Abstract

Summary

Тo assess the psycho-emotional status of primiparous women after cesarean section, and to identify clinical and organizational factors that contribute to the development of anxiety-depressive states in the early postpartum period.

Materials and Methods

A prospective study of 120 primiparous women: 70 after emergency CS (study group), 50 after planned CS (control group) .The Edinburgh Postpartum Depression Scale (EPDS) was used to identify postpartum depression. The Spielberger–Hanin Anxiety Scale and the Visual Analogue Pain Scale (VAS), a quantitative assessment of patient pain intensity, were used to assess reactive anxiety.
 

Results

The average age of women in the main group was 23.9±0.5 years, in the control group - 30.1±0.4 years. The obstetric and gynecological history of primiparous women with a planned cesarean section was 2.4 times more often than with an emergency one (48.0±1.9% and 20.0±2.4%, respectively). The main indications for an emergency cesarean section were obstructive labor (20.0%), fetal distress (18.5%). In the control group, the main indications were age-related primiparity (16.0%), age combined with infertility (18.0%), and myopia (26.0%). The level of personal and reactive anxiety in women of the main group was higher compared to the control group (44.2±5.0% and 38.0±4.6%; 47.1±5.4% and 40.0±4.9%, respectively; p<0.001). The relative risk of developing non-clinically expressed postpartum depression after an emergency cesarean section was RR=3.39 (95% CI 1.23–9.37). Severe pain syndrome (VAS ≥6) was noted in 35.7% of women in the main group and in 20.0% of women in the control group (p<0.05). The average depression score on the EPDS scale on days 3–5 after delivery in women after an emergency cesarean CS was significantly higher (12.8±3.1 and 8.0±2.7) (p<0.05).
 

Conclusion

Emergency CS is associated with higher levels of anxiety and depression compared to planned delivery. Screening for psychoemotional state using the EPDS and STAI should become standard postpartum care, especially for women following an emergency cesarean section. The Robson classification can be used to predict psychoemotional stress and identify at-risk groups, emphasizing the need for early psychological support.
 

Keywords

primiparous women cesarean section Robson psychoemotional status depression anxiety

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References

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