Emergency Caesarean Section Research Articles

6290513 Spinal Needle Fracture during Emergency Cesarean Section: A Rare Complication Requiring Prompt Intervention

6290513 Spinal Needle Fracture during Emergency Cesarean Section: A Rare Complication Requiring Prompt Intervention

6283989 “Expect the unexpected” or “Situational irony”: Seizure and cardiac arrest during emergency caesarean section

6283989 “Expect the unexpected” or “Situational irony”: Seizure and cardiac arrest during emergency caesarean section

6301558 Women's experiences of anesthesia care during urgent or emergent cesarean section: a qualitative study examining stressors and potential solutions

6301558 Women's experiences of anesthesia care during urgent or emergent cesarean section: a qualitative study examining stressors and potential solutions

Effect of Hyponatremia in Preeclamptic Patients With Severe Features [ID 2683491

INTRODUCTION: Hyponatremia, although common in expectant women with preeclampsia, has not been well studied in a multicenter fashion, and it is unknown whether it is associated with adverse events related to severe preeclampsia. Our primary objectives are to assess the clinical characteristics and emergency therapy applied to participants diagnosed with preeclampsia. We hypothesize that hyponatremia present in preeclamptic patients with severe features is associated with greater use of emergency hypertensives, antenatal steroids, and cesarean delivery. METHODS: This is a retrospective cohort study utilizing a multicenter electronic health record database (TriNetX). We collected and evaluated the following data of participants aged 15–54 years with a diagnosis of preeclampsia with severe features: demographics, diagnostic codes, medication codes, procedure codes, deaths, and laboratory results. RESULTS: A total of 2,901 participants (215 [7.4%] with a sodium level below 134 mEq/L and 2,686 [92.6%] with a sodium level above 135 mEq/L) were included. A higher proportion of participants in the below 134 sodium group received emergency antihypertensives (165 [76.7%] versus 1,811 [67.4%]; P=.01), antenatal steroids (103 [47.9%] versus 953 [35.5%]; P=.001), and cesarean section (27 [12.6%] versus 97 [3.6%]; P<.001). CONCLUSION: We found that hyponatremia may be associated with emergency antihypertensive use, antenatal steroid use, and cesarean section in patients with preeclampsia with severe features. Future research is needed to determine whether routine sodium levels assessed in preeclamptic subjects with severe features identify subjects at risk of receiving these treatments.

6301375 Emergency thoracotomy and caesarian section at 29 weeks gestation for suspected oesophageal rupture

6301375 Emergency thoracotomy and caesarian section at 29 weeks gestation for suspected oesophageal rupture

Successful management of postpartum venous thrombosis following splenectomy for traumatic splenic rupture: a case report.

Traumatic splenic rupture is rare in pregnant women; and multiple venous thromboses of the portal vein system, inferior vena cava and ovarian vein after caesarean section and splenectomy for splenic rupture has not been previously reported. This case report describes a case of multiple venous thromboses after caesarean section and splenectomy for traumatic splenic rupture in late pregnancy. A 34-year-old G3P1 female presented with abdominal trauma at 33+1 weeks of gestation. After diagnosis of splenic rupture, she underwent an emergency caesarean section and splenectomy. Multiple venous thromboses developed during the recovery period. The patient eventually recovered after anticoagulation therapy with low-molecular-weight heparin and warfarin. These findings suggest that in patients that have had a caesarean section and a splenectomy, which together might further increase the risk of venous thrombosis, any abdominal pain should be thoroughly investigated and thrombosis should be ruled out, including the possibility of multiple venous thromboses. Anticoagulant therapy could be extended after the surgery.

Comparison of the Adjunctive Effect of Tranexamic Acid and Infusion Oxytocin on Blood Loss at Caesarean Section - A Randomised Study

