(725) Symptoms of Post Traumatic Stress Disorder Among Placenta Accreta Spectrum Providers

Friday, January 31, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Christina M. Duzyj, MD, MPH (she/her/hers)

Director, Maternal Fetal Medicine Fellowship Program
Massachusetts General Hospital
Boston, MA, United States

Coauthor(s)

Alireza A. Shamshirsaz, MD (he/him/his)

Department Director, Professor of Surgery
Fetal Surgeon Chief, Division of Fetal Medicine and Surgery Director of the Maternal Fetal Care Center Director of the Perinatal Surgery Fellowship Professor of Surgery, Boston Children’s Hospital Harvard Medical School
Boston, Massachusetts, United States
Daniela A. Carusi, MD, MSc (she/her/hers)

Associate Professor
Brigham and Women's Hospital
Boston, Massachusetts, United States

Objective: Physicians as a second victim have been increasingly recognized since the COVID-19 pandemic. However, physician post-traumatic stress disorder (PTSD) is less frequently recognized. We sought to evaluate for symptoms of PTSD among physicians caring for women with placenta accreta spectrum (PAS), a medical condition with known high acuity and high mortality.

Study Design: This is a cross-sectional study consisting of a quantitative survey distributed via email to physicians who either are members of the Pan-American Society for Placenta Accreta Spectrum, or who attended a PAS Post-Graduate Course or Scientific Session at the SMFM Annual Meeting in 2024. The survey included the PTSD Checklist for DSM-5 (PCL-5), as well as demographic questions, and open ended questions regarding institutional support after severe cases of PAS. Scoring was performed as recommended by the National Center for PTSD.

Results: The email containing the survey was opened by 71 individuals, and the survey completed by 21 (30%). All responders cared for women with PAS, the majority for 3-5 years (38.1%) although 28.6% reported greater than 10 years experience in caring for PAS, and 38.1% reported caring for a women who died of PAS. Most (71.4%) reported perceiving personal psychologic impact occasionally from severe PAS cases, with only one respondent never impacted. 66.6% of the cohort met diagnostic criteria for PTSD (PCL-5 >30), with highest responses being for unwanted memories (42.9%), strong negative feelings, feeling superalert or onguard, and difficulty concentrating (38.1% each). 28.6% reported that their institution provided no psychological support after difficult cases.

Conclusion: This preliminary study demonstrates that physicians caring for the obstetric patients at highest risk for mortality are themselves at high risk for post-traumatic stress disorder. Although our results are likely biased towards respondents experiencing the outcome of interest, we demonstrate that institutions must build capacity for supporting their physicians when adverse obstetric outcomes occur, particularly among patients with PAS.