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Printable Handouts
Navigable Slide Index
- Introduction
- Complications in previous pregnancy
- Why are previous pregnancy complications important?
- What are women’s experiences in subsequent pregnancies?
- Line of argument synthesis
- Anxiety and stress in pregnancy after stillbirth
- QoL & depression in pregnancy after stillbirth
- Qualitative study of PALC
- Qualitative Interview Study - Manchester, UK
- Qualitative interview study
- What are women’s experiences in subsequent pregnancies in the UK?
- Women’s experiences in the UK (n=547)
- Care in pregnancies after stillbirth - international HIC perspective
- Outcomes for parents in the UK
- Risk factors and stillbirth
- Previous stillbirth as a risk factor
- Other complications in subsequent pregnancy
- Increased risk of complications is not ameliorated by live birth
- Complications after prior 2nd trimester loss
- Why do complications recur?
- Subsequent pregnancy outcome
- Maternal vascular underperfusion and subsequent pregnancy outcome
- Factors predicting outcome in subsequent pregnancy
- Cochrane review (1)
- Cochrane review (2)
- Care pathway after perinatal death
- RCOG - recommendations (1)
- RCOG - recommendations (2)
- RCOG - recommendations (3)
- International consensus statement
- Interpregnancy interval after stillbirth (1)
- Interpregnancy interval after stillbirth (2)
- Looking at outcomes and service utilization (1)
- Looking at outcomes and service utilization (2)
- Rainbow Clinic
- Care in subsequent pregnancy
- Interventions in subsequent pregnancy
- Panel of ultrasound investigation
- Pregnancy outcome
- Next pregnancy outcome
- Data - patient experience
- Qualitative data - patient experience
- Social return on investment
- Scaling up and evaluating Rainbow Clinic
- Conclusion
- Some (simple) changes
- Thank you for your attention
Topics Covered
- Complications in previous pregnancy
- Pregnancies after stillbirth
- Recurrence of complications
- Rainbow Clinic
- Care in subsequent pregnancies
- Interventions in subsequent pregnancies
Links
Categories:
Therapeutic Areas:
External Links
Talk Citation
Heazell, A.E.P. (2024, September 30). Pregnancy after stillbirth and loss [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 2, 2024, from https://doi.org/10.69645/JNRH2873.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Hello, my name is Prof.
Alexander Heazell.
I'm one of the Professors
of Obstetrics at
the University of Manchester.
I'm going to talk
to you today about
pregnancy after stillbirth
and other forms of loss.
0:17
I'm going to focus on
stillbirth in this talk.
However, there are
other complications in
previous pregnancies that
have overlapping pathology.
Including late miscarriage,
neonatal death, and also
pregnancies affected by
severe congenital
abnormalities can end in
a termination for
fetal abnormality,
stillbirth, or neonatal death.
To a lesser extent,
what I'm going to talk about
is applicable to
pregnancies complicated by
severe fetal growth
restriction and preeclampsia.
0:52
Why are previous pregnancy
complications important?
Well, the first is that
there is biomedical
evidence that
there is a high risk
of recurrence of
previous pregnancy
complications.
There is also significant
psychological impact on
both parents—largely mothers,
but there is impact
on both parents,
showing high levels
of anxiety and stress
during pregnancy which
actually can impact,
ultimately, the bonding
between the mom and the baby.
Also, we know that
high levels of stress
can actually increase
the likelihood of adverse
outcomes in pregnancy
thus linking the psychological
and biomedical outcomes.
1:37
Prior to establishing a
specialist antenatal service,
we conducted a
systematic review and
meta-synthesis to describe
women's experiences in
subsequent pregnancies.
This systematic review
identified 14 studies,
none of which had
been conducted in
the UK at that point.
This review found
three main themes.
The first is that
emotions can co-exist.
Parents often described
ongoing grief and anxiety for
the death of their baby,
and anxiety for
the well-being of their
current pregnancy.
This isolated them from
friends and family.
Parents also embarked on
helpful and unhelpful
coping activities.
In some cases, they
delayed attachment to
their unborn child because
they couldn't envisage
going home with
a live-born baby and
they didn't want to
emotionally invest in
their unborn child.
Also, they may try
to seek control.
They may sometimes
be labelled as
difficult patients because
they want to know the answers.
They don't just want their
concerns to be dismissed.
Lastly, parents sought
reassurance through
interactions with
care providers,
with their baby, and
with technology.