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[因胎儿畸形终止妊娠后的再次妊娠——一切皆被遗忘,新的开始?]

[A subsequent pregnancy after a termination of pregnancy because of fetal anomaly--all forgotten and a new beginning?].

作者信息

Wollenschein Melanie, Gustke Matthias, Woopen Christiane, Rohde Anke

机构信息

Gynäkologische Psychosomatik, Universitätsfrauenklinik Bonn.

出版信息

Prax Kinderpsychol Kinderpsychiatr. 2007;56(9):741-57. doi: 10.13109/prkk.2007.56.9.741.

DOI:10.13109/prkk.2007.56.9.741
PMID:18188973
Abstract

There is a lack of profound research on the experiences of a new pregnancy following a subsequent late termination of pregnancy (TOP). Results from late pregnancy losses indicate that women do grieve even during a new pregnancy and therefore the process of bonding can be affected. 56 women were investigated within the project "psychosocial counselling in the context of prenatal diagnosis," which recruited 512 patients. Results on the experience of a new pregnancy after late TOP will be presented. In general women experienced a normal level of bereavement 2 years after TOP (PGS), but 11-21% showed significant symptoms of distress (BSI). 50% were aware of the terminated pregnancy furthermore and they felt an emotional distance to their unborn child. This is remarkable because most subsequent pregnancies were planned and desired. Many patients showed feelings of fear, worries and uncertainties. Time since TOP and new conception was not predictive of feelings during pregnancy. If a pregnant woman had a TOP because of fetal anomaly in the preceding pregnancy this should be taken into account during medical care. If symptoms of distress are persisting there is an indication for additional care. The intention is to release the patient and to support a sound relationship between mother and child.

摘要

对于晚期终止妊娠(TOP)后再次怀孕的经历,目前缺乏深入研究。晚期妊娠流产的结果表明,女性即使在再次怀孕时也会悲伤,因此母婴联结过程可能会受到影响。在“产前诊断背景下的心理社会咨询”项目中,对56名女性进行了调查,该项目共招募了512名患者。本文将呈现晚期TOP后再次怀孕的经历相关结果。总体而言,女性在TOP后2年经历了正常程度的丧亲之痛(PGS),但11% - 21%表现出明显的痛苦症状(BSI)。此外,50%的女性仍记得终止的妊娠,她们对未出生的孩子感到情感上有距离。这很值得注意,因为大多数后续怀孕都是计划内且期望的。许多患者表现出恐惧、担忧和不确定感。TOP与再次受孕之间的时间并不能预测孕期的感受。如果孕妇前次怀孕因胎儿异常而进行了TOP,那么在医疗护理过程中应予以考虑。如果痛苦症状持续存在,则表明需要额外的护理。目的是让患者解脱,并支持母婴之间建立良好的关系。

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Prax Kinderpsychol Kinderpsychiatr. 2007;56(9):741-57. doi: 10.13109/prkk.2007.56.9.741.
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