A preliminary investigation of psychological distress following surgical management of early pregnancy loss detected at initial ultrasound scanning: A trauma perspective

Abstract

Recent research has focused on the occurrence of anxiety symptoms after miscarriage and has suggested that early pregnancy loss (EPL) should be conceptualised from the perspective of a trauma experience. We hypothesised that women who have perceived warning signs of an EPL will be less psychologically distressed in a 3-week period after this pregnancy loss than women with no prior perceived warning signs. The prevalence of Acute Stress Disorder (ASD), post traumatic stress symptoms, anxiety and depression was assessed in 40 women, who had experienced an EPL approximately 3 weeks beforehand and, with the exception of ASD, this was also investigated at 3-month follow-up. Evidence of psychological distress was expected to decrease over time in all women regardless of whether they had perceived warning signs or not. It was found that the presence of perceived warning signs did not determine levels of psychological distress. We ascertained that the experience of EPL itself increased post traumatic stress symptoms and anxiety, regardless of perceived warning signs of a pregnancy complication. Psychological distress subsided over time with the exception of anxiety, which remained high. The present study supported the conceptualisation of EPL as a trauma experience and, at a more practical level, highlighted a need for routine follow-up care.