title: Psychological response to multifetal reduction and pregnancy termination due to fetal abnormality.
abstract: OBJECTIVE
  To investigate the emotional response in cases of multifetal reduction and pregnancy termination and to compare the psychological response between these two groups.
  
  
  METHODS
  A prospective study in a tertiary-care, university-affiliated medical center. The study group included 65 women who had been advised to terminate pregnancy because of a finding of a severe fetal abnormality on ultrasound screening (pregnancy termination group) and 41 women advised to undergo reduction because of the presence of multiple fetuses (multifetal reduction group). All women underwent psychological testing using validated questionnaires addressing perinatal grief and anxiety levels.
  
  
  RESULTS
  Women in both the multifetal reduction and the pregnancy termination groups reported significant degree of grief and anxiety before and after the procedure, although the levels of anxiety on the day of procedure and anxiety and grief at follow up were higher in the pregnancy termination group (t = 2.438, p = 0.016; t = 2.441, p = 0.017; and t = 3.111, p = 0.03, respectively). In both groups there was a gradual decrease in the state anxiety with time (48.01 ± 8.26 to 37.59 ± 9.23; t = -9.931; p < 0.001). Several factors affected the emotional response in the cases, including marital status, level of education, employment status, and gestational age. There was no association between a history of prior perinatal loss and emotional response.
  
  
  CONCLUSIONS
  There is need for a continuing psychosocial support of women undergoing multifetal reduction and pregnancy termination for fetal abnormalities.
authors.affiliation: Department of Obstetrics and Gynecology, Rabin Medical Center, Petach Tikva, Israel. mashiach@inter.net.il
authors.forename: Reuven
authors.initials: R
authors.lastname: Mashiach
authors.forename: Dianne
authors.initials: D
authors.lastname: Anter
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
authors.forename: Menachem
authors.initials: M
authors.lastname: Ben-Ezra
authors.forename: Israel
authors.initials: I
authors.lastname: Meizner
authors.forename: Yaira
authors.initials: Y
authors.lastname: Hamama-Raz
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000328:Adult; D001007:Anxiety; D005260:Female; D005333:Fetus / Q000002:abnormalities; D005865:Gestational Age; D006167:Guilt; D006801:Humans; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000523:psychology*; D011446:Prospective Studies