Background: Postpartum haemorrhage is a major complication at caesarean section. Tranexamic acid and oxytocin infusion have been used for prophylaxis. Aim: To compare the effectiveness of prophylactic adjunctive use of Tranexamic acid and oxytocin infusion at caesarean section to reduce blood loss. Method: A randomised study at ABUTH, Zaria, in which 144 women, scheduled for elective or emergency caesarean section at term, were sequentially randomised into two groups of 72 each. The Tranexamic acid group received 1g intravenous and 500ml of Normal saline as placebo while the oxytocin group received placebo and 500ml of Normal saline containing 20IU of oxytocin after delivery of the neonate. Both adjunctive groups received 10IU Oxytocin as part of AMTSL. Trial registry: PACTR 202004568331645. Ethical approval: ABUTHZ/HREC/D37/2018. Result: There was no significant difference in parity, gestational age and indication for caesarean section in both groups p<0.287, 0.270 and 0.095 respectively. There was no significant difference in primary outcome with mean blood loss 561.06 ± 209.23ml versus 567.78 ± 205.91ml in the Tranexamic acid and oxytocin group respectively, p<0.847. Need for additional uterotonic agent and side effect profile were significantly reduced in the Tranexamic acid group. There was no significant difference in need for blood transfusion and haemodynamic status of parturient in both groups. There was no significant difference in mean blood loss at emergency versus elective caeserean section, 565.83± 205.51ml versus 567.97± 217.42ml respectively, p<0.921.Blood loss in those with 1 previous CS was comparable in both groups 537.75± 209.69ml versus 522.05± 176.43ml respectively, p<0.374, however, for those with 2 or more CS, while there was a clinical (reduction) difference of 80ml in the Tranexamic acid group, it was not statistically significant. 594.55± 0.91ml versus 674.06± 1.99ml respectively, p<0.476. Conclusion: There is comparative adjunctive efficacy of Tranexamic acid and oxytocin infusion at caesarean section. Keywords: Caesarean delivery, Oxytocin infusion, Tranexamic acid, Postpartum haemorrhage

High Risk Pregnancy and its Outcome in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

High-risk pregnancy is defined as one which is complicated by factors or factors that adversely affect the pregnancy outcome (maternal, perinatal or both). Early detection and effectivemanagement of high risk pregnancy helps in achieving favorable maternal and perinatal outcomes. This study aimed to find the prevalence of high risk pregnancy and its outcome among pregnant women admitted for delivery in the obstetrics and gynecology department of a tertiary care hospital Methods: A descriptive cross sectional study was conducted in a tertiary care hospital among high risk pregnant women admitted for delivery using structured proforma, from April 2023 to September 2023 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling was used among pregnant women who met the inclusion criteria. Data was entered in excel and analysis was done using IBM SPSS Statistics. Point estimate was calculated at 95% Confidence Interval Results: Among 350 deliveries, high risk pregnancy was seen in 91 (26%) (16.15-32.00, 95% Confidence Interval). The high risk factors were previous history of cesarean section 25 (27.47 %) followed by hypothyroidism 19 (20.87%) and gestational diabetes mellitus 15 (16.48%). Out of 90 high risk pregnancy, 84 (92.30%) had term delivery. Lower segment cesarean section was done in 69 (75.82%) patients of which 26 (28.57%) underwent emergency cesarean section. The total number of births among high risk preganancies were 93 with two sets of twin births. A total of 13 (13.97%) of the babies had low-birth weight. The prevalence of high risk pregnancy was found to be similar as compared to studies done in similar settings.

Assessment of preparedness for emergency cesarean section by utilizing a checklist before and after an educational intervention: A quality improvement study.

Using cognitive aids, like checklists, for clinical practices will significantly improve the quality of patient care and thereby reduce morbidities and mortalities. We used one such checklist to assess preparedness for emergency cesarean sections. Sixty-five emergency cesarean sections were assessed in the baseline period without informing the residents and other operating room staff. We then conducted educational intervention sessions for residents of obstetrics and anesthesiology and for nursing officers on the significance of each step in the checklist, focusing on the steps that were often missed. The checklist had 22 actions. The mean percentage of each checklist action in all 65 assessments was computed. The average of these values was the overall percentage of completed actions in 65 assessments, which was 78.80%. In the post-intervention period, this increased to 92.48%. The results of our study indicate that residents understood the importance of each checklist action and it reflects their positive attitude towards improving patient care. Although we did not measure our intervention in terms of patient outcomes, our assessment has helped us identify lacunae in our hospital practice.

Mode of birth and DNA methylation at birth, in childhood, and in adolescence: Uncovering the relationship using ALSPAC data.

Mode of birth has been linked to offspring health. Changes in DNA methylation (DNAm) may represent a potential mechanism; however, findings are heterogeneous and limited to early infancy. This preregistered study examined whether mode of birth (vaginal birth compared with elective or emergency cesarean section) affects DNAm at birth, in childhood, and adolescence and whether these effects are modified by the postnatal care environment, specifically by breastfeeding and mother-infant bonding. Using data from 876 mother-infant dyads from the U.K. Avon Longitudinal Study of Parents and Children, we examined differentially methylated cytosine-phosphate-guanine dinucleotides and regions associated with mode of birth. DNAm was quantified using Illumina Infinium Human Methylation 450 K BeadChip in cord blood (at birth) and in peripheral blood (at 7 and 15-17 years). Analyses controlled for maternal age, education, smoking during pregnancy, child sex, gestational week at birth, and batch effects. We also examined interactions of mode of birth with breastfeeding practices and mother-infant bonding. In cord blood, two cytosine-phosphate-guanine dinucleotides (cg05230316; cg13230077) were linked to mode of birth (pFDR < .050). DNAm in childhood or adolescence was not statistically associated with mode of birth (pFDR > .050), and breastfeeding and mother-infant bonding were not moderators (p > .050). Overall, findings suggest mode of birth may have a small effect on cord blood DNAm, but these effects may not persist into later developmental stages. Other postnatal influences should be considered, and further investigation is needed to address study limitations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Emergency transfusion of different rhesus blood type: Will there be complications?

