Reproductive Loss

• Perinatal Loss

  -Includes fetal death (miscarriage of less than 20 weeks) and stillbirth (more than 20 weeks) and death of a live-born neonate in the first 28 days after birth
• Late pregnancy loss

  -Stillbirth death after 20 weeks gestation prior to birth

  -Most occur prior to woman going into labor

  -Common risk factors: obesity, pregnancy with multiples, AMA, chronic conditions such as diabetes, HTN, primip, smokers or substance abusers

  -Common causes: birth defects, Rh incompatability, cytomegalovirus, 5th disease, STIs, UTIs, listeriosis, and toxoplasmosis
• Swanson's model of nursing care after pregnancy loss

  -Maintaining belief: conveying confidence and faith in couple's ability to heal after loss experience

  -Knowing: striving to understand their loss experience from their point of view

  -Being with: conveying emotional presence and connectedness

  -Doing for: comforting them, anticipating their needs, protecting from harm, advocating for them and preserving their dignity

  -Enabling: assisting in the passage through unfamiliar events (coaching informing, explaining, supporting and allowing them to have their own life experience)
• Infertility: failure to conceive after 12 months of intercourse without contraceptive use.
• In Vitro fertilization

  Develop follicles-> retrieve eggs -> fertilize in lab -> insert in uterus
• Gamete intrafallopian transfer (GIFT)


  Insert sperm/egg mixture in fallopian tube by laparoscope
• Zygote intrafallopain transfer (ZIFT)

  Develop follicles -> retrieve eggs -> fertilize in lab -> insert in tube by laparoscope
• Cryopreservation

  Preserve embryos: freeze and store
• Micromanipulation (sperm problem)

  Intracytoplasmic sperm injection and inject a single sperm into egg
• Assisted Hatching

  A hole is artificially produced in embryo's covering

  Used to increased embryo development, hx of thick zone pellucida or implantation failures