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Factors associated with mothers selecting general anesthesia for lower segment caesarean section
A Holdcroft1, A M Parshall, M G Knowles
1Department of Anaesthesia, Royal Postgraduate Medical School, London, UK.
Journal of Psychosomatic Obstetrics and Gynaecology
|September 1, 1995
Summary
Women who experienced pregnancy loss showed higher depression and fear, leading to general anesthesia preference for C-sections. Early psychological support after fetal loss is recommended.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Psychology
Background:
- Regional anesthesia is preferred for Cesarean sections, but patient choice varies.
- Sociodemographic and psychological factors influence anesthesia decisions.
- Understanding these factors is crucial for patient-centered care.
Purpose of the Study:
- To investigate sociodemographic and psychological factors associated with choosing or refusing regional anesthesia for Cesarean sections.
- To identify predictors of general anesthesia preference in this population.
Main Methods:
- A semi-structured questionnaire was administered to 39 women undergoing elective Cesarean sections.
- Data collected included sociodemographic, obstetric, and anesthetic history.
- Psychological assessments used the Hospital Anxiety and Depression scale, FEAR questionnaire, and a visual analog scale for fear.
Main Results:
- Ten women requested general anesthesia.
- These women had similar anxiety levels but significantly higher depression.
- They reported more previous pregnancies, more pregnancies without live babies, and greater fear of specific procedural aspects.
Conclusions:
- Previous pregnancy loss and associated grief contribute to reluctance for conscious operative delivery.
- Identifying and addressing unresolved fears, particularly after fetal loss, is important.
- Preoperative screening using a visual analog scale can identify at-risk women for psychological assessment.