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Trastorno de estrés postraumático después del segundo trimestre Terminación médica del embarazo

O Anselem¹, A J Vivanti², H Bouchghoul³

¹Maternité Port-Royal, FHU PremIMPACT, Hôpital Cochin, AP-HP.Centre-Université de Paris, AP-HP, Paris, France.

American journal of obstetrics and gynecology

|February 22, 2026

Resumen

Casi la mitad de las mujeres que se someten a la interrupción del embarazo por indicación médica en el segundo trimestre (TOP) están en riesgo de trastorno de estrés postraumático (TEPT). Más de un tercio puede experimentar TEPT grave, lo que pone de relieve la necesidad de un cribado psicológico universal después de la TEP.

Área de la Ciencia:

Salud mental perinatal en la salud mental perinatal.
Investigación de trauma psicológico investigación de trauma psicológico.
Los resultados de la salud reproductiva.

Sus antecedentes:

La interrupción del segundo trimestre del embarazo (TOP) puede ser psicológicamente angustiosa.
El trastorno de estrés postraumático (TEPT) es un resultado adverso potencial.
La identificación de los factores de riesgo es crucial para las intervenciones específicas.

Objetivo del estudio:

Para evaluar la prevalencia de trastorno de estrés postraumático después del segundo trimestre.
Identificar los factores maternos y obstétricos asociados con el TEPT severo.
Para informar las estrategias de apoyo psicológico post-TOP.

Principales métodos:

Análisis secundario de un ensayo controlado aleatorizado en el que participaron 347 mujeres sometidas a TOP en el segundo trimestre.
Los síntomas de TEPT se evaluaron utilizando la Escala de Impacto de Eventos Revisada (IES-R) 1-4 meses después del TOP.
Análisis estadístico utilizando modelos mixtos para identificar los factores de riesgo para el TEPT grave (puntuación IES-R ≥37).

Principales resultados:

De 247 mujeres con datos de IES-R, el 44,9% tenía riesgo de TEPT (puntuación ≥33) y el 35,8% tenía riesgo de TEPT grave (puntuación ≥37).
No se encontraron asociaciones significativas entre los factores maternos / obstétricos (paridad, edad gestacional, duración del trabajo de parto, dolor, complicaciones) y el TEPT severo.
Los resultados se mantuvieron consistentes después de tener en cuenta los datos faltantes y en el análisis completo del caso.

Conclusiones:

Una proporción sustancial de mujeres experimentan TEPT o síntomas graves de TEPT después del segundo trimestre.
La falta de factores de riesgo identificables sugiere una necesidad universal de evaluación psicológica.
Se recomienda el cribado sistemático para apoyar la salud mental de las mujeres después de la OP.

Palabras clave:

Terminación del embarazo (TOP)salud mental salud mental.trastorno de estrés postraumático (TEPT)

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