Management of Subsequent Pregnancy After Perinatal Death: Results from the UNSURENESS Study
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis and Data Presentation
3. Results
3.1. Characteristics of the Sample
3.2. Professional Experience
3.3. Management of Pregnancies After a Loss
3.3.1. Multidisciplinarity
3.3.2. Shared Decision Making
3.3.3. Clinical Management of Pregnancies After a Loss
3.3.4. Labor and Birth Management
3.3.5. Information and Psychological Aspects
3.3.6. Easy and Difficult Aspects in Assisting Pregnancies After Perinatal Loss
- Easier Aspects of Care
- More Difficult Aspects of Care
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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n | % | ||
---|---|---|---|
Geographical Zone | North | 141 | 70.5% |
Center | 36 | 18.0% | |
South | 23 | 11.5% | |
Age Class | <35 y | 80 | 40.0% |
36–42 y | 63 | 31.5% | |
≥43 y | 57 | 28.5% | |
Years of Work | <8 y | 74 | 37.0% |
9–16 y | 60 | 30.0% | |
≥17 y | 66 | 33.0% | |
Job | Midwife | 156 | 78.0% |
Doctor | 26 | 13.0% | |
Nurse | 12 | 6.0% | |
Psychologist | 6 | 3.0% | |
200 | 100.0% |
N (%)/ Mean (SD) | ||
---|---|---|
N | 200 (100.0%) | |
Presence of a center for at-risk pregnancies | ||
Yes, I refer women there | 165 (88.2%) | |
Yes, I don’t refer women there | 8 (4.3%) | |
No | 5 (2.7%) | |
Don’t know | 9 (4.8%) | |
Perinatal deaths assisted | ||
None | 15 (8.0%) | |
<3 | 33 (17.6%) | |
3–5 | 46 (24.6%) | |
6–10 | 47 (25.1%) | |
>10 | 46 (24.6%) | |
Subsequent pregnancies assisted | ||
None | 26 (13.9%) | |
<3 | 49 (26.2%) | |
3–5 | 50 (26.7%) | |
6–10 | 29 (15.5%) | |
>10 | 33 (17.6%) | |
Assisted only labor, not pregnancy | ||
Yes | 138 (73.8%) | |
No | 37 (19.8%) | |
Don’t remember | 12 (6.4%) | |
Debriefing experience available | ||
Yes | 57 (30.5%) | |
No | 122 (65.2%) | |
Don’t know | 8 (4.3%) | |
Debriefing experience importance (0–4) | ||
Available and attended | 3.6 (0.5) | |
Not available/never attended | 3.6 (0.6) | |
Specific training on perinatal loss | ||
Yes | 59 (32.8%) | |
No | 119 (66.1%) | |
Don’t remember | 2 (1.1%) | |
Usefulness of training (0–4) | 3.6 (0.6) | |
Attended | 3.7 (0.7) | |
Never attended | 3.6 (0.5) |
Test/Procedure | N (%) |
---|---|
1st trimester | |
Vital signs | 95 (81.9%) |
Urine test | 102 (87.9%) |
Urine culture | 96 (82.8%) |
Blood test | 113 (97.4%) |
Ultrasound | 113 (97.4%) |
Pap test | 44 (37.9%) |
Nuchal translucency | 104 (89.7%) |
Chorionic villus sampling | 19 (16.4%) |
Amniocentesis | 15 (12.9%) |
2nd trimester | |
Blood test | 112 (96.6%) |
Vital signs | 109 (94.0%) |
Fundal height | 97 (83.6%) |
Glucose test | 82 (70.7%) |
Ultrasound | 115 (99.1%) |
3rd trimester | |
Blood test | 115 (99.1%) |
Vital signs | 110 (94.8%) |
Fundal height | 105 (90.5%) |
Strep test | 106 (91.4%) |
Anti-d prophylaxis | 110 (94.8%) |
Information Provided | I Trimester | II Trimester | III Trimester | Post-Partum | Never |
---|---|---|---|---|---|
Lifestyle counseling | 95 (88.0%) | 3 (2.8%) | 1 (0.9%) | 3 (2.8%) | 6 (5.6%) |
Psychological wellbeing | 84 (77.8%) | 3 (2.8%) | 4 (3.7%) | 5 (4.6%) | 12 (11.1%) |
Nurturing care | 26 (24.1%) | 20 (18.5%) | 34 (31.5%) | 20 (18.5%) | 8 (7.4%) |
Labor | 3 (2.8%) | 29 (26.9%) | 69 (63.9%) | 1 (0.9%) | 6 (5.6%) |
Birth mode | 7 (6.5%) | 35 (32.4%) | 57 (52.8%) | 1 (0.9%) | 8 (7.4%) |
Pain management | 1 (0.9%) | 23 (21.3%) | 72 (66.7%) | 1 (0.9%) | 11 (10.2%) |
Hospital contacts | 6 (5.6%) | 21 (19.4%) | 73 (67.6%) | 1 (0.9%) | 7 (6.5%) |
Breastfeeding | 1 (0.9%) | 17 (15.7%) | 65 (60.2%) | 13 (12.0%) | 12 (11.1%) |
Psychological support | 69 (63.9%) | 15 (13.9%) | 11 (10.2%) | 4 (3.7%) | 9 (8.3%) |
Prenatal classes | 36 (33.3%) | 55 (50.9%) | 6 (5.6%) | 2 (1.9%) | 9 (8.3%) |
Cephalic presentation | 5 (4.6%) | 33 (30.6%) | 59 (54.6%) | 1 (0.9%) | 10 (9.3%) |
Postpartum services | 16 (14.8%) | 7 (6.5%) | 53 (49.1%) | 20 (18.5%) | 12 (11.1%) |
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Ravaldi, C.; Mosconi, L.; Cancellieri, G.; Caglioni, M.; Vannacci, A. Management of Subsequent Pregnancy After Perinatal Death: Results from the UNSURENESS Study. J. Clin. Med. 2025, 14, 5748. https://doi.org/10.3390/jcm14165748
Ravaldi C, Mosconi L, Cancellieri G, Caglioni M, Vannacci A. Management of Subsequent Pregnancy After Perinatal Death: Results from the UNSURENESS Study. Journal of Clinical Medicine. 2025; 14(16):5748. https://doi.org/10.3390/jcm14165748
Chicago/Turabian StyleRavaldi, Claudia, Laura Mosconi, Greta Cancellieri, Martina Caglioni, and Alfredo Vannacci. 2025. "Management of Subsequent Pregnancy After Perinatal Death: Results from the UNSURENESS Study" Journal of Clinical Medicine 14, no. 16: 5748. https://doi.org/10.3390/jcm14165748
APA StyleRavaldi, C., Mosconi, L., Cancellieri, G., Caglioni, M., & Vannacci, A. (2025). Management of Subsequent Pregnancy After Perinatal Death: Results from the UNSURENESS Study. Journal of Clinical Medicine, 14(16), 5748. https://doi.org/10.3390/jcm14165748