Poronienie – Charakterystyka, pielęgnacja i opieka

Poronienie
Charakterystyka, pielęgnacja i opieka

Poronienie definiuje się jako samoistne zakończenie ciąży przed 20. tygodniem, dotykające 10-20% klinicznie rozpoznanych ciąż, z 80% przypadków w pierwszym trymestrze. Najczęstszą przyczyną są aberracje chromosomalne, stanowiące co najmniej połowę poronień, zwykle przypadkowe i nie wskazujące na genetyczne problemy rodziców. Czynniki ryzyka obejmują wiek matki, przewlekłe choroby (np. niekontrolowana cukrzyca, RZS, toczeń), nieprawidłowości anatomiczne macicy, używki (palenie, alkohol, kokaina, kofeina), niedowagę lub nadwagę oraz historię nawracających poronień (≥2). Objawy to krwawienie z pochwy (od plamienia do obfitego, często ze skrzepami) i ból lub skurcze w podbrzuszu. Diagnostyka opiera się na wywiadzie, badaniu fizykalnym, ultrasonografii oraz oznaczeniu β-hCG. Poronienia klasyfikuje się m.in. na zagrażające, w toku, niekompletne, kompletne, zatrzymane i nawykowe (≥3 kolejne).

Poronienie (Miscarriage) – definicja i rozpowszechnienie

Poronienie (ang. miscarriage) definiuje się jako samoistne zakończenie ciąży przed ukończeniem 20. tygodnia ciąży, licząc od ostatniej miesiączki. Jest to powszechne zjawisko, dotyczące około 10-20% wszystkich klinicznie rozpoznanych ciąż. Niektóre badania wskazują, że odsetek ten może sięgać nawet 30%¹². Zdecydowana większość poronień (około 80%) ma miejsce w pierwszym trymestrze ciąży, przed ukończeniem 13. tygodnia³⁴.

Mimo powszechności tego zjawiska, poronienie pozostaje trudnym doświadczeniem zarówno pod względem fizycznym, jak i emocjonalnym. Ważne jest, aby kobieta wiedziała, że poronienie najczęściej nie jest spowodowane niczym, co zrobiła – w większości przypadków dochodzi do niego z powodu nieprawidłowego rozwoju płodu⁵⁶.

Przyczyny poronień

Najczęstszą przyczyną poronień są zaburzenia chromosomalne prowadzące do nieprawidłowego rozwoju zarodka. Szacuje się, że stanowią one podłoże co najmniej połowy wszystkich poronień⁷. Nieprawidłowości te zazwyczaj nie świadczą o problemach genetycznych u rodziców i nie oznaczają zwiększonego ryzyka w przyszłych ciążach – najczęściej występują przypadkowo podczas podziału i rozwoju zapłodnionej komórki jajowej⁸.

Inne czynniki, które mogą przyczyniać się do poronień, obejmują:

Wiek matki – ryzyko poronienia wzrasta wraz z wiekiem⁹
Przewlekłe choroby matki, takie jak niekontrolowana cukrzyca, reumatoidalne zapalenie stawów czy toczeń¹⁰
Ciężkie urazy i poważne infekcje¹¹
Nieprawidłowości w budowie macicy, takie jak tkanka bliznowata czy mięśniaki macicy (zwłaszcza w przypadku poronień po 3. miesiącu ciąży)¹²
Palenie tytoniu, spożywanie alkoholu, używanie kokainy oraz wysokie spożycie kofeiny¹³
Niedowaga lub nadwaga¹⁴
Historia wcześniejszych poronień – osoby, które doświadczyły dwóch lub więcej poronień z rzędu, mają większe ryzyko kolejnych utrat ciąży¹⁵

Warto podkreślić, że w większości przypadków nie można jednoznacznie ustalić przyczyny poronienia. Co istotne, poronienie zazwyczaj nie jest wywołane przez aktywność fizyczną, stres czy współżycie seksualne¹⁶¹⁷.

Objawy poronienia

Główne objawy poronienia to krwawienie z pochwy oraz ból lub skurcze w dolnej części brzucha¹⁸. Krwawienie może być od lekkiego plamienia do obfitego, często z towarzyszącymi skrzepami. Inne objawy mogą obejmować:

Zmiany w wydzielinie z pochwy¹⁹
Tępy ból w dolnej części pleców²⁰
Ustąpienie objawów ciąży, takich jak tkliwość piersi czy nudności²¹

Należy podkreślić, że wystąpienie tych objawów nie zawsze oznacza poronienie, jednak kobieta doświadczająca krwawienia lub bólu podczas ciąży powinna natychmiast skontaktować się z lekarzem²². Jeśli w trakcie poronienia dojdzie do wydalenia tkanek, należy je zachować do badania przez lekarza²³.

Rozpoznanie poronienia

Diagnoza poronienia zazwyczaj opiera się na wywiadzie, badaniu fizykalnym oraz badaniach obrazowych, głównie ultrasonografii²⁴. USG pozwala ocenić stan ciąży i potwierdzić, czy doszło do obumarcia zarodka lub płodu. W niektórych przypadkach mogą być również wykonane badania krwi w celu oznaczenia poziomu hormonów ciążowych (β-hCG)²⁵.

W zależności od obrazu klinicznego i wyników badań, poronienie może być sklasyfikowane jako:

Poronienie zagrażające (threatened abortion) – występuje krwawienie z pochwy z lub bez bólu brzucha, ale szyjka macicy jest zamknięta, a ciąża nadal żywa²⁶
Poronienie w toku (inevitable abortion) – krwawienie i bóle nasilają się, szyjka macicy zaczyna się rozwierać²⁷
Poronienie niekompletne (incomplete abortion) – część tkanek ciążowych została wydalona, ale część pozostaje w macicy²⁸
Poronienie kompletne (complete abortion) – wszystkie tkanki ciążowe zostały wydalone z macicy²⁹
Poronienie zatrzymane (missed abortion) – płód obumarł, ale nie został wydalony z macicy³⁰
Poronienie nawykowe (habitual abortion) – trzy lub więcej następujących po sobie poronień³¹

Opcje leczenia poronienia

Po rozpoznaniu poronienia, kobieta ma zazwyczaj trzy główne opcje postępowania, które zależą od jej stanu klinicznego, preferencji oraz indywidualnej sytuacji³²³³:

Postępowanie wyczekujące (expectant management)

Ta opcja polega na czekaniu, aż organizm samoistnie wydali tkanki ciążowe bez interwencji medycznej czy chirurgicznej³⁴. Badania wskazują, że w około 70-80% przypadków ciąża zostaje wydalona samoistnie w ciągu 3 tygodni³⁵. Proces ten może jednak trwać nawet do 8 tygodni³⁶.

Zalety postępowania wyczekującego to brak konieczności ingerencji farmakologicznej czy chirurgicznej oraz bardziej naturalne przeżycie procesu poronienia. Wady obejmują niepewność co do momentu rozpoczęcia i zakończenia procesu wydalania ciąży, co może być emocjonalnie trudne³⁷. Istnieje również ryzyko niekompletnego poronienia, które może wymagać późniejszej interwencji medycznej lub chirurgicznej³⁸.

Postępowanie farmakologiczne (medical management)

W przypadku postępowania farmakologicznego stosuje się leki, które wywołują skurcze macicy i umożliwiają wydalenie tkanek ciążowych³⁹. Najczęściej stosowana jest kombinacja dwóch leków: mifepristonu podawanego w placówce medycznej oraz misoprostolu przyjmowanego w domu⁴⁰⁴¹.

Skuteczność tej metody wynosi około 80-85%⁴². Badania wskazują, że leczenie mifepristonem z następczym podaniem misoprostolu zwiększa szansę na skuteczne opróżnienie macicy w porównaniu do stosowania samego misoprostolu⁴³.

Zaletą tej metody jest większa kontrola nad czasem i przebiegiem poronienia oraz szybsze rozwiązanie sytuacji niż w przypadku postępowania wyczekującego⁴⁴. Do wad należą potencjalne działania niepożądane leków, takie jak dolegliwości żołądkowo-jelitowe (nudności, wymioty, biegunka), ból głowy czy gorączka⁴⁵. Skurcze wywołane farmakologicznie mogą być silniejsze niż te występujące podczas samoistnego poronienia⁴⁶.

Postępowanie chirurgiczne (surgical management)

Zabieg chirurgiczny, znany jako łyżeczkowanie (dilatation and curettage, DC) lub aspiracja próżniowa (vacuum aspiration), polega na rozszerzeniu szyjki macicy i usunięciu tkanek ciążowych z jamy macicy⁴⁷⁴⁸.

Procedura ta jest wykonywana ambulatoryjnie, zwykle z zastosowaniem znieczulenia ogólnego lub głębokiej sedacji⁴⁹. Sam zabieg trwa około 10-15 minut, choć pacjentka może pozostać w placówce medycznej do kilku godzin⁵⁰.

Zalety interwencji chirurgicznej to najszybsze rozwiązanie sytuacji, często mniejsze krwawienie niż przy postępowaniu wyczekującym czy farmakologicznym oraz największa pewność co do usunięcia wszystkich tkanek ciążowych⁵¹. Wady obejmują ryzyko związane z zabiegiem chirurgicznym i znieczuleniem, w tym możliwość infekcji, perforacji macicy, uszkodzenia szyjki macicy czy powstania blizn w jamie macicy⁵²⁵³.

Opieka nad pacjentką z poronieniem

Opieka fizyczna

Prawidłowa opieka fizyczna nad pacjentką doświadczającą poronienia jest kluczowa dla jej bezpieczeństwa i komfortu⁵⁴. Obejmuje ona:

Monitorowanie stanu klinicznego – regularna ocena parametrów życiowych, ilości i charakteru krwawienia oraz objawów potencjalnych powikłań⁵⁵
Leczenie bólu – zastosowanie leków przeciwbólowych, takich jak paracetamol czy niesteroidowe leki przeciwzapalne (ibuprofen, naproksen)⁵⁶⁵⁷
Profilaktyka konfliktu serologicznego – kobiety z grupą krwi Rh-ujemną mogą wymagać podania immunoglobuliny anty-D (RhoGAM) w ciągu 72 godzin od poronienia⁵⁸⁵⁹
Zapobieganie infekcjom – zaleca się unikanie stosowania tamponów, współżycia seksualnego oraz kąpieli (w wannie, basenie, jacuzzi) przez 1-2 tygodnie po poronieniu lub do ustania krwawienia⁶⁰⁶¹
Suplementacja żelaza – w przypadku znacznej utraty krwi może być zalecana dieta bogata w żelazo i witaminę C lub suplementacja⁶²⁶³

Pacjentka powinna być poinformowana o możliwych objawach wymagających natychmiastowej konsultacji medycznej, takich jak:⁶⁴⁶⁵

Obfite krwawienie (przemoczenie więcej niż jednej podpaski na godzinę przez 2 godziny z rzędu)
Ból brzucha nieustępujący po lekach przeciwbólowych
Gorączka powyżej 38°C (100,4°F)
Dreszcze
Nieprzyjemnie pachnąca wydzielina z pochwy

Wsparcie psychologiczne

Poronienie może mieć głęboki wpływ emocjonalny na kobietę i jej partnera⁶⁶. Reakcje emocjonalne mogą obejmować smutek, poczucie winy, szok, złość, lęk, a nawet depresję⁶⁷. Ważne jest, aby personel medyczny był świadomy tych aspektów i zapewniał odpowiednie wsparcie psychologiczne.

Kluczowe elementy wsparcia psychologicznego obejmują:⁶⁸⁶⁹

Stworzenie bezpiecznej przestrzeni do wyrażania emocji – umożliwienie kobiecie i jej partnerowi swobodnego wyrażania swoich uczuć, bez oceniania
Normalizacja reakcji emocjonalnych – zapewnienie, że odczuwane emocje są naturalną reakcją na stratę
Unikanie minimalizowania straty – uznanie znaczenia utraty ciąży dla konkretnej osoby, niezależnie od jej etapu
Aktywne słuchanie – poświęcenie czasu na wysłuchanie obaw i pytań pacjentki
Zapewnienie informacji o dostępnych formach wsparcia – grupy wsparcia, poradnictwo psychologiczne, organizacje pomagające rodzinom po stracie ciąży

Należy pamiętać, że proces żałoby po poronieniu jest indywidualny i może przebiegać różnie u różnych osób. Partner kobiety również doświadcza straty i może potrzebować wsparcia, choć jego reakcje emocjonalne mogą różnić się od reakcji partnerki⁷⁰.

Edukacja i wsparcie informacyjne

Zapewnienie rzetelnych informacji jest kluczowym elementem opieki nad pacjentką z poronieniem. Pacjentka powinna otrzymać informacje dotyczące:⁷¹

Fizycznych aspektów poronienia – jakich objawów może się spodziewać, jak długo mogą one trwać, jakie są normalne reakcje organizmu
Opcji postępowania – szczegółowe wyjaśnienie dostępnych metod (wyczekująca, farmakologiczna, chirurgiczna) wraz z ich zaletami, wadami i potencjalnymi ryzykami
Zaleceń po poronieniu – informacje o ograniczeniach aktywności, higienie, kontrolach lekarskich
Przyszłych planów reprodukcyjnych – kiedy możliwe jest ponowne zajście w ciążę, czy istnieją wskazania do dodatkowych badań przed kolejną ciążą
Możliwych reakcji emocjonalnych – jakie emocje mogą się pojawić, jak długo mogą się utrzymywać, kiedy warto rozważyć profesjonalną pomoc psychologiczną
Dostępnych form wsparcia – grupy wsparcia, organizacje pomagające po stracie ciąży, literatura na temat poronienia

Szczególnie istotne jest podkreślenie, że poronienie zazwyczaj nie jest spowodowane działaniami pacjentki i w większości przypadków nie oznacza problemów z przyszłymi ciążami⁷².

