(163) Examining psychometric screening scores for depression, anxiety, and post-traumatic stress after fetal KCL injection

Objective: To examine the incidence of positive screens for depression, anxiety, and post-traumatic stress among patients undergoing therapeutic abortion at ≥ 22 weeks’ gestation.

Study Design: This was a prospective, observational cohort study of patients undergoing fetal potassium chloride (KCL) injection for therapeutic abortion at ≥ 22 weeks’ gestation. All patients scheduled for said procedure were approached within 48 hours of the scheduled termination. After obtaining informed consent, basic demographic information was collected. Patients completed the Edinburgh Postnatal Depression Scale (EPDS), General Anxiety Disorder-7 (GAD-7), and Primary Care Post-Traumatic Stress Disorder-5 (PC-PTSD-5) questionnaires twice, first prior to their KCL procedure and then again two weeks later. Consents and questionnaires were provided in both English and Spanish. Patients who scored positive on any tool were referred to an in-house social worker and connected to ongoing mental health care as appropriate.

Results: 41 patients were screened for this study, of whom 24 enrolled. The mean gestational age in weeks was 24.8 (Table 1). Fetal anomaly was the indication for termination in 70.8% of patients. 14 patients (58.3%) completed the two-week follow-up surveys. The median baseline and two-week follow up scores for the EPDS, GAD-7, and PC-PTSD-5 were, respectively, 13.5 and 10, 7 and 4.5, and 1 and 2 (Table 2). There was no difference in the proportion who screened positive on any measures between those patients who completed the follow up surveys and those who did not. There were also no differences in the proportion of positive screens by evacuation method or termination indication.

Conclusion: Most patients undergoing termination at ≥ 22 weeks’ gestation at our institution during the study period did so for fetal anomalies. Patients undergoing these terminations should be screened for depression, anxiety, and PTSD, and those who screen positive should be connected to resources for further care. More research is needed on the long-term mental health outcomes of patients undergoing termination after 22 weeks.