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

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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.

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Acknowledgments

The authors would like to acknowledge the following for their assistance and guidance in conducting this study. Nelson Figueroa (IT, National Maternity Hospital), Margaret Reynolds (CMM, National Maternity Hospital), Grace Curtain (CMS Bereavement, National Maternity Hospital), Dr Michael Robson, (Consultant Obstetrician National Maternity Hospital) Anne McMahon (Lecturer in Midwifery, University College Dublin) Denise McGuiness (CMS Lactation, National Maternity Hospital), Lucille Sheehy (Clinical skills facilitator, National Maternity Hospital), Joan Ward (CMM2, National Maternity Hospital), Ann Calnan (CMM3 National Maternity Hospital) and members of the UCD/NMH Joint Research Network.

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Authors and Affiliations

  1. National Maternity Hospital, Holles street, Dublin 2, Ireland

    S. Cullen & M. Brosnan

  2. Dublin, Ireland

    S. Power

  3. UCD School of Nursing, Midwifery and Health Systems, College of Health Sciences, Belfield, Dublin 4, Ireland

    B. Coughlan

  4. UCD School of Nursing, Midwifery and Health Systems, National Maternity Hospital, Dublin 2, Ireland

    J. Chaney

  5. The University of British Columbia, 2329 W Mall, Vancouver, BC V6T 1Z4, Canada

    M. Butler

Authors
  1. S. Cullen
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  2. S. Power
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  3. B. Coughlan
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  4. J. Chaney
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  5. M. Butler
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  6. M. Brosnan
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Corresponding author

Correspondence to S. Cullen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The study was funded by the HSE Office of the Nursing and Midwifery Services Director–Service Innovation and Research Funding 2013.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Permission for this retrospective chart audit was obtained from the Director of Midwifery and the board of Management.

Informed consent

For this type of study (retrospective audit) formal consent is not required.

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Cullen, S., Power, S., Coughlan, B. et al. An exploration of the prevalence and patterns of care for women presenting with mid-trimester loss. Ir J Med Sci 186, 381–386 (2017). https://doi.org/10.1007/s11845-016-1413-y

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  • DOI: https://doi.org/10.1007/s11845-016-1413-y

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