Rola personelu pielęgniarskiego w opiece nad pacjentką z poronieniem

Personel pielęgniarski odgrywa kluczową rolę w kompleksowej opiece nad pacjentką doświadczającą poronienia⁷³. Zadania obejmują zarówno aspekty fizyczne, jak i psychologiczne opieki:

Ocena i monitorowanie stanu pacjentki

Regularna ocena parametrów życiowych⁷⁴
Monitorowanie ilości i charakteru krwawienia⁷⁵
Ocena natężenia bólu i skuteczności leczenia przeciwbólowego⁷⁶
Obserwacja pod kątem potencjalnych powikłań, takich jak infekcja czy nadmierne krwawienie⁷⁷
Ocena stanu emocjonalnego pacjentki i jej potrzeb w zakresie wsparcia psychologicznego⁷⁸

Wykonywanie zabiegów i procedur medycznych

Przygotowanie pacjentki do procedur diagnostycznych (np. USG) i terapeutycznych⁷⁹
Asystowanie podczas zabiegu łyżeczkowania lub aspiracji próżniowej, jeśli takie postępowanie zostało wybrane⁸⁰
Podawanie leków przeciwbólowych, antybiotyków czy immunoglobuliny anty-D zgodnie z zaleceniami⁸¹
Zapewnienie komfortu fizycznego (np. ciepłe okłady na brzuch w celu zmniejszenia bólu)⁸²

Wsparcie emocjonalne i komunikacja

Stworzenie atmosfery empatii i zrozumienia⁸³
Aktywne słuchanie i zachęcanie do wyrażania emocji⁸⁴
Używanie odpowiedniego języka – unikanie określeń, które mogą minimalizować stratę⁸⁵
Uznanie indywidualnego charakteru doświadczenia straty dla każdej pacjentki⁸⁶
Włączenie partnera i rodziny w proces wsparcia, zgodnie z życzeniem pacjentki⁸⁷

Edukacja i informowanie pacjentki

Wyjaśnienie procesu poronienia i dostępnych opcji leczenia⁸⁸
Instruktaż dotyczący samoopieki po powrocie do domu⁸⁹
Informowanie o objawach wymagających natychmiastowej konsultacji medycznej⁹⁰
Przekazanie zaleceń dotyczących aktywności, higieny i planowania przyszłej ciąży⁹¹
Informowanie o dostępnych formach wsparcia psychologicznego⁹²

Wsparcie w procesie podejmowania decyzji

Dostarczenie rzetelnych informacji o wszystkich dostępnych opcjach postępowania⁹³
Pomoc w rozważeniu zalet i wad każdej z opcji w kontekście indywidualnej sytuacji pacjentki⁹⁴
Wspieranie prawa pacjentki do dokonania świadomego wyboru⁹⁵
Organizacja dostępu do badań genetycznych, jeśli są wskazane, szczególnie w przypadku nawracających poronień⁹⁶

Koordynacja opieki i planowanie wypisu

Organizacja konsultacji z innymi specjalistami (np. psychologiem, genetykiem) według potrzeb⁹⁷
Planowanie wizyt kontrolnych po poronieniu⁹⁸
Przekazanie pisemnych zaleceń i materiałów edukacyjnych przed wypisem⁹⁹
Zapewnienie kontaktu do placówki medycznej w przypadku pytań czy problemów po wypisie¹⁰⁰

Specyficzne aspekty opieki pielęgniarskiej

Opieka nad pacjentką z postępowaniem wyczekującym

W przypadku wyboru postępowania wyczekującego, opieka pielęgniarska powinna obejmować:¹⁰¹¹⁰²

Dokładne wyjaśnienie, czego pacjentka może się spodziewać (czas trwania procesu, charakter krwawienia, nasilenie bólu)
Instrukcje dotyczące monitorowania krwawienia i innych objawów w domu
Wyposażenie w odpowiednie środki przeciwbólowe i instrukcje ich stosowania
Jasne wytyczne dotyczące sytuacji wymagających natychmiastowego kontaktu z placówką medyczną
Zaplanowanie regularnych wizyt kontrolnych w celu oceny postępu procesu poronienia
Instrukcje dotyczące wykonania testu ciążowego 3 tygodnie po poronieniu
Wsparcie psychologiczne w radzeniu sobie z niepewnością związaną z oczekiwaniem

Opieka nad pacjentką z postępowaniem farmakologicznym

W przypadku wyboru postępowania farmakologicznego, opieka pielęgniarska powinna uwzględniać:¹⁰³¹⁰⁴

Wyjaśnienie schematu dawkowania leków (mifepriston w placówce medycznej, następnie misoprostol w domu)
Szczegółowe informacje o możliwych działaniach niepożądanych leków i sposobach ich łagodzenia
Instrukcje dotyczące postępowania w przypadku silnego bólu (stosowanie leków przeciwbólowych, okłady cieplne)
Zalecenia dotyczące odpoczynku i obecności osoby wspierającej w czasie działania leków
Wyraźne wskazówki dotyczące okoliczności wymagających pilnej konsultacji medycznej
Informacje o oczekiwanym czasie rozpoczęcia działania leków (zwykle w ciągu kilku godzin)
Instrukcje dotyczące wykonania testu ciążowego 3 tygodnie po zastosowaniu leków

Opieka nad pacjentką po zabiegu chirurgicznym

Opieka pielęgniarska po zabiegu łyżeczkowania lub aspiracji próżniowej powinna obejmować:¹⁰⁵¹⁰⁶

Monitorowanie parametrów życiowych w okresie pozabiegowym
Ocenę ilości i charakteru krwawienia
Monitorowanie bólu i zapewnienie odpowiedniego leczenia przeciwbólowego
Obserwację pod kątem potencjalnych powikłań (nadmierne krwawienie, infekcja, reakcje na leki)
Instrukcje dotyczące samoopieki po wypisie (ograniczenia aktywności, higiena, stosowanie leków)
Informacje o spodziewanym czasie trwania krwawienia (zwykle 1-2 tygodnie) i jego charakterze
Wyjaśnienie konieczności unikania tamponów, stosunków seksualnych i kąpieli przez co najmniej 2 tygodnie
Przypomnienie o wizycie kontrolnej

Opieka nad pacjentką z nawracającymi poronieniami

W przypadku pacjentek z historią nawracających poronień (dwa lub więcej), opieka pielęgniarska powinna uwzględniać dodatkowe aspekty:¹⁰⁷¹⁰⁸

Szczegółowy wywiad dotyczący wcześniejszych poronień i ich okoliczności
Koordynacja badań diagnostycznych mających na celu identyfikację potencjalnych przyczyn nawracających poronień (badania genetyczne, hormonalne, obrazowe)
Edukacja na temat możliwych przyczyn nawracających poronień (problemy chromosomalne, nieprawidłowości macicy, zaburzenia hormonalne, choroby autoimmunologiczne)
Informacje o dostępnych metodach leczenia w zależności od zidentyfikowanej przyczyny
Wsparcie w radzeniu sobie z lękiem i obawami związanymi z planowaniem kolejnej ciąży
Informacje o możliwości skierowania do specjalisty leczenia niepłodności lub poradni genetycznej

Wyzwania i trudności w opiece pielęgniarskiej nad pacjentkami z poronieniem

Bariery organizacyjne i systemowe

Personel pielęgniarski może napotykać różnorodne wyzwania w zapewnianiu optymalnej opieki pacjentkom z poronieniem:¹⁰⁹¹¹⁰

Przeciążenie oddziałów ratunkowych, gdzie często trafiają pacjentki z objawami poronienia
Brak wyspecjalizowanych jednostek zajmujących się wczesną utratą ciąży
Ograniczenia czasowe utrudniające zapewnienie kompleksowej opieki psychologicznej
Niewystarczająca liczba personelu przeszkolonego w zakresie postępowania w przypadku poronienia
Ograniczony dostęp do specjalistycznych metod leczenia i diagnostyki
Bariery prawne i regulacyjne wpływające na dostęp do niektórych leków stosowanych w leczeniu poronienia (np. mifepristonu)

Wyzwania emocjonalne dla personelu pielęgniarskiego

Opieka nad pacjentkami doświadczającymi poronienia może być emocjonalnie obciążająca również dla personelu pielęgniarskiego:¹¹¹¹¹²

Własne doświadczenia straty ciąży mogą wpływać na sposób sprawowania opieki
Trudności w znajdowaniu odpowiednich słów pocieszenia
Poczucie bezradności wobec cierpienia emocjonalnego pacjentek
Obciążenie wynikające z częstej ekspozycji na traumatyczne sytuacje
Konflikt między profesjonalnym dystansem a empatycznym zaangażowaniem

Dla personelu pielęgniarskiego pracującego na oddziałach położniczych, który sam doświadczył poronienia, szczególnym wyzwaniem może być codzienna praca z ciężarnymi pacjentkami i noworodkami¹¹³.

Strategie poprawy jakości opieki nad pacjentkami z poronieniem

W celu optymalizacji opieki nad pacjentkami z poronieniem, warto rozważyć następujące strategie:¹¹⁴¹¹⁵¹¹⁶

Tworzenie wyspecjalizowanych jednostek zajmujących się wczesną utratą ciąży (Early Pregnancy Assessment Units)
Wdrażanie programów edukacyjnych dla personelu pielęgniarskiego w zakresie opieki nad pacjentkami z poronieniem
Opracowanie standardowych procedur postępowania uwzględniających zarówno aspekty fizyczne, jak i psychologiczne opieki
Współpraca z organizacjami wspierającymi osoby po stracie ciąży
Zapewnienie superwizji i wsparcia psychologicznego dla personelu zajmującego się opieką nad pacjentkami z poronieniem
Przeprowadzanie badań dotyczących najskuteczniejszych metod wsparcia psychologicznego po poronieniu
Promowanie podejścia skoncentrowanego na pacjentce i jej indywidualnych potrzebach

Wnioski i zalecenia dla praktyki pielęgniarskiej

Opieka nad pacjentką doświadczającą poronienia wymaga holistycznego podejścia, uwzględniającego zarówno aspekty fizyczne, jak i psychologiczne¹¹⁷. Kluczowe zalecenia dla praktyki pielęgniarskiej obejmują:

Indywidualizacja opieki – rozpoznanie i uwzględnienie indywidualnych potrzeb, preferencji i okoliczności każdej pacjentki¹¹⁸
Kompleksowe informowanie – zapewnienie rzetelnych i zrozumiałych informacji o wszystkich aspektach poronienia i dostępnych opcjach postępowania¹¹⁹
Empatyczna komunikacja – stosowanie języka wyrażającego troskę i uznanie znaczenia straty, unikanie określeń mogących minimalizować doświadczenie pacjentki¹²⁰
Zaangażowanie partnera i rodziny – uwzględnienie potrzeb i roli bliskich osób w procesie wsparcia, zgodnie z życzeniem pacjentki¹²¹
Ciągłość opieki – zapewnienie kompleksowej opieki przed, w trakcie i po poronieniu, włącznie z odpowiednim wsparciem po wypisie¹²²
Współpraca interdyscyplinarna – koordynacja działań różnych specjalistów (lekarzy, psychologów, pracowników socjalnych) w celu zapewnienia kompleksowej opieki¹²³
Ciągłe doskonalenie zawodowe – regularne podnoszenie kwalifikacji w zakresie opieki nad pacjentkami z poronieniem, w tym najnowszych metod leczenia i wsparcia psychologicznego¹²⁴

