Billert Hanna
Zakład Anestezjologii Doświadczalnej, Katedra Anestezjologii i Intensywnej Terapii, Uniwersytet Medyczny im. K. Marcinkowskiego, Poznań.
Ginekol Pol. 2007 Oct;78(10):807-11.
Pathological fear of childbirth known as "tokophobia" affects about 6-10% pregnancies and is of concern mainly because of remarkable sequele regarding women's morbidity, the neurobehavioral development of their children, and cesarean section on maternal request (CSMR). Fear of labor is a multidimensional problem involving a number of biological, psychological and social background factors and may be divided into primary and secondary tokophobia and tokophobia as a symptom of depression. Fear of childbirth is closely related to the fear of labor pain. It appears that women who experience fear, suffer from more pain due to alterations in the mechanisms of pregnancy induced analgesia. Despite no relevant connection between tokophobia and request for effective analgesia for labor pain relief, neuraxial techniques should always be available, especially to women with increased levels of negative emotions. However, epidural analgesia itself may increase fear level at the end and after labor and delivery. The mainstay of tokphobia treatment constitutes psychotherapeutic methods, which decrease negative labor experience; their impact on CSMR is controversial. There is a strong need for multidisciplinary approach to tokophobia due to its complexity and obstetric, anesthesiological, psychological and psychiatric implications.
对分娩的病理性恐惧，即“恐娩症”，影响着约6% - 10%的孕期女性，主要令人担忧的原因在于它会对女性的发病率、子女的神经行为发育以及产妇要求下的剖宫产（CSMR）产生显著的后遗症。对分娩的恐惧是一个多维度问题，涉及许多生物、心理和社会背景因素，可分为原发性和继发性恐娩症以及作为抑郁症症状的恐娩症。对分娩的恐惧与对产痛的恐惧密切相关。似乎经历恐惧的女性，由于妊娠诱导镇痛机制的改变，会遭受更多疼痛。尽管恐娩症与要求有效缓解产痛的镇痛之间没有相关联系，但神经轴技术应始终可用，尤其是对于负面情绪水平较高的女性。然而，硬膜外镇痛本身可能会在分娩结束后及分娩后增加恐惧程度。恐娩症治疗的主要方法是心理治疗方法，这些方法可减少负面的分娩体验；它们对CSMR的影响存在争议。由于恐娩症的复杂性以及产科、麻醉学、心理学和精神病学方面的影响，强烈需要采用多学科方法来应对恐娩症。
