Acute and post-traumatic stress disorder after spontaneous abortion

When a spontaneous abortion is followed by complicated bereavement, the pri mary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as dissociation , reliving the trauma, avoiding stimuli associated with the trauma and incr eased arousal are present for at least two days but not longer than four we eks. When the symptoms persist beyond four weeks, the patient may have post -traumatic stress disorder. The symptoms of distress response after spontan eous abortion include psychologic, physical, cognitive and behavioral effec ts; however, patients with distress response after spontaneous abortion oft en do not meet the criteria for acute or post-traumatic: stress disorder. A fter spontaneous abortion, as many as 10 percent of women may have acute st ress disorder and up to 1 percent may have post-traumatic stress disorder. Critical incident stress debriefing, which may be administered by trained f amily physicians or mental health practitioners, may help patients who are having a stress disorder after a spontaneous abortion.