Dept of UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.
BMC Pregnancy Childbirth. 2022 May 10;22(1):397. doi: 10.1186/s12884-022-04726-8.
Placenta Accreta Spectrum is associated with significant clinical maternal morbidity and mortality, which has been extensively described in the literature. However, there is a dearth of research on the lived experiences of pregnant people and their support partners. The aim of this study is to describe living beyond a pregnancy and birth complicated by PAS for up to four years postpartum. Participants experiences inform the development of an integrated care pathway of family centered support interventions.
An Interpretative Phenomenological Analysis approach was applied to collect data through virtual interviews over a 3-month period from February to April 2021. Twenty-nine participants shared their stories; six people with a history of PAS and their support partners were interviewed together (n = 12 participants), six were interviewed separately (n = 12 participants), and five were interviewed without their partner. Pregnant people were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. This paper focuses on the postnatal period, with data from the antenatal and intrapartum periods described separately.
One superordinate theme "Living beyond PAS" emerged from interviews, with 6 subordinate themes as follows; "Living with a different body", "The impact on relationships", "Coping strategies", "Post-traumatic growth", "Challenges with normal care" and recommendations for "What needs to change". These themes informed the development of an integrated care pathway for pregnant people and their support partners to support them from diagnosis up to one year following the birth.
Parents described the challenges of the postnatal period in terms of the physical and emotional impact, and how some were able to make positive life changes in the aftermath of a traumatic event. An integrated care pathway of simple supportive interventions, based on participant recommendations, delivered as part of specialist multidisciplinary team care may assist pregnant people and their support partners in alleviating some of these challenges.
胎盘部位滋养细胞肿瘤（PAS）与显著的产妇发病率和死亡率相关，这在文献中有广泛的描述。然而，对于受 PAS 影响的孕妇及其支持伴侣的生活体验，研究却相对较少。本研究旨在描述 PAS 妊娠和分娩后长达四年的产后生活。参与者的经历为制定以家庭为中心的支持干预措施的综合护理途径提供了信息。
采用解释现象学分析方法，在 2021 年 2 月至 4 月的 3 个月期间通过虚拟访谈收集数据。29 名参与者分享了他们的故事；6 名有 PAS 病史的人和他们的支持伴侣一起接受了访谈（n=12 名参与者），6 名单独接受了访谈（n=12 名参与者），5 名没有伴侣的情况下接受了访谈。如果孕妇在过去 5 年内被诊断为 PAS，则有资格纳入研究。本文重点关注产后时期，产前和产时时期的数据分别进行描述。
从访谈中出现了一个超主题“超越 PAS 的生活”，有 6 个下属主题，分别是：“生活在不同的身体中”、“对人际关系的影响”、“应对策略”、“创伤后成长”、“正常护理的挑战”和“需要改变的建议”。这些主题为制定针对孕妇及其支持伴侣的综合护理途径提供了信息，以支持他们从诊断到分娩后一年的时间。
父母描述了产后时期的身体和情感影响方面的挑战，以及一些人如何在创伤事件后做出积极的生活改变。基于参与者的建议，作为专科多学科团队护理的一部分，提供简单的支持性干预的综合护理途径，可能有助于减轻孕妇及其支持伴侣的一些挑战。