Poronienie, mimo swojej powszechności, pozostaje doświadczeniem głęboko osobistym i potencjalnie traumatycznym dla wielu kobiet i ich rodzin. Profesjonalna, empatyczna i kompleksowa opieka pielęgniarska może znacząco wpłynąć na proces fizycznego i emocjonalnego zdrowienia po tej stracie, a także przyczynić się do lepszego przygotowania do ewentualnych przyszłych ciąż.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
It is the spontaneous loss of a pregnancy before the 20th week. This can be physically and emotionally painful. They often happen before 12 weeks. 10 to 20 percent of known pregnancies end in a miscarriage. Some studies show it may be closer to 30%. The fact miscarriage is common does not make it feel better. We want to reassure you that there is likely nothing wrong with your body. Future pregnancies can and should go well. […] We often cannot find an answer for why a pregnancy stops developing. It is important to know you did not cause the miscarriage. Many happen because the fetus did not grow normally. […] There are 3 ways to treat a miscarriage. […] The body is given time to recognize the pregnancy stopped developing. It can pass the pregnancy without medicine or a procedure. This results in passing the pregnancy about 70 to 80% of the time over 3 weeks.
#2 Miscarriage: Causes, Symptoms, Risks, Treatment & Prevention
https://my.clevelandclinic.org/health/diseases/9688-miscarriage
A miscarriage is the loss of a pregnancy before 20 weeks gestation. Most miscarriages happen in the first trimester of pregnancy. Chromosomal problems cause most miscarriages. […] A miscarriage (also called a spontaneous abortion) is the unexpected ending of a pregnancy in the first 20 weeks of gestation. Just because its called a miscarriage doesnt mean you did something wrong in carrying the pregnancy. Most miscarriages are beyond your control and occur because the fetus stops growing. […] Your pregnancy care provider may diagnose you with the following types of miscarriage: […] If you experience the loss of a pregnancy, the fetus must be removed from your uterus. If any parts of the pregnancy are left inside your body, you could experience infection, bleeding or other complications.
#3 Miscarriages (for Parents) | Nemours KidsHealth
https://kidshealth.org/en/parents/miscarriage.html
A miscarriage usually happens in the first 3 months of pregnancy, before 12 weeks’ gestation. […] If a woman miscarries, her doctor will do a pelvic exam and an ultrasound to confirm the miscarriage. […] Sometimes, the uterus still contains the fetus or other tissues from the pregnancy. A doctor will need to remove this. […] Women who have had several miscarriages may want to get checked to see if any anatomic, genetic, or hormonal problems are making miscarriages more likely. […] In most cases, a miscarriage cannot be prevented because its caused by a chromosomal abnormality or problem with the development of the fetus. […] If you’ve had a miscarriage, take time to grieve. The loss of a baby during pregnancy is like the loss of any loved one. Give yourself time to heal emotionally and physically. Some health care providers recommend that women wait one menstrual cycle or more before trying to get pregnant again.
#4 They Had Miscarriages, and New Abortion Laws Obstructed Treatment – The New York Times
https://www.nytimes.com/2022/07/17/health/abortion-miscarriage-treatment.html
Delays in expelling tissue from a pregnancy that is no longer viable can lead to hemorrhaging, infections, and sometimes life-threatening sepsis, obstetricians say. […] âIn this post-Roe world, women with miscarriages may die,â said Dr. Monica Saxena, an emergency medicine physician at Stanford Hospital. […] Medical experts define miscarriage as a pregnancy that ends naturally before 20 weeksâ gestation. Most miscarriages occur in the first 13 weeks; pregnancy losses after 20 weeks are considered stillbirths. Miscarriage befalls about one in 10 known pregnancies, and may occur in as many as one in four when including miscarriages that occur before patients realize they are pregnant. […] In typical early miscarriages, when cardiac activity has stopped, patients should be offered three options to expel tissue, said Dr. Sarah Prager, an obstetrics and gynecology professor at the University of Washingtonâs School of Medicine.
#5
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7231
For some, the loss of a pregnancy can be very hard. You may wonder why it happened. Miscarriages are common and are not caused by exercise, stress, or sex. Most happen because the fertilized egg in the uterus does not develop normally. […] There is no treatment that can stop a miscarriage. If you are having a miscarriage, you have several options. As long as you do not have heavy blood loss, fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This can take several days. If you don’t want to wait, you can take medicine to help the pregnancy tissue pass. Or you can have a surgical procedure to remove the tissue. […] Your body will recover over the next several weeks. Having a miscarriage does not mean you cannot have a normal pregnancy in the future.
#6 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
It is the spontaneous loss of a pregnancy before the 20th week. This can be physically and emotionally painful. They often happen before 12 weeks. 10 to 20 percent of known pregnancies end in a miscarriage. Some studies show it may be closer to 30%. The fact miscarriage is common does not make it feel better. We want to reassure you that there is likely nothing wrong with your body. Future pregnancies can and should go well. […] We often cannot find an answer for why a pregnancy stops developing. It is important to know you did not cause the miscarriage. Many happen because the fetus did not grow normally. […] There are 3 ways to treat a miscarriage. […] The body is given time to recognize the pregnancy stopped developing. It can pass the pregnancy without medicine or a procedure. This results in passing the pregnancy about 70 to 80% of the time over 3 weeks.
#7 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#8 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#9 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#10 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#11 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#12 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
It may be difficult for health care providers to know what caused a miscarriage. But we do know some things that make miscarriage more likely in general: […] The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages. […] A persons risk of miscarriage increases as they age. […] Severe chronic illness poorly controlled diabetes, rheumatoid arthritis, or lupus can cause miscarriage. […] Severe trauma and serious infections can also cause miscarriage. […] Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages after three months.
#13 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#14 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#15 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#16
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7231
For some, the loss of a pregnancy can be very hard. You may wonder why it happened. Miscarriages are common and are not caused by exercise, stress, or sex. Most happen because the fertilized egg in the uterus does not develop normally. […] There is no treatment that can stop a miscarriage. If you are having a miscarriage, you have several options. As long as you do not have heavy blood loss, fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This can take several days. If you don’t want to wait, you can take medicine to help the pregnancy tissue pass. Or you can have a surgical procedure to remove the tissue. […] Your body will recover over the next several weeks. Having a miscarriage does not mean you cannot have a normal pregnancy in the future.
#17 Miscarriage: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.miscarriage-care-instructions.uf7231
For some, the loss of a pregnancy can be very hard. You may wonder why it happened. Miscarriages are common and are not caused by exercise, stress, or sex. Most happen because the fertilized egg in the uterus does not develop normally. […] There is no treatment that can stop a miscarriage. If you are having a miscarriage, you have several options. As long as you do not have heavy blood loss, fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This can take several days. If you don’t want to wait, you can take medicine to help the pregnancy tissue pass. Or you can have a surgical procedure to remove the tissue. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
#18 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#19 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#20 Planned Parenthood
https://www.plannedparenthood.org/planned-parenthood-south-east-north-florida/medical-services/miscarriage
Smoking, the use of alcohol or cocaine, and heavy caffeine have ties to miscarriage. […] Individuals who are underweight or overweight have a greater risk of miscarriage than others. […] People who have had two or more miscarriages in a row are at a greater risk of future miscarriages. […] Signs of a miscarriage may include: […] Vaginal bleeding or spotting […] Severe abdominal pain […] Severe cramping […] Dull, lower-back ache, pressure, or pain […] A change in vaginal discharge […] Your health care provider can give you medicine and advice about managing the pain and cramps during your miscarriage and guidance about what you can expect. […] Your health care provider will perform an ultrasound to ensure all tissue has naturally exited the uterus. […] You may need further treatment to clear the uterine lining after a miscarriage.
#21 Navigating Recurrent Miscarriages: A Comprehensive Guide to Care
https://fertility.womenandinfants.org/services/women/recurrent-miscarriage
Recurrent miscarriage is when a woman has two or more clinical pregnancy losses (miscarriages). […] After three miscarriages, the American College of Obstetricians and Gynecologists (ACOG) recommends a physical exam and further testing, but Women Infants Fertility Center initiates an evaluation after two miscarriages. […] Nearly two-thirds of women who have recurrent miscarriages will eventually carry a full-term, healthy pregnancy, often without treatment. […] Some women who have a miscarriage or recurrent miscarriages experience vaginal bleeding, loss of tenderness or fullness in the breasts, and the loss of fetal movement or sound. Women should report such signs to their doctor or midwife and keep track of the amount of bleeding that occurs. […] If a patient passes tissue during a miscarriage, she should save it. A doctor can later use it to help determine the cause of the miscarriage.
#22 Early Pregnancy Loss | ACOG
https://www.acog.org/womens-health/faqs/early-pregnancy-loss
The loss of a pregnancy before 13 completed weeks is called early pregnancy loss. It also may be called a miscarriage or spontaneous abortion. […] In almost every case, miscarriage is not a woman’s fault. This is important to understand. Miscarriage usually is a random event. […] Bleeding is the most common sign of miscarriage. Call your obstetrician-gynecologist (ob-gyn) if you have signs or symptoms of miscarriage, including vaginal spotting or bleeding with or without pain. […] After a miscarriage, some of the pregnancy tissue may be left in the uterus. This is called an incomplete miscarriage. There are options to remove this tissue. […] If you do not show any signs of an infection, your ob-gyn may recommend waiting and letting the tissue pass naturally. […] To help prevent infection, you should not put anything in your vagina for 1 to 2 weeks. This includes not using tampons, not having sexual intercourse, and not having sex with penetration.
#23 Navigating Recurrent Miscarriages: A Comprehensive Guide to Care
https://fertility.womenandinfants.org/services/women/recurrent-miscarriage
Recurrent miscarriage is when a woman has two or more clinical pregnancy losses (miscarriages). […] After three miscarriages, the American College of Obstetricians and Gynecologists (ACOG) recommends a physical exam and further testing, but Women Infants Fertility Center initiates an evaluation after two miscarriages. […] Nearly two-thirds of women who have recurrent miscarriages will eventually carry a full-term, healthy pregnancy, often without treatment. […] Some women who have a miscarriage or recurrent miscarriages experience vaginal bleeding, loss of tenderness or fullness in the breasts, and the loss of fetal movement or sound. Women should report such signs to their doctor or midwife and keep track of the amount of bleeding that occurs. […] If a patient passes tissue during a miscarriage, she should save it. A doctor can later use it to help determine the cause of the miscarriage.
#24 Miscarriage care | BPAS
https://www.bpas.org/more-services-information/pregnancy-miscarriage/miscarriage-care/
The most common symptoms of a miscarriage are pain and bleeding. […] A miscarriage is usually diagnosed by a combination of symptoms and one or more ultrasound scans. […] Once a diagnosis is made you will have the time to talk about your thoughts and feelings and discuss treatment. […] Approximately 20% of women who know they are pregnant are at risk of having miscarriage in the first 3 months of pregnancy. […] Most miscarriages happen as a one-off event and there is a good chance of having a successful pregnancy in the future, should you want one. […] A lot is still unknown about why early miscarriage happens. […] If you choose medical management at home or expectant management, you can bring the tissue back to us to dispose of or dispose of it yourself. […] All tissue from the procedure will be disposed of in a sensitive way.
#25 Miscarriage – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/diagnosis-treatment/drc-20354304
Your health care team might do a variety of tests: […] If your test results show that you had a miscarriage or are at risk of having one, your health care professional might use one of the following medical terms to describe what happened: […] If you have bleeding from the vagina early in your pregnancy, your health care team might recommend that you rest until your symptoms get better. […] If tests show that you’re having or will have a miscarriage, your health care team might recommend one of the following treatment choices: […] After a miscarriage, if you are blood type Rh negative, you also may get a shot of medicine called Rh immunoglobulin. […] In most cases, physical recovery from miscarriage takes only a few hours to a couple of days. […] It’s possible to become pregnant during the menstrual cycle right after a miscarriage. […] If you have more than one miscarriage, think about getting tested to find any underlying causes. […] Emotional healing can take much longer than physical healing. […] If you have symptoms of miscarriage, call your health care team right away.
#26 Threatened Miscarriage: Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/25055-threatened-miscarriage
A threatened miscarriage describes vaginal bleeding and pelvic pain in the first trimester of pregnancy. Treatment usually involves watchful waiting. In most cases, the pregnancy continues and doesn’t end in miscarriage. […] A threatened miscarriage (threatened abortion) describes a pregnancy that could possibly end in miscarriage due to mild vaginal bleeding with or without abdominal pain or cramping. […] It’s common to experience vaginal bleeding or mild cramping during pregnancy. This doesn’t mean that there’s a problem with the pregnancy or that miscarriage will happen. In many cases, you’ll go on to have a healthy pregnancy. […] Contact your pregnancy care provider if you have vaginal bleeding, abdominal pain or cramping. […] Yes, many fetuses survive and the pregnancy continues.
#27 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
In managing a threatened abortion, nurses should provide patient education on activity restrictions, the importance of follow-up visits, and when to seek immediate medical attention. […] The term incomplete abortion best describes the condition in which some of the pregnancy tissue has been expelled, but the placenta remains attached, leading to continued symptoms of heavy bleeding and cramping. […] In cases of incomplete abortion, the nurse’s role includes monitoring vital signs, assessing the amount of bleeding, providing emotional support, and preparing the patient for potential medical or surgical management. […] The term complete abortion best describes the situation where all the products of conception (including the fetus and placental tissue) have been expelled from the uterus.
#28 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
In managing a threatened abortion, nurses should provide patient education on activity restrictions, the importance of follow-up visits, and when to seek immediate medical attention. […] The term incomplete abortion best describes the condition in which some of the pregnancy tissue has been expelled, but the placenta remains attached, leading to continued symptoms of heavy bleeding and cramping. […] In cases of incomplete abortion, the nurse’s role includes monitoring vital signs, assessing the amount of bleeding, providing emotional support, and preparing the patient for potential medical or surgical management. […] The term complete abortion best describes the situation where all the products of conception (including the fetus and placental tissue) have been expelled from the uterus.
#29 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
In managing a threatened abortion, nurses should provide patient education on activity restrictions, the importance of follow-up visits, and when to seek immediate medical attention. […] The term incomplete abortion best describes the condition in which some of the pregnancy tissue has been expelled, but the placenta remains attached, leading to continued symptoms of heavy bleeding and cramping. […] In cases of incomplete abortion, the nurse’s role includes monitoring vital signs, assessing the amount of bleeding, providing emotional support, and preparing the patient for potential medical or surgical management. […] The term complete abortion best describes the situation where all the products of conception (including the fetus and placental tissue) have been expelled from the uterus.
#30 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
The term habitual abortion (also known as recurrent pregnancy loss) refers to the occurrence of three or more consecutive spontaneous abortions. […] In habitual abortion due to cervical insufficiency, the cervix may begin to dilate painlessly and without contractions, leading to premature birth or pregnancy loss in the second trimester. […] The term missed abortion refers to a condition where the embryo or fetus has died in utero but has not been expelled by the body.
#31 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
