Risk factors of acute stress disorder after emergency cesarian section in Mahajanga

Abstract

Introduction: Emergency caesarean section is decided when vaginal delivery is not possible, in order to save the mother and her child. The objective of our study was to determine the risk factors for the occurrence of an acute stress disorder after an emergency cesarean section. Methods: We conducted a descriptive and analytical prospective study over a period of 3 months from September to December 2020, at the Mother-Child Center of the Universitary Hospital Pzaga Androva Mahajanga, in Madagascar. Results: The practice rate of caesarean section was 44.66% with a predominance of emergency caesarean section in 65% of cases compared to planned caesarean section (34.4%). These emergency caesareans were performed more in young parturients (p=0.001), nulliparous (p=0.005) and with a low level of education (p=0.016). The Acute Stress Disorder was found only and significantly in emergency caesareans in 15.3% of cases than planned caesareans with p-value=0.022 (OR=1.620 and CI: [1365-1.923]. The history of a traumatic event (p=0.004) and the perception of a negative experience of the cesarean section (p<0.001) were the determining factors significantly associated with the occurrence of the Acute Stress Disorder after emergency cesarean section. Conclusion: The urgency of the caesarean section would be a risk factor for acute stress disorder. A psychological intervention in the immediate postpartum would be an asset in the care of women undergoing caesarean emergency.