Mental health support to perinatal women with COVID-19 pneumonia, intensive care unit and post-intensive care syndromes

Abstract

Intensive care unit syndrome and post-intensive care unit syndrome became one of urgent and global problems of current medicine. Their development is associated, among other causes, with the specific environment and modalities of an ICU in combination with COVID-19 pneumonia which could have adverse effect on the mental health of patients. This cross-sectional, hospital-based study was conducted in December 2020 - January 2022 in the cohort of 677 perinatal women with mental health disorders associated with severe and critical COVID-pneumonia. They were recruited at the Maternity Hospital ICU of the National Specialized Versatile Medical Center Zangiota-1 in Tashkent, Uzbekistan. Most patients had post-traumatic stress disorder (56.6%; 383 of 677). Generalized anxiety disorder was diagnosed in 26.7% (181 of 677) while depressive conditions were found in 16.7% (113 of 677) of cases. In the postpartum period, PTSD, anxiety, and depression combinations were identified in 46.1% (312 of 677) of cases according to the PHQ-ADS combined scale; it was typical for women with severe and critical COVID-19 in trimester 3 of pregnancy. The therapy for mental health disorders in perinatal women was focused on reducing the frequency of threats of pregnancy loss, ICUS, and PICS development. Psychotherapy was supplemented with sedative and metabolic drugs. After discharge from the hospital ICU (n=613), an individual rehabilitation program was made for each of them. By month 8 all women have been successfully rehabilitated and had no signs of mental health disorders. An effective therapeutic tactics for mental health disorders and differentiated psychotherapy as well as delivery in a specialized medical center may improve significantly the pregnancy outcomes and shorten the rehabilitation period.