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Linical Ounds Management Options For Women With Midtrimester Fetal Loss: A Case Report
Linical Ounds Management Options For Women With Midtrimester Fetal Loss: A Case Report
Midwifery Role In Supporting Women With A Midtrimester 2. Autry AM, Hayes EC, Jacobson GF, Kirby RS. A compar-
ison of medical induction and dilation and evacuation for second-
Fetal Loss
trimester abortion. Am J Obstet Gynecol 2002;187:393–397.
The role of the midwife may include assuring that the
3. Burgoine GA, Van Kirk SD, Romm J, Edelman AB, Jacob-
woman makes an informed decision based on her needs, son S, Jensen JT. Comparison of perinatal grief after dilation and
beliefs, physical and emotional status, and available re- evacuation or labor induction in second trimester terminations for
sources. The midwife should know the indications, contra- fetal anomalies. Am J Obstet Gynecol 2005;192:1928 –1932.
indications, and general procedures for both management
options. Contraindications to misoprostol use include pre- 4. Jain JK, Kuo J, Mishell DR Jr. A comparison of two dosing
regimens of intravaginal misoprostol for second trimester preg-
vious uterine surgery and allergy to prostaglandins.
nancy termination. Am J Obstet Gynecol 1999;93:571–575.
Misoprostol induction may be managed collabora-
tively with a physician, with the midwife still centrally 5. Grimes DA, Schulz KF, Cates JrCW. Tyler JrW, Methods of
involved in the hands-on care; referral to a physician is midtrimester abortion: Which is safest? Int J Gynaecol Obstet
necessary for D&E. It may be an additional stressor for 1977;15:184 –188.
a woman in this situation to see an unfamiliar and as 6. Chasen ST, Kalish RB, Gupta M, Kaufman JE, Rashbaum
yet untrusted medical provider, especially if the pa- WK, Chervenak FA. Dilation and evacuation at ⱖ20 weeks:
tient has to be referred to a different institution. Comparison of operative techniques. Am J Obstet Gynecol
Ideally, the midwife in this case would already have a 2004;190:1180 –1183.
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