Changes in the Mental Status of Pregnant Women with Multiple Congenital Fetal Anomaly


Background: A diagnosis of Congenital Fetal Anomaly (CFA) is an unexpected event and will cause adequate psychological distress for the woman and her family and can be associated with a severe emotional trauma. This will present a new challenge whether to continue the pregnancy or to terminate the pregnancy. Termination of pregnancy caused by a CFA will cause significant long-term psychological stress to the mother and family.


Objective: To study and determine the changes of mental status in a pregnant patient with CFA who will undergo pregnancy termination.


Methods: This is a case report of pregnant women with CFA whose pregnancy will be terminated at the Obstetrics and Gynecology Polyclinic of Prof. dr. I.G.N.G. Ngoerah Central General Hospital Denpasar. In-depth interviews were conducted to assess mental conditions before and after the termination of pregnancy was carried out. 


Results and Discussion: It was reported a woman with 22 weeks of pregnancy with CFA who was undergo antenatal care in the Obstetrics and Gynecology Polyclinic Room at Prof. dr. I.G.N.G Ngoerah Central General Hospital Denpasar and the pregnancy will be terminated. There are feelings of sadness, loss of interest, and anxiety after knowing that the fetus has CFA and must be terminated. There is a feeling of guilt because she feels her actions caused the death of the patient's fetus. At the time of termination of pregnancy, the patient feels sad and cries when she sees the fetus. She feels that she already has a bond with the fetus that she carried even though it is not yet fully formed. 


Conclusion: Termination of pregnancy is a difficult process for both parents. This process can cause a number of mental disorders such as anxiety disorders, depression and post-traumatic stress disorder in both parents. The decision-making process is a difficult time that can lead to feelings of guilt. In the decision-making process, the pregnancy termination team must consider all aspects, both psychological and cultural, that the patient adheres to.