The term habitual abortion (also known as recurrent pregnancy loss) refers to the occurrence of three or more consecutive spontaneous abortions. […] In habitual abortion due to cervical insufficiency, the cervix may begin to dilate painlessly and without contractions, leading to premature birth or pregnancy loss in the second trimester. […] The term missed abortion refers to a condition where the embryo or fetus has died in utero but has not been expelled by the body.
#32 What Happens After a Miscarriage? An Ob-Gyn Discusses the Options. | ACOG
https://www.acog.org/womens-health/experts-and-stories/the-latest/what-happens-after-a-miscarriage-an-ob-gyn-discusses-the-options
Miscarriage, the loss of a pregnancy thats in the uterus, is common. It happens in about 1 in 10 women who know theyre pregnant. But many people dont know what to expect afterward. […] Heres what to know about care and recovery. […] There are three main treatments for early pregnancy loss. The goal for all three is to remove any pregnancy tissue left in the uterus. There are two nonsurgical treatments: expectant management (letting the tissue pass on its own) and medication. The third treatment is a surgical procedure called dilation and curettage (also known as DC or suction curettage). […] Expectant management is giving your body time to pass the tissue on its own. This doesnt involve medication or surgery. Some women choose this because its the most natural option, but it is more unpredictable than other treatments.
#33 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
It is the spontaneous loss of a pregnancy before the 20th week. This can be physically and emotionally painful. They often happen before 12 weeks. 10 to 20 percent of known pregnancies end in a miscarriage. Some studies show it may be closer to 30%. The fact miscarriage is common does not make it feel better. We want to reassure you that there is likely nothing wrong with your body. Future pregnancies can and should go well. […] We often cannot find an answer for why a pregnancy stops developing. It is important to know you did not cause the miscarriage. Many happen because the fetus did not grow normally. […] There are 3 ways to treat a miscarriage. […] The body is given time to recognize the pregnancy stopped developing. It can pass the pregnancy without medicine or a procedure. This results in passing the pregnancy about 70 to 80% of the time over 3 weeks.
#34 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
It is the spontaneous loss of a pregnancy before the 20th week. This can be physically and emotionally painful. They often happen before 12 weeks. 10 to 20 percent of known pregnancies end in a miscarriage. Some studies show it may be closer to 30%. The fact miscarriage is common does not make it feel better. We want to reassure you that there is likely nothing wrong with your body. Future pregnancies can and should go well. […] We often cannot find an answer for why a pregnancy stops developing. It is important to know you did not cause the miscarriage. Many happen because the fetus did not grow normally. […] There are 3 ways to treat a miscarriage. […] The body is given time to recognize the pregnancy stopped developing. It can pass the pregnancy without medicine or a procedure. This results in passing the pregnancy about 70 to 80% of the time over 3 weeks.
#35 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
It is the spontaneous loss of a pregnancy before the 20th week. This can be physically and emotionally painful. They often happen before 12 weeks. 10 to 20 percent of known pregnancies end in a miscarriage. Some studies show it may be closer to 30%. The fact miscarriage is common does not make it feel better. We want to reassure you that there is likely nothing wrong with your body. Future pregnancies can and should go well. […] We often cannot find an answer for why a pregnancy stops developing. It is important to know you did not cause the miscarriage. Many happen because the fetus did not grow normally. […] There are 3 ways to treat a miscarriage. […] The body is given time to recognize the pregnancy stopped developing. It can pass the pregnancy without medicine or a procedure. This results in passing the pregnancy about 70 to 80% of the time over 3 weeks.
#36
http://www.bcwomens.ca/health-info/pregnancy-parenting/miscarriage/treatment-options-for-miscarriage
Understanding your treatment options may help you to feel more in control. Once an ultrasound confirms a miscarriage will occur, there are three treatment options available to you: Expectant management, Medical management, Surgical management (Dilation and curettage or 'DC’). These options are safe and do not affect your future pregnancies. Your healthcare provider will discuss each of these with you to help you determine the best option for you. […] Expectant management is when you wait for the miscarriage to occur on its own. Approximately 50% of patients will miscarry on their own within 2 weeks of a diagnosis of pregnancy demise in the first trimester. The timing of miscarriage can vary significantly. It can sometimes take up to 6-8 weeks for miscarriage to occur after diagnosis. Most who choose expectant management will have a complete miscarriage on their own, however approximately 1 in 4 will need an emergency dilation and curettage (DC), a surgical procedure to make sure all the pregnancy tissue is removed.
#37 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
This is the least interventive approach and allows you space and time to process the loss and see how things would evolve on their own timeline. […] Waiting can be mentally and emotionally challenging knowing the pregnancy will not continue to develop but also being uncertain of when the process of passing the embryo will begin and be complete. […] Sometimes expectant management results in an incomplete miscarriage and medical or procedural follow up will be necessary. […] This option involves taking medication by mouth to encourage the pregnancy to pass. […] Our care team will counsel you, obtain informed consent, and then prescribe medication to begin the miscarriage process. […] Two medicines will be used to treat your miscarriage mifepristone and misoprostol. […] You are able to better control the timing and overall experience of your miscarriage and to prepare yourself, both physically and mentally, to go through the process in a safe space with a support person when possible.
#38
http://www.bcwomens.ca/health-info/pregnancy-parenting/miscarriage/treatment-options-for-miscarriage
Understanding your treatment options may help you to feel more in control. Once an ultrasound confirms a miscarriage will occur, there are three treatment options available to you: Expectant management, Medical management, Surgical management (Dilation and curettage or 'DC’). These options are safe and do not affect your future pregnancies. Your healthcare provider will discuss each of these with you to help you determine the best option for you. […] Expectant management is when you wait for the miscarriage to occur on its own. Approximately 50% of patients will miscarry on their own within 2 weeks of a diagnosis of pregnancy demise in the first trimester. The timing of miscarriage can vary significantly. It can sometimes take up to 6-8 weeks for miscarriage to occur after diagnosis. Most who choose expectant management will have a complete miscarriage on their own, however approximately 1 in 4 will need an emergency dilation and curettage (DC), a surgical procedure to make sure all the pregnancy tissue is removed.
#39
https://www.nhs.uk/conditions/miscarriage/what-happens/
This involves taking tablets that cause the cervix to open, allowing the tissue to pass out. […] In most cases, you’ll be offered tablets called pessaries that are inserted directly into your vagina, where they dissolve. […] The tablets usually begin to work within a few hours. […] You’ll experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. […] You should be advised to take a home pregnancy test 3 weeks after taking this medicine. […] If the pregnancy test shows you’re still pregnant, contact a healthcare professional as you may need to have further tests. […] You should also contact a healthcare professional if your pregnancy test is negative and you’re still having bleeding or other symptoms, such as pelvic pain or a high temperature (fever), after 3 weeks.
#40 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
Medicines are given to cause the body to pass the pregnancy. Mifepristone is given in the clinic. Misoprostol is taken at home. These increase the chance that the body will pass the pregnancy without needing a procedure. It works 80 to 85% of the time. […] A procedure called a uterine aspiration can be done in clinic with IV sedation. Suction is used to remove pregnancy tissue from the uterus. The procedure takes about 10 minutes. […] Call your care team if you do not know your blood type or you are Rh negative. You may need Rh D immune globulin (Rhogam) within 72 hours after you miscarry. […] No sex, tampons, or douching for 2 weeks. […] Each person will feel different. It may help to talk about your feelings. A support group or grief and loss website may be helpful.
#41
http://www.bcwomens.ca/health-info/pregnancy-parenting/miscarriage/treatment-options-for-miscarriage
Medical management allows you to miscarry at home with greater control over when it may occur. In BC, medical management is possible using a 2-drug combination of mifepristone and misoprostol. Mifepristone helps to prepare your uterus for miscarriage, followed by misoprostol 24-48 hours later which helps the cervix soften and dilate to expedite the miscarriage. Depending on the timing of your pregnancy demise, this 2-drug combination can be up to 92% successful in completing your miscarriage. […] Dilation and curettage (DC) is a surgical procedure in which the cervix is gently opened (dilation) and the pregnancy is removed with a suction device (curettage). Depending on your health history and the size of the pregnancy demise, your provider may recommend this procedure for you.
#42 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
Medicines are given to cause the body to pass the pregnancy. Mifepristone is given in the clinic. Misoprostol is taken at home. These increase the chance that the body will pass the pregnancy without needing a procedure. It works 80 to 85% of the time. […] A procedure called a uterine aspiration can be done in clinic with IV sedation. Suction is used to remove pregnancy tissue from the uterus. The procedure takes about 10 minutes. […] Call your care team if you do not know your blood type or you are Rh negative. You may need Rh D immune globulin (Rhogam) within 72 hours after you miscarry. […] No sex, tampons, or douching for 2 weeks. […] Each person will feel different. It may help to talk about your feelings. A support group or grief and loss website may be helpful.
#43 Early Pregnancy Loss Treatment & Management: Medical Care, Surgical Care
https://emedicine.medscape.com/article/266317-treatment
A study by Schreiber et al that included 300 women who had an early pregnancy loss and received pretreatment with oral 200 mg of mifepristone followed by vaginal 800 g of misoprostol (mifepristone-pretreatment group), or vaginal 800 g of misoprostol alone (misoprostol-alone group) reported that 83.8% of the mifepristone-pretreatment group had complete expulsion after one dose of misoprostol compared to 67.1% in the misoprostol-alone group. […] In patients with recurrent pregnancy loss (2 miscarriages) and cellur immunity anomalies (eg, elevated natural killer cell levels or cytotoxicity and increased T-helper cell 1 (Th1) to Th2 ratio), intravenous immunoglobulin (IVIG) may improve pregnancy outcomes. […] For a complete abortion, the medical care is to treat any remaining anemia and to evaluate the blood type and treat the patient with RhoGAM when indicated.
#44 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
This is the least interventive approach and allows you space and time to process the loss and see how things would evolve on their own timeline. […] Waiting can be mentally and emotionally challenging knowing the pregnancy will not continue to develop but also being uncertain of when the process of passing the embryo will begin and be complete. […] Sometimes expectant management results in an incomplete miscarriage and medical or procedural follow up will be necessary. […] This option involves taking medication by mouth to encourage the pregnancy to pass. […] Our care team will counsel you, obtain informed consent, and then prescribe medication to begin the miscarriage process. […] Two medicines will be used to treat your miscarriage mifepristone and misoprostol. […] You are able to better control the timing and overall experience of your miscarriage and to prepare yourself, both physically and mentally, to go through the process in a safe space with a support person when possible.
#45 Managing Your Miscarriage
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=custom.ab_managing_your_miscarriage_inst
A miscarriage is the loss of a pregnancy during the first 20 weeks. Most happen because the fertilized egg in the uterus doesn’t develop normally. Miscarriages are very common. […] For many people, the body completes the miscarriage on its own. If you don’t have heavy blood loss, a fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This time of waiting, called expectant management, allows the miscarriage to end naturally while your health care provider watches for and treats any complications. It could take days or several weeks to complete. […] Mifepristone and Misoprostol can be used to help the uterus pass the pregnancy tissue. The medicine gets the uterus ready and makes the uterus squeeze and empty. You can be at home during this process and the pregnancy usually passes in 1 to 2 days. The medicine may cause pain and side effects including headache, fever, nausea, vomiting, and diarrhea.
#46 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
The overall parameters of what to expect is more predictable than a spontaneous miscarriage and the process is complete more quickly. […] Medication induced cramps can be stronger than those that occur spontaneously. […] In rare instances, not all parts of the pregnancy tissue will be expelled and procedural care would be recommended. […] If you prefer, you can have a procedure to clear the pregnancy out of the uterus. […] Options for procedures include a suction procedure called vacuum aspiration, done as an outpatient at a GYN providers office with one of our clinical partners. […] This procedure empties the uterus with gentle suction and is done by a doctor, midwife or advanced practice clinician skilled in early pregnancy care. […] An additional procedural option is a Dilation Curettage, also known as a DC.
#47
https://www.nhs.uk/conditions/miscarriage/what-happens/
You should be advised to contact your healthcare professional to discuss your options if bleeding has not started within 48 hours of taking the medicine. […] In some cases, surgery is used to remove any remaining pregnancy tissue. […] You may be advised to have immediate surgery if you experience continuous heavy bleeding, there’s evidence the pregnancy tissue has become infected, medicine or waiting for the tissue to pass out naturally has been unsuccessful. […] Surgery involves removing any remaining tissue in your womb with a suction device. […] A miscarriage can be very upsetting, and you and your partner may need counselling or support.
#48 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
D&C Procedure After a Miscarriage […] What is a D&C Procedure? […] A D&C, also known as dilation and curettage, is a surgical procedure often performed after a first-trimester miscarriage. In a D&C, dilation refers to opening the cervix; curettage refers to removing the contents of the uterus. Curettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration). […] Do You Need a D&C After a Miscarriage? […] The procedure is done to: […] Remove tissue in the uterus during or after a miscarriage or abortion or to remove small pieces of placenta after childbirth. This helps prevent infection or heavy bleeding. […] About 50% of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice that is best decided after talking with your healthcare provider. For some women, the emotional toll of waiting to miscarry naturally is too unpredictable and too much to handle in an already challenging situation. Healing for them may start upon having a D&C procedure. A D&C may be recommended for women who miscarry later than 10-12 weeks, have had any complications, or have medical conditions in which emergency care could be needed.
#49 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
How is a D&C Performed? […] You can have a D&C in your doctorâs office, an outpatient clinic, or the hospital. It usually takes only 10 to 15 minutes, but you may stay in the office, clinic, or hospital for up to five hours. […] A sedative is usually given first to help you relax. Most often, general anesthesia is used, but IV anesthesia or paracervical anesthesia may also be used. […] The vacuum aspiration (also called suction curettage) procedure uses a plastic cannula (a flexible tube) attached to a suction device to remove the contents of the uterus. […] The tissue removed during the procedure may be sent off to a pathology lab for testing. […] Once the health care provider has seen that the uterus has become firm and the bleeding has stopped or is minimal, the speculum will be removed and you will be sent to recovery.
#50 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
How is a D&C Performed? […] You can have a D&C in your doctorâs office, an outpatient clinic, or the hospital. It usually takes only 10 to 15 minutes, but you may stay in the office, clinic, or hospital for up to five hours. […] A sedative is usually given first to help you relax. Most often, general anesthesia is used, but IV anesthesia or paracervical anesthesia may also be used. […] The vacuum aspiration (also called suction curettage) procedure uses a plastic cannula (a flexible tube) attached to a suction device to remove the contents of the uterus. […] The tissue removed during the procedure may be sent off to a pathology lab for testing. […] Once the health care provider has seen that the uterus has become firm and the bleeding has stopped or is minimal, the speculum will be removed and you will be sent to recovery.
#51 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
