Psychological treatment of women with psychological complaints after pre-eclampsia.
OBJECTIVE
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).


CONCLUSIONS
Psychological treatment in cases of psychological complaints increases coping possibilities in women after exposure to PE and timely recognition reduces the treatment duration.
Poel
Yvonne H M
YH
Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands.
Swinkels
Petrouschka
P
de Vries
Johanna I P
JI
D000223:Adaptation, Psychological; D000328:Adult; D001792:Blood Platelets / Q000378:metabolism; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004730:Endothelium, Vascular / Q000503:physiopathology; D004798:Enzymes / Q000097:blood; D005260:Female; D006461:Hemolysis / Q000502:physiology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D011247:Pregnancy; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D013577:Syndrome
D004798:Enzymes