减胎术对孕妇心理健康影响的研究进展

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (601 KB) HTML (32 KB)
输出: BibTeX | EndNote (RIS)

摘要孕期的心理健康问题与母胎围产期异常以及儿童期发育密切相关。而接受减胎术者面临多胎妊娠、孕期接受宫内干预、减胎术致胎死宫内等多重压力,其出现心理健康问题的潜在风险高于一般的单胎妊娠孕妇。本文对减胎术后孕妇心理健康的文献进行了汇总,并梳理了可以应用于临床的心理干预措施,为进一步改善减胎术的预后提供参考。结果显示,减胎术后的孕妇心理健康状况比一般孕妇要差,其主要表现包括抑郁、焦虑、压力及悲伤等症状,和流产后的孕妇接近。目前可用于术后心理健康干预的有效措施包括社会支持、团体心理辅导、一对一心理咨询等。建议在临床实践中,需要密切关注减胎术后孕妇的心理健康,积极开展心理问题的早期诊断与干预,以改善远期预后。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	孙澳
	吴天晨
	魏瑗

关键词 ：减胎术, 心理健康, 双胎妊娠, 综述

收稿日期: 2021-12-22

ZTFLH:	R17
	R71

基金资助:首都临床诊疗技术研究及转化应用项目(项目编号:Z201100005520074)。

通讯作者: 魏瑗(weiyuanbysy@163.com)

引用本文:

孙澳, 吴天晨, 魏瑗. 减胎术对孕妇心理健康影响的研究进展[J]. 中国生育健康杂志, 2023, 34(1): 94-97.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2023/V34/I1/94

