Sjögren B, Thomassen P
Center for Women and Children's Health, Division of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 1997 Nov;76(10):948-52. doi: 10.3109/00016349709034907.
Extreme fear of delivery with request of cesarean section is a problem. The obstetric outcome in women given psychological and obstetric support is described.
Women, consecutively referred to the Psychosomatic outpatient clinic because of fear of delivery (n = 100), were compared to a matched reference group (n = 100).
The women in the study group had higher frequency of psychic problems than the references. The majority, 68 of the women (68%) initially requested cesarean section (CS). After individualized psychological and obstetrical support, 38 of these women agreed to vaginal delivery (38%) and 30 had an elective CS (30%). In the end another 13 (13%) women had a CS for obstetric or mixed reasons. Complication rate was low and similar in the groups. The 57 women who eventually had a vaginal delivery (57%) showed an obstetric outcome similar to the reference group. They had a higher frequency of induction of labor (p = 0.02). and of epidural and pudendal blocks for pain relief (p = 0.002 and 0.05 respectively). They had shorter labor time (p = 0.05). The cost of the psychological therapy was well compensated for by the savings due to the reduction in the number of CS.
Psychosomatic support for women with severe fear of delivery resulted in a 50% reduction of CS for psychosocial indications and vaginal deliveries similar to a reference group. The cost of psychosomatic support was less than savings due to fewer cesarean sections.
因极度害怕分娩而要求剖宫产是一个问题。本文描述了给予心理和产科支持的女性的产科结局。
将因害怕分娩而连续转诊至身心门诊的女性（n = 100）与匹配的对照组（n = 100）进行比较。
研究组女性心理问题的发生率高于对照组。大多数女性，即68名（68%）最初要求剖宫产。经过个体化的心理和产科支持后，其中38名女性同意阴道分娩（38%），30名进行择期剖宫产（30%）。最后，另有13名（13%）女性因产科或混合原因进行了剖宫产。两组的并发症发生率都很低且相似。最终进行阴道分娩的57名女性（57%）的产科结局与对照组相似。她们引产的频率更高（p = 0.02），使用硬膜外阻滞和阴部神经阻滞缓解疼痛的频率更高（分别为p = 0.002和0.05）。她们的产程更短（p = 0.05）。心理治疗的费用因剖宫产数量减少所节省的费用而得到了很好的补偿。
对严重害怕分娩的女性给予身心支持，使因心理社会指征而进行剖宫产的比例降低了50%，且阴道分娩情况与对照组相似。身心支持的费用低于因剖宫产数量减少而节省的费用。