You will be offered anesthesia or sedation during the procedure. […] This is the quickest and most efficient way to complete the miscarriage. […] While these procedures have an overall low risk profile, all interventions carry some increased risk of infection, pain, bleeding, damage to your uterus, or retained pregnancy tissue. […] Each option has different benefits and risks. […] Our care team will provide options counseling to you to review the details of your clinical care and the risks, benefits and alternatives of each management pathway. […] Follow up is important so we can make sure that the miscarriage is complete, and that you are physically and mentally well after experiencing a miscarriage. […] If you have: a fever of 100.4F or higher more than 24 hours after youve taken the misoprostol, abdominal pain or cramps that dont get better with pain medicine or you are unable to manage at home, bleeding that is heavy, soaks 2 maxi pads an hour for more than 2 hours, any clots larger than the size of a lemon passed for more than 2 hours, moderate or heavy bleeding that does not abate, or any bleeding associated with feelings of dizziness, shortness of breath, fainting or loss of consciousness.
#52 Managing Your Miscarriage
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=custom.ab_managing_your_miscarriage_inst
The surgery is called dilation and curettage (DC). The doctor opens the cervix and removes tissue from the uterus. This procedure offers the quickest treatment for a miscarriage. You could have less bleeding than with medicine or no treatment. Surgery has risks including infection, uterine perforation (hole in the uterus), or scarring of the uterus. Youll have sedation medicine that doesnt require you to need a breathing tube. Most people wont remember the procedure. […] It’s common to have bleeding after a miscarriage. Generally, it lasts 1 to 2 weeks, and it should get lighter with time. Your flow should change from period-like to spotting. […] Until your bleeding stops, you should not have anything in your vagina. You can shower, but dont go into hot tubs, swimming pools, or baths. Avoid sexual intercourse and vaginal douching. Use pads instead of tampons.
#53 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
Are There Risks and Complications? […] Risks associated with anesthesia such as an adverse reaction to medication and breathing problems […] Hemorrhage or heavy bleeding […] Infection in the uterus or other pelvic organs […] Perforation or puncture to the uterus […] Laceration or weakening of the cervix […] Scarring of the uterus or cervix, which may require further treatment […] Incomplete procedure that requires another procedure to be performed. […] What to Expect After a D&C […] Most women are discharged from the surgical center or hospital within a few hours of the procedure. […] You will more than likely be given an antibiotic to help prevent infection and possibly some pain medication to help with the initial cramping after the procedure. […] Light cramping and bleeding can be expected from a few days to up to 2 weeks. Ibuprofen is usually suggested for treating cramps. […] You should not insert anything into the vaginal area (including using a douche or having sexual intercourse) for at least 2 weeks or until the bleeding stops. […] Tampons should not be used until you start your next regular period, which could be anywhere from 2-6 weeks after the D&C procedure. […] Make sure to attend your follow-up appointment.
#54 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Healthcare provider training. Promoting education and training for healthcare providers to enhance their sensitivity, knowledge, and skills in supporting individuals and families dealing with perinatal loss. […] Grief is a deeply personal process that nevertheless follows a fairly predictable course. Although the parents have not built up a relationship with their infant, grief after pregnancy loss does not differ significantly in intensity from other loss scenarios. As has been found in bereavement involving first-degree relatives, grief symptoms usually decrease in intensity over the first 12 months. Perinatal losses have also been shown to have a substantial psychological impact on parents and families. Overall, high levels of complicated grieving are generally associated with a poorer state of mental health. One of the most difficult situations for nurses is caring for a client and her family when the pregnancy has spontaneously resulted in the baby’s death. Parents grieve in complex, individual, and powerful ways and require significant emotional support. Nurses must provide sensitive and supportive care for vulnerable families while coping with their emotional responses to the situation.
#55 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Observe the clients activity level, sleep pattern, appetite, and personal hygiene. These areas may be neglected because of the process of grieving and associated depression. Sleep patterns may be disrupted, leading to fatigue and further failure to cope with distress. The client may require support in meeting physical needs and may need assurance that it is acceptable to resume usual activities. Be certain before the client is discharged from the healthcare facility that she has a support person she can rely on during the following week or month when the full impact of the fetal loss registers with her. […] Consider religious beliefs, cultural processes, and ethnic background. Perinatal loss is the only type of loss in Western society for which there are no culturally sanctioned rituals or traditions to help the bereaved to say goodbye. It is important to understand the cultural context in which these parents are forced to grieve in isolation and the psychological consequences of grieving a loss not recognized by society.
#56
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7231
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] You will probably have some vaginal bleeding for 1 to 2 weeks. It may be similar to or slightly heavier than a normal period. The bleeding should get lighter after a week. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding. […] Take an over-the-counter pain medicine, such as acetaminophen (Tylenol) for cramps. Talk to your doctor before you take ibuprofen (Advil, Motrin) or naproxen (Aleve). Read and follow all instructions on the label. You may have cramps for several days after the miscarriage.
#57 Miscarriage: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.miscarriage-care-instructions.uf7231
You will probably have some vaginal bleeding for 1 to 2 weeks. It may be similar to or slightly heavier than a normal period. The bleeding should get lighter after a week. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding. […] Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve) for cramps. Read and follow all instructions on the label. You may have cramps for several days after the miscarriage. […] If you would like to try to get pregnant again, it is usually safe whenever you feel ready. Talk with your doctor about any future pregnancy plans. […] If you do not want to get pregnant, ask your doctor about birth control. You can get pregnant again before your next period starts if you are not using birth control.
#58 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
Medicines are given to cause the body to pass the pregnancy. Mifepristone is given in the clinic. Misoprostol is taken at home. These increase the chance that the body will pass the pregnancy without needing a procedure. It works 80 to 85% of the time. […] A procedure called a uterine aspiration can be done in clinic with IV sedation. Suction is used to remove pregnancy tissue from the uterus. The procedure takes about 10 minutes. […] Call your care team if you do not know your blood type or you are Rh negative. You may need Rh D immune globulin (Rhogam) within 72 hours after you miscarry. […] No sex, tampons, or douching for 2 weeks. […] Each person will feel different. It may help to talk about your feelings. A support group or grief and loss website may be helpful.
#59 Miscarriage | Better Health Channel
https://www.betterhealth.vic.gov.au/health/healthyliving/miscarriage
Most of the problems that cause miscarriage happen by chance and are not likely to happen again. […] There is no right time to try for another pregnancy. […] If you have an Rh negative blood group, you will require an injection of anti-D immunoglobulin following a miscarriage. […] Although the common reasons for miscarriage cannot be prevented, you can improve your chances for long-term fertility and a successful pregnancy by: stopping smoking, taking regular exercise and having a balanced diet, reducing stress, maintaining your weight within recommended limits. […] It is recommended that all women planning a pregnancy take folic acid as it helps promote the normal development of a baby’s nervous system.
#60 Managing Your Miscarriage
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=custom.ab_managing_your_miscarriage_inst
The surgery is called dilation and curettage (DC). The doctor opens the cervix and removes tissue from the uterus. This procedure offers the quickest treatment for a miscarriage. You could have less bleeding than with medicine or no treatment. Surgery has risks including infection, uterine perforation (hole in the uterus), or scarring of the uterus. Youll have sedation medicine that doesnt require you to need a breathing tube. Most people wont remember the procedure. […] It’s common to have bleeding after a miscarriage. Generally, it lasts 1 to 2 weeks, and it should get lighter with time. Your flow should change from period-like to spotting. […] Until your bleeding stops, you should not have anything in your vagina. You can shower, but dont go into hot tubs, swimming pools, or baths. Avoid sexual intercourse and vaginal douching. Use pads instead of tampons.
#61 Miscarriage Care InstructionsâExpectant Management | University of Iowa Health Care
https://uihc.org/educational-resources/miscarriage-care-instructions-expectant-management
Medicines are given to cause the body to pass the pregnancy. Mifepristone is given in the clinic. Misoprostol is taken at home. These increase the chance that the body will pass the pregnancy without needing a procedure. It works 80 to 85% of the time. […] A procedure called a uterine aspiration can be done in clinic with IV sedation. Suction is used to remove pregnancy tissue from the uterus. The procedure takes about 10 minutes. […] Call your care team if you do not know your blood type or you are Rh negative. You may need Rh D immune globulin (Rhogam) within 72 hours after you miscarry. […] No sex, tampons, or douching for 2 weeks. […] Each person will feel different. It may help to talk about your feelings. A support group or grief and loss website may be helpful.
#62 Miscarriage: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.miscarriage-care-instructions.uf7231
You may be low in iron because of blood loss. Eat a balanced diet that is high in iron and vitamin C. Foods rich in iron include red meat, shellfish, eggs, beans, and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes, and broccoli. Talk to your doctor about whether you need to take iron pills or a multivitamin. […] For some, the loss of a pregnancy can be very hard. You may have a range of emotions. If you need help coping, talking to family members, friends, a counselor, or your doctor may help.
#63
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7231
If you would like to try to get pregnant again, it is usually safe whenever you feel ready. Talk with your doctor about any future pregnancy plans. […] If you do not want to get pregnant, ask your doctor or midwife about birth control. You can get pregnant again before your next period starts if you are not using birth control. […] You may be low in iron because of blood loss. Eat a balanced diet that is high in iron and vitamin C. Foods rich in iron include red meat, shellfish, eggs, beans, and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes, and broccoli. Talk to your doctor about whether you need to take iron pills or a multivitamin. […] If you need help coping, talking to family members, friends, a counsellor, or your doctor may help.
#64 Managing Your Miscarriage
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=custom.ab_managing_your_miscarriage_inst
Seek immediate medical attention if you experience any of the following: heavy bleeding (soaking a pad per hour for 2 hours in a row or soaking more than 1 pad per hour), abdominal pain not controlled with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), fever over 38C (100.4F), chills, foul smelling discharge.
#65 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
When to Contact the Doctor […] Most women experience few complications after a D&C procedure after miscarriage, but you should be aware of symptoms that could signal a possible problem. […] Contact them as soon as possible if you experience any of the following: […] Dizziness or fainting […] Prolonged bleeding (over 2 weeks) […] Prolonged cramping (over 2 weeks) […] Bleeding heavier than a menstrual period, or filling more than one pad per hour […] Severe or increased pain […] Fever over 100.4 Â°F […] Chills […] Foul smelling discharge.
#66
https://www.nhs.uk/conditions/miscarriage/afterwards/
A miscarriage can have a profound emotional impact on you and also on your partner, friends and family. […] Advice and support are available during this difficult time. […] Sometimes the emotional impact is felt immediately after the miscarriage, whereas in other cases it can take several weeks. Many people affected by a miscarriage go through a bereavement period. […] It’s common to feel tired, lose your appetite and have difficulty sleeping after a miscarriage. You may also feel a sense of guilt, shock, sadness and anger sometimes at a partner, or at friends or family members who have had successful pregnancies. […] Miscarriage can also cause feelings of anxiety or depression, and can lead to relationship problems. […] If you’re worried that you or your partner are having problems coping with grief, you may need further treatment and counselling. There are support groups that can provide or arrange counselling for people who have been affected by miscarriage.
#67
https://www.nhs.uk/conditions/miscarriage/afterwards/
A miscarriage can have a profound emotional impact on you and also on your partner, friends and family. […] Advice and support are available during this difficult time. […] Sometimes the emotional impact is felt immediately after the miscarriage, whereas in other cases it can take several weeks. Many people affected by a miscarriage go through a bereavement period. […] It’s common to feel tired, lose your appetite and have difficulty sleeping after a miscarriage. You may also feel a sense of guilt, shock, sadness and anger sometimes at a partner, or at friends or family members who have had successful pregnancies. […] Miscarriage can also cause feelings of anxiety or depression, and can lead to relationship problems. […] If you’re worried that you or your partner are having problems coping with grief, you may need further treatment and counselling. There are support groups that can provide or arrange counselling for people who have been affected by miscarriage.
#68 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Allot a private room if the client wants it, with regular contact by care providers. Encourage feelings by unlimited visiting of family and friends. A place where family and friends can open up and share their feelings without restriction promotes comfort. Based on stress theory, social support is thought to have a buffering effect, and poor social support from family and friends is associated with complicated grieving reactions. […] Support free flow of emotional expression. Only restrict behavior that is dangerous to the well-being of the client/couple (e.g., pulling out IV, using fists to pound on the abdomen). Expression of grief is influenced by cultural/religious beliefs and expectations, running the gamut from stoic silence to screaming and pounding ones chest/throwing objects, etc. While expression of loss is cathartic, extended stoicism may impede the mourning process. Giving the client opportunities to express how she feels about this loss. This must be a very difficult day for you is the kind of statement that opens up the topic for discussion.
#69 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Reinforce the familys expression of feelings and listen (remaining calm or commenting as appropriate). Observe body language. Promote a relaxed atmosphere. Grieving families need repeated opportunities to verbalize their experiences. Verbal and nonverbal cues provide hints about the familys degree of sadness, guilt, and fear. Active listening conveys caring, demonstrating an awareness of the unique significance of the loss to the client. Significant others should be encouraged to express how they feel about the babys death and the meaning this will have to the family and avoid minimizing the loss. […] Recognize what has happened as often as necessary, reinforcing the reality of the situation and encouraging discussion by the client. Many families have no earlier struggle in coping with the death of a young person and have few role models to whom they can relate. The nurse can act as an educator and facilitator concerning ways to act and talk about the experience and explain and correct misconceptions. The couple may experience less stress in their relationship if each can accept how the other feels about the loss and the normality of those reactions.
#70 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Include the partner in the planning of care. Grant opportunity for the partner to be seen individually. Reinforce discussion of concerns. Partnership in planning and decision-making acknowledges that the partner has also lost a child and may need time to express feelings of loss and receive support without having to be supportive of the client and others. The loss of an infant during pregnancy can deeply distress a client and can put a strain on her relationship with the father, but it may also have a distinct psychological impact on the grieving father. Symptoms of grieving in men were found to be similar to those of women, except that men report less crying and feel the need to talk less about their loss. […] Consider the individual nature of movement through the stages of grief; inform the client/couple that delays in the grief process or relapses of grief are normal. The process of grieving is not usually a fluid progression through the stages to resolution; it is rather a fluctuation between stages and possibly involves skipping of stages. Knowing that grieving is individual helps the couple let each other grieve at his or her own pace. There are no set time limitations for resolving grief, and it is not unusual for the family to be actively dealing with the loss one to two years later.
