Psychological treatment of women with psychological complaints after pre-eclampsia

Abstract

Aim. Pre-eclampsia (PE), eclampsia (E) and/or hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome cause major perinatal and maternal morbidity, mortality and have extensive psychosocial impact. The aim of this study is to describe psychological consequences, interventions and outcomes in a population of women from a tertiary centre.

Methods. From February 2004 through April 2007, 25/141 (18%) women with a history of PE, E and/or HELLP syndrome were referred to the medical psychologist. Obstetrical history, reason for referral to medical psychologist, medical psychological conclusion after intake, treatment and outcome were evaluated.

Results. Twenty-four women were reached for informed consent. Their referral was mainly for dysfunctional coping. A fifth (5/24) had posttraumatic stress disorder. Most women were Caucasian primiparous who delivered preterm by ceserean section of growth-restricted infants. Twenty-two women received therapy, one was referred to a medical social worker, one did not need therapy. The main interventions were psycho-education (n = 18), supportive techniques (n = 10), increasing autonomy techniques (n = 8) and eye movement desensitisation and reprocessing (n = 7). Duration between PE and consultation of medical psychologist was significantly related to the number of sessions (p < 0.01, Pearson correlation = 0.609).

Conclusion. Psychological treatment in cases of psychological complaints increases coping possibilities in women after exposure to PE and timely recognition reduces the treatment duration.

Keywords:

• Pre-eclampsia
• dysfunctional coping
• PTSD
• psychological interventions