title: An exploration of the prevalence and patterns of care for women presenting with mid-trimester loss.
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.
  
  
  OBJECTIVE
  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.
  
  
  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 >500 g). The mean gestational age was 17.69 weeks (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.
authors: National Maternity Hospital, Holles street, Dublin 2, Ireland. scullen@nmh.ie.
authors: S
authors: S
authors: Cullen
authors: , Dublin, Ireland.
authors: S
authors: S
authors: Power
authors: UCD School of Nursing, Midwifery and Health Systems, College of Health Sciences, Belfield, Dublin 4, Ireland.
authors: B
authors: B
authors: Coughlan
authors: UCD School of Nursing, Midwifery and Health Systems, National Maternity Hospital, Dublin 2, Ireland.
authors: J
authors: J
authors: Chaney
authors: The University of British Columbia, 2329 W Mall, Vancouver, BC V6T 1Z4, Canada.
authors: M
authors: M
authors: Butler
authors: National Maternity Hospital, Holles street, Dublin 2, Ireland.
authors: M
authors: M
authors: Brosnan
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007494:Ireland; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies
keywords: Bereavement; Mid-trimester loss; Miscarriage; Pregnancy loss