专家呼吁：全球推行针对流产照护及治疗的全面改革，取消目前的碎片化服务体系

NOTES TO EDITORS

The Series received no direct funding. However, the Series was led and co-ordinated by the Tommy’s National Centre for Miscarriage Research, which is supported by Tommy’s Charity. A full list of authors and their institutes is available in the paper.

The Lancet Series on Miscarriage is a collection of three papers examining global evidence on the epidemiological, physical, psychological, and economic costs of these early pregnancy losses, as well as making recommendations for best practice care and support based on this review. Tommy’s National Centre for Miscarriage Research led an international group of authors in the Series, and their findings underpin the calls for UK policy change in Tommy’s new Miscarriage Matters campaign.

[1] Quote direct from author and cannot be found in the text of the Article.

[2] The definition of miscarriage varies amongst countries and international organisations, based on different gestational ages of the foetus, whether pregnancy was confirmed by a urine test (for β-human chorionic gonadotropin) or by ultrasound scan, and, for recurrent miscarriage, if the pregnancy losses are consecutive or if the woman has livebirths in between miscarriages.

[3] Miscarriage management options are either expectant (ie, without medical intervention), medical (misoprostol, with or without mifepristone), or surgical (suction aspiration, or suction aspiration plus cervical preparation).

[4] The essential investigations include measurements of lupus anticoagulant, anticardiolipin antibodies, thyroid function, and a transvaginal pelvic ultrasound scan. Chromosome analysis of pregnancy tissue can be done for explanatory purposes. Selected women can benefit from parental karyotyping.

The key treatments to consider are first trimester progesterone administration, levothyroxine in women with subclinical hypothyroidism, and the combination of aspirin and heparin in women with antiphospholipid antibodies. They note that the evidence for these treatments is of moderate and low quality, and there is no high-quality evidence for any treatments to prevent recurrent miscarriage.