Factors affecting the grieving process after perinatal loss

Background Factors associated with the grief process in response to perinatal loss have been investigated. However, few studies focused on the intrapersonal factors, such as developmental and personality traits. Hence, this study aimed to investigate medical and psychosocial risk factors, including inter- and intrapersonal factors for the development of complicated grief following perinatal loss, while considering emotional support. Methods A total of 50 patients who were treated for grief due to perinatal loss at the National Center for Child Health and Development were divided into two groups according to the treatment period (< 6 months: n = 28; ≥ 6 months: n = 22). We compared medical and psychosocial variables between the two groups using the χ2 test and t test. All data were further analyzed using a logistic regression model to adjust for confounding effects. Results Patients who had traits of developmental/personality disorders (adjusted odds ratio [OR]: 7.21, 95% confidence interval (CI): 1.21–42.9, P = .030), and those treated with psychoactive drugs (adjusted OR: 5.77, 95% CI 1.09–30.5, P = .039) required a longer treatment period (≥ 6 months). Conclusions Patients with personality/developmental traits and those with active psychiatric symptoms required a more extended treatment period in response to loss, suggesting the accumulation of negative factors in these patients; thus, more intensive and specialized care is necessary for these patients. Precise analysis of the coping style, attachment style, communication skills, and life history including relationship with the original family of the patients may have implications on the approach toward patients with complicated grief after perinatal loss. Studies with larger sample size are required to increase the reliability of the present findings, and future research should address the effects of the differential attachment and coping styles of patients with developmental/personality traits on the grief process.

Resourcing Popular Music for Relevant Themes in Music Therapy with Perinatal Loss

Perinatal loss poses unique challenges to grief work because of the complexity of dynamics it carries. Historically shrouded in socially and culturally based belief systems often impeding normal grief responses, the barriers to healthy processing have been surmounted in recent decades. The emergence of music therapy in partnership with social work is one such approach to addressing both anticipatory grief and bereavement of parents enduring the death of their infant prenatally. This retrospective article highlights the resourcing of popular music within a clinical music therapy approach to the curation of a perinatal bereavement event within a large hospital system in a metropolitan area. Popular music as a ubiquitous art form lends tangibility and relevance to the complicated themes of perinatal loss in a manner that invites bereft parents into a forum of acceptance and acknowledgment of a loss that for too long has remained in the shadows.

Legal aspects of perinatal loss

BACKGROUND: Perinatal death is the death of the fetus, starting from 22 weeks of pregnancy and in childbirth, as well as the death of a newborn in the first seven days of life. Despite the fact that reducing perinatal losses is one of the most important tasks of contemporary medicine, the level of perinatal mortality in Russia in recent years has been about 7.5 . AIM: The aim of this study was to analyze documentation related to the legal aspects of perinatal loss. MATERIALS AND METHODS: The article analyzes the main federal laws, agency regulations, orders, methodological letters, recommendations, and materials on the Internet concerning the main aspects and questions that most often arise among doctors, as well as postpartum women who have undergone perinatal loss and their family members. RESULTS: The article provides data on: the medical criteria for birth, basic documentation issued in case of stillbirth, the birth of a live child who died in the perinatal period, and the rules for their issuance; the rules and procedure for notifying state bodies in case of perinatal death, the rules for registering a stillborn and a child who died in the first 168 hours of extrauterine life; the types of perinatal death certificate; the rules for conducting a pathological autopsy and the possibility of refusing it; the issues of burial of children who died perinatally; the rules for handling material obtained during termination of pregnancy up to 22 weeks. CONCLUSIONS: The legislative framework was analyzed and answers were given to the most frequently asked questions regarding the legal aspects of perinatal loss.

Perinatal Loss: Experiences of Midwives and Nurses

The aim was to determine the experiences of Turkish midwives and nurses when caring for families with perinatal loss. It was a descriptive and qualitative study. One-to-one interviews were conducted with ten midwives and five nurses using a semi-structured interview form. It was found that the nurses and midwives experienced pain and grief during caring for women who had perinatal losses, and they tried to relieve these feelings by using positive thinking and prayer. The nurses and midwives stated that they were unsure how to approach women or family experiencing perinatal loss, and they needed mentoring and training. The results showed that it would be beneficial to plan training for nurses and midwives and to conduct mentoring for those experiencing difficulties. For nurses and midwives frequently facing perinatal loss, there will be benefit in planning grief care training at regular intervals and mentoring for those experiencing difficulties.

OBSERVATION OF MORPHOLOGICAL CHANGES IN THE FETUS AND PLACENTA OF PREGNANT WOMEN INFECTED WITH CYTOMEGALOVIRUS THROUGH ULTRASOUND EXAMINATION

In 2008-2018, 89 pregnant women registered at the Beaumonde Clinic were observed with only cytomegalovirus activity. Laboratory tests for cytomegalovirus were performed 4 times in total, and ultrasound examination was performed 3 times during pregnancy. The results were distributed as follows: (1) We could have assumed with high probability that we had reinfection processes and not a primary infection. (2) During the ultrasound examinations, no significant organic disturbances in the development of the fetus were detected. (3) In all cases, various morphological changes were observed in the placenta, which are not specific for CMV and are found during any infectious process: premature aging of the placenta, increase in thickness and enhanced calcification. Degenerative changes in placental tissues increase the risk of perinatal loss. (4) As a result of childbirth, all newborns were born without visible pathology. However, this did not rule out latent disease and later detected pathologies.