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Despite Improvements, COVID-19’s Health Care Disruptions Persist
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2021
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Reproductive HealthGynecologyCovid-19 ’Covid-19 EpidemiologyReproductive EpidemiologyCovid-19Reproductive EndocrinologyHigh-risk PregnancyPreventive MedicineMiscarriage.the 15Clinical EpidemiologyPrenatal CareObstetricsPublic HealthInfertilityMaternal ComplicationUltrasound MachinesGlobal Health CrisisCovid-19 PandemicMaternal HealthMaternal-fetal MedicineAbortionComprehensive CarePregnancyMedicineWomen's Health
More Comprehensive Care for Miscarriage Needed WorldwideAbout 1 in 10 women will have a miscarriage over a lifetime-a statistic that represents 23 million pregnancies lost annually, or 44 per minute worldwide, according to a series of articles in The Lancet.Despite the magnitude, the articles described miscarriage as a misunderstood phenomenon and called for more comprehensive care to prevent and treat miscarriage.The 15% of pregnancies that end in a miscarriage can be attributed to risk factors including age during pregnancy, smoking, stress, air pollution, and exposure to pesticides, 1 of the studies reported.For repeated miscarriages, which affect about 2% of women, another study indicated that progesterone could increase live-birth rates and that levothyroxine may decrease the risk of miscarriage for women with subclinical hypothyroidism.Repeated miscarriages can be emotionally devastating and pose a risk of future pregnancy complications, the authors noted.In some cultures, they added, women who are unable to have children and their partners may face discrimination, stigma, and ostracism.Another study in the series recommended using high-quality ultrasound for accurate miscarriage diagnoses and surgical management with vacuum suction aspiration as the preferred approach for missed miscarriages-those that occur without pain or bleeding.The authors noted that dedicated early pregnancy units are emerging as a model of care in the UK, Canada, Australia, and other countries.These units should be equipped with appropriate medications, ultrasound machines, efficient blood test processing, and staff who are properly trained in ultrasound scanning, giving bad news, and providing psychological support, the authors wrote.Co-lead author of the series, Siobhan Quenby, MD, of the University of Warwick in the UK, said in a statement that many women who've had a miscarriage are advised only to try again."That is not good enough, and we must ensure women are properly supported."