White-van Mourik M C, Connor J M, Ferguson-Smith M A
Duncan Guthrie Institute of Medical Genetics, Yorkhill, Glasgow, U.K.
Prenat Diagn. 1992 Mar;12(3):189-204. doi: 10.1002/pd.1970120308.
A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.
本文描述了一项回顾性研究，旨在调查孕中期因胎儿异常而终止妊娠（TOP）后的心理社会后遗症。在获得适当同意后，对84名女性和68名配偶在事件发生2年后进行了走访，并要求他们填写一份详尽的问卷。大多数夫妇报告称在终止妊娠后处于情绪动荡状态。夫妇应对这种情感困惑的方式存在差异。2年后，约20%的女性仍抱怨经常哭泣、悲伤和易怒。丈夫们报告称，在终止妊娠后的长达12个月内，无精打采、注意力不集中和易怒的情况有所增加。在同一时期，婚姻不和加剧，其中12%的夫妇暂时分居，一对夫妇离婚。这些问题可归因于悲伤过程中缺乏同步性。困惑和矛盾的情绪导致社会孤立和缺乏沟通。人们发现，难以接受胎儿丢失与胎儿异常的类型或宗教信仰无关，而是与父母不成熟、无法表达需求、怀孕前根深蒂固的自卑、缺乏支持性的人际关系以及继发性不孕有关。文中给出了改进管理的建议。
