miscarriage. Patients with elevated BMI and a higher number of miscarriages were at increased risk of miscarriage.
CONCLUSION
After a single euploid FBT, BMI and number of previous miscarriages are predictors of miscarriage. Lifestyle interventions before FBT may decrease miscarriage rates.
Topics: Abortion, Spontaneous; Adult; Body Mass Index; Embryo Transfer; Female; Humans; Middle Aged; Pregnancy; Retrospective Studies; Young Adult
PubMed: 33832867
DOI: 10.1016/j.rbmo.2021.03.004 -
Death Studies 2016The study aimed to explore the bereavement experiences of women after miscarriage. Ten women who experienced miscarriages of their first child were interviewed. Verbatim...
The study aimed to explore the bereavement experiences of women after miscarriage. Ten women who experienced miscarriages of their first child were interviewed. Verbatim interviews were analyzed through the principles of Interpretative Phenomenological Analysis that yielded eight super ordinate themes: shattered planning; physical and emotional pain; reaction to miscarriage; transformed marital relationships; in-laws' support; blame attribution; identity and well-being; and posttraumatic growth. The participants shared the constant psychological and physical pain they felt after miscarriage. The results reveal that cultural awareness is crucial when addressing the healthcare needs of women who undergo similar reproductive losses in different cultures.
Topics: Abortion, Spontaneous; Adaptation, Psychological; Adult; Denial, Psychological; Emotions; Female; Grief; Humans; Interpersonal Relations; Life Change Events; Pakistan; Stress, Psychological; Young Adult
PubMed: 27603758
DOI: 10.1080/07481187.2016.1203376 -
MCN. the American Journal of Maternal... 2018
Topics: Abortion, Spontaneous; Adult; Chorionic Gonadotropin; Education, Nursing, Continuing; Female; Humans; Middle Aged; Pregnancy
PubMed: 29215430
DOI: 10.1097/NMC.0000000000000414 -
Nursing New Zealand (Wellington, N.Z. :... Nov 1998
Topics: Abortion, Spontaneous; Adaptation, Psychological; Attitude to Health; Empathy; Female; Grief; Humans; Maternal-Child Nursing; Nursing Staff; Pregnancy; Social Support
PubMed: 10586766
DOI: No ID Found -
Journal of Emergency Nursing Nov 2016Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a...
INTRODUCTION
Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of symptoms. Although women experiencing a miscarriage are frequently directed to seek medical care in emergency departments, the patients are often triaged as nonemergent patients unless they are unstable, which exposes women to potentially prolonged wait times. Research about miscarriages and emergency departments predominantly focus on medical management with little understanding of how emergency care shapes the experience of miscarriage for women.
METHODS
Seeking to describe the experiences of women coming to the emergency department for care while having a miscarriage, interpretive phenomenology-a form of qualitative research-guided this study. Eight women were recruited to participate in semi-structured face-to-face interviews of 60 to 90 minutes in length. Data were analyzed using hermeneutics and thematic analysis.
RESULTS
Five themes emerged: "Pregnant/Life: Miscarriage/Death"; "Deciding to go to the emergency department: Something's wrong"; "Not an illness: A different kind of trauma"; "Need for acknowledgement"; and "Leaving the emergency department: What now?". Participants believed their losses were not acknowledged but instead dismissed. These experiences, combined with a perceived lack of discharge education and clarity regarding follow-up, created experiences of marginalization.
DISCUSSION
This study describes the experience of miscarrying in emergency departments and provides insights regarding how nursing and physician care may affect patient perceptions of marginalization.
Topics: Abortion, Spontaneous; Adult; Emergency Nursing; Emergency Service, Hospital; Female; Humans; Nova Scotia; Qualitative Research; Young Adult
PubMed: 27507550
DOI: 10.1016/j.jen.2016.05.011 -
Molecular Human Reproduction Aug 2015Studies of copy number variants (CNVs) in miscarriages are rare in comparison to post-natal cases with developmental abnormalities. The overall characteristics of...
Studies of copy number variants (CNVs) in miscarriages are rare in comparison to post-natal cases with developmental abnormalities. The overall characteristics of miscarriage CNVs (size, gene content and function) are therefore largely unexplored. Our goal was to assess and compare the characteristics of CNVs identified in 101 euploid miscarriages from four high-resolution array studies that documented both common miscarriage CNVs (i.e. CNVs found in controls from the Database of Genomic Variants, DGV) and rare miscarriage CNVs (not reported in DGV). Our miscarriage analysis included 24 rare CNVs with 93 genes, and 372 common CNVs (merged into 119 common CNV regions; CNVRs) with 354 genes. The rare and common CNVs were comparable in size (median size of ∼ 0.16 and 0.14 Mb, respectively); however, rare CNVs showed a significantly higher gene density, with 56 genes/Mb in rare and 24 genes/Mb in common CNVs (P = 0.03). Rare CNVs also had two times more genes with mouse knock-out models which were reported for 42% of rare and 19% of common CNV genes. No specific pathway enrichment was noted for 24 rare CNV genes, but common CNV genes showed significant enrichment in genes from immune-response related pathways and pregnancy/reproduction-related biological processes. Our analysis of CNVs from euploid miscarriages suggests that both rare and common CNVs could have a role in miscarriage by impacting pregnancy-related genes or pathways. Cataloguing of all CNVs and detailed description of their characteristics (e.g. gene content, genomic breakpoints) is desirable in the future for better understanding of their relevance to pregnancy loss.
Topics: Abortion, Spontaneous; DNA Copy Number Variations; Female; Genome, Human; Genomics; Humans; Microarray Analysis
PubMed: 26071097
DOI: 10.1093/molehr/gav030 -
BMJ Open Dec 2023This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and...
OBJECTIVE
This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and cytogenetic investigations.
DESIGN
A qualitative interview study with a phenomenological approach. Semistructured interviews were conducted using video conferencing software. Two researchers coded the transcripts and developed themes.
SETTING
A National Health Service (NHS) hospital in central England between May 2021 and July 2021, during the COVID-19 pandemic.
PARTICIPANTS
Patients attending a specialist recurrent miscarriage clinic and their partners. This clinic accepts referrals from all over the UK for couples who have suffered two or more miscarriages.
RESULTS
Seventeen participants were interviewed: 14 women and 3 male partners. Six main themes were identified from the data. Three related to the women's lived experience of recurrent miscarriage (emotions in pregnancy, confidence in their bodies, expectations and coping strategies) and three related to the clinical support offered by the NHS service (impact of early pregnancy scanning, effect of the COVID-19 pandemic and cytogenetic investigations).
CONCLUSIONS
Pregnancy following recurrent miscarriage is extremely difficult. Recurrent miscarriage specialist services can provide couples with support and access to early pregnancy scanning, which can make the first trimester of pregnancy manageable. Partners should not be excluded from the clinic as it can result in a feeling of disconnect. Cytogenetic testing of pregnancy tissue can offer couples with recurrent miscarriage closure after pregnancy loss and is a desired investigation.
Topics: Pregnancy; Female; Humans; Male; State Medicine; Pandemics; Abortion, Habitual; Abortion, Spontaneous; Qualitative Research; COVID-19
PubMed: 38123186
DOI: 10.1136/bmjopen-2023-075062