Abstract
The article evaluates the effect of various anesthetic techniques in delivery on the frequency of postpartum depression in new mothers. Materials and methods. 209 women were enrolled into the study, medium age made 31 years and gestation period made 39.4 weeks. All patients were divided into 4 groups: groups 1 and 2 had vaginal delivery; continuous epidural anesthesia was used in group 1, 0.08% solution of ropivacaine hydrochloride was used as a local anesthetic. No pain relief was used in group 2. Cesarean section with intraspinal anesthesia was performed in groups 3 and 4; transversus abdominis plane block with parenteral administration of non-steroidal anti-inflammatory agents was used in group 3. Only system narcotic analgesics and non-steroidal anti-inflammatory agents were used for anesthetic purposes in group 4. Specific features of postpartum depression were searched for within the following time periods: in 6 hours, 3 days and 6 weeks after the delivery. Results of the study. It has been found out that using continuous epidural anesthesia for pain relief purposes during vaginal delivery results in no reduction of postpartum depression frequency in 6 weeks after the delivery compared to the patients who had no anesthesia during delivery. No effect of delivery type on postpartum depression frequency has been observed. The reduction of postpartum blues has been noted when transversus abdominis plane block was used as a part of multi-modal pain relief. No effect of transversus abdominis plane block on the postpartum depression development in 6 weeks after delivery has been observed.
Highlights
The article evaluates the effect of various anesthetic techniques in delivery on the frequency of postpartum depression in new mothers
All patients were divided into 4 groups: groups 1 and 2 had vaginal delivery; continuous epidural anesthesia was used in group 1, 0.08% solution of ropivacaine hydrochloride was used as a local anesthetic
Cesarean section with intraspinal anesthesia was performed in groups 3 and 4; transversus abdominis plane block with parenteral administration of non-steroidal anti-inflammatory agents was used in group 3
Summary
В основу исследования положены результаты клинико-психологического обследования 209 женщин, обратившихся в плановом порядке в Перинатальный центр Санкт-Петербургского государственного педиатрического медицинского университета с декабря 2015 г. по май 2016 г. при сроке беременности 34−35 нед. Пациенткам 1-й группы при родоразрешении через естественные родовые пути с целью обезболивания применяли длительную эпидуральную анальгезию. Результаты исследования тельной эпидуральной анальгезии с целью обезболивания во время родоразрешения через естественные родовые пути не привело к снижению частоты развития послеродовой депрессии через 6 нед. 2, в 1-е сут после родов отмечалась более высокая частота встречаемости беби-блюза у родильниц, родоразрешенных через естественные родовые пути, по сравнению с оперативным родоразрешением, но эта разница была статистически не значима и составила 34,3 и 28,1% соответственно (p = 0,839). При исследовании влияния послеоперационного обезболивания на риск развития послеродовой депрессии выявили отсутствие значимой разницы частоты развития ПРД через 6 нед. 3, имеет место более низкая частота развития беби-блюза в 1-е и 3-и сут после операции у пациенток, где с целью обезболивания раннего послеоперационного периода использовали Как видно из рис. 3, имеет место более низкая частота развития беби-блюза в 1-е и 3-и сут после операции у пациенток, где с целью обезболивания раннего послеоперационного периода использовали
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