1 Vehmeijer FOL,Guxens M,Duijts L,et al.Maternal psychological distress during pregnancy and childhood health outcomes:a narrative review.J Dev Orig Health Dis,2019,10:274-285.
2 Isgut M,Smith AK,Reimann ES,et al.The impact of psychological distress during pregnancy on the developing fetus:biological mechanisms and the potential benefits of mindfulness interventions.J Perinat Med,2017,45:999-1011.
3 胡琳莉,黄国宁,孙海翔,等.多胎妊娠减胎术操作规范(2016).生殖医学杂志,2017,26:193-198.
4 Committee Opinion No.719:Multifetal pregnancy reduction.Obstet Gynecol,2017,130:e158-e163.
5 Martin JA,Hamilton BE,Osterman MJK,etal.Births:Final Data for 2019. National vital statistics reports:from the Centers for Disease Control and Prevention,National Center for Health Statistics,National Vital Statistics System,2021,70:1-51.
6 Sunderam S,Kissin DM,Zhang Y,et al.Assistedreproductive technology surveillance- United States,2017. Morbidity and mortality weekly report Surveillance summaries (Washington,DC:2002),2020,69:1-20.
7 李洋洋,张志涛,刘彩霞,等.《双胎门诊分级指南》团体标准的制定与实践.中国实用妇科与产科杂志,2021,37:1170-1172.
8 Fisher J,Stocky A.Maternal Perinatal Mental Health and Multiple Births:Implications for practice.Twin Res,2012,6:506-513.
9 Ystrom E,Reichborn-Kjennerud T,Tambs K,et al.Multiple births and maternal mental health from pregnancy to 5 years after birth:A longitudinal population-based cohort study.Nor Epidemiol,2014,24.
10 王谢桐,李红燕.重视单绒毛膜双胎妊娠的临床研究.中华妇产科杂志,2013,48:401-404.
11 Beauquier-Maccotta B,Chalouhi GE,Picquet AL,et al.Impact of Monochorionicity and twin to twin transfusion syndrome on prenatal attachment,post traumatic stress disorder,anxiety and depressive symptoms.PLoS One,2016,11:e0145649.
12 Mautner E,Kalchmair H,Avian A,et al.Health-Related Quality of life and depression in women following intrauterine interventions in complicated monochorionic twin pregnancies.Fetal Diagn Ther,2019,46:125-132.
13 Vergote S,Lewi L,Gheysen W,et al.Subsequent fertility,pregnancy,and gynecologic outcomes after fetoscopic laser therapy for twin-twin transfusion syndrome compared with normal monochorionic twin gestations.Am J Obstet Gynecol,2018,218:447.e1-447.e7.
14 French A,Le Q,Defranco E,et al.Reproductive Outcomes following Laser Surgery for Twin-Twin Transfusion Syndrome.Fetal Diagn Ther,2020,47:464-470.
15 Kersting A,Wagner B.Complicated grief after perinatal loss.Dialogues Clin Neurosci,2012,14:187-194.
16 Jacob L,Polly I,Kalder M,et al.Prevalence of depression,anxiety,and adjustment disorders in women with spontaneous abortion in Germany- A retrospective cohort study.Psychiatry Res,2017,258:382-386.
17 Farren J,Jalmbrant M,Falconieri N,et al.Posttraumatic stress,anxiety and depression following miscarriage and ectopic pregnancy:a multicenter,prospective,cohort study.Am J Obstet Gynecol,2020,222:367.e1-367.e22.
18 Bellieni CV,Buonocore G.Abortion and subsequent mental health:Review of the literature.Psychiatry Clin Neurosci,2013,67:301-310.
19 Broen AN,Moum T,Bodtker AS,et al.The course of mental health after miscarriage and induced abortion:a longitudinal,five-year follow-up study.BMC Med,2005,3:18.
20 Falletta L,Fischbein R,Bhamidipalli SS,et al.Depression,anxiety,and mental health service experiences of women with a twin-twin transfusion syndrome pregnancy.Arch Womens Ment Health,2018,21:75-83.
21 Sebghati M,Khalil A.Reduction of multiple pregnancy:Counselling and techniques.Best Pract Res Clin Obstet Gynaecol,2021,70:112-122.
22 Druguet M,Nuño L,Rodó C,et al.Emotional effect of the loss of one or both fetuses in a monochorionic twin pregnancy.J Obstet Gynecol Neonatal Nurs,2018,47:137-145.
23 原鹏波,王学举,王颖,等.中孕期选择性减胎术在复杂性单绒毛膜双胎治疗中的应用.中华围产医学杂志,2016,19:827-832.
24 石晓梅,何薇,刘倩,等.射频消融术在三胎妊娠减胎中的运用分析.现代妇产科进展,2021,30:606-609.
25 Bergh C,Möller A,Nilsson L,et al.Obstetric outcome and psychological follow-up of pregnancies after embryo reduction.Hum Reprod,1999,14:2170-2175.
26 Garel M,Stark C,Blondel B,et al.Psychological reactions after multifetal pregnancy reduction:a 2-year follow-up study.Hum Reprod,1997,12:617-622.
27 Mckinney M,Downey J,Timor-Tritsch I.The psychological effects of multifetal pregnancy reduction.Fertil Steril,1995,64:51-61.
28 Schreiner-Engel P,Walther VN,Mindes J,et al.First-trimester multifetal pregnancy reduction:acute and persistent psychologic reactions.Am J Obstet Gynecol,1995,172:541-547.
29 Britt DW,Risinger ST,Mans M,et al.Anxiety among women who have undergone fertility therapy and who are considering multifetal pregnancy reduction:trends and implications.J Matern Fetal Neonatal Med,2003,13:271-278.
30 Mashiach R,Anter D,Melamed N,et al.Psychological response to multifetal reduction and pregnancy termination due to fetal abnormality.J Matern Fetal Neonatal Med,2013,26:32-35.
31 Leithner K,Stammler-Safar M,Springer S,et al.Three or less? Decision making for or against selective reduction and psychological outcome in forty women with a triplet pregnancy.J Psychosom Obstet Gynaecol,2021,42:286-292.
32 Ben Barnes J,Hayes AM,Contractor AA,et al.The structure of co-occurring PTSD and depression symptoms in a cohort of Marines pre- and post-deployment.Psychiatry Res,2018,259:442-449.
33 许敏,张宪英.舒适护理对多胎妊娠早期经阴道选择性减胎术病人焦虑抑郁状态的影响.护理研究,2009,23:1448-1449.
34 赵静,陈小燕,凌秀凤.对于多胎妊娠早期选择性减胎术的护理体会.现代医学,2017,45:463-464.
35 巫丽琼,陈咏莲,董兴盛,等.团体心理辅导结合同伴教育在改善多胎妊娠选择性减胎术孕妇负情绪中的作用.中国医学创新,2019,16:88-92.
36 Robinson M,Baker L,Nackerud L.The relationship of attachment theory and perinatal loss.Death Stud,1999,23:257-270.
37 Leon IG.The psychoanalytic conceptualization of perinatal loss:a multidimensional model.Am J Psychiatry,1992,149:1464-1472.
38 Richards J,Graham R,Embleton ND,et al.Mothers′ perspectives on the perinatal loss of a co-twin:a qualitative study.BMC Pregnancy Childbirth,2015,15:143.
39 Swanson PB,Kane RT,Pearsall-Jones JG,et al.How couples cope with the death of a twin or higher order multiple.Twin Res Hum Genet,2009,12:392-402.
40 Mcgrath JM,Butt ML,Samra H.Supporting parents who lose a child of a multiple birth:A critical review of research in the neonatal intensive care unit.Newborn Infant Nurs Rev,2011,11:203-214.
41 Woolhouse H,Mercuri K,Judd F,et al.Antenatal mindfulness intervention to reduce depression,anxiety and stress:a pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital.BMC Pregnancy Childbirth,2014,14:369.40 Koopmans L,42 Wilson T,Cacciatore J,et al.Support for mothers,fathers and families after perinatal death.Cochrane Database Syst Rev,2013:CD000452.