Women's Psychological Adjustment Following Emergency Cesarean Versus Vaginal Delivery

1988 ◽  
Vol 12 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Jill A. Padawer ◽  
Corey Fagan ◽  
Ronnie Janoff-Bulman ◽  
Bonnie R. Strickland ◽  
Max Chorowski

The present study was designed to investigate possible differences in psychological adjustment and satisfaction between women delivering vaginally and those delivering by emergency cesarean section. Women's satisfaction with the birth experience was distinguished from postpartum psychological adjustment, as measured by depression, anxiety, and confidence in mothering ability. Twenty-two women who delivered vaginally and twenty-two women who delivered by emergency cesarean section were selected according to stringent criteria, to control for factors known to be associated with positive cesarean outcomes. Significant differences were found in level of satisfaction, with cesarean mothers reporting less satisfaction with the delivery than vaginal mothers. However, no differences were found between the groups on the three measures of psychological adjustment. Under optimal conditions, cesarean deliveries are not associated with adverse early postpartum psychological adjustment.

2020 ◽  
pp. 000486742095428
Author(s):  
Lei Sun ◽  
Su Wang ◽  
Xi-Qian Li

Background: Postpartum depression is one of the most common postpartum diseases, which has an important impact on the interaction between mother, infant, partner and family, as well as the long-term emotional and cognitive development of infants. However, there are still great disagreements on whether the delivery mode will affect the risk of postpartum depression. The purpose of this study is to explore whether the mode of delivery will affect the risk of postpartum depression through the comprehensive network meta-analysis of elective cesarean section, emergency cesarean section, instrumental vaginal delivery and spontaneous vaginal delivery. Methods: We searched in three electronic databases: PubMed, EMBASE and Cochrane Library. Results: This paper included 43 studies with a total sample size of 1,827,456 participants. Direct meta-analysis showed that the odds ratio of postpartum depression risk was 1.33 (95% confidence interval = [1.21, 1.46]) between cesarean section and vaginal delivery. The odds ratios of high Edinburgh Postpartum Depression Scale score between cesarean section and vaginal delivery in the three postpartum periods (within 2 weeks, within half a year and over half a year) were basically the same. There was no difference between cesarean section and vaginal delivery in the risk of severe postpartum depression at the Edinburgh Postpartum Depression Scale cut-off point ⩾13 (odds ratio = 1.07; 95% confidence interval = [0.99, 1.16]). Network meta-analysis showed that the risk of postpartum depression in the pairwise comparisons emergency cesarean section vs spontaneous vaginal delivery and elective cesarean section vs spontaneous vaginal delivery was odds ratio = 1.53 (95% confidence interval = [1.22, 1.91]) and 1.47 (95% confidence interval = [1.16, 1.86]). Conclusion: The mode of delivery has a significant effect on the occurrence of mild postpartum depression. Women who give birth by cesarean section, especially who give birth by emergency cesarean section, are at a higher risk of mild postpartum depression. We should carefully monitor the progress of postpartum mental disorders in women who delivered by cesarean section and make it possible for women to have a quick access to mental healthcare.


2020 ◽  
Author(s):  
Evangelia Antoniou ◽  
Eirini Orovou ◽  
Maria Iliadou ◽  
Angeliki Sarella ◽  
Ermioni Palaska ◽  
...  

Abstract Background Cesarean Section was historically performed to save the lives of mothers and infants. Ηowever, in the past decades, a significant increase in Cesarean Section rates have been observed in Greece and worldwide. The purpose of this research was to investigate the contributing factors to the increase in the Cesarean Section rate (emergency and elective) and postoperative complications.Methods A total of births in 6 months (August 2019- February 2020) at the University Hospital of Larisa in Greece was collected. The performed analysis included the available socio-demographic and medical information in the medical records and a socio-demographic and medical questionnaire for women with cesarean deliveries. We also analyzed the importance of the variables in cesarean deliveries compared to vaginal deliveries and postoperative complications.Results Out of the total number of the included 633 births, the vaginal delivery rate was 42% (n = 268), and the cesarean delivery rate was 58% (n = 365); Elective Cesarean Section was performed in 36% (n = 230) of the Cesarean Section cases and Emergency Cesarean Section in 22% (n = 135). Women with a previous Cesarean Section and women with in vitro fertilization showed higher percentages for Elective Cesarean Section (46%) compared to women who underwent an Emergency Cesarean Section for the same reasons (42.2%). Besides, a higher percentage of Emergency Cesarean Sections was observed in women living in urban centers (OR = 4.044, p = 0.002) and those diagnosed with stress disorders (OR = 7.048, p = 0.004). Furthermore, Cesarean Section complications were more common among women having undergone Emergency Cesarean Section (OR = 10.357, p < 0.001).Conclusion The overall high rates of Cesarean Section in Greece demonstrate the lack of national strategies and prevention mechanisms from iatrogenic interventions and lack of promoting good midwifery practices. More specifically, a decrease in iatrogenic factors leading to the primary Cesarean Section will decrease Cesarean Section rates in Greece.


2020 ◽  
Vol 68 (3) ◽  
pp. 799-806 ◽  
Author(s):  
Ping Guan ◽  
Fei Tang ◽  
Guoqiang Sun ◽  
Wei Ren

ObjectiveTo analyze the maternal and fetal factors affecting emergency cesarean section (EmCS) and establish a risk scoring system to quantitatively predict the risk of EmCS.DesignA total of 10,295 pregnant women were enrolled in this study. The influence of maternal and fetal factors on the risk of EmCS was analyzed.Results991 (9.63%) cases of failed vaginal delivery received EmCS. The two main causes of EmCS were fetal distress (67.21%) and abnormal fetal position (14.93%). There were significant differences in 17 maternal and fetal factors between the normal vaginal delivery (NVD) and EmCS groups (p<0.05 for all). Univariate and multivariate regression analyses showed that nine maternal and infant factors were independent risk factors (p<0.05 for all). The major factors were abnormal quantity of amniotic fluid (OR 6.867, 95% CI 4.442 to 10.618), nulliparous (OR 4.336, 95% CI 3.074 to 6.115), induction of labor (OR 5.300, 95% CI 4.514 to 6.224) and abnormal characters of amniotic fluid (OR 3.126, 95% CI 2.708 to 3.608). A risk scoring system (six grades) was established based on those factors which showed high discriminative power. The rate of EmCS was 1.30%, 2.57%, 5.83%, 13.94%, 21.75% and 39.71% in grades 1, 2, 3, 4, 5 and 6, respectively. The area under the curve of the risk scoring system was 0.787, indicating that the regression model of the risk factors had a good predictive ability.ConclusionAn effective risk scoring system has been developed to quantitatively assess the risk of EmCS based on measurable maternal and fetal factors. The system is simple, easy to operate and has good repeatability in clinical practice.


2010 ◽  
Vol 17 (01) ◽  
pp. 164-167
Author(s):  
SARWAT ARA

Placenta percreta with urinary bladder invasion is a rare but potentially lethal condition with a high mortality rate. A 28 years old woman, gravida three para two with previous 2 cesarean deliveries, at 30 weeks of gestation, was admitted with frank haematuria. The diagnosis of placenta percreta with involvement of urinary bladder was confirmed. An emergency cesarean section and obstetric hysterectomy was performed and urinary bladder was repaired.


2020 ◽  
pp. 1-6

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.


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