Parental reaction and adaptability to the prenatal diagnosis of fetal defect or genetic disease leading to pregnancy interruption

Abstract

The objective of the study was to evaluate the psychological reaction of two groups of parents to a pregnancy termination after they had undergone a prenatal diagnostic procedure. The analysis involved interviews with a study group of 76 patients who were at risk of giving birth to a child with a genetic disease or defect and a comparison group of 124 who had a pregnancy termination after a major anomaly had been detected by routine ultrasound and who were not at known risk for a genetic disease. Only patients in the study group had received counselling before the prenatal diagnosis and were aware that the fetus could be affected. The overall reaction of the comparison group was one of shock, denial of fetal abnormality, and guilt over 'abandoning the fetus'. A feeling of guilt was expressed by patients in the comparison group (73 per cent versus 29 per cent) in the period immediately following the interruption. One-third of patients in both groups felt obliged to undergo a therapeutic abortion. More patients in the study group than in the comparison group expressed the need to see a psychiatrist at the time of the study (19 per cent versus 7 per cent) and viewed future pregnancies as a replacement for the lost pregnancy (63 per cent versus 19 per cent). The recommendations of the study focus on information sessions to personnel, nursing support, analgesia during the expulsion period, an atmosphere of respect that should be present at the time that the fetus is viewed, the anticipation of mourning, and the long-term follow-up of the couple to ensure that counselling for future pregnancies and psychological support are provided when needed.

Second-Trimester Ultrasound to Detect Fetuses With Down Syndrome

“…Additionally, because the false-positive rate is 1% or greater for most of the markers, when all of these markers are used in aggregate, the false-positive rate may approach 10% or more, leading to much needless anxiety throughout pregnancy and beyond. 50,[102][103][104] Furthermore, if women who are at elevated risk of carrying a fetus with Down syndrome based on maternal age or serum testing results are dissuaded from amniocentesis due to the absence of ultrasonographic markers, this will reduce the prenatal detection of fetuses with Down syndrome as well as the effectiveness of biochemical screening. 49 Finally, there are significant costs associated with ultrasound screening for Down syndrome, particularly those that relate to the further evaluation of detected findings.…”

Pastoral Care Utilization among Women Electing Pregnancy Termination for Fetal Anomalies

“…Couples have been reported to experience grief [4] and depression [5]; anger, guilt, relief, sadness, fatigue, and blame [6], and shock, and mariage and relationship difficulties [7]. Fear, failure, shame, isolation, numbness, panic spells, as well as sleeplessness, listlessness, loss of concentration, irritability, and crying [8] have also been observed.…”

“…These include provision of information about both the technical and emotional facets of prenatal diagnosis, a supportive hospital staff, follow-up counseling [5], an opportunity to speak with other couples [6], a liaison between medical staff and patient through a social worker or volunteer, and a referral to a parents' group or association [7].…”

Different Policies on Prenatal Ultrasound Screening Programmes and Induced Abortions Explain Regional Variations in Infant Mortality with Congenital Malformations

“…Several groups [16][17][18] have described the psychosocial consequences of prenatal diagnosis of severe congenital malformations, of 2nd-trimester IA, and of fetal or neonatal deaths. There is no doubt that all these events have a major psychological influence on the parents, but, as far as we know, there are no studies comparing the psychosocial consequences of a 2nd-trimester IA and a neonatal death because of malformations.…”