Schreurs Amf, Lier McI, Koning Dbm, Brals Cwa, De Boer M A, Lambalk C B, De Wit M, Mijatovic V
Facts Views Vis Obgyn. 2021 Jun;13(2):159-168. doi: 10.52054/FVVO.13.2.021.
Spontaneous Haemoperitoneum in Pregnancy (SHiP) is a rare, but life-threatening complication of pregnancy that occurs predominantly in the third trimester of pregnancy and is associated with adverse pregnancy outcomes. Recently the largest case series in literature was published describing 11 Dutch cases of SHiP in women with endometriosis.
To investigate experiences, psychological impact, and quality of life after SHiP.
A mixed-methods study was performed in women with a history of SHiP and their partners, including all known cases in the Netherlands between 2007 to 2015. Semi-structured in-depth interviews were organized between 2016 and 2017 and analysed thematically with a framework approach. Participants were asked to complete questionnaires investigating the impact of the event (Impact of Event Scale) and Quality of Life (RAND-36).
Out of a total of 11 known cases, 7 women agreed for be individually interviewed. From these, all women described a freeze response at the moment of SHiP, combined with either an anxious reaction or a survival mode mind-set. All women received psychological help after SHiP. Still, the feeling of not being heard by the medical staff was present in all women. Other themes such as postpartum period, bonding with their child, effect on daily life, reviving the event, and future pregnancies were also identified in the interviews. In regard to their partners, 3 were interviewed, hence no saturation was achieved. Finally, the questionnaires showed lower Quality of Life and an impact score of ≥ 8/10.
SHiP had a profound impact on women and their partners. Dedicated psychological help should be offered to all women after experiencing SHiP.
妊娠自发性腹腔内出血（SHiP）是一种罕见但危及生命的妊娠并发症，主要发生在妊娠晚期，且与不良妊娠结局相关。最近，文献中发表了最大的病例系列，描述了11例荷兰子宫内膜异位症女性的SHiP病例。
调查SHiP后的经历、心理影响和生活质量。
对有SHiP病史的女性及其伴侣进行了一项混合方法研究，包括2007年至2015年荷兰所有已知病例。2016年至2017年组织了半结构化深度访谈，并采用框架方法进行主题分析。要求参与者完成调查问卷，调查该事件的影响（事件影响量表）和生活质量（兰德36项健康调查量表）。
在总共11例已知病例中，7名女性同意接受单独访谈。其中，所有女性都描述了在SHiP发生时的冻结反应，同时伴有焦虑反应或生存模式心态。所有女性在SHiP后都接受了心理帮助。然而，所有女性都有未被医护人员倾听的感觉。访谈中还发现了其他主题，如产后时期、与孩子的亲密关系、对日常生活的影响、回忆该事件以及未来妊娠。关于她们的伴侣，有3人接受了访谈，因此未达到饱和状态。最后，调查问卷显示生活质量较低，影响得分≥8/10。
SHiP对女性及其伴侣产生了深远影响。所有经历过SHiP的女性都应获得专门的心理帮助。
