Comparison of the psychological impact of medical versus surgical management of miscarriage

Document Type : Original Article

Authors

1 Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University

2 Lecturer of Psychiatry, Faculty of Medicine, Mansoura University

3 Associate Prof. of Obstetrics and Gynecology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt

Abstract

Introduction : psychological morbidities include anxiety, depression, and post-traumatic stress disorder occur after miscarriage. Multiple factors make the patients more vulnerable to psychiatric complications. We aimed to compare the psychological impact of medically terminated versus surgical evacuated miscarriage patients. 
Patients and Methods: Our comparative descriptive study was conducted on patients from the Gynaecology and Obstetrics clinic of Mansoura Hospital, Egypt. 
All patients were divided into two groups according to their mode of termination: group A, who had surgical evacuation, and group B, who had medical termination. 
Both groups underwent psychological function assessment. The results compared to each other. The psychological function of each participant was evaluated by the Arabic version of the Hospital Anxiety and Depression Scale (HADS) within three months of miscarriage. We used the PSTD checklist for the Diagnostic Statistical Manual of Mental Disorders—5th Edition (DSM-5). 
Results : Twenty-five patients in group A and twenty-five in group B. women in both groups have increased rates of psychiatric disorders affection regarding depression, anxiety, and PTSD. It shows that 68% in group A have depression compared with 68% in group B indicating no significant difference between the two groups. It shows that 72% are suffering from anxiety in group A compared with 68% having anxiety indicating no significant difference between both groups. According to PTSD, there were no significant differences between the two groups with a high rate of affection around 72% in group A versus 68% in group B.
Conclusion: increased rates of depression, anxiety, and PTSD in women in both groups without any significant difference between the two groups with the hypothesis of the effect mainly related to the loss of pregnancy itself regardless of the method of termination. 

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