The grief of late pregnancy loss

We studied 46 women who had an ultrasound diagnosis of a lethal fetal anomaly (gestational age greater than or equal to 24 weeks). Shortly after the diagnosis, 45% of these 46 women showed severe psychological instability established by a consensus diagnosis. Three months later, this percentage had diminished significantly to 22%. The total GHQ-28 score revealed that after 4 years, 11 out of the 29 remaining participants (38%) had a score of 5 or more, which indicated a clinically significant degree of general psychological distress. Depression and despair measured with the Perinatal Grief scale, did not decrease significantly over the 4-year period, Women with a strong disposition towards feelings of inadequacy or 'neuroticism', measured with the Dutch Personality Questionnaire, displayed significantly more intense grief reactions than women without such a strong disposition. The implications of our study are that in the face of (threatened) late pregnancy loss, medical care should include (i) paying attention to the need for medical information and emotional support and (ii) performing psychosocial screening of women identified as showing signs of inadequacy.