Psychological сomponents of miscarriage. Ways to overcome

Authors

  • A. A. Zhyvetska-Denysova SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv, Ukraine, Ukraine https://orcid.org/0000-0001-8418-5740
  • V. B. Tkachenko SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0001-6622-9324
  • I. I. Vorobiova SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv, Ukraine, Ukraine https://orcid.org/0000-0002-6836-5845

DOI:

https://doi.org/10.14739/2310-1210.2021.3.208711

Keywords:

pregnancy, miscarriage, chronic stress, psychotherapy

Abstract

Habitual miscarriage is a stressful condition and a significant factor of frustration for married couples. The psycho-emotional state of the pregnant woman affects the course of the subsequent pregnancy and its outcome. Correction of the psychological component of habitual miscarriage is a promising direction for preventing reproductive losses.

The aim of the work is to study the psychological components of miscarriage and determine the ways of their correction.

Materials and methods. The level of chronic stress was studied in pregnant women with symptoms of miscarriage and a history of habitual reproductive losses (main group) based on indicators of psychoemotional state, the condition of the autonomic nervous system, and the degree of activation of stress-implementing systems. The results were evaluated with the scale PSS, PSM-25 as adapted by N. Ye. Vodopianova, Spielberger–Khanin inventory and the scale by L. D. Malkova, Baevsky index, cortisol content in the blood and urine. The pregnant women with a physiological course of pregnancy and uncomplicated history were included in the control group. Based on the fact that the etiology of habitual miscarriage is multifactorial, and the psychological component is amenable to correction, stress-protective therapy was included in the treatment complex of habitual miscarriage. To assess the effectiveness of treatment, the main group was divided into subgroups: 1 – with psychotherapy, 2 – without psychotherapy.

Results. A high level of personal perception of stress, anxiety and asthenia determine the psycho-emotional state of the main group pregnant women, among whom two dominant psycho types were identified: A – a high level of anxiety and low neuropsychic resistance; B – poise and good adaptive ability against the background of stress. Non-drug stress-protective therapy in the complex of miscarriage treatment contributes to: a decrease in psycho-emotional stress in pregnant women with psycho type A – 2.6 times, anxiety level – 1.7 times, asthenia level – 2.3 times; and also: a decrease in similar indicators in pregnant women with psycho type B – 1.6 times, 3.9 times and 2.5 times, respectively (P < 0.05); a decrease in the frequency of premature termination of pregnancy by more than 11 %.

Conclusions. The psychological component of miscarriage is a high level of personal perception of stress, anxiety and asthenia. Stress-protective therapy in combination with pathogenetic therapy of miscarriage improves pregnancy outcomes for the mother and the fetus. It is advisable to conduct pregravid training with the participation of a psychologist in women with a history of reproductive losses in order to overcome the psychological component of stress perception, expand adaptive potential, increase neuropsychic stability, and form a positive orientation toward pregnancy and motherhood.

Author Biographies

A. A. Zhyvetska-Denysova, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv, Ukraine

MD, PhD, Senior Researcher of the Department of Scientific Problems of Miscarriage

V. B. Tkachenko, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv

MD, PhD, Leading Researcher of the Department of Scientific Problems of Miscarriage

I. I. Vorobiova, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. M. Lukianova of the National Аcademy of Мedical Sciences of Ukraine”, Kyiv, Ukraine

MD, PhD, DSc, Head of the Department of Scientific Problems of Miscarriage

References

Zhivetskaya-Denisova, A. A., Vorobyova, I. I., Tkachenko, V. B., & Rudakova, N. V. (2017). Nevynoshuvannia vahitnosti: suchasni pidkhody do diahnostyky, profilaktyky ta likuvannia [Miscarriage of pregnancy: modern approaches to diagnostics, prevention, and treatment]. Perinatologiya i pediatriya, (2), 91-98. https://doi.org/10.15574/pp.2017.70.91 [in Ukrainian].