#71 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Talk about anticipated physical and emotional responses to loss. Evaluate coping skills. This aids the couple in recognizing the normalcy of their initial and subsequent responses. Grieving is individual, and the extent and nature of the response are influenced by personality traits, past coping skills, religious beliefs, and ethnic background. Reactions to the loss of a significant person often include temporary impairment of day-to-day function, retreat from social activities, intrusive thoughts, and feelings of yearning and numbness, which can continue for varying periods. […] Review role changes and plans to deal with loss. Note the presence of siblings. Most families anticipate a healthy pregnancy and positive outcomes and are not prepared to focus on funeral arrangements, what to do with the nursery, how to carry on their lives, and how to plan for the care of the other children.
#72 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Explore destructive behaviors, differentiating the responses of others from self-elicited responses (e.g., expressions of blame and/or guilt). Destructive behaviors may be obvious during the phases of anger, isolation, and depression. Denial may be used as protection against loss of self-esteem. Guilt may be verbalized, especially if the loss is related to a genetic problem, uterine trauma (e.g., car accident or fall), or teratogens from environmental exposure or drug ingestion. Self-blame may prolong the normal grieving process, especially if there was a feeling of ambivalence towards the pregnancy. […] Present positive reinforcement for expressing needs and identifying concerns. This helps in coping with the sadness of the situation. It aids the parents in accepting themselves as worthy human beings. Couples may experience less stress in their relationship if each can accept how the other feels about the loss and the normality of those reactions, as well as differences between men and women. Nurses can counsel couples on the importance of sharing feelings, experiences, and needs in a non-threatening manner and encourage men to do little things that show their partner that he cares for them and will not abandon them.
#73 Miscarriage Support: Therapy, Grief & Groups | StudySmarter
https://www.studysmarter.co.uk/explanations/nursing/midwifery/miscarriage-support/
When it comes to nursing care, miscarriage support is one key area that requires a compassionate and understanding approach. The compassionate role of nurses can pave the way for a more effective healing process for those who have experienced this heartbreaking event. […] In nursing, providing emotional help to patients, particularly women who experience a miscarriage, is crucial. Miscarriage is not only physically painful but also emotionally devastating. The nursing profession has an essential role in providing miscarriage support to these individuals, offering a platform for healing and recovery. […] Nurses play a critical role in dispensing miscarriage care. They offer medical care, emotional support, and information about the physical and psychological processes of recovery. […] Providing miscarriage grief support and loss support is part of a nurse’s responsibilities. This can entail validating feelings, facilitating sharing of experiences, and suggesting coping mechanisms to help process the grief.
#74 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Assess the severity of depression. The client/couple may detach themselves and have a problem making decisions. These early and late perinatal losses may have profound, negative effects on bereaved parents and have been associated with the development of severe anxiety, major depression, posttraumatic stress disorder (PTSD), increased suicidal ideation, and up to four times the rate of divorce. In subsequently healthy pregnancies after perinatal loss, increased health care use, anxiety, and depression were common, and increased postpartum depression was found after the birth of subsequent healthy infants. […] Observe the clients/couples verbal cues often. Recognize signs of developing or increasing somatic complaints, preoccupation with the death, loss of normal behavior patterns, overactivity with no apparent sense of loss, excessive hostility, or agitated depression. This may mean a sudden alteration in the clients or couples way of coping with the situation. Guilt, failure, and depression may be more pronounced in couples with a history of child loss(es). Other signs may suggest dysfunctional grieving.
#75 Spontaneous Abortion Nursing Management – RNpedia
https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/
Spontaneous abortion is the expulsion of the fetus and other products of conception from the uterus before the fetus is capable of living outside of the uterus. […] Provide appropriate management and prevent complications. […] Assess and record vital signs, bleeding and cramping of pain. […] Prepare for PhoGAM administration to an Rh-negative mother, as prescribed. […] Offer anticipatory guidance relative to expected recovery, the need for rest and delay of another pregnancy until the client fully recovers. […] Explain that in many cases, no cause for the spontaneous abortion is ever identified. […] Address emotional and psychosocial needs. […] The most appropriate term for the patient’s condition, given the symptoms of bleeding and cramping in early pregnancy with a closed cervix and intact membranes, is threatened abortion (or threatened miscarriage).
#76 Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage | Free NURSING.com Courses
https://nursing.com/lesson/nursing-care-plan-for-abortion-spontaneous-abortion-miscarriage?view_quiz=open&from_search=
Understanding the Types of Abortion: Define and differentiate between spontaneous abortion (miscarriage) and induced abortion. Understand the physiological and emotional implications of each type. […] Recognizing Signs and Symptoms: Identify the signs and symptoms of spontaneous abortion, including vaginal bleeding, abdominal pain, and passage of tissue. Recognize the potential emotional distress experienced by the patient. […] Providing Emotional Support: Develop skills to provide empathetic and compassionate care to individuals experiencing a miscarriage. Address the emotional impact, grief, and psychological aspects associated with pregnancy loss. […] Ensuring Physical Well-being: Focus on monitoring the physical health of the patient, including assessing vital signs, managing bleeding, and identifying signs of complications. Collaborate with the healthcare team to ensure appropriate medical interventions.
#77 Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage | Free NURSING.com Courses
https://nursing.com/lesson/nursing-care-plan-for-abortion-spontaneous-abortion-miscarriage?view_quiz=open&from_search=
Facilitating Grief Support and Coping: Equip nurses with tools to support patients and their families in coping with grief after a spontaneous abortion. Provide resources for grief counseling and support groups. […] The primary goal is to support the woman’s physical recovery following a spontaneous abortion. This includes monitoring vital signs, managing pain, and addressing any complications to ensure the restoration of physiological stability. […] Provide emotional support to help the woman cope with the grief and emotional distress associated with a spontaneous abortion. Encourage open communication, offer counseling services, and involve mental health professionals as needed to assist in the healing process. […] Focus on preventing and promptly managing any potential complications that may arise during or after the abortion. This involves close monitoring for signs of infection, excessive bleeding, or other complications, and taking appropriate interventions to mitigate risks.
#78 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Refer for counseling or psychiatric therapy, if necessary. Severe grief response may be noted in older women and those with longer-term pregnancies. In addition, carrying the fetus for one or more days after death increases the risk. In cases of pathological grief, ongoing counseling may be necessary to help the individual(s) identify possible causes of the abnormal reaction and resolve the grieving process. Note: The risk of a major depressive episode is highest during the first month following the loss, whereas women without other children or who have had a prior depressive episode remain at increased risk for six months. […] Assess the present family situation and psychological status. Members of the family may provide support for one another. But, disbelief, anger, and denial may momentarily weaken parenting skills, and other children may be neglected or handled differently from the way they had been handled before the death of the infant. Evaluate the meaning or significance of the loss for the family before intervening, or they may make assumptions in their care that will cause further pain.
#79 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Assist in obtaining requests and signatures for the performance of an autopsy if appropriate. Review the benefits and limitations of the autopsy. Families may want or need an explanation of the cause of death, which may not be possible. Explain hospital procedures such as when the body will be released or what additional permission for an autopsy is needed. […] Give information about the disposition of the infants body. Contact a mortician of the familys choice if assistance is required. Bodies of children, like those of adults, must be transferred from hospitals to mortuary facilities or other dispositions, usually within 24 hours of death. While burial may be delayed in most instances, Jewish tradition requires burial within 24 hours, which may further complicate the clients grieving process if she cannot attend the ceremony. Israeli society is becoming more aware of the potential negative consequences of certain traditional attitudes around perinatal loss, and starting in 2014, parents of stillborn babies or fetuses that died toward the end of pregnancy are permitted to participate in funerals.
#80 Miscarriage care can be hard to come by in the ER : Shots – Health News : NPR
https://www.npr.org/sections/health-shots/2023/01/04/1146801914/many-ers-offer-minimal-care-for-miscarriage-one-group-wants-that-to-change
Those patients bleeding too heavily to be sent home are typically referred to the OB-GYN on call or transferred to another facility for a surgical evacuation in the operating room. […] As a TEAMM trainer, Quinley has helped emergency departments across the country change the way they operate, namely by advocating for and teaching health providers to use a tool long underused by American hospitalswhat’s known as the manual vacuum aspiration (MVA) kit. […] „It’s the quickest, most effective way to treat a first-trimester miscarriage,” says Quinley. […] „Although the technology for [manual vacuum aspiration curettage] has been available for 20 years, its use has never become popular in the U.S.,” wrote the authors of a 1994 study of the MVA kit at Johns Hopkins Bayview Medical Center in Baltimore.
#81 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Take pictures of the child wrapped in newborn attire. Allow the couple to accompany or hold the child, if appropriate. Offer the couple footprints, hospital bracelets, or a lock of hair, if desired. Pictures and touching or holding an infant can be effective and may begin acceptance of the reality of the loss. Ask if the parents wish to see the child after birth. Point out endearing features of the child as these can provide a focus for memories. However, some couples may not be able to cope with the loss. Remembrances of the infant, if not taken by the parents, should be filed with the chart so that they are prepared if the couple requests them at a later time. […] Render physical care (e.g., bath, back rub, nourishment) as needed. Allow the client to engage at a level of ability. Normal grief may include a period during which activities of daily living are impaired. Assisting in the clients physical care displays caring and nurturing and helps the client conserve the energy required to meet the demands of the grieving process. Involvement in self-care maintains self-esteem and a sense of competence.
#82 Miscarriage â Treatment : Emergency Care BC
https://emergencycarebc.ca/clinical_resource/clinical-summary/1st-trimester-bleeding-miscarriage-treatment/
300 mcg dose is acceptable. […] If >12 weeks GA: dose = 300 mcg IM. […] Symptom management: […] Naproxen 500 mg q12h or Ibuprofen 800 mg q8h […] Acetaminophen 1000 mg q6h […] Heating pads […] Consider antiemetics, especially if receiving medical management with misoprostol […] Address psychological concerns: […] Acknowledge distress and grief […] Reassure that they are not at fault […] Reassure that they are not at increased risk of future miscarriages. Fewer than 5% of women will experience two miscarriages, and only 1% experience three or more. […] B) Treatment by Miscarriage Category: […] Incomplete, inevitable or missed miscarriage: […] Consider OB/GYN consult to discuss surgical, medical, and expectant options. […] The MIST trial found no difference in rates of infection between all three options, but an increased rate of unplanned admissions and surgical management with expectant and medical management.
#83 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Perinatal Loss (Miscarriage) Nursing Care Plans and Nursing Diagnosis […] The loss of an infant through miscarriage, stillbirth, or neonatal death is perceived as a traumatic life experience. It is recognized as a tough life event, which can oftentimes cause complicated grief (CG) reactions that risk negatively influencing psychological and physical well-being. Generally, when a pregnancy ends in the death of a fetus or neonate, the loss is both unexpected and devastating for the mothers or the couple. They usually struggle with post-traumatic stress disorder (PTSD), anxiety, and depression, especially when not approached or managed properly. […] Perinatal loss is a crisis within a crisis. Women and their partners undergoing pregnancy loss frequently talk of not getting on with their life goals, plans, and dreams. They appear stuck, off track, as if they are running in place as life passes them by. This care plan is directed at the emotional needs of the postpartum client who must cope with the death of a child.
#84 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Allot a private room if the client wants it, with regular contact by care providers. Encourage feelings by unlimited visiting of family and friends. A place where family and friends can open up and share their feelings without restriction promotes comfort. Based on stress theory, social support is thought to have a buffering effect, and poor social support from family and friends is associated with complicated grieving reactions. […] Support free flow of emotional expression. Only restrict behavior that is dangerous to the well-being of the client/couple (e.g., pulling out IV, using fists to pound on the abdomen). Expression of grief is influenced by cultural/religious beliefs and expectations, running the gamut from stoic silence to screaming and pounding ones chest/throwing objects, etc. While expression of loss is cathartic, extended stoicism may impede the mourning process. Giving the client opportunities to express how she feels about this loss. This must be a very difficult day for you is the kind of statement that opens up the topic for discussion.
#85 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Develop a sense of self-awareness before exploring the clients feelings. In addition to understanding the clients culture and worldview, the nurse must also actively cultivate self-awareness, including understanding their religion/spirituality attitudes, beliefs, and values. Self-reflection and the cultivation of self-awareness are ethical and professional duties for counselors. Understanding themselves and the limits of their understanding will help the nurse to use consultation and make referrals appropriately. […] Communicate with the client or couple therapeutically, giving importance to the clients cultural and religious/spiritual beliefs. Competent counselors use language and approaches that are consistent with the clients culture and worldview, including their religion/spirituality perspectives. As the client processes their experiences of early pregnancy loss, the nurse must recognize and address therapeutically relevant religion/spirituality themes in client communication. The nurse should take care to use and explore the meaning of the clients language concerning their experience of early pregnancy loss, as well as their culture and worldview, including religion/spirituality, gender, and affectional identities.
#86 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Assist the couple when they decide to try again. When the time comes for parents to decide to become pregnant again after a perinatal loss, they want health care providers to explain the risks and benefits of becoming pregnant within a given period, and then they want the decision to be left up to them. In a subsequent pregnancy, couples with a history of losses need help from their health care providers regarding increased fear and anxiety, decreased self-esteem and sense of self, managing complex parenting issues, and increasing support and trust. […] Assess the clients religious or cultural beliefs concerning pregnancy loss. Examining the clients reproductive story can serve as an assessment and intervention, wherein the nurse and the client use narratives to more deeply understand the clients culture, worldview, and meaning-making for early pregnancy loss. For example, the nurse may use genograms, life maps, or ecomaps.
#87 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Give the client simple choices of activities, with the opportunity to do more as she progresses. The client must convey that she is seen as a functional, competent person, even though she may not feel that way. Encouraging the client to clarify and express clearly their needs and expectations from their partner, their family members, and their healthcare provider is helpful. […] Identify ways in which the family may support the client after the loss. Friends and family are often unsure how to provide support to bereaved parents. How families and friends support parents can have lasting effects. If parents perceive that they are not supported, they may feel isolated and misunderstood in their grief. Furthermore, a lack of social support has been linked to complicated or chronic grief. Often, many family members came to the hospital to be with the parents, and in many cases, parents explained that family bonds were strengthened after the loss because of their familys presence.
#88 Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage | Free NURSING.com Courses
https://nursing.com/lesson/nursing-care-plan-for-abortion-spontaneous-abortion-miscarriage?view_quiz=open&from_search=
