Psychological Impact on the Patient With a History of Pregnancy Loss
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Abstract
Pregnancy loss is a traumatic event that deeply affects the mental health of women, predisposing them to the development of disorders such as perinatal grief, anxiety, post-traumatic stress and depression. This study aimed to evaluate the psychological impact on obstetric women with a history of pregnancy loss. An observational and prospective study was conducted at the UMAE Hospital de Gíneco-Obstetricia CMNO. Of the patients initially included, 51 completed the evaluation at the first and third month after the loss. Instruments such as the Perinatal Grief Scale, the Checklist for Post-Traumatic Stress Disorder and the Hamilton scales for depression and anxiety were applied. The results at the first month showed a high prevalence of active (98%) and complicated (94.1%) grief, along with anxiety (84.4%), post-traumatic stress (31.4%) and moderate depression (62.8%, according to the Hamilton scale). At three months, active grief persisted in 88.2% of patients, while depression remained in 60.8%, mostly at moderate levels. Anxiety was the most frequent disorder, presenting in 84.4% of patients with active grief. These findings highlight the need for an early and multidisciplinary psychological approach, especially for those women with active or complicated grief, given its strong association with other mental disorders.
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References
Contreras-Carreto NA, Moreno-Sánchez P, Márquez-Sánchez E, Vázquez-Solares V, Pichardo-Cuevas M, Ramírez-Montiel ML, et al. Perinatal mental health and recommendations for its comprehensive care in gyneco-obstetric hospitals. Cir Cir [Internet]. 2022 Jul 15;90(4). Available from: https://www.cirugiaycirujanos.com/frame_esp.php?id=709
Valenzuela MT, Bernales M, Jaña P. Review Articles Perinatal Grief: Perspectives of Health Professionals. Vol. 85, REV CHIL OBSTET GINECOL. 2020.
Gómez López ME. Guide for the psychological care of women with obstetric complications. Perinatol Reprod Hum. 2018 Jun;32(2):85–92.
Mónica Bascuñana Garde. Debate: Open questions about surrogacy.
Cardoso Escamilla ME, Zavala Bonachea MT, Alva López MDC. Depression and post-traumatic stress in women with induced and involuntary gestational losses. Pensamiento Psicológico. 2017 Aug 3;15(2).
Calderer A, Obregón N, Cobo JV, Goberna J. Perinatal death: Accompanying women and couples. Vol. 19, Matronas Prof. 2018.
Westby CL, Erlandsen AR, Nilsen SA, Visted E, Thimm JC. Depression, anxiety, PTSD, and OCD after stillbirth: A systematic review. BMC Pregnancy Childbirth. 2021 Dec 1;21(1).
Farren J, Jalmbrant M, Falconieri N, Mitchell-Jones N, Bobdiwala S, Al-Memar M, et al. Prognostic factors of post-traumatic stress, anxiety, and depression in women after early pregnancy loss: A prospective multicenter cohort study. BMJ Open. March 1, 2022;12(3):e054490.
• Tseng YF, Cheng HR, Chen YP, Yang SF, Cheng PT. Grief reactions of couples after perinatal loss: a one-year prospective follow-up. J Clin Nurs. December 1, 2017;26(23–24):5133–42.
• Clinical Skills.
• Malpartida Ampudia MK. Postpartum depression in primary care. Revista Médica Sinergia. February 1, 2020;5(2):e355.
• Aspera-Campos T, Compean-Ortiz LG, Gaspar Hernández-Carranco R, César León-Hernández R, González-Pérez B. Maternal depression as a mediator in the development of childhood overweight and obesity: an integrative review. Rev Enferm Inst Mex Seguro Soc [Internet]. 2021;29(2):105–18. Available from: http://revistaenfermeria.imss.gob.mx/
• Nájera RM, Doctorate in P, P Department, LA Health. Perinatal Depression.
• Zimmerman M. Use of the 9-item Patient Health Questionnaire to detect and monitor depression. Vol. 322, JAMA - Journal of the American Medical Association. American Medical Association; 2019. p. 2125–6.
• Purriños MJ. HAMILTON SCALE - Hamilton Depression Rating Scale (HDRS).
• Postpartum depression, a public health problem (2).
• Ordóñez EF, Díaz CR, Gil IMM, Manzanares MTL. Post-traumatic stress disorder after childbirth following gestational loss: an observational study. Salud Mental. 2020;43(3):129–36.
• Durón Figueroa R. Adaptation of the PTSD Checklist for DSM-5 in the Mexican Population. Acta Investig Psicol. April 30, 2019;9(1):26–36.
• HAMILTON ANXIETY SCALE (HAS).
• Marcos-Nájera R, Rodríguez-Muñoz M de la F, Izquierdo-Méndez N, Olivares-Crespo ME, Soto C. Perinatal depression: profitability and expectations of preventive intervention. Clin Salud. July 1, 2017;28(2):49–52.
• Mota González C, Calleja Bello N, Aldana E, María C, Gómez López E, Antonio M, et al. Perinatal Grief Scale. Revista Latinoamericana de Psicología. Vol. 43, No. 3, pp.: 2011.
• Ordóñez EF, Díaz CR, Gil IMM, Manzanares MTL. Post-traumatic stress and related symptoms in a pregnancy after gestational loss: Narrative review. Vol. 41, Salud Mental. Instituto Nacional de Psiquiatría Ramón de la Fuente; 2018. p. 237–43.
• Blank RR, Carlos J, García S. Perinatal grief. Systematic CVRS review during pregnancy and postpartum. View project: Center for Simulation of the Sanitary Corps in the Spanish Armed Forces. Available from: http://cyberindex.com/p/pd/e1
• Carter D, Misri S, Tomfohr L. Psychological aspects of early pregnancy loss.
• Velasteguí Egüez JE, Isabel M, Navarro H, Joe J, Cotto R, Jazmín A, et al. Perinatal complications associated with pregnancy in adolescents from Atacames [Internet]. Vol. 34, Revista Cubana de Medicina General Integral. 2018. Available from: http://scielo.sld.cu38
• Hernandez P. Detection of psychiatric disorders in patients diagnosed with spontaneous abortion [Internet]. 2019. Available from: https://www.researchgate.net/publication/341526080
• Patiño E, Porzio M. Frequency of spontaneous abortions in patients who attend the gynecology-obstetrics service of the Clínicas Hospital. Medicina Clínica y Social. May 1, 2021;5(2):76–9.
• Páez Cala ML, Arteaga Hernández LF. Grief due to perinatal death. The need for differential and comprehensive care. Archivos de Medicina (Manizales). March 11, 2019;19(1):32–45.
• Parro-Jiménez E, Morán N, Gesteira C, Sanz J, García-Vera MP. Complicated grief: A systematic review of prevalence, diagnosis, risk, and protective factors in the adult population of Spain. Anales de Psicología. 2021;37(2):189–201.
• Latifi H, GAM, & LD. Anxiety scale in surgical abortions and drug-induced abortions: A comparative study. Romanian Journal of Neurology. 2021.
• Soto-Balbuena C, RMEGAFBFLHPHGI. Incidence, prevalence, and risk factors related to anxiety symptoms during pregnancy. PMID: 30009746. 2018.