Abstract

There is a lack of research and published national or international guidelines on second trimester pregnancy loss. We conducted a survey of professionals working in maternity services in the UK and Ireland to find out how second trimester pregnancy loss was managed within hospitals.

How second trimester pregnancy loss was defined varied between hospitals, as did the location of care for the assessment and management of second trimester pregnancy loss. Two in five women could self-refer to hospitals for assessment in the second trimester. The amount (dose) of misoprostol used for second trimester pregnancy loss varied between hospitals and three in five people who responded to the survey were unsure about the best dose to use. Surgical management was rarely offered. Although almost all units reported consultant follow-up, just under half of survey respondents reported routine follow up took place in a dedicated pregnancy loss clinic. Only about half of respondents reported that post-mortem examination (autopsy) was routinely offered after second trimester pregnancy loss.

There is confusion over the definitions, appropriate location in hospitals for care, best medication treatment options and the type of follow up needed following second trimester pregnancy loss. High quality research is needed to develop evidence-based clinical guidance to reduce differences in care.