Psychological impact on women undergoing termination of pregnancy due to fetal anomalies during pregnancy

Doctoral Dissertation uoadl:1519414 299 Read counter

Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
Maniatelli Elissavet
Dissertation committee:
Νικόλαος Σαλάκος, Αναπληρωτής Καθηγητής,Ιατρική, ΕΚΠΑ
Ιωάννης Ζέρβας, Καθηγητής,Ιατρική, ΕΚΠΑ
Παναγιώτης Χαλβατσιώτης, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Κωνσταντίνος Πανουλής, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ευθύμιος Δεληγεώρογλου, Καθηγητής, Ιατρική, ΕΚΠΑ
Λέων Αραβαντινός, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Χαράλαμπος Χρέλιας, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Ψυχολογική επιβάρυνση μετά απο διακοπή κύησης λόγω συγγενών ανωμαλίων ανάλογα με το τρίμηνο κύησης
Translated title:
Psychological impact on women undergoing termination of pregnancy due to fetal anomalies during pregnancy
Introduction: The psychological impact after pregnancy loss (either 1st or 2nd
trimester trimester miscarriage, termination due to congenital or chromosomal
abnormalities) is a multifactorial phenomenon. This phenomenon is of great concern
in modern day scientific literature, due to its high frequency and the short and long
term consequences for the woman and the family. The early detection of perinatal
grief leads to faster resolving of its great implications. The short version (33 - Item
Short Version) of the Perinatal Grief Scale (PGS) has been used in a large number of
studies around the world during the last 30 years, to identify perinatal grief. The PGS
scale self-completed questionnaire has not been validated up to now for the Greek
Purpose: The primary aim of this study was to identify the psychological outcomes
and predictors for adverse outcome in women after termination of pregnancy in the 1st
and 2nd trimester. The secondary aim of this study was to translate the PGS into the
Greek language, assess its reliability and validate its use for measuring perinatal grief.
Method: The sample comprised 176 women from a public and a private maternity
hospital in Athens who had experienced perinatal loss of pregnancy up to 26 weeks of
gestation between 2014 and 2016. The assessment of psychological impact was
assessed in the date of loss, at 6 weeks and at 6 months after the loss. The participants
completed the validated self-completed questionnaires, Edinburgh Postpartum
Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Hospital Anxiety
and Depression Scale (HADS), Dyadic Adjustment Scale (DAS), Impact of Events
Scale-revised (IES-R) and the PGS.
Results: The PGS was validated, by using confirmation factor analysis while its
reliability was assessed by using Cronbach’s alpha coefficient. The Cronbach’s alpha
coefficients for the subscales of the PGS were for the "Active Grief" 0.90, for the
"Difficulty Coping" 0.82, for "Despair" 0.88 and for the total scale 0.94. There was a
decrease in scores of scales from baseline to 6 months, with the only exception the
dimension "Despair" in PGS, which is not altered at all during the assessment. There
was a significant positive correlation between the DAS scale and other scales. The
participants who had terminated the pregnancy after 12 weeks had higher scores
compared with participants who had terminated the pregnancy before 12 weeks.
Those who had terminated the pregnancy due to congenital anomaly had higher
scores, compared with the participants who terminated the pregnancy due to 1st
trimester miscarriage. Also, the better the relationship of the couple, the more reduced
the symptoms of depression, anxiety, posttraumatic stress and perinatal grief.
Conclusions: Our results, applying for the first time to a Greek population, are
similar to those that have been found in previous studies, performed in other
countries. Significant prognostic factors for the manifestation of depression, anxiety,
posttraumatic stress and perinatal grief, seemed to be the quality of the partnership,
the gestational age and the termination of pregnancy due to congenital abnormalities.
Finally, the Greek PGS is a reliable tool for identifying perinatal grief intensity.
Main subject category:
Health Sciences
Psychological impact, Perinatal Grief Scale, Pregnancy loss
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