Strategies for Addressing Recurrent Pregnancy Loss (Virtual Symposium)-07-Mak-Physicians

07-Mak-Physicians_Role

Pdf Summary

Dr. Winifred Mak’s presentation addresses the physician’s role in caring for patients with recurrent pregnancy loss (RPL). The talk highlights common misconceptions about miscarriage found in a U.S. national survey, including the mistaken beliefs that miscarriages are uncommon (55%) and that lifestyle factors or stress are primary causes rather than genetic factors. Men were more likely to hold these misconceptions. About 15% of respondents had experienced miscarriage themselves or through their partners.<br /><br />RPL patients often see OB-GYN providers first after loss, and their primary need is answers about why the loss occurred. Despite many desiring referral to pregnancy loss specialists, this is infrequently offered. The importance of empathy in communication is emphasized. When diagnosing miscarriage, doctors should acknowledge pregnancy loss (including biochemical pregnancies), avoid impersonal actions like handing tissues abruptly, and schedule follow-ups to discuss treatment options.<br /><br />Genetic workup is important; chromosomal microarray analysis of miscarriage tissue is recommended, as illustrated by data from 1398 couples. For patients attempting pregnancy after RPL, a Tender Loving Care (TLC) protocol is advised, supporting the patient emotionally and medically.<br /><br />Women with RPL experience increased anxiety and depression during subsequent pregnancies, underscoring the need for psychological support. Adjusted analyses show significantly elevated anxiety and depression scores compared to controls.<br /><br />Overall, the presentation advocates compassionate, patient-centered care, appropriate genetic evaluation, referral to specialists, and attentiveness to mental health in managing RPL patients. The goal is to address both medical and emotional needs to better support patients through loss and future pregnancies.

Keywords

recurrent pregnancy loss

miscarriage misconceptions

genetic factors in miscarriage

OB-GYN role

pregnancy loss specialists

empathy in patient care

chromosomal microarray analysis

Tender Loving Care protocol

anxiety and depression in pregnancy

patient-centered care