Emotional Effect of the Loss of One or Both Fetuses in a Monochorionic Twin Pregnancy

Abstract

ObjectiveTo examine the psychological effect on women of the loss of one or both fetuses during a monochorionic twin pregnancy and to identify associated protective and risk factors. DesignDescriptive, cross-sectional, correlational study. SettingMaternity unit of the Vall d’Hebron University Hospital in Barcelona, Spain. ParticipantsTwenty-eight White Spanish women who lost one or both fetuses during a monochorionic twin pregnancy. MethodsIn an individual interview with each participant, we collected sociodemographic information, psychiatric history, and clinical data regarding the pregnancy. Participants also completed the following questionnaires: Spanish Short Version of the Perinatal Grief Scale, Impact of Event Scale–Revised, Beck Depression Inventory, and the State–Trait Anxiety Inventory. ResultsGreater levels of grief after fetal loss during a monochorionic twin pregnancy were associated with increased symptoms of depression, anxiety, and posttraumatic stress. The intensity of grief did not depend on the number of weeks of pregnancy at which the loss occurred, a history of miscarriage, the survival of one of the twins, the presence of living children, or any of the sociodemographic variables considered. ConclusionFetal loss in a monochorionic twin pregnancy has a considerable emotional effect and leaves the mother vulnerable to psychological problems. The survival of one of the twins or the presence of living children is no guarantee that the grieving mother’s mental health will be less affected.