An Exploration of the Prevalence and Patterns of Care for Women Presenting with Mid-Trimester Loss

Background: Mid-trimester loss (MTL) is an area that is poorly defined in the literature and often under reported in clinical practice. The prevalence of MTL in Ireland is uncertain and has a huge impact on the woman, her... [ view full abstract ]

Background: Mid-trimester loss (MTL) is an area that is poorly defined in the literature and often under reported in clinical practice. The prevalence of MTL in Ireland is uncertain and has a huge impact on the woman, her family and maternity care services.
Aims: To explore the prevalence and patterns of care for women with MTL in a large Maternity hospital in Ireland.
Methods: A descriptive, exploratory study was used involving a retrospective chart audit. Permission for this retrospective chart audit was obtained from the Director of Midwifery and the board of Management.
Results: 220 women presented with MTL over the 3 year data collection period (January 2011-December 2013), giving a rate of 0.8% of all deliveries. The majority of women had no previous pregnancy losses and were multiparous (i.e. had a previous pregnancy >500g). The mean gestational age was 17.69wks (SD= 2.73). The mean length of hospital stay was 1.89 days. Intra muscular (IM) analgesia was the most commonly (58.5%) used medication. Follow up hospital care was received in over 78% of cases. The majority of women were referred the CMS Bereavement and Chaplain services, with a small number (approx. 5%) referred to the social worker. Over 46.4% of families availed of the hospital burial service.
Conclusions: Results suggest the incidence of mid-trimester loss may be slightly lower than the 1 or 2% of pregnancies reported in the literature. The incidence of mid-trimester loss in multiparous women is approximately twice that of nulliparous women. The referral services offered in the study were utilised by most of the women, as were follow-up clinic appointments.