TRAUMATIC STRESS DISORDERS

Traumatic stress disorders following first-trimester spontaneous abortion

By Stephen V. Bowles, PhD, Rebecca S. Bernard, PhD, Ted Epperly, MD, Stephanie Woodward, MA, Karni Ginzburg, PhD, Raymond Folen, PhD, Theresita Perez, Cheryl Koopman, PhD

QUOTES:

(I have bolded certain passages.)

  • Would you know the key symptoms or historical factors to look for in determining whether a patient will develop acute stress disorder (ASD) or posttraumatic stress disorder (PTSD)? Most women discharged from the hospital after spontaneous abortion consult their primary care doctor for emotional distress related to the lost pregnancy.

  • Some authors have projected that 10% of women who experience a spontaneous abortion meet criteria for acute stress disorder and 1% for posttraumatic stress disorder. Subsequent research has indicated even higher levels of acute stress disorder and posttraumatic stress disorder. Approximately 15% met criteria for acute stress disorder at 3 weeks/ 25% met criteria for posttraumatic stress disorder at 1 month, and 7% met criteria for posttraumatic stress disorder- at 4 months.
  • Our pilot study sought to validate research that found high rates of acute stress disorder and posttraumatic stress disorder in this population, examine potential risk-factors for acute stress disorder, examine women’s perception of support after their spontaneous abortion, and determine whether acute stress disorder is predictive of posttraumatic stress disorder.
  • We begin by sharing the take-home points of our study, and follow with the details of methods used and study results.
  • Approximately 15% met criteria for acute stress disorder at 3 weeks/ 25% met criteria for posttraumatic stress disorder at 1 month, and 7% met criteria for posttraumatic stress disorder- at 4 months.

____________________________________________________________________________________________________

Symptom of acute stress disorder and posttraumatic stress disorder

Exposure to a traumatic event

Response involves intense fear, helplessness, or horror

Repeatedly re-experience trauma (dreams, flashbacks, thoughts)

Avoidance of trauma-related stimuli

Increased arousal (hypervigilance, exaggerated startle response, irritability)

Significant impairment in important areas of functioning Three or more dissociative symptoms (derealization, depersonalization, numbing) (for ASD only)

Duration: 2 days-4 weeks (for ASD), >1 month (for PTSD)

__________________________________________________________________________________________________

  • 39% met criteria for posttraumatic stress disorder at 1 month. These findings were consistent with other research. Moreover, women who developed acute stress disorder were significantly more likely to exhibit subsequent posttraumatic stress disorder.
  • Women whose acute stress disorder symptoms remain untreated following a miscarriage may maintain their symptom level or experience further exacerbation of acute stress disorder symptoms.
  • Echoing previous research, women reporting an abuse history were more likely to experience acute stress disorder. Thus, physicians should assess for past traumatic experiences that could influence the patient’s emotional response to the spontaneous abortion.
  • Several psychological beliefs and perceptions also were related to acute stress disorder. Women were significantly more likely to develop acute stress disorder if they felt personally responsible for the miscarriage, lacked a sense of control in their lives, or reported feeling bonded to the unborn child.
  • Women lacking spousal support may need increased support from you and other health care team members
 
Advertisements
Leave a comment

Leave a reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

  • Enter your email address to receive notifications of new posts by email.

    Join 214 other followers

  • Posts By Month

  • tut072012@gmail.com

  • DMCA.com© the unexpected trip, theunexpectedtrip.wordpress.com, 2012-2017.
  • Recent Posts By Title

  • About Me

    Me: 41
    DH: 38

    Fertility issue:
    Recurrent Pregnancy Loss
    6 pregnancy losses
    All early
    5 with my own eggs
    1 with donor egg

    DOR
    Abnormal embryos

    Blood:
    Factor V Leiden heterozygous
    MTHFR heterozygous

    AFC: 2 - 12
    AMH: 0.2
    FSH: 6.8
    E2: 40
    LH: 2.8

    History:

    April 2011 -
    Natural conception, first try. Blighted ovum (gestational sac only). D&C to remove products of conception at 9 weeks.

    Oct 2011 -
    Natural conception, first try. Blighted ovum (gestational sac & yolk sac). Took Cytotec to induce miscarriage at 9 weeks. PTSD, depression, anxiety, insomnia, night terrors followed.

    Winter 2012 -
    Two rounds of Femara/Clomid + IUIs at Columbia and RS of NY. The idea: to produce more eggs and increase chances of catching a good one. BFNs.

    April 2012 -
    Natural conception, first try. Ultrasound showed activity in the uterus, but no complete sac. Diagnosed with "missed abortion." Natural miscarriage at 5 weeks.

    June 2012 -
    Conception after 7 mg Femara for 5 days + IUI. Diagnosed with chemical pregnancy. Natural miscarriage at 4.5 weeks.

    August 2012 -
    Natural conception, without trying. Chemical pregnancy and natural miscarriage at 5 weeks.

    October 2012 -
    ODWU at Colorado Center for Reproductive Medicine (CCRM).

    January 2013 -
    IVF with Dr. Schoolcraft.
    Straight Antagonist protocol

    What he predicted:
    I will produce 11 eggs
    Good chance 1 will be normal
    30% chance 2 will be normal
    Transfer 1, then a 45% chance of success
    Transfer 2, then a 65% chance of success

    What happened:
    7 follicles stimulated
    6 mature eggs retrieved
    2 died during ICSI
    4 fertilized
    3 out of 4 embryos CCS-tested
    All abnormal

    ***
    Aug/Sept 2013-
    Frozen Donor Egg IVF at Reproductive Biology Associates (RBA)
    What Dr. Shapiro predicted:
    6 or 7 will fertilize
    1 we will transfer
    1 - 3 we will freeze

    Protocol: Lupron, Vivelle patches, Crinone

    8 frozen eggs from donor thawed
    6 fertilized
    1 Day-5 Grade A XBbb blastocyst transferred
    1 Day-5 Grade A EBbb blastocyst frozen
    1 Day-6 Grade A XBbb blastocyst frozen

    September 13, 2013: Pregnant

    Protocol:
    Prenatal vitamins & baby aspirin,
    Vivelle patches & Crinone

    Beta #1: 171
    Beta #2: 706
    Beta #3: 7,437

    6 w 3 d: measured 6 w 1 d
    FHR: 80 bpm
    Fetus did not grow
    7 w: FHR 121 bpm
    8 w: heart stopped
    9 w: D and C

    Test results: We lost a normal karyotype male for unexplained reasons

    Quit stressful job
    Anti-inflammation diet
    Gluten-free diet
    Vit D, DHA/EPA
    Zoloft
    Therapy/energy work
    Creative Visualization
    Art Therapy

    March 14, 2014:
    Double FET at RBA
    1 Day-5 Grade A EBbb blastocyst
    1 Day-6 Grade A XBbb blastocyst

    March 24, 2014:
    Pregnant

    Protocol:
    Prenatals, baby aspirin, Folgard, Vivelle, Crinone, Lovenox

    Beta #1: 295
    Beta #2: 942
    Beta #3: 12,153

    1 fetus implanted

    Measured on track

    Fetal heart rate:
    7 wk: 127 bpm, 8wk:159 bpm, 9wk: 172 bpm

    Due date: Dec, 4 2014!

    NatureMade (USP Seal) Prenatals and 4000 Vit D3
    Baby aspirin
    40 mg Lovenox
    DHA and EPA
    Folgard 2.2

    Born: One perfect baby boy 12.4.14

  • Advertisements
%d bloggers like this: