Paternal and maternal long-term psychological outcomes after uterine artery embolization for severe post-partum hemorrhage

Abstract

This study intend to compare the long-term psychological impact (depression, post-traumatic stress disorder) on both partners between patients that underwent uterine artery embolization (UAE) for post-partum hemorrhage (PPH) and uneventful deliveries. Women who experienced severe PPH treated by UAE in our institution between 2003 and 2013 were identified in our obstetrical database. These cases were matched to controls with uneventful deliveries. Matching criteria were maternal age, parity, ethnicity, year of delivery, birthweight, gestational age and mode of delivery. Patients and their partners completed validated questionnaires measuring post-traumatic stress (TSQ), as well as depression symptoms (MINI). A total of 63 cases of PPH and 189 matched controls (1:3) participated in a study exploring gynecological and obstetrical outcomes. With a mean of 8 years post-index delivery, patients after PPH showed increased risk of depression (p = 0.015) and post-traumatic stress disorder (22.2% versus 4.8%, p < 0.005) compared to controls. PPH remains strongly associated with post-traumatic stress disorder, even after adjustment for depression (adjusted odds ratio 5.1; 95% confidence intervals 1.5–17.5). Similarly, partners of patients with PPH showed a propensity to depression (p = 0.029) and post-traumatic stress disorder (11.5% versus 1.5%, p = 0.019). In conclusion, both women and their partners are at increased risk of long-term psychological adverse outcomes after PPH. Couples may benefit from psychological support.

Childbirth Experience, Risk of PTSD and Obstetric and Neonatal Outcomes According to Antenatal Classes Attendance

“…Furthermore, this study included all the antenatal classes that women attended, regardless of their speci c methods or settings (at the hospital or in private settings). Additionally, the low response rate (27.6%) is also an important limitation, although it is comparable to other questionnaire studies (Baud, Meyer, Vial, Hohlfeld, & Achtari, 2011; Bernasconi et al, 2021;Eggel et al, 2021), particularly to online surveys (Nulty, 2008;Lambelet et al, 2021). It is possible that women with traumatic childbirth experiences, particularly following emergency caesarean sections, did not participate in this study.…”

“…Childbirth experience is one of these risk factors, as well as the mode of childbirth, the fear of childbirth, mental health status during pregnancy, and social support. The childbirth experience is a self-assessment of what a woman remembers about her birth (Taheri, Takian, Taghizadeh, Jafari, & Sarafraz, 2018), sometimes even many years later (Bernasconi et al, 2021;Simkin, 1991). More than just satisfaction with pain or care, the childbirth experience attempts to "measure feelings of control, expectancy satisfaction, con dence, and participation in decision making" (Taheri et al, 2018, p. 3).…”

Primary postpartum haemorrhage and longer-term physical, psychological, and psychosocial health outcomes for women and their partners: a mixed-methods systematic review

“…Seven studies explored the association between PPH and post-traumatic stress disorder (PTSD) at different time points ranging from 1 month to 8 years after birth, indicating a potential association between PPH and PTSD. (16, 37, 40, 44, 47, 53, 60) Five studies found a higher risk of PTSD among women who had a PPH and/or UAE or EPH compared with women who did not experience a PPH. (16, 37, 44, 53, 60) Four of these studies also reported adjusted odds (aOR), risk ratios (aRR) or aHR and these studies suggested a significant association between PPH and PTSD up to eight years after birth [aRR=4.45 (1.5 month); aRR=2.46 (6 months); aHR= 3.44 (within 12 months); aRR=1.90 (36 months); aOR=5.1 (8 years)].…”

“…(16, 37, 40, 44, 47, 53, 60) Five studies found a higher risk of PTSD among women who had a PPH and/or UAE or EPH compared with women who did not experience a PPH. (16, 37, 44, 53, 60) Four of these studies also reported adjusted odds (aOR), risk ratios (aRR) or aHR and these studies suggested a significant association between PPH and PTSD up to eight years after birth [aRR=4.45 (1.5 month); aRR=2.46 (6 months); aHR= 3.44 (within 12 months); aRR=1.90 (36 months); aOR=5.1 (8 years)]. (37, 44, 53, 60) The other two studies did not have comparison groups, but reported respectively 5% prevalence of PTSD among women who had a PPH at two months after birth (40) and 64% prevalence of PTSD among women who had an EPH at the median follow-up of 26.5 months.…”

Investigation and Analysis of Influencing Factors of Moderate to Severe Pain After Uterine Artery Embolization in Patients with Cesarean Scar Pregnancy

“…10 Therefore, it is of great significance to be familiar with and master the factors of pain in patients undergoing UAE and properly foresee the implementation of intervention measures to improve the overall quality of patients during hospitalization and improve treatment satisfaction. UAE is widely adopted for patients with various gynecological and obstetric conditions, such as adenomyosis, 11 postpartum hemorrhage, 12 and CSP. 13 Patients were placed in a flat position and routinely disinfected and covered with aseptic hole towels.…”