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Abstract
An understanding of the psychological aspects of recurrent miscarriage involves an analysis of the anecdotal and research literature focused on cause, effects, and treatment. Despite methodological flaws, it is possible to derive fairly specific strategies for physicians that hold promise in mitigating the potentially damaging effects of recurrent miscarriage. The provision of psychological support should include open discussion of the emotional aspects of recurrent miscarriage, the provision of timely and detailed medical information, and referral to a mental health professional if the patient needs more support than the obstetrician/gynaecologist is comfortable providing. The role of psychotherapeutic intervention as a treatment for the pregnant patient is less clear, but there are suggested physician behaviours that have been tentatively linked with improved rates of term pregnancy. These include continuity of the treatment team throughout pregnancy, frequent office visits, reinforced and updated patient teaching, and referral to a psychotherapist who deals with pregnancy-related issues.
Resume
Pour bien saisir les conséquences psychologiques des fausses couches récurrentes, il est essentiel d’analyser les rapports anecdotiques et les rapports de recherche qui s’intéressent aux causes, aux effets et au traitement de ce problème. En dépit des lacunes que présente la méthodologie, il est possible d’echafauder des stratégies assez spécifiques auxquelles le médecin pourra recourir en vue d’atténuer les répercussions potentiellement dommageables d’une succession de fausses couches. Le soutien psychologique devrait comprendre une discussion franche des aspects affectifs du problème, la diffusion d’information médicale détaillée au moment opportun et l’aiguillage vers un professionnel de la santé mentale, advenant le cas où la patiente souhaite un soutien que l’obstétricien-gynécologue est dans l’incapacité de lui fournir. Le rôle de la psychothérapie dans le traitement de la patiente enceinte est plus confus, mais on croit que certains comportements du médecin pourraient contribuer à une issue heureuse de la grossesse, à terme. Citons, entre autres, l’intégrite de l’équipe chargée de dispenser les soins pendant la gestation, la fréquence des consultations, une meilleure sensibilisation, plus suivie, de la patiente ainsi que le renvoi à un psychothérapeute spécialisé dans les problèmes de la grossesse.
Key Words
References
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Article info
Publication history
Accepted:
June 2,
1997
Received in revised form:
June 2,
1997
Received:
March 3,
1997
Identification
Copyright
© 1997 Published by Elsevier Inc.
