scholarly journals Dealing with the Melancholy Void: Responding to Parents Who Experience Pregnancy Loss and Perinatal Death

2021 ◽  
pp. 315-325
Author(s):  
Hedy Cleaver ◽  
Wendy Rose
Keyword(s):  
Pregnancy Loss ◽  
Perinatal Death

Perinatal Outcomes in Women with a History of Recurrent Pregnancy Loss

2020 ◽  
Vol 38 (01) ◽  
pp. 010-015
Author(s):  
Elizabeth B. Ausbeck ◽  
Christina Blanchard ◽  
Alan T. Tita ◽  
Jeff M. Szychowski ◽  
Lorie Harper
Keyword(s):  
Gestational Diabetes ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Subsequent Pregnancy ◽  
Gestational Age At Delivery ◽  
History Of ◽  
Nicu Admission

Objective This study aimed to evaluate perinatal outcomes in women with a history of recurrent pregnancy loss. Study Design Retrospective cohort study of singleton and nonanomalous gestations at ≥ 20 weeks who delivered at our academic institution. The exposed group was defined as women with a history of ≥ 2 consecutive spontaneous abortions (SABs) at < 12 weeks. These women were compared with women with a history of ≤ 1 SAB at < 12 weeks. The primary outcome was preterm birth (PTB) at < 37 weeks. Secondary outcomes included gestational age at delivery, gestational diabetes, small for gestational age birth weight, hypertensive diseases of pregnancy, fetal demise, cesarean delivery, and a composite of neonatal complications (5-minute Apgar score < 5, perinatal death, and NICU admission). Multivariable logistic regression was performed to adjust for confounders. Results Of 17,670 women included, 235 (1.3%) had a history of ≥ 2 consecutive SABs. Compared with women with a history of ≤ 1 SAB, women with ≥ 2 consecutive SABs were not more likely to have a PTB (19.6 vs. 14.0%, p = 0.01, adjusted odds ratios (AOR): 0.91, 95% confidence interval [CI]: 0.62–1.33). However, they were more likely to deliver at an earlier mean gestational age (37.8 ± 3.4 vs. 38.6 ± 2.9 weeks, p < 0.01) and to have gestational diabetes (12.3 vs. 6.6%, p < 0.01, AOR: 1.69, 95% CI: 1.10–2.59). Other outcomes were similar between the two groups. Conclusion A history of ≥ 2 consecutive SABs was not associated with an increased incidence of PTB but may be associated with gestational diabetes in a subsequent pregnancy. Key Points

scholarly journals Pregnancy before recurrent pregnancy loss more often complicated by post-term birth and perinatal death

2017 ◽  
Vol 97 (1) ◽  
pp. 82-88 ◽  
Author(s):  
Marise M. Wagner ◽  
Jantien Visser ◽  
Harjo Verburg ◽  
Chantal W.P.M. Hukkelhoven ◽  
Jan M.M. Van Lith ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Perinatal Death ◽  
Term Birth

scholarly journals Record linkage improves assessment of interpregnancy interval (IPI)

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Christine Roberts ◽  
Charles S. Algert ◽  
Tanya A. Nippita ◽  
Jonathan M. Morris ◽  
Jane B. Ford
Keyword(s):  
Record Linkage ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Fetal Loss ◽  
Interpregnancy Interval ◽  
Hospital Data ◽  
Nulliparous Women ◽  
Birth Data ◽  
Birth Records ◽  
The Impact

ABSTRACTObjectiveTo examine the impact on interpregnancy interval, of linking miscarriage and termination records to birth records.ApproachInterpregnancy interval (IPI) is the time between the end of one pregnancy and conception in a subsequent pregnancy. IPI is one of the few modifiable risk factors for adverse birth outcomes. Information about the effect of IPI is particularly important to women who have suffered a pregnancy loss (miscarriage, termination or perinatal death) and want to conceive again. Accurate measurement of the IPI is important for research into its effect. However, most population-based studies have been limited to the use of birth data, which typically only records births of ≥20 weeks gestation. Record linkage offers the opportunity to identify pregnancies ending <20 weeks. Our study population was all pregnancies ≥20 weeks in New South Wales, Australia in 2012. The birth records were longitudinally linked to all prior birth records and, to all hospitalisations for pregnancy losses <20 weeks gestation. We compared the IPI using birth records alone to the IPI when fetal loss data were included. We also determined the impact on the proportion of women identified with a prior pregnancy loss.ResultsOf 97,991 maternities in 2012 and using birth data alone, 49,650 (50.7%) women had a record of a previous birth with a mean IPI of 2.6 years (standard deviation +/-2.3; median 1.9 years). Linkage to hospital data identified 9,430 (9.6%) women with an early pregnancy loss in the preceding pregnancy, reducing the mean IPI to 2.3+/-2.2 years (median 1.7 years).Incorporating hospital records increased the number of women whose previous pregnancy had resulted in a loss. Using only the birth records, 616 (0.6%) pregnancies had been preceded by a loss. With the expanded records of loss, there were 10,046 (10.3%) women whose pregnancy was preceded by a loss. This subgroup of women had a shorter mean IPI 1.7+/-2.0 years (median 0.8 years). The impact was greater among nulliparous women.ConclusionsInclusion of records of pregnancy loss is important not just for accurate calculation of the IPI, but also for identification of women who have had a prior pregnancy; nulliparous women may have a preceding loss which goes unrecognised. Further, ascertainment of pregnancy losses can make a big difference in the calculated IPI for women whose preceding birth was a loss. This subgroup is one that can potentially benefit the most from accurate research on the effect of IPI.

