title: The postnatal morbidity associated with second-trimester miscarriage.
abstract: OBJECTIVE
  To describe the complications, and their incidence, associated with the management and delivery of a distinct second-trimester miscarriage cohort.
  
  
  METHODS
  A retrospective cohort study was undertaken in a large, tertiary-referral university hospital (8500 deliveries per annum). All cases of pregnancy loss occurring between 14(+0) and 23(+6) were identified from July 2009 to June 2013 (n = 181). Medical notes were reviewed and the number of complications among this cohort was identified. Logistic regression was conducted to assess associations with clinical presentation and management.
  
  
  RESULTS
  The mean gestation of loss was 18(+2) weeks (SD: 2(+2)). 64.6% (n = 117) of the total losses were of intrauterine fetal demise (IUFD) with 17.7% (n = 32) following preterm premature rupture of membranes (PPROM) and 17.7% (n = 32) following preterm labour (PTL). All women required inpatient admission with 59.1% (n = 107) undergoing medical induction of labour. PPROM cases, compared with cases of IUFD, had increased odds of requiring antibiotic therapy (OR 13.75, 95% CI: 4.88-38.72) and readmission (OR OR 4.15, 95% CI 1.12-15.36).
  
  
  CONCLUSIONS
  These women represent a small proportion of the obstetric population but remain a distinct cohort whose management is complicated by high rates of morbidity requiring medical intervention. An awareness of these risks should inform future clinical practice.
authors.affiliation: a Department of Obstetrics & Gynaecology , Cork University Maternity Hospital , Cork , Ireland and.
authors.forename: Aoife
authors.initials: A
authors.lastname: Morris
authors.affiliation: b National Perinatal Epidemiology Centre , University College , Cork , Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Meaney
authors.affiliation: a Department of Obstetrics & Gynaecology , Cork University Maternity Hospital , Cork , Ireland and.
authors.forename: Niamh
authors.initials: N
authors.lastname: Spillane
authors.affiliation: a Department of Obstetrics & Gynaecology , Cork University Maternity Hospital , Cork , Ireland and.
authors.forename: Keelin
authors.initials: K
authors.lastname: O'Donoghue
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D055815:Young Adult
keywords: Miscarriage; morbidity; postnatal; second-trimester