Anxiety scale in surgical abortions and drug-induced abortions: A comparative study

Abstract

Introduction. It is well known that many events during life can be stressful events, specifically events related to health. Abortion is an event that represents a robust risk factor for the development of anxiety symptoms. Induced abortions occur for many reasons, including genetic defect, missed abortion, various diseases of the mother, trauma etc. The impact of abortion (as stressful life events) in the etiology of anxiety disorders has been described in the literature. Anxiety disorders are defined as excessive worry or fear and tension about everyday events and problems or for any sudden stressful life events. Anxiety levels are typically classified into four categories: mild, moderate, severe and panic level anxiety. Objective. The primary objective of the study was to determine the anxiety scale before an induced abortion. Materials and methods. This is a cohort study. The study was conducted at the University Clinical Center of Kosovo, a tertiary care hospital. 189 women participated in the study waiting for abortions. The women were divided into two groups; 87 women designated for surgical abortion and 102 for drug-induced abortion. Both groups were assessed separately for presence and degree of anxiety. To evaluate these two parameters were used Hopkins Symptoms Checklist (HSCL-25). Only the first 10 HSCL-25 questions were used to assess the presence and anxiety scale. The anxiety scale was measured before the abortion. The primary outcome measures studied were the incidence of abortions, the average maternal age, type of induced abortion, presence of anxiety, and anxiety scale. Results. During the study period in our clinic, 1376 pregnant women were hospitalized, out of which 189 cases for abortion. The incidence rate of abortions was 13.7 per 1000 women aged 15-44 years. Of these 189 cases for abortion in both groups, 110 women or 58.2% had anxiety. The mean age of patients was 28.76 ± 6.2 years. Out of 110 cases that experienced anxiety during an induced abortion; 78.2% (86 cases) had mild anxiety, 19.1% (21 cases) moderate anxiety, and 2.7% (3 cases) severe anxiety. A comparison was made between the two groups, and it turned out those women with surgical abortions had a relative risk (RR) OF 1.5 times higher to experience anxiety during abortion procedures than not even women with drug-induced abortions. Anxiety was experienced by women in the form of phobias. Women who underwent surgical abortion mostly had phobias such as; phobia by uncontrollable bleeding (31.7%), followed by phobia by surgical abortion procedures (27%), phobia associated with anesthesia (14.3%), while women who underwent drug-induced abortion mostly had phobias by phobia associated with abortion failure, and likelihood for surgical abortion (44.7%), followed by phobia for developing infections (31.9%) etc. Conclusions. The results of this study show that the incidence of abortions was 13.7 per 1000 women aged 15-44 years. Regardless of the method of abortion, 58% of women experienced anxiety during the abortion procedure. Of these, 78% had low levels of anxiety, 19% moderate and 3% severe anxiety. Findings from our analysis show that women who had abortions with surgical abortions experienced 1.5 times more anxiety than women with drug-induced abortions.