Facilitating Grief Support and Coping: Equip nurses with tools to support patients and their families in coping with grief after a spontaneous abortion. Provide resources for grief counseling and support groups. […] The primary goal is to support the woman’s physical recovery following a spontaneous abortion. This includes monitoring vital signs, managing pain, and addressing any complications to ensure the restoration of physiological stability. […] Provide emotional support to help the woman cope with the grief and emotional distress associated with a spontaneous abortion. Encourage open communication, offer counseling services, and involve mental health professionals as needed to assist in the healing process. […] Focus on preventing and promptly managing any potential complications that may arise during or after the abortion. This involves close monitoring for signs of infection, excessive bleeding, or other complications, and taking appropriate interventions to mitigate risks.
#89 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Explore destructive behaviors, differentiating the responses of others from self-elicited responses (e.g., expressions of blame and/or guilt). Destructive behaviors may be obvious during the phases of anger, isolation, and depression. Denial may be used as protection against loss of self-esteem. Guilt may be verbalized, especially if the loss is related to a genetic problem, uterine trauma (e.g., car accident or fall), or teratogens from environmental exposure or drug ingestion. Self-blame may prolong the normal grieving process, especially if there was a feeling of ambivalence towards the pregnancy. […] Present positive reinforcement for expressing needs and identifying concerns. This helps in coping with the sadness of the situation. It aids the parents in accepting themselves as worthy human beings. Couples may experience less stress in their relationship if each can accept how the other feels about the loss and the normality of those reactions, as well as differences between men and women. Nurses can counsel couples on the importance of sharing feelings, experiences, and needs in a non-threatening manner and encourage men to do little things that show their partner that he cares for them and will not abandon them.
#90 Managing Your Miscarriage
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=custom.ab_managing_your_miscarriage_inst
Seek immediate medical attention if you experience any of the following: heavy bleeding (soaking a pad per hour for 2 hours in a row or soaking more than 1 pad per hour), abdominal pain not controlled with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), fever over 38C (100.4F), chills, foul smelling discharge.
#91 Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage | Free NURSING.com Courses
https://nursing.com/lesson/nursing-care-plan-for-abortion-spontaneous-abortion-miscarriage?view_quiz=open&from_search=
Offer education and information regarding future reproductive health, including family planning options, contraception methods, and strategies to optimize the chances of a healthy pregnancy in the future. Empower the woman with knowledge to make informed decisions about her reproductive well-being. […] Establish a plan for follow-up care to monitor the woman’s physical and emotional well-being. Schedule regular check-ups to assess recovery progress, address any ongoing concerns, and provide additional support as needed. This ongoing care is crucial for promoting overall health and preventing potential complications.
#92 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Refer to, or contact, social services, if necessary. The family may need support in planning the cost of a funeral and other necessities. Effective social and professional support matches the needs and expectations of the recipient comes from a preferred individual, and does not have an excessive payback cost of returning the favor. Professional support interventions should be as close as possible to the parents standard of the desirable after the caring process of knowing has commenced. […] Plan follow-up meetings or phone calls, as appropriate. Refer to community resources/support groups (e.g., visiting nurse services, Compassionate Friends, etc.). This provides the client or the couple with the opportunity to discuss and ask questions. This assists the client or couple at crucial moments in the grief process, providing role models and the opportunity to discuss the loss with others who share the same experience. Support is often viewed as most credible when it comes from someone who has previously experienced and successfully managed a similar crisis. Some parents will appreciate and use a referral to a support group for bereaved parents; others will not. However, this information should always be made available to them in case they change their minds.
#93 Reproductive & Maternal Health
https://www.healio.com/news/womens-health-ob-gyn/20241015/outpatient-early-pregnancy-loss-clinics-may-improve-poorly-managed-miscarriage-care
Miscarriage care is often suboptimal for women in Canada experiencing early pregnancy loss and providers should be aware of maternal psychological effects to provide compassionate assessment, management and follow-up, researchers reported. […] Care for women experiencing miscarriage should be individualized for each patient and decided through shared decision-making and informed consent, researchers wrote. The three methods used for miscarriage are expectant, medical and surgical management. […] Most women living in Canada experiencing early pregnancy loss receives care through the ED, Tunde-Byass told Healio, where patients perceive their care as suboptimal and less compassionate. […] The psychological impact may include anxiety, depression and PTSD and may last beyond 6 months, Tunde-Byass said.
#94 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
When we have gathered all necessary clinical information and you are diagnosed with a miscarriage, you will have a few options to discuss with our care team. […] Which option is best for you depends on your individual situation and is highly personal. We can talk about any of these options with you in more detail and help you feel safe and supported whatever you decide to do. No matter which option is best for you, we will be here to support you every step of the way. […] This option allows for a period to wait and see if the pregnancy passes on its own. […] We recommend intervention (with medication or a surgical procedure) if you have not passed the pregnancy four weeks after diagnosis of a miscarriage. […] Some people opt to take a mixed approach and will try expectant management for a week or two before opting into active management.
#95 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
When we have gathered all necessary clinical information and you are diagnosed with a miscarriage, you will have a few options to discuss with our care team. […] Which option is best for you depends on your individual situation and is highly personal. We can talk about any of these options with you in more detail and help you feel safe and supported whatever you decide to do. No matter which option is best for you, we will be here to support you every step of the way. […] This option allows for a period to wait and see if the pregnancy passes on its own. […] We recommend intervention (with medication or a surgical procedure) if you have not passed the pregnancy four weeks after diagnosis of a miscarriage. […] Some people opt to take a mixed approach and will try expectant management for a week or two before opting into active management.
#96 Navigating Recurrent Miscarriages: A Comprehensive Guide to Care
https://fertility.womenandinfants.org/services/women/recurrent-miscarriage
A miscarriage can cause deep-rooted feelings of loss and sorrow. Some doctors suggest that patients join a support group to talk about their experience and grief associated with the loss of the pregnancy and the baby. […] To determine the cause of recurrent miscarriages, a fertility specialist or an ob/gyn will review a patients medical history and past pregnancies. […] Approximately 50 percent of patients who are evaluated for recurrent miscarriage have a clear diagnosis. […] Treatments for recurrent miscarriage can involve lifestyle changes, medications, surgery or genetic tests to increase the chance of a successful pregnancy. […] Even after having three miscarriages, a woman has a 60 to 80 percent chance of conceiving and carrying a full-term pregnancy. […] Surgery can fix problems with a septate uterus and can eliminate some fibroids or scar tissue irregularities.
#97 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Refer for psychiatric counseling or psychotherapy, if indicated. Extra support in coping with grief may be necessary. Psychotherapy may be effective in cases of pathological grief or overprotectiveness, which can negatively affect normal parenting and the integration of loss into usual activities. A further recent study examining the efficacy of an Internet-based cognitive behavioral therapy for mothers after pregnancy loss showed positive treatment effects, with the intervention group showing significantly reduced symptoms of grief, PTSD, and depression after treatment relative to the waiting-list group, and these symptoms reduction was maintained at 3-month follow-up. […] Self-esteem typically refers to feelings of self-worth or a global evaluation of the self, which has profound implications for individual well-being. For many women, motherhood is a role full of meaning and expectations. The loss of a baby or child represents the loss or shaking of that significant role. This may greatly affect the clients concept of self. Birth and death are two of the most significant life events in their own right: in stillbirth, they fuse inseparably, with a devastating impact not just on the infant who has died but also on parents, families, healthcare professionals, communities, and the wider society. For all parents, the death of their baby caused them to reflect existentially on their life values and belief systems.
#98 Miscarriage â Treatment : Emergency Care BC
https://emergencycarebc.ca/clinical_resource/clinical-summary/1st-trimester-bleeding-miscarriage-treatment/
If available F/U with OB/GYN for monitoring of miscarriage completion through expectant, medical, or surgical management often best. […] Threatened Miscarriage: […] Viability confirmed: Return care to main OB provider. […] Viability uncertain: see PECS Miscarriage â Diagnosis. […] Provide anticipatory guidance on possibility of future miscarriage. […] Completed Miscarriage: […] F/U with primary OB provider (or Early Pregnancy Assessment Clinic if in the Lower Mainland) to ensure resolution of bleeding (< 72 hours). [...] C) Discharge planning: [...] Discharge Instructions: Return to ED if: significant increase in bleeding, pain, lightheadedness or fainting, fever, foul-smelling discharge. [...] F/U with main OB provider within 72 hours. [...] Counselling: [...] Miscarriage and Bleeding in Early Pregnancy â Patient Information Sheet
#99 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Help the couple recognize their needs and accept help from others. Health care providers should encourage the couple to ask for and accept help from various sources, including family, friends, coworkers, health care providers, and support groups. Providers can also assist the couple in recognizing that strains in family communication often occur after a perinatal loss and encourage them to deal with it proactively. […] Consider referrals for counseling and assist with coordination of appointments (e.g., with social services or support groups). The clients or the couples ability to coordinate and perform tasks may be compromised. Referrals help provide support and assistance, which can facilitate the integration of loss into daily life and enhance self-esteem. Parents may not be ready to consider a support group until several weeks after the loss. This information should not be provided until after the birth.
#100 Discharge Instructions for Miscarriage | Saint Luke’s Health System
https://www.saintlukeskc.org/health-library/discharge-instructions-miscarriage
You have had a miscarriage. This is the unplanned end of a pregnancy before the baby can live outside the uterus. You may feel a roller coaster of emotions as well as physical symptoms as your body recovers. It may take a few weeks to a month or more to recover physically depending on how far along you were in the pregnancy. […] Suggestions for care at home include: […] Reach out to those closest to you for understanding, comfort, and support. Give yourself the time you need to grieve your loss. Ask your healthcare provider about support groups in your area. It may be helpful to talk with others who have had a miscarriage. […] Call your healthcare provider or seek medical care right away if you have any of the following: […] Bright red vaginal bleeding or a smelly discharge. […] Vaginal bleeding that soaks more than one menstrual pad per hour. […] Belly pain that’s severe or getting worse.
#101
https://www.nhs.uk/conditions/miscarriage/what-happens/
If there’s no pregnancy tissue left in your womb, no treatment is required. […] However, if there’s still some pregnancy tissue in your womb, your options are: expectant management wait for the tissue to pass out of your womb naturally, medical management take medicine that causes the tissue to pass out of your womb, surgical management have the tissue surgically removed. […] It’s important to discuss them all with the doctor in charge of your care. […] If you have a miscarriage in your first trimester, you may choose to wait 7 to 14 days after a miscarriage for the tissue to pass out naturally. This is called expectant management. […] If the pain and bleeding have lessened or stopped completely during this time, this usually means the miscarriage has finished. […] You should be advised to take a home pregnancy test after 3 weeks.
#102
http://www.bcwomens.ca/health-info/pregnancy-parenting/miscarriage/treatment-options-for-miscarriage
Understanding your treatment options may help you to feel more in control. Once an ultrasound confirms a miscarriage will occur, there are three treatment options available to you: Expectant management, Medical management, Surgical management (Dilation and curettage or 'DC’). These options are safe and do not affect your future pregnancies. Your healthcare provider will discuss each of these with you to help you determine the best option for you. […] Expectant management is when you wait for the miscarriage to occur on its own. Approximately 50% of patients will miscarry on their own within 2 weeks of a diagnosis of pregnancy demise in the first trimester. The timing of miscarriage can vary significantly. It can sometimes take up to 6-8 weeks for miscarriage to occur after diagnosis. Most who choose expectant management will have a complete miscarriage on their own, however approximately 1 in 4 will need an emergency dilation and curettage (DC), a surgical procedure to make sure all the pregnancy tissue is removed.
#103
https://www.nhs.uk/conditions/miscarriage/what-happens/
This involves taking tablets that cause the cervix to open, allowing the tissue to pass out. […] In most cases, you’ll be offered tablets called pessaries that are inserted directly into your vagina, where they dissolve. […] The tablets usually begin to work within a few hours. […] You’ll experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. […] You should be advised to take a home pregnancy test 3 weeks after taking this medicine. […] If the pregnancy test shows you’re still pregnant, contact a healthcare professional as you may need to have further tests. […] You should also contact a healthcare professional if your pregnancy test is negative and you’re still having bleeding or other symptoms, such as pelvic pain or a high temperature (fever), after 3 weeks.
#104 Miscarriage Care Options - Oula
https://oulahealth.com/blog/miscarriage-pregnancy-loss-care-options/
This is the least interventive approach and allows you space and time to process the loss and see how things would evolve on their own timeline. […] Waiting can be mentally and emotionally challenging knowing the pregnancy will not continue to develop but also being uncertain of when the process of passing the embryo will begin and be complete. […] Sometimes expectant management results in an incomplete miscarriage and medical or procedural follow up will be necessary. […] This option involves taking medication by mouth to encourage the pregnancy to pass. […] Our care team will counsel you, obtain informed consent, and then prescribe medication to begin the miscarriage process. […] Two medicines will be used to treat your miscarriage mifepristone and misoprostol. […] You are able to better control the timing and overall experience of your miscarriage and to prepare yourself, both physically and mentally, to go through the process in a safe space with a support person when possible.
#105 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
Are There Risks and Complications? […] Risks associated with anesthesia such as an adverse reaction to medication and breathing problems […] Hemorrhage or heavy bleeding […] Infection in the uterus or other pelvic organs […] Perforation or puncture to the uterus […] Laceration or weakening of the cervix […] Scarring of the uterus or cervix, which may require further treatment […] Incomplete procedure that requires another procedure to be performed. […] What to Expect After a D&C […] Most women are discharged from the surgical center or hospital within a few hours of the procedure. […] You will more than likely be given an antibiotic to help prevent infection and possibly some pain medication to help with the initial cramping after the procedure. […] Light cramping and bleeding can be expected from a few days to up to 2 weeks. Ibuprofen is usually suggested for treating cramps. […] You should not insert anything into the vaginal area (including using a douche or having sexual intercourse) for at least 2 weeks or until the bleeding stops. […] Tampons should not be used until you start your next regular period, which could be anywhere from 2-6 weeks after the D&C procedure. […] Make sure to attend your follow-up appointment.
#106 D&C Procedure After a Miscarriage: Risks & Complications
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/d-and-c-procedure-after-miscarriage/
When to Contact the Doctor […] Most women experience few complications after a D&C procedure after miscarriage, but you should be aware of symptoms that could signal a possible problem. […] Contact them as soon as possible if you experience any of the following: […] Dizziness or fainting […] Prolonged bleeding (over 2 weeks) […] Prolonged cramping (over 2 weeks) […] Bleeding heavier than a menstrual period, or filling more than one pad per hour […] Severe or increased pain […] Fever over 100.4 Â°F […] Chills […] Foul smelling discharge.
#107 Recurrent Miscarriage Care in Charlotte | RSC Fertility
https://fertilitycarolinas.com/fertility-treatment/recurrent-miscarriage