Vorobyova, I. I., Zhivetskaya-Denisova, A. A., Tkachenko, V. B., Rudakova, N. V., & Tolkach, S. M. (2017). Nevynoshuvannia vahitnosti: suchasni pohliady na problemu (ohliad literatury) [Miscarriage of pregnancy: current views on the problem (literature review)]. Zdorov'e zhenshchiny, (3), 113-117. [in Ukrainian].

Aganezov, S. S., & Aganezova, N. V. (2015). Vozmozhnosti snizheniya riska prezhdevremennyh rodov s pozicii dokazatelnoj mediciny [Possibilities for reducing the risk of preterm birth in the context of evidence-based medicine]. Akusherstvo i ginekologiya, (4), 62-68. [in Russian].

Chechuga, S. B., Nochvina, E. A., & Abdallah Sali. (2012). Patogeneticheskaya terapiya nevynashivaniya beremennosti u zhenshchin s gipergomotsisteinemiei i gestagennoi nedostatochnost'yu [Pathogenetic therapy of miscarriage in women withhyperhomocysteinemia and progestogen deficiency]. Zdorov'e zhenshchiny, (5), 80-85. [in Ukrainian].

Vorobiova, I. I., Skrypchenko, N. Ya., Livshyts, L. A., Zhyvetska-Denysova, A. A., Pysarieva, S. P., Tkachenko, V. B., Rudakova, N. V., Tolkach, S. M., & Chernenko, T. S. (2016). Imuno-henetychni pidkhody do diahnostyky nevynoshuvannia vahitnosti yak multyfaktorialnoho zakhvoriuvannia (metodychni rekomendatsii) [Immuno-genetic approaches to the diagnosis of miscarriage as a multifactorial illness (guidelines)]. Кyiv. [in Ukrainian].

Mihalevich, S. I., Hryshkevich, A. N., Markovskaya, T. V., & Grakovich, L. G. (2012). Privychnoe nevynashivanie beremennosti: sotsial'naya problema, meditsinskie resheniya. [Habitual miscarriage of pregnancy: social problem, medical decisions]. Meditsinskie novosti, (2), 12-18. [in Russian].

Zhivetskaya-Denisova, A. A., Vorobyova, I. I., Tkachenko, V. B., Podolskyi, V. V., & Tykha, V. G. (2019). Platsenta yak dzerkalo vahitnosti (Ohliad literatury) [Placenta - mirror of pregnancy (Literature review)]. Zdorov'e zhenshchiny, (3), 101-106.

Antipkin, Yu. G., Zadorozhnaya, T. D., & Parnitskaya, O. I. (Eds.). (2016). Patologiya platsenty (sovremennye aspekty) [Pathology of placenta: modern aspects]. OOO «Atopol». [in Russian].

Agarkova, L. A., Buharina, I. Yu., Ulianich, A. L., Bershkova, E. M., & Tolmachev, I. V. (2016). Osobennosti kachestva zhizni vo vzaimosvyazi s pokazatelyami psikhoemotsional'nogo sostoyaniya zhenshchin na kazhdom trimestre beremennosti [Features of quality of life interrelated with indicators of psychoemotional state of women in the period of every trimestre of pregnancy]. Kemerovskogo gosudarstvennogo universiteta, (4), 108-119. https://doi.org/10.21603/2078-8975-2016-4-108-119 [in Russian].

Shkurotenko, O. S., & Kovalenko, N. P. (2016). Aleksitimiya v period beremennosti kak mekhanizm psikhologicheskoi zashchity [Aleksitimiya during pregnancy, as the mechanism of psychological protection]. Vestnik psikhoterapii, (59), 75-86. [in Russian].

