Evaluation of Acute Stress Disorder following Pregnancy Losses

Year 2015, , 226 - 232, 14.09.2015

Hamit Keten , Salih Gençoğlan Ahmet Dalgacı Fazıl Avcı Yılmaz Satan Soner Ölmez Mustafa Çelik

https://doi.org/10.17826/cutf.79332

Cited By: 4

Abstract

Purpose: The aim of this study was to evaluate acute stress disorder in women experiencing a pregnancy loss. Material and Methods: The study included 170 pregnant women presenting to the Obstetrics and Gynecology Clinic in research and training hospital of Kahramanmaraş Sütçü İmam University between February 2013 and July 2013. Fiftyfour women experiencing a pregnancy loss before the 21st week of gestation (31%) were assigned into the pregnancy loss group and 116 women whose pregnancy continued without any problems (69%) were assigned into the control group. Data were collected with Posttraumatic Stress disorder Scale (PTSDS) and a questionnaire composed of questions about socio-demographic features and history of pregnancy and diseases.. Results: The mean ages of the pregnancy loss group the control group were 28.83±7.30 years and 28.87±5.87 years respectively without a significant difference (p=0.968). The mean score for PTSDS was 32.40±10.24 (min: 17 and max: 52) in all the participants, 35.83±11.51 in the pregnancy loss group and 30.81±9.21 in the control group. The women experiencing a pregnancy loss had significantly higher scores for PTSDS. Conclusion: The study revealed that symptoms of posttraumatic stress disorder increased after pregnancy losses. It is of great importance to provide social and psychological support for the couples experiencing a pregnancy loss in terms of their wellbeing. Inability to implement support mechanisms effectively in cases of increased acute stress such as pregnancy loss can predispose to progression to posttraumatic stress disorder

Keywords

Acute Stress, pregnancy loss, miscarriage

Gebelik Kaybı Sonrası Akut Stres Bozukluğunun Değerlendirilmesi

Abstract

Amaç: Bu çalışmada gebelik kaybı yaşayan kadınların, akut stres bozukluğu durumunun değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Bu çalışmaya Kahramanmaraş Sütçü İmam Üniversitesi Araştırma ve Uygulama Hastanesi Kadın Hastalıkları ve Doğum Kliniğine Şubat-Temmuz 2013 tarihleri arasında başvuran gebeler alınmıştır. Başvuru sonrası gebelik kaybı (<21hafta) olan hastalar ‘gebelik kaybı yaşayan grubu’, gebeliği sağlıklı devam edenler ise ‘kontrol grubunu’ oluşturdu. Katılımcıların sosyodemografik verileri, gebelik ve hastalık öyküleri anket ile sorgulandı. Ayrıca hastalardan Travma Sonrası Stres Bozukluğu Ölçeğini (TSSBÖ) yanıtlaması istendi. Anket formunu tam dolduran 170 Araştırma Makalesi / Research Article 226 Keten ve ark. Cukurova Medical Journal hastanın 54’ü (%31) gebelik kaybı yaşayan gruptan, 116’sı (%69) ise kontrol grubundan çalışmaya dahil oldu. İstatistiksel anlamlılık p <0.05 olarak belirlendi. Bulgular: Gebelik kaybı yaşayan hastaların yaş ortalaması 28.83±7.30, kontrol grubunda ki gebelerin ise 28.87±5.87 olarak saptandı. Her iki grubun yaş ortalaması benzer idi (p=0.968). Katılımcıların TSSBÖ puanı 32.40±10.24 (min=17, max=52) olarak saptandı. Gebelik kaybı yaşayan olguların TSSBÖ puanı ortalaması 35.83±11.51, kontrol grubunun ise 30.81±9.21 olarak belirlendi. Gebelik kaybı yaşayan grubun TSSBÖ puanının, kontrol grubuna göre anlamlı derecede yüksek olduğu tespit edildi (p=0.006). Sonuç: Çalışmamızda gebelik kaybı sonrası akut stres bozukluğu semptomlarının arttığı belirlenmiştir. Gebelik kaybı yaşayan ailelere sosyal ve psikolojik destek vermek, ailenin iyilik hali için çok önemlidir. Gebelik kaybı gibi akut stresin arttığı durumlarda destek mekanizmalarının etkili uygulanamaması bireyin post-travmatik stres bozukluğuna geçmesine önayak olacaktır