scholarly journals Causes of Abortions in South American Camelids in Switzerland—Cases and Questionnaire

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1956
Author(s):  
Isabelle Rüfli ◽  
Corinne Gurtner ◽  
Walter U. Basso ◽  
Beatriz Vidondo ◽  
Gaby Hirsbrunner ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Coxiella Burnetii ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Nationwide Survey ◽  
Meat Production ◽  
Special Focus ◽  
South American ◽  
South American Camelids ◽  
Zoonotic Risk

Over the last decade, South American camelids (SAC) have gained increasing popularity in Switzerland. They are used for several purposes such as fiber and meat production, as companion or guard animals and for trekking activities. The purpose of this study was to investigate the frequency and reasons for pregnancy loss and perinatal death in SAC herds. Within the scope of this study, early embryonic losses could not be identified, as pregnancy examinations by ultrasonography are not performed routinely. Aborted and stillborn fetuses were collected, necropsied and analyzed for infectious abortifacients. A nationwide survey among breeders was carried out. During a 1.5-year period, only eight cases of aborted or stillborn alpaca and llama (out of a population of 6550 animals) were reported by the breeders, and their causes were subsequently analyzed. In half of the cases, Coxiella burnetii was identified in the fetoplacental material. Abortions and stillbirths were reported to be rare in Swiss herds. As a conclusion, recording of embryonic losses through ultrasound training of veterinarians should be impaired and breeders motivated to have abortions and perinatal mortality examined. Special focus should be laid on C. burnetii due to its zoonotic risk.

Reproductive Failure

2018 ◽  
Author(s):  
R. J McKinlay Gardner ◽  
David J Amor
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Chromosomal Abnormalities ◽  
Perinatal Death ◽  
Hydatidiform Mole ◽  
Great Majority ◽  
Human Species ◽  
Maternal Age Effect ◽  
Robust Process ◽  
Normal Baby

Human conception and pregnancy is both a vulnerable and a robust process. It is vulnerable in that a large proportion of all conceptions are chromosomally abnormal, with the great majority of such pregnancies aborting. It is robust in that more than 99% of the time, a term pregnancy results in a chromosomally normal baby; unbalanced chromosomal abnormalities are seen in less than 1% of newborns. This chapter considers the somewhat surprising vulnerability of the human species to chromosome abnormality, from prior to, at, and following conception. A remarkable fraction of pregnancy loss is due to chromosomal imbalance, and there is an associated maternal age effect. This chapter considers the chromosomal contribution to miscarriage, fetal death in utero, and perinatal death. Recurrent pregnancy loss may have a chromosomal basis, and male and female infertility may relate to abnormality of, in particular, the sex chromosomes. The genetics of hydatidiform mole is reviewed.

scholarly journals Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes

2020 ◽  
Vol 02 (02) ◽  
pp. 53-60
Author(s):  
Rachelle Warner ◽  
Jodie C. Avery ◽  
Susan Neuhaus ◽  
Michael J. Davies
Keyword(s):  
Middle East ◽  
Reproductive Health ◽  
Childhood Cancer ◽  
Birth Defects ◽  
Neonatal Death ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Descriptive Analysis ◽  
Perinatal Outcomes ◽  
Self Report

Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.

scholarly journals Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sergio A. Silverio ◽  
Abigail Easter ◽  
Claire Storey ◽  
Davor Jurković ◽  
Jane Sandall ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Future Health ◽  
Care Services ◽  
Bereaved Parents ◽  
Care And Support ◽  
Template Analysis ◽  
Bereavement Care ◽  
Late Miscarriage

Abstract Background The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care and support. PUDDLES is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic, in seven countries. In this study, we aim to present early findings from qualitative work undertaken with recently bereaved parents in the United Kingdom about how access to healthcare and support services was negotiated during the pandemic. Methods In-depth semi-structured interviews were undertaken with parents (N = 24) who had suffered a late miscarriage (n = 5; all mothers), stillbirth (n = 16; 13 mothers, 1 father, 1 joint interview involving both parents), or neonatal death (n = 3; all mothers). Data were analysed using a template analysis with the aim of investigating bereaved parents’ access to services, care, and networks of support, during the pandemic after their bereavement. Results All parents had experience of utilising reconfigured maternity and/or neonatal, and bereavement care services during the pandemic. The themes utilised in the template analysis were: 1) The Shock & Confusion Associated with Necessary Restrictions to Daily Life; 2) Fragmented Care and Far Away Families; 3) Keeping Safe by Staying Away; and 4) Impersonal Care and Support Through a Screen. Results suggest access to maternity, neonatal, and bereavement care services were all significantly reduced, and parents’ experiences were notably affected by service reconfigurations. Conclusions Our findings, whilst preliminary, are important to document now, to help inform care and service provision as the pandemic continues and to provide learning for ongoing and future health system shocks. We draw conclusions on how to enable development of safe and appropriate services during this pandemic and any future health crises, to best support parents who experience a pregnancy loss or whose babies die.

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