A Review of Management for Women Having Later Pregnancy Loss

Late miscarriage or stillbirth may occur anywhere, at a primary clinic or at a tertiary center, and may involve deep grief and mental stress for women. The women would miss the chance to receive better management for the next pregnancy, or even they could feel sorrow more than necessary if they would take only a conventional postpartum course. Here we have reviewed the management for the cases of ours and discussed how we should respond to them.

We had fifty-eight cases of late miscarriage or stillbirth, excluding partial fetal loss of multiples, between 2014 and 2015. Gestational age was distributed between 13 to 36 weeks. Nineteen cases were induced abortion based on the woman’s will. Fetal morphological anomaly was found in eight cases and evident obstetric complication was found in sixteen cases such as rupture of membrane, placental abruption, or fetofetal transfusion syndrome in monochorionic multiples.

Investigating the cause of the pregnancy loss may help to interpret the circumstance for the women and to bring them motivation to the consequent pregnancy. Induced abortion cases based on the women’s social reason may be apparently excluded from the consideration. Fetal sporadic anomaly or evident obstetric complication may be interpreted as accidental and they would not require special preparation for the consequent pregnancy. On the contrary, fetal growth restriction or placental insufficiency may bring suspicion of predisposition of recurrent pregnancy loss.

Appropriate and faithful approach to the women with later pregnancy loss should be performed in practice and it may bring a ray of light to them.