Strategies to communicate pregnancy complications: a systematic review and practical points for healthcare professionals

Curr Opin Obstet Gynecol. 2023 Oct 1;35(5):411-419. doi: 10.1097/GCO.0000000000000899. Epub 2023 Aug 9.

Abstract

Purpose/methods: This systematic review aims to provide an overview of strategies available for healthcare professionals (HCPs) to effectively communicate unexpected news in pregnancy, specifically for the most common pregnancy complications. Three medical databases and grey literature were searched until March 2023 using subject headings and keywords. Snowball techniques were also used. The articles were reviewed at each stage of screening independently by two separate authors. Qualitative, quantitative and mixed methods studies were included.

Recent findings: Forty-three studies were included and grouped according to the gestational age of the pregnancy complication - miscarriage, increased risk screening, foetal conditions, stillbirth. The main key points for communication were outlined at each specific complication and eventually the six common themes that emerged from all the categories were included in the acronym PRICES (Preparation - Referral - Individualized care - Clarity - Empowerment - Sensitivity).

Summary: Given the negative impact of failed communications both in pregnancy outcomes and patients' experience, we advocate that communication training for HCP providing pregnancy care should be mandatory, and skills should be updated at regular intervals. Tools like our acronym PRICES can be used during teaching HCPs how to communicate more effectively.

Publication types

  • Systematic Review

MeSH terms

  • Abortion, Spontaneous*
  • Communication
  • Delivery of Health Care
  • Female
  • Health Personnel / education
  • Humans
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Outcome
  • Stillbirth