Stratton Katrina, Lloyd Libby
Discipline of Social Work and Social Policy, University of Western Australia, Perth, Western Australia, Australia.
Aust N Z J Obstet Gynaecol. 2008 Feb;48(1):5-11. doi: 10.1111/j.1479-828X.2007.00806.x.
It is estimated that up to one in five pregnancies will result in miscarriage, the spontaneous loss of pregnancy up to 20 weeks gestation. Miscarriage is such a common form of reproductive loss that it is often under acknowledged by the community, including health professionals. Dissatisfaction with care following miscarriage is well noted despite evidence that the care provided in hospital can have a significant effect on the experience of and the emotional and physical recovery from a miscarriage.
The aim of this literature review was to determine any evidence-based guidelines for hospital-based medical and psychosocial services following a miscarriage.
A search was made of medical and psychosocial databases for key terms. Further searches were then carried out using references. Articles were critically analysed and implications for service delivery derived.
Indications for service delivery at the time of miscarriage and follow up are clear from the reported experiences of women and the psychological sequelae of miscarriage. However, there is little evidence to support the efficacy of follow up postdischarge. There are implications for service delivery and research in six domains: staff care, assessment, information, phone follow up, risk assessment and care during subsequent pregnancies.
Further research is needed to establish the impact on women and staff of routine follow-up care after a miscarriage.
据估计，高达五分之一的妊娠会以流产告终，即妊娠20周内的自然流产。流产是一种常见的生殖损失形式，但往往未得到社会的充分认识，包括卫生专业人员在内。尽管有证据表明医院提供的护理对流产经历以及流产后的情绪和身体恢复有重大影响，但流产后对护理的不满却屡见不鲜。
本综述的目的是确定流产后基于医院的医疗和心理社会服务的循证指南。
在医学和心理社会数据库中搜索关键词。然后利用参考文献进行进一步检索。对文章进行批判性分析，并得出对服务提供的启示。
从女性的报告经历和流产的心理后遗症中可以清楚地看出流产时及随访时服务提供的指征。然而，几乎没有证据支持出院后随访的有效性。在六个领域对服务提供和研究有启示：工作人员护理、评估、信息、电话随访、风险评估以及后续妊娠期间的护理。
需要进一步研究以确定流产后常规随访护理对女性和工作人员的影响。