Objective: Antepartum hemorrhage (APH) is one of the leading causes of maternal and fetal mortality worldwide, complicating 2–4% of pregnancies. Considering the probability of blood transfusion, blood testing and cross-matching are essential for the anesthesiologist during perioperative management. Rhesus (Rh) is the second most significant blood group system after ABO. Hence, this blood type system needs to be taken into consideration. Furthermore, in Indonesia, Rh-negative blood types are rare. Case Presentation: A 39-year-old woman with Gravida IV, three term pregnancies, no preterm pregnancies, no abortions, and three living children (GIVP3003) and gestational age 26 to 27 weeks arrived at the hospital with massive bleeding from the birth canal three hours before admission. The bleeding was fresh red, and the patient had changed diapers twice before arriving at the hospital. She presented hypovolemic shock, a blood pressure of 71/39 mm Hg, and anemic conjunctivas, with a history of B Rh (-) blood type, ongoing HIV therapy, and completed pulmonary tuberculosis (TB) treatment. The hospital’s and PMI’s (Indonesian Red Cross) blood bank had no Rh (-) bloodstock. An emergency cesarean section under general anesthesia was performed, and a 900 g neonate was delivered. The patient received a total of four stored whole blood (SWB) bags of type B Rh (+) blood products, one SWB bag during surgery, and three SWB bags during recovery in the intensive care unit (ICU). Conclusion: Rh (+) transfusion in patients with Rh (-) should be the last option in an emergency. The transfusion reaction did not occur right away in the initial transfusion. Under prompt management, the transfusion response and the life-threatening condition were then successfully managed.

Mechanical Birth Injuries: A Comprehensive Five-Year Analysis From a Tertiary Care Hospital.

Birth injury or birth trauma refers to physical damage or trauma that occurs to a newborn during the birthing process. To ensure continuous care and improve neonatal outcomes, it is crucial to know the incidence, types, relation to the mode of delivery, and their management. This is a retrospective cohort study conducted at Aga Khan University Hospital, Pakistan from January 2018 to December 2022. Neonates aged from birth to 28 days of life identified to sustain any form of mechanical birth injuries were included. Data analysis was done using SPSS version 19 (IBM Corp., Armonk, NY). In the last five years, 51 mechanical birth injuries were found among 27,854 deliveries, which accounts for one in 546 births with an overall prevalence of 0.001%. Out of the total mechanical birth injuries, 12 (23.5%) were noticed in spontaneous vaginal delivery, six (11.8%) had instrumental delivery, and 33 (64.7%) patients had cesarean sections. More birth injuries were noticed in emergency cesarean section as compared to vaginal deliveries. There were 40 babies (78%) with soft tissue injuries, seven (14%) had musculoskeletal injuries/fractures, two (4%) babies had intracranial bleeding, andtwo (4%) had fractures along with intracranial bleeding. There was no mortality reported among these neonates. The overall rate of birth injuries was significantly lower as compared to other low and middle-income countries. Most of the birth injuries were soft tissue injuries in patients with cesarean sections. The rate of birth injury did not show any association with the time of delivery. More frequent obstetric emergency drills would improve complications associated with shoulder dystocia.

Maternal Experience of Spinal Anesthesia for Cesarian Section, A Cross-Sectional Study

Background: Cesarian section, an increasingly popular obstetric procedure, can be performed under general and regional anesthesia. Spinal anesthesia, a form of regional anesthesia has gained popularity over time due to its overall safety.Objectives: To study the maternal experience after going through cesarian under spinal anesthesia.Material and Methods: This was a cross sectional study carried out on admitted patients in Lady Reading Hospital, MTI, Peshawar. About 196 post-op admitted patients were selected by non-probability convenience sampling from 1st November 2023 till 15th December 2023. They were assessed with the help of questionnaire on their experience of spinal anesthesia on 3rd post cesarian day. Patents having had surgery under general anesthesia, primarily or secondarily, and those who had any additional procedure post operatively after cesarian were excluded. Data was analyzed on SPSS v23. Frequency and percentages were determined for categorical variables. Chi square test was applied for categorical variables with p value of &lt;0.05 taken significant.Results: Of 196 patients, mean age of the participants was 29 ± 6 years, of whom 74 (37%) had elective and 122 (63%) had emergency cesarian section. Parity ranged from 1 to 13, with most parturients having parity in the range of 1-6. 90% of patients were satisfied with preoperative information provided. About 55% had nausea, 15% had dyspnea while 39% (n=77) had palpitation during the surgery. Nearly 18% did not like the feeling of being aware intraoperatively. However 98% (n=193) of patients were satisfied with responsiveness of anesthesia staff to their situation. About 105 (53%) patients affirmed that would like to have spinal anesthesia again in future if needed, 39% were unsure and 14 (7%) patients did not like it.Conclusion: Spinal anesthesia is an effective way of providing surgical anesthesia while maintaining high level of maternal satisfaction.Keywords: Cesarian section, Maternal satisfaction, Spinal anesthesia.

