Heis C, Olieric M F, Eszto M L, Goetz C, Matuszewski L
Service de gynécologie-obstétrique, CHR de Metz-Thionville, 1-3, rue du Friscaty, 57100 Thionville, France.
Service de gynécologie-obstétrique, CHR de Metz-Thionville, 1, allée du Château, 57330 Ars-Laquenexy, France.
Gynecol Obstet Fertil Senol. 2022 Jul-Aug;50(7-8):511-518. doi: 10.1016/j.gofs.2022.04.003. Epub 2022 Apr 30.
The presence of the father or companion during planned caesarean section presents several benefits. However, we found no study regarding the mother's experience of his presence or absence.
We conducted an observational, prospective, two-centre study based on the data of women who had a planned caesarean section in Bel Air and Mercy Maternities between November 17th 2020 and June 4th 2021. Two groups were formed : a control group, including women who had a c-section in the presence of the father or companion, and a case group, including women who had a c-section without the father or companion due to Covid-19 pandemic-related containment measures. The primary endpoint was to assess the mother's anxiety regarding the presence or absence of the father or companion during planned c-section, by the use of a numerical scale of stress and STAI YA inventory. The secondary endpoint was the appraisal of information given by the medical team concerning c-section and the containment measures.
Regarding the level of stress during the c-section, we did not find a significant difference by the use of the numerical scale of stress. With a mean of 53 in the case group and 49 in the focus group (P=0,048), the STAI YA scores showed a significant difference. Between the day before and the day of the c-section, we found no significant difference by the use of the numerical scale of stress. STAI YA scores showed a significant difference, with a delta of 5 in the case group against 1 in the focus group (P=0,01). Most patients estimated that the information given by the medical team helped to reduce their stress. 93 % of the patients in the focus group reckoned they would have been more stressed in the absence of the father or companion.
The significant results of this study suggest the absence of the father or companion during planned caesarean section has an impact on mother's experience. Therefore, this should be considered in order to better our practices and improve mother's experience. In the long term, we could imagine making their presence possible during emergency caesarean sections as well (general anesthesia excluded). We could also envision adding to preparation courses to c-section to birth preparation courses, for mothers (to reduce psychological impact) but also for fathers or companions (to allow their presence in the operation room).
在计划剖宫产时父亲或陪伴者在场有诸多益处。然而，我们未发现关于母亲对其在场或不在场体验的研究。
我们基于2020年11月17日至2021年6月4日期间在贝莱尔妇产医院和梅西妇产医院进行计划剖宫产的女性数据开展了一项观察性、前瞻性、双中心研究。形成了两组：对照组，包括在父亲或陪伴者在场的情况下进行剖宫产的女性；病例组，包括因新冠疫情相关防控措施在父亲或陪伴者不在场的情况下进行剖宫产的女性。主要终点是通过使用压力数值量表和状态 - 特质焦虑问卷（STAI YA）来评估母亲在计划剖宫产时对父亲或陪伴者在场或不在场的焦虑程度。次要终点是对医疗团队提供的有关剖宫产及防控措施信息的评估。
关于剖宫产期间的压力水平，使用压力数值量表我们未发现显著差异。病例组平均分为53分，对照组平均分为49分（P = 0.048），状态 - 特质焦虑问卷（STAI YA）得分显示出显著差异。在剖宫产的前一天和当天，使用压力数值量表我们未发现显著差异。状态 - 特质焦虑问卷（STAI YA）得分显示出显著差异，病例组的差值为5分，对照组为1分（P = 0.01）。大多数患者认为医疗团队提供的信息有助于减轻他们的压力。对照组中93%的患者认为如果父亲或陪伴者不在场，他们会感到更大的压力。
本研究的显著结果表明，计划剖宫产时父亲或陪伴者不在场会对母亲的体验产生影响。因此，为了改进我们的做法并改善母亲的体验，应考虑这一点。从长远来看，我们可以设想在紧急剖宫产时（不包括全身麻醉）也让他们有可能在场。我们还可以设想将剖宫产准备课程纳入分娩准备课程，既为母亲（以减轻心理影响），也为父亲或陪伴者（以便他们能在手术室陪伴）。
