Document Detail


First-trimester multifetal pregnancy reduction: acute and persistent psychologic reactions.
MedLine Citation:
PMID:  7856683     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to determine acute and persistent psychologic impacts of multifetal pregnancy reductions and patients' ability to cope with fetal loss while simultaneously bonding to surviving infants. STUDY DESIGN: The first 100 women to undergo a multifetal reduction were invited to participate in a retrospective telephone study assessing their emotional reactions and attitudes toward multifetal reduction. The semistructured interview elicited demographic and obstetric data and contained scales used in previous studies of reproductive loss, which assessed repetitive thoughts about reduced fetuses, catastrophic fears, and lingering depressive feelings. RESULTS: More than 65% of the sample recalled acute feelings of emotional pain, stress, and fear during the reduction procedure. Mourning for the lost fetuses was reported by 70% of women, but most grieved for only 1 month. Thoughts about reduced fetuses occurred moderately frequently after the reduction but rarely at follow-up. Persistent depressive symptoms were mild, although moderately severe levels of sadness and guilt continued for many. Nonetheless, 93% would make the same decision again. Emotional reactions of patients who miscarried differed little. The small subsample who continued to be most affected were younger (p < 0.02), were more religious (p < 0.003), and had viewed the multifetal pregnancy on ultrasonography more often (p < 0.009). CONCLUSIONS: Multifetal reductions, although highly stressful psychologically, are well tolerated. Sadness and guilt may persist, especially for an identifiable subgroup. Normal maternal bonding and achievement of parenthood goals facilitate grief resolution. The large majority were reconciled to the termination of some fetuses to perserve the lives of a remaining few.
Authors:
P Schreiner-Engel; V N Walther; J Mindes; L Lynch; R L Berkowitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  172     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-15     Completed Date:  1995-03-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  541-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, NY.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / psychology
Adult
Depression
Female
Grief
Guilt
Humans
Male
Middle Aged
Pregnancy
Pregnancy Reduction, Multifetal / psychology*
Pregnancy Trimester, First
Pregnancy, Multiple*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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