Perinatal Grief and Postpartum Nursing Care Following Intrauterine Fetal Loss in a Twin Pregnancy Conceived Through In Vitro Fertilization (IVF): A Case Report

6. Uluslararası ve 7. Ulusal Doğum Sonu Bakım Kongresi, Niğde, Türkiye, 17 - 20 Eylül 2026, ss.1, (Özet Bildiri)

Yayın Türü: Bildiri / Özet Bildiri
Basıldığı Şehir: Niğde
Basıldığı Ülke: Türkiye
Sayfa Sayıları: ss.1
Gazi Üniversitesi Adresli: Evet

Özet

Case Presentation

Objective: This case report aimed to present the birth process, perinatal grief-related needs, and postpartum nursing care of a woman who experienced intrauterine death of both fetuses in a twin pregnancy conceived through in vitro fertilization (IVF).

Methods: The case was followed at the obstetrics and gynecology clinic of a university hospital in November 2024. The woman’s clinical course, physical and psychosocial needs during childbirth and the postpartum period, and the nursing care provided were evaluated. Written informed consent was obtained from the woman for the scientific presentation of the case, and measures were taken to protect her privacy and confidentiality.

Results: A 42-year-old woman with no living children conceived a twin pregnancy following her fifth IVF attempt. At 33 weeks of gestation, she presented to the hospital because she could no longer perceive fetal movements. Obstetric evaluation revealed intrauterine fetal death of both fetuses. Following the diagnosis of fetal loss, the woman expressed her desire to resume assisted reproductive treatment as soon as possible and attempt to conceive again. Given her future reproductive plans, she stated that she did not want a cesarean delivery and preferred vaginal delivery if medically feasible. Induction of labor for vaginal delivery was initiated on the first day of hospitalization. Her husband and mother supported her throughout the process. Despite induction, labor failed to progress and fetal descent did not occur; therefore, a cesarean delivery was decided upon. Following this decision, the woman was observed to cry and experience emotional distress. After the cesarean delivery, she saw her babies. During postpartum nursing care, her vital signs, bleeding, uterine involution, pain, and cesarean incision were assessed, and her physical recovery was monitored. Her emotional responses to the perinatal loss and psychosocial needs were also evaluated. A nonjudgmental, privacy-sensitive, therapeutic communication approach was adopted to facilitate the expression of her emotions. Continued support from her husband and mother was encouraged. Pharmacological treatment was administered as prescribed by the physician to suppress lactation, and information regarding breast care was provided. Following the loss, the woman continued to express her desire to resume IVF treatment as soon as possible. Given the loss of both fetuses and her observed emotional responses, she was referred to the psychiatry department for psychiatric evaluation and support. During discharge, counseling was provided regarding physical recovery, lactation management, emotional responses that may occur during the perinatal grief process, and situations requiring professional support.

Conclusion: Postpartum nursing care following perinatal loss should not focus solely on physical recovery but should also encompass the assessment of grief responses, therapeutic communication, lactation management, strengthening family support, consideration of future reproductive expectations, and referral to mental health professionals when necessary. Particularly following the loss of pregnancies conceived through assisted reproductive technologies, addressing the woman’s desire for another pregnancy and future reproductive plans together with her psychosocial needs is essential for woman-centered and holistic postpartum care.

Keywords: in vitro fertilization, intrauterine fetal death, twin pregnancy, perinatal loss, postpartum care