Unusual cerebral intraventricular hemorrhage and cardiomyopathy related to congenital cytomegalovirus from non-primary maternal infection: a case report

BackgroundCongenital cytomegalovirus (cCMV) infection, resulting from non-primary maternal infection or reactivation during pregnancy, can cause serious fetal abnormalities, complications in the immediate neonatal period, and severe sequelae later in childhood. Maternal non-primary cytomegalovirus infection in pregnancy is transmitted to the fetus in 0.5-2% of cases (1).Case presentationAn African full term male newbornwas delivered by emergency caesarean section. Due to signs of asphyxia at birth and clinical moderate encephalopathy, he underwent therapeutic hypothermia. Continuous full video-electroencephalography monitoring showed no seizures during the first 72 h, however, soon after rewarming, he presented refractory status epilepticus due to an intracranial hemorrhage, related to severe thrombocytopenia. The patient also presented signs of sepsis (hypotension and signs of reduced perfusions). An echocardiography revealed severe cardiac failure with an ejection fraction of 33% and signs suggestive of cardiomyopathy. Research for CMV DNA Polymerase Chain Reaction (PCR) on urine, blood, cerebrospinal fluid, and nasopharyngeal secretions was positive.The mother had positive CMV IgG with negative IgM shortly before pregnancy. Serology for CMV was therefore not repeated during pregnancy, but CMV DNA performed on the Guthrie bloodspot taken at birth yielded a positive result, confirming the intrauterine transmission and congenital origin of the infection. The baby was discharged in good general condition and follow up showed a normal neurodevelopmental outcome at 9 months.ConclusionAlthough uncommon, congenital cytomegalovirus infection should be included in the differential diagnosis of intraventricular hemorrhage and cardiomyopathy. Furthermore, this case highlights the possible severity of congenital cytomegalovirus infection, even in cases of previous maternal immunity.

Appropriateness, timeliness and perinatal outcomes of obstetric referrals managed by caesarean section: A prospective observational cohort study

AbstractObjectiveTo evaluate the appropriateness, timeliness and perinatal outcomes of obstetric referrals compared to nonreferrals managed by caesarean section (CS) at a tertiary hospital.MethodsResearch assistants observed and recorded every delivery prospectively. Neonates were followed to discharge or up to 7 days, and outcomes were recorded. Proportions were used to describe baseline characteristics of the groups, and logistic regression was used to determine factors associated with CS in the referral group.ResultsA total of 10 353 deliveries occurred during the study period: 7.4% (768) were referrals and 92.6% (9585) were nonreferrals. The proportion of CS among referrals was 41.5% (319), nonreferrals 22.5% (2152) and overall 23.8% (2471). Compared to nonreferrals, referred women arrived at the second stage of labour with complications, ending up with emergency CS (p &lt; 0.001). Factors associated with CS with odds ratio (OR) in the referral group were previous CS (11.06), abnormal foetal heart rate (4.96), breech presentation (4.61) and thick meconium (3.61). The referral group had higher proportions of stillbirths and neonatal admissions compared to nonreferrals (p &lt; 0.001).ConclusionReferred women arrived late with complications ending with CSs and adverse perinatal outcomes. Earlier identification of complications and timely referral from lower‐level facilities may have the potential to prevent adverse outcomes.

Determinants of obstructed labour and associated outcomes in referral hospitals in Nigeria.

To estimate the prevalence of obstructed labour, associated risk factors and outcomes across a network of referral hospitals in Nigeria. Retrospective observational study. A total of 54 referral-level hospitals across the six geopolitical regions of Nigeria. Pregnant women who were diagnosed with obstructed labour during childbirth and subsequently underwent an emergency caesarean section between 1 September 2019 and 31 August 2020. Secondary analysis of routine maternity care data sets. Random-effects multivariable logistic regression was used to ascertain the factors associated with obstructed labour. Risk factors for obstructed labour and related postpartum complications, including intrapartum stillbirth, maternal death, uterine rupture, postpartum haemorrhage and sepsis. Obstructed labour was diagnosed in 1186 (1.7%) women. Among these women, 31 