Keywords

Akut Stres, gebelik kaybı, düşük

References

• Ayvaz S, Hocaoğlu Ç, Tiryaki A Ak İ. Trabzon il
• merkezinde doğum sonrası depresyon sıklığı ve gebelikteki ilişkili demografik risk etmenleri. Türk Psikiyatri Dergisi. 2006;17:243-51.
• Robinson GE. Dilemmas related to pregnancy loss. J Nerv Ment Dis, 2011;199:571-4.
• Scotchie JG, Fritz MA. Early pregnancy loss. Postgraduate Obstetrics and Gynecology. 2006;26:1–7.
• Athey J, Spielvogel AM. Risk factors and interventions for psychological sequelae in women after miscarriage. Prim Care Update Ob Gyns. 2000;7:64-9.
• Lok IH, Neugebauer R. Psychological morbidity following miscarriage. Best Pract Res Clin Obstet Gynecol. 2007;21:229-47.
• Bowles SV, James LC, Solursh DS, Yancey MK, Epperly TD, Folen RA. Acute and post-traumatic stress disorder after spontaneous abortion. Am Fam Physician. 2000;15;61:1689-96.
• Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy 1996;34:669-73.
• Turan MT, Eşel E, Keleş S. Motorlu araç kazası geçiren kişilerde semptomlarının değerlendirilmesi. Klinik Psikiyatri. 2003;6:12-17. stres bozukluğu
• Brewin CR, Andrews B, Rose S ve Kirk M. Acute stress disorder and posttraumatic stress disorder in victims of violent crime. Am J Psychiatry. 1999;156:360-6.
• Bryant RA, Moulds ML, Guthrie RM. Acute stress disorder scale: A self report measure of acute stress disorder. Psychol Assess. 2000;12:61-8.
• Engelhard IM, van den Hout MA, Arntz A.Posttraumatic stress disorder after pregnancy loss. Gen Hosp Psychiatry. 2001;23:62-6.
• Walker TM, Davidson KM. A preliminary investigation of psychological distress following surgical management of early pregnancy loss detected at initial ultrasound scanning: A trauma perspective. Journal of Reproductive and Infant Psychology. 2001;19:7-16.
• Friedman T, Gath D. The psychiatric consequences of spontaneous abortion. Br J Psychiatry. 1989;155:810-3.
• Beutel M, Deckardt R, von Rad M, Weiner H. Grief and depression after miscarriage: their separation, antecedents and course. Psychosom Med. 1995;57:517-26.
• Prettyman RJ, Cordle CJ, Cook GD. A three-month follow-up of psychological morbidity after early miscarriage. Br J Med Pscyhol. 1993;66:363-72.
• Thapar AK,Thapar A. Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital anxiety and depression scale. Br J Gen Pract. 1992;42:94-6.
• Garel M, Blondel B, Lelong N, Papin C, Bonenfaut S, Kaminski M. Reactions depressive apresune fausse- couche. Contracept Fertil Sex. 1992;20:75–81.
• Neugebauer R, Kline J, O’Connor P, Shrout P, Johnson J, Skodol A, et al. Determinants of depressive symptoms in the early weeks after miscarriage. Am J Public Health. 1992;82:1332-9.
• Lee DT. Wong CK. Cheung LP. Leung HC. Haines CJ. Chung TK. Psychiatric morbidity following miscarriage: A prevalence study of Chinese women in Hong Kong. J Affect Disord. 1997;43:63–8.
• Toffol E, Koponen P, Partonen T. Miscarriage and mental health: results of two population-based studies. Psychiatry Res. 2013;205:51-8.
• Condon JT. The parental-foetal relationship-a comparison of male and female expectant parents. J Psychosom Obstet Gynecol. 1985;4:271-84.
• Kirkley-Best E. Grief in response to prenatal loss: an argument for the earliest maternal attachment. Diss Abstr Int. 1981;42:2560.
• LaRoche C, Lalinec-Michaud M, Engelsmann F, Fuller N, Copp M, McQuade–Soldatos L et al. Grief reactions to perinatal death: an exploratory study. Psychosomatics. 1982;23:510-8.
• Theut SK, Pedersen FA, Zaslow MJ, Cain RL, Rabinovich BA, Morihisa JM. Perinatal loss and parental bereavement. Am J Psychiatry. 1989;146:635–9.
• Toedter LJ, Lasker JN, Alhadeff JM. The Perinatal Grief Scale: Development and initial validation. Am J Orthopsychiatry. 1988;58:435–49.
• Janssen HJEM, Cuisinier CJM, Hoogduin KAL, de Graauw KPHM. Controlled prospective study on the mental health of women following pregnancy loss. Am J Psychiatry. 1996;153:226-30.
• Thapar AK, Thapar A. Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital anxiety and depression scale. Br J Gen Pract. 1992;42:94-6.
• Neugebauer R, Kline J, Shrout P, Skodol A, O'Connor P, Geller PA et al. Major depressive disorder in the 6 months after miscarriage. JAMA. 1997;277:383-8.
• Klier CM, Geller PA, Neugebauer R. Minor depressive disorder in the context of miscarriage. J Affect Disord. 2000;59:13-21.