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Centre for Evidence-
Based Medicine

Prognosis: Clinical Scenario

You are a nurse caring for a 28-year old woman who has just had a D & C following a spontaneous miscarriage. She was 10 weeks pregnant and this was her first pregnancy. In a team meeting, one of your colleagues vaguely recalls seeing an article about grief after miscarriage and you decide to track it down to determine whether your patient is at risk of severe or prolonged grief.

You formulate the question, in healthy women who have recently had a miscarriage, what is the usual grieving process and are any factors associated with longer than normal grieving?

Searching terms and evidence source:
Both a MEDLINE search and a search in Best Evidence produced the same citation. Search terms in MEDLINE were "grief" as a subject heading and text word; "abortion" as a subject term or "pregnancy loss" as a text word; and "risk" as an index term or text word. The Best Evidence search used just the terms "grief" and "pregnancy loss".

Read the article and decide:

  1. Is the evidence from this study valid?
  2. If valid, is this evidence important?
  3. If valid and important, can you apply this evidence in caring for your patient?

Continue to completed worksheet