A proposed obstetric care model for a patient experiencing recurrent miscarriages – a case report
DOI:
https://doi.org/10.12923/pielxxiw-2026-0043Keywords:
recurrent miscarriage, case study, midwife, nursing modelAbstract
Aim. The aim of the study was to present a model of obstetric care for patients experiencing recurrent miscarriage based on case analysis, the identification of nursing problems and the implementation of interventions aligned with current recommendations.
Material and methods. An individual case study was conducted. Data were obtained through interviews, patient observation and medical record analysis. ICNP (International Classification for Nursing Practice) terminology and C-HOBIC indicators supported care planning. The model was developed by integrating ESHRE (European Society of Human Reproduction and Embryology) guidelines, Callista Roy’s adaptation theory and the ICF (International Classification of Functioning, Disability and Health) classification, enabling multidimensional assessment. The case report followed CARE (for CAse REports) guidelines.
Results. Key nursing problems were identified: risk of intrauterine infection, moderate pain, depressive mood and feelings of helplessness. The patient required emotional and informational support. The implementation of the care plan reduced discomfort, improved comfort and increased sense of security as well as self-care ability.
Conclusions. Holistic midwifery care based on adaptive models and current guidelines is essential in managing recurrent miscarriages. Integration of the ICNP, ICF and Roy’s theory may support practice standardisation and the development of integrated perinatal care. This approach strengthens coordinated patient-centred management in clinical practice.
References
1. ESHRE Guideline on Recurrent Pregnancy Loss. [cytowane 26 października 2025]. Dostępne na: https://www.eshre.eu/guidelines-and-legal/guidelines/recurrent-pregnancy-loss
2. Turesheva A, Aimagambetova G, Ukybassova T, et al. Recurrent pregnancy loss etiology, risk factors, diagnosis, and management. Fresh look into a full box. J. Clin. Med. 2023;12(12):4074. https://doi.org/10.3390/jcm12124074
3. Regan L, Rai R, Saravelos S, et al. the Royal College of Obstetricians and Gynaecologists. Recurrent MiscarriageGreen-top Guideline No. 17. BJOG. 2023;130(12):e9-39. https://doi.org/10.1111/1471-0528.17515
4. Van Dijk MM, Kolte AM, Limpens J, et al. Recurrent pregnancy loss: diagnostic workup after two or three pregnancy losses? A systematic review of the literature and meta-analysis. Hum Reprod Update. 2020;26(3):356-367. https://doi.org/10.1093/humupd/dmz048
5. Boedeker D, Hunkler K, Mahdy H. Recurrent Pregnancy Loss. W: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 [cytowane 15 października 2025]. http://www.ncbi.nlm.nih.gov/books/NBK554460/
6. De Assis V, Giugni CS, Ros ST. Evaluation of Recurrent Pregnancy Loss. Obstet Gynecol. 2024;143(5):645-659. https://doi.org/10.1097/AOG.0000000000005498
7. Opieka nad pacjentkami w przypadkach poronień i martwych urodzeń – Najwyższa Izba Kontroli [cytowane 26 października 2025]. Dostępne na: https://www.nik.gov.pl/kontrole/wyniki-kontroli-nik/kontrola,20906.html
8. Riley DS, Barber MS, Kienle GS, et al. CARE guidelines for case reports: explanation and elaboration document. J. Clin. Epidemiol. 2017;89:218-335. https://doi.org/10.1016/j.jclinepi.2017.04.026
9. ICNP Browser ICN – International Council of Nurses. [cytowane 26 października 2025]. https://www.icn.ch/icnp-browser
10. Płaszewska-Żywko L. Model teoretyczny pielęgniarstwa Callisty Roy. [w:] Ślusarska B, Zarzycka D, Zahradniczek K, red. Podstawy pielęgniarstwa. Tom 1. Warszawa: PZWL Wydawnictwo Lekarskie; 2017, s. 213-221.
11. World Health Organization. International Classification of Functioning, Disability and Health. Geneva: WHO; 2001. Polish translation: Międzynarodowa Klasyfikacja Funkcjonowania, Niepełnosprawności i Zdrowia. CSIOZ; 2009.
12. Ockhuijsen HDL, van den Hoogen A, Boivin J, et al. Pregnancy after miscarriage: balancing between loss of control and searching for control. Res. Nurs. Health. 2014;37(4):267-275. https://doi.org/10.1002/nur.21610
13. Ford HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev. Obstet. Gynecol. 2009;2(2):76-83.
14. Farren J, Jalmbrant M, Ameye L, et al. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open. 2016;6(11):e011864. https://doi.org/10.1136/bmjopen-2016-011864
15. Turesheva A, Aimagambetova G, Ukybassova T, et al. Recurrent pregnancy loss etiology, risk factors, diagnosis, and management. Fresh look into a full box. J. Clin. Med. 2023;12(12):4074. https://doi.org/10.1136/bmjopen-2016-011864
16. Ratola A, Martins P, Coutinho E. Atitudes do Enfermeiro Obstetra no cuidar casais com perda gestacional. Millenium: J. Educ. Technol. Health 2025;(17e):e40386-e40386. https://doi.org/10.29352/mill0217e.40386
17. Białek K, Malmur M. Risk of post-traumatic stress disorder in women after miscarriage. Med Stud. 2020;36(2):134-141. https://doi.org/10.5114/ms.2020.96794
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Copyright (c) 2026 Julia Bożena Wiczkowska, Anna Weronika Szablewska (Autor)
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