Tkachenko, V., Vorobieva, I., Kolomiytseva, K., & Chernenko, T. (2012). Osoblyvosti vplyvu deiakykh psykholohichnykh kharakterystyk na formuvannia piznikh akusherskykh uskladnen [Effects of some psychological characteristics on formation of late obstetrical complications]. Neonatolohiia, khirurhiia ta perynatalna medytsyna, 2(4), 69-74. [in Ukrainian].

Koreneva, J. (2018). Psykholohichne stavlennia do materynstva y uskladneni psykhostany vahitnoi zhinky: teoretyko-empirychnyi analiz problemy [Psychological Attitude to Maternity and Complicated Mental States of a Pregnant Woman: Theoretical and Empirical Analysis of the Problem]. Psykholohichni perspektyvy, (32), 149-161. https://doi.org/10.29038/2227-1376-2018-32-149-161 [in Ukrainian].

Kupriyanova, I. E., Efanova, T. S., & Zakharov, R. I. (2014). Psikhoterapevticheskaya korrektsiya i reabilitatsiya narushenii psikhicheskogo zdorov'ya u beremennykh s ugrozoi nevynashivaniya [Psychotherapeutic correction and rehabilitation of mental disorders in pregnant women with threatened miscarriage]. Nevrologiya, neiropsikhiatriya, psikhosomatika, 6(4), 46-50. https://doi.org/10.14412/2074-2711-2014-4-46-50 [in Russian].

Torchinov, A. M., Filippova, G. G., Tsagolov, V. A., & Yurina, E. V. (2015). Rol' psikhologicheskoi reabilitatsii v vedenii beremennosti u zhenshchin s nerazvivayushcheisya beremennost'yu v anamneze [The role of psychological rehabilitation in the management of pregnant women with the missed abortion history]. Problemy reproduktsii, (21), 132-136. https://doi.org/10.17116/repro2015215132-136 [in Russian].

Tagirova, Z. M., Umahanova, M. M., Philippova, G. G., & Tzidaeva, M. M. (2018). Otsenka psikhologicheskogo statusa u beremennykh s nevynashivaniem beremennosti [Assessment of the psychological status of pregnant women with miscarriage]. Problemy reproduktsii, (2), 108-111. https://doi.org/10.17116/repro2018242108-111 [in Russian].

Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5(7), 374-381. https://doi.org/10.1038/nrendo.2009.106

Cohen, S., & Williamson, G. M. (1988). Perceived Stress in a Probability Sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health. Claremont Symposium on Applied Social Psychology (pp. 31-67). Sage.

Vodop'yanova, N. E. (2009). Psikhodiagnostika stressa [Psychodiagnostics of Stress]. Piter. [in Russian].

Dermanova, I. B. (Ed.). (2002). Diagnostika emotsional'no-nravstvennogo razvitiya [Diagnostic of emotional and moral development]. Rech'. [in Russian].

Malkina-Pykh, I. G. (2003). Psikhosomatika : noveishii spravochnik [Psychosomatics: the latest guide]. Eksmo. [in Russian].

Baevskii, R. M., & Berseneva, A. P. (1997). Otsenka adaptatsionnykh vozmozhnostei organizma i risk razvitiya zabolevanii [Assessment of the adaptive capabilities of the body and the risk of developing diseases]. Moscow. [in Russian].

Polushkina, E. S., & Shmakov, R. G. (2020). Rol' didrogesterona v privychnom nevynashivanii beremennosti [The role of dydrogesterone in habitual miscarriage]. Meditsinskii Sovet, (3), 74-77. https://doi.org/10.21518/2079-701X-2020-3-74-77 [in Russian].

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Published

2021-06-07

How to Cite

1.
Zhyvetska-Denysova AA, Tkachenko VB, Vorobiova II. Psychological сomponents of miscarriage. Ways to overcome. Zaporozhye Medical Journal [Internet]. 2021Jun.7 [cited 2024Nov.23];23(3):348-55. Available from: http://zmj.zsmu.edu.ua/article/view/208711

Issue

Vol. 23 No. 3 (2021)

Section

Original research

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