Recurrent pregnancy loss (RPL) is a condition characterized by having two or more miscarriages. […] RPL is sometimes associated with underlying medical conditions that impact the endocrine system. Women with conditions such as hypothyroidism or diabetes can sometimes have a higher risk of experiencing repeated miscarriages. […] Anatomical issues with the female reproductive system can sometimes cause RPL. Some examples include abnormal uterus shape, uterine fibroids, and intrauterine scar tissue or adhesions. […] One of the biggest lifestyle factors associated with RPL is smoking. Other lifestyle factors that can increase the chances of RPL include drug use, alcohol consumption, excessive caffeine, and obesity. […] Treatment for RPL largely depends on what is causing the issue in the first place, and typically involves genetic screening, correcting underlying medical and anatomical issues, and/or adjusting the patients lifestyle.
#108 Navigating Recurrent Miscarriages: A Comprehensive Guide to Care
https://fertility.womenandinfants.org/services/women/recurrent-miscarriage
A miscarriage can cause deep-rooted feelings of loss and sorrow. Some doctors suggest that patients join a support group to talk about their experience and grief associated with the loss of the pregnancy and the baby. […] To determine the cause of recurrent miscarriages, a fertility specialist or an ob/gyn will review a patients medical history and past pregnancies. […] Approximately 50 percent of patients who are evaluated for recurrent miscarriage have a clear diagnosis. […] Treatments for recurrent miscarriage can involve lifestyle changes, medications, surgery or genetic tests to increase the chance of a successful pregnancy. […] Even after having three miscarriages, a woman has a 60 to 80 percent chance of conceiving and carrying a full-term pregnancy. […] Surgery can fix problems with a septate uterus and can eliminate some fibroids or scar tissue irregularities.
#109 Reproductive & Maternal Health
https://www.healio.com/news/womens-health-ob-gyn/20241015/outpatient-early-pregnancy-loss-clinics-may-improve-poorly-managed-miscarriage-care
Miscarriage care is often suboptimal for women in Canada experiencing early pregnancy loss and providers should be aware of maternal psychological effects to provide compassionate assessment, management and follow-up, researchers reported. […] Care for women experiencing miscarriage should be individualized for each patient and decided through shared decision-making and informed consent, researchers wrote. The three methods used for miscarriage are expectant, medical and surgical management. […] Most women living in Canada experiencing early pregnancy loss receives care through the ED, Tunde-Byass told Healio, where patients perceive their care as suboptimal and less compassionate. […] The psychological impact may include anxiety, depression and PTSD and may last beyond 6 months, Tunde-Byass said.
#110 Care for those who have a miscarriage may be compromised in states that restrict abortion, study finds – University at Buffalo
https://www.buffalo.edu/news/releases/2023/02/06.html
A study led by a University at Buffalo physician has found that people experiencing a miscarriage in states with restrictive abortion policies may be less likely to receive optimal care than those in states with supportive abortion policies. […] Our study is consistent with the notion that general pregnancy care suffers where abortion is restricted. […] I had a hunch that restricting abortion means less ideal care for people experiencing miscarriage, said Tal, who focuses on complex family planning at UB and is a physician with UBMD Obstetrics Gynecology. […] We know abortion restrictions correlate with higher rates of maternal mortality, so it follows that other aspects of health care would be affected, especially miscarriage care, which so closely mirrors abortion care. […] That would apply to routine early miscarriage, more complicated miscarriage like second trimester fetal demise, and abortion for life-threatening situations.
#111 Question about miscarriage – Ob/Gyn Nursing
https://allnurses.com/question-miscarriage-t199200/
Just wondering how you recover emotionally from a miscarriage when you work in LD. It just feels like it’s being rubbed in my face all day long. Anyone have this experience? […] Not well. That hasn’t been my experience, but a coworker’s, who struggled with seven losses in one year while working in the nursery. It was really difficult for her. […] I had a miscarriage between my two children that I have now. I did not work in OB at that time, but it was still very hard. I actually was resentful to pregnant women I seen because I thought that was the end for me. I was heartbroken each time I seen a brand new baby, because I should have had one too. […] I finally did get pregnant again about 4 months after the miscarriage, and I tell you it was the scariest pregnancy I have ever had. I was afraid every minute for 9 whole months that I would lose that baby.
#112 Question about miscarriage – Ob/Gyn Nursing
https://allnurses.com/question-miscarriage-t199200/
I worked in NICU while undergoing fertility treatments and suffering the loss of my first pregnancy. […] It is perfectly understandable that you might have difficulty supporting maternity patients when you are suffering a great loss yourself. […] I had a 16 week loss of my little boy in October. […] Overall going back to work is not as bad as you think, I did cry the first night but who wouldn’t? […] Take all the time you need before going back. You will be OK, but not on the first day back. […] I am so sorry for your loss. Please take care of yourself. […] Really, the only thing that „healed” me was getting pregnant again. It took almost six months for that to happen. […] What works for me is: 1) I never count chickens anymore – after 4 miscarriages, I know better than to think I’m going to win the lottery each time.
#113 Question about miscarriage – Ob/Gyn Nursing
https://allnurses.com/question-miscarriage-t199200/
Just wondering how you recover emotionally from a miscarriage when you work in LD. It just feels like it’s being rubbed in my face all day long. Anyone have this experience? […] Not well. That hasn’t been my experience, but a coworker’s, who struggled with seven losses in one year while working in the nursery. It was really difficult for her. […] I had a miscarriage between my two children that I have now. I did not work in OB at that time, but it was still very hard. I actually was resentful to pregnant women I seen because I thought that was the end for me. I was heartbroken each time I seen a brand new baby, because I should have had one too. […] I finally did get pregnant again about 4 months after the miscarriage, and I tell you it was the scariest pregnancy I have ever had. I was afraid every minute for 9 whole months that I would lose that baby.
#114 Reproductive & Maternal Health
https://www.healio.com/news/womens-health-ob-gyn/20241015/outpatient-early-pregnancy-loss-clinics-may-improve-poorly-managed-miscarriage-care
Investing in dedicated clinics to provide a compassionate, streamlined approach to care with reduced wait times and better patient experiences will reduce suffering by bypassing overcrowded EDs. […] Prioritization of patients experiencing early pregnancy loss would seem deserving of attention, given their risk for enduring physical and psychological effects related to existing models of care, Varner wrote. It is time to invest in early pregnancy assessment clinics that are better equipped to provide a more tailored, patient-centered experience and greater understanding of early pregnancy complications and loss than can be found in an overcrowded emergency department.
#115 Miscarriage care can be hard to come by in the ER : Shots – Health News : NPR
https://www.npr.org/sections/health-shots/2023/01/04/1146801914/many-ers-offer-minimal-care-for-miscarriage-one-group-wants-that-to-change
„We encountered a ton of resistance by nurses and other staff who felt that their religious beliefs precluded them from doing that,” said Dr. Mira Mamtani, an associate professor of emergency medicine at Penn Medicine. […] Prager and colleagues say they’ve frequently faced similar challenges over the years, but now the stakes are even higher. […] If the patient is bleeding heavily, „she can get really sick, really fast.” That’s when an MVA becomes a time-sensitive, life-saving procedure, she said, „and something I think we all should know how to do.” […] „But emergency medicine has been in flux since its inception,” she says. „We have continuously expanded our skill set and added to our toolkit. I think it’s time we consider offering our patients more options for miscarriage care.”
#116 Educating Emergency Department Nurses About Miscarriage – PubMed
https://pubmed.ncbi.nlm.nih.gov/29215421/
Miscarriage is the unwanted ending of a pregnancy before 20 weeks gestation. Women experiencing miscarriage require specialized care from nurses and other healthcare professionals. Many women are dissatisfied with emergency care related to miscarriage and desire honest communication, validation of urgency, and more robust information at discharge. Perinatal bereavement education offers an opportunity for emergency department nurses to acquire specific knowledge and communication skills that assist with understanding the individualized experience of early pregnancy loss. […] Therefore, assessing the meaning of miscarriage is an essential step to providing sensitive, supportive care. Education was offered to emergency department nurses based on a 4-hour Resolve Through Sharing curriculum. Education focused on knowledge of policy and practice, medical aspects of pregnancy loss, information on how to assess the meaning of the miscarriage, respectful handling and disposition of the remains, and communication strategies to initiate and sustain a meaningful relationship with the woman and her family, within the barriers to care that are exclusive to the emergency department. Participants embraced the information and actively participated in dialogue of an evaluation process to identify needed revisions in current policies and practices for caring for this patient population. Recommendations and guidance for emergency room nurses who care for women experiencing miscarriage are offered.
#117 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Perinatal Loss (Miscarriage) Nursing Care Plans and Nursing Diagnosis […] The loss of an infant through miscarriage, stillbirth, or neonatal death is perceived as a traumatic life experience. It is recognized as a tough life event, which can oftentimes cause complicated grief (CG) reactions that risk negatively influencing psychological and physical well-being. Generally, when a pregnancy ends in the death of a fetus or neonate, the loss is both unexpected and devastating for the mothers or the couple. They usually struggle with post-traumatic stress disorder (PTSD), anxiety, and depression, especially when not approached or managed properly. […] Perinatal loss is a crisis within a crisis. Women and their partners undergoing pregnancy loss frequently talk of not getting on with their life goals, plans, and dreams. They appear stuck, off track, as if they are running in place as life passes them by. This care plan is directed at the emotional needs of the postpartum client who must cope with the death of a child.
#118 Reproductive & Maternal Health
https://www.healio.com/news/womens-health-ob-gyn/20241015/outpatient-early-pregnancy-loss-clinics-may-improve-poorly-managed-miscarriage-care
Miscarriage care is often suboptimal for women in Canada experiencing early pregnancy loss and providers should be aware of maternal psychological effects to provide compassionate assessment, management and follow-up, researchers reported. […] Care for women experiencing miscarriage should be individualized for each patient and decided through shared decision-making and informed consent, researchers wrote. The three methods used for miscarriage are expectant, medical and surgical management. […] Most women living in Canada experiencing early pregnancy loss receives care through the ED, Tunde-Byass told Healio, where patients perceive their care as suboptimal and less compassionate. […] The psychological impact may include anxiety, depression and PTSD and may last beyond 6 months, Tunde-Byass said.
#119 Miscarriage care | BPAS
https://www.bpas.org/more-services-information/pregnancy-miscarriage/miscarriage-care/
We are here to help, provide information and support you as well as providing medical care. […] We understand that being told you are having a miscarriage can be confusing and you may experience a mixture of feelings. […] Our staff will treat you sensitively and professionally, so if you have any questions, or would like anything explained further, please ask. […] Your treatment and care are designed with your needs, medical safety, and personal preferences in mind. […] We understand that there may be a variety of things you are thinking and feeling concerning this miscarriage, so we will be guided by you. […] You can choose to receive your miscarriage care from BPAS or we can refer you into your local NHS service. […] We offer the following miscarriage care: […] Early miscarriage is where the pregnancy stops growing in the first 13 weeks of pregnancy.
#120 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Develop a sense of self-awareness before exploring the clients feelings. In addition to understanding the clients culture and worldview, the nurse must also actively cultivate self-awareness, including understanding their religion/spirituality attitudes, beliefs, and values. Self-reflection and the cultivation of self-awareness are ethical and professional duties for counselors. Understanding themselves and the limits of their understanding will help the nurse to use consultation and make referrals appropriately. […] Communicate with the client or couple therapeutically, giving importance to the clients cultural and religious/spiritual beliefs. Competent counselors use language and approaches that are consistent with the clients culture and worldview, including their religion/spirituality perspectives. As the client processes their experiences of early pregnancy loss, the nurse must recognize and address therapeutically relevant religion/spirituality themes in client communication. The nurse should take care to use and explore the meaning of the clients language concerning their experience of early pregnancy loss, as well as their culture and worldview, including religion/spirituality, gender, and affectional identities.
#121 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Include the partner in the planning of care. Grant opportunity for the partner to be seen individually. Reinforce discussion of concerns. Partnership in planning and decision-making acknowledges that the partner has also lost a child and may need time to express feelings of loss and receive support without having to be supportive of the client and others. The loss of an infant during pregnancy can deeply distress a client and can put a strain on her relationship with the father, but it may also have a distinct psychological impact on the grieving father. Symptoms of grieving in men were found to be similar to those of women, except that men report less crying and feel the need to talk less about their loss. […] Consider the individual nature of movement through the stages of grief; inform the client/couple that delays in the grief process or relapses of grief are normal. The process of grieving is not usually a fluid progression through the stages to resolution; it is rather a fluctuation between stages and possibly involves skipping of stages. Knowing that grieving is individual helps the couple let each other grieve at his or her own pace. There are no set time limitations for resolving grief, and it is not unusual for the family to be actively dealing with the loss one to two years later.
#122 Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage | Free NURSING.com Courses
https://nursing.com/lesson/nursing-care-plan-for-abortion-spontaneous-abortion-miscarriage?view_quiz=open&from_search=
Offer education and information regarding future reproductive health, including family planning options, contraception methods, and strategies to optimize the chances of a healthy pregnancy in the future. Empower the woman with knowledge to make informed decisions about her reproductive well-being. […] Establish a plan for follow-up care to monitor the woman’s physical and emotional well-being. Schedule regular check-ups to assess recovery progress, address any ongoing concerns, and provide additional support as needed. This ongoing care is crucial for promoting overall health and preventing potential complications.
#123 Clinical care for women seeking pregnancy after miscarriage
https://www1.racgp.org.au/ajgp/2024/november/clinical-care-for-women-seeking-pregnancy-after-mi
Miscarriage is a common and distressing event that impacts womens physical and psychological wellbeing. […] Current evidence suggests that delaying conception does not yield any tangible benefits, and conception immediately after a miscarriage is safe. Psychological support, screening for depression and access to mental health services are crucial for comprehensive care. […] Addressing the psychological aspects of miscarriage is an essential component of comprehensive care for affected individuals. Healthcare providers should screen for depression and ensure patients have access to appropriate mental health support services, such as counselling and support groups. […] Post-miscarriage management requires a comprehensive and multidisciplinary approach that encompasses medical considerations, psychological support and lifestyle modifications.
#124 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs
https://nurseslabs.com/perinatal-loss-nursing-care-plans/
Recognize the stage of grief being displayed, e.g., denial, anger, bargaining, depression, and acceptance. Use therapeutic communication skills (e.g., Active-listening, acknowledgment), respecting the clients desire/request not to talk. If the process of grieving is not completed, grief may become dysfunctional, resulting in behaviors that are disturbing to personal safety and the future of the family and marriage/relationship. The nurse can counsel the couple on the importance of sharing feelings, experiences, and needs in a non-threatening manner and encourage the partner to do the little things that show his partner that he cares for her and will not abandon her. […] Regarding communication patterns among the couple and support systems. In various instances, parents display anger and blame toward one another. Anger may arise from fear of losing another child or a threat to self-esteem. Projections of guilt and blame, as well as angry feelings towards a partner and the loss of the vision of a future as a family, may put considerable stress on the relationship.