Complicated grief after traumatic loss

Abstract

The traumatic loss of an unborn child after TOP due to fetal malformation and/or severe chromosomal disorders in late pregnancy is a major life-event and a potential source of serious psychological problems for those women. To obtain information on the course of grief following a traumatic loss, 62 women who had undergone TOP between the 15th and 32nd gestational week were investigated in a longitudinal study design and compared with 65 women after spontaneous delivery of a full-term healthy child. Grief, posttraumatic stress, depression, anxiety and psychiatric disorders were evaluated 14 days, 6 months and 14 months after the event, implementing validated self-report and clinician rated instruments. Compared to women after spontaneous delivery, women after induced TOP were significantly more stressed regarding all psychological outcomes at all three measuring points. Especially, 14 months after TOP 13.7% of the women fulfilled all criteria of a complicated grief diagnoses following Horowitz et al. (1997, Am J Psychiat 154:7904-7910). 16.7% were diagnosed as having a manifest psychiatric disorder according to DSM-IV. All in all, 25% of these women were critically affected by the traumatic loss. TOP for fetal anomaly is to be seen as a major life event, which causes complicated grief reactions and psychiatric disorders for a substantial number of women.

Brief Internet-Based Intervention Reduces Posttraumatic Stress and Prolonged Grief in Parents after the Loss of a Child during Pregnancy: A Randomized Controlled Trial

“…The loss of an infant due to stillbirth, miscarriage, neonatal death, or termination on the grounds of fetal abnormalities is recognized as a traumatic life event and can cause parents intensive grief and symptoms of posttraumatic stress [2,3,4]. In particular, women whose pregnancies were terminated after the discovery of fetal malformation or severe chromosomal disorders have been found to experience severe symptoms of posttraumatic stress disorder (PTSD) and prolonged grief even years later [4,5,6]. However, despite the increasing recognition that prenatal loss can lead to psychiatric disorders, few of the women affected receive psychological support [7].…”

Effects of a family‐support programme for pregnant women with foetal abnormalities requiring pregnancy termination: A randomized controlled trial in China

“…Termination of pregnancy because of a foetal abnormality is devastating for mothers and their families; most mothers experience significant long-term psychological distress (Cacciatore, 2010;Kersting et al, 2007). Various studies have shown that the death of a baby during pregnancy or shortly after birth triggers long-lasting grief (Badenhorst & Hughes, 2007;Brier, 2008;Kersting et al, 2007) and is associated with high levels of anxiety, depression, and post-traumatic stress symptoms (Badenhorst & Hughes, 2007;Heazell et al, 2016;Hutti, 2005). One report noted that approximately 20% of women experiencing a perinatal loss fulfilled the criteria for post-traumatic stress disorder (PTSD) (Turton, Hughes, Evans, & Fainman, 2001).…”

Die Verarbeitung von Trauer nach einer Totgeburt

“…Anpassungsstö-rungen und akute Belastungsreaktionen sind häufige psychische Störungen, die in kurzem zeitlichen Abstand nach der Totgeburt auftreten können. Im weiteren Verlauf können posttraumatische Belastungsstörungen, persistierende somatoforme Beschwerden oder andere psychische Symptome wie depressive Erkrankungen oder Angsterkrankungen vorherrschen [3,10,14]. Eine Untersuchung von Cougle et al [5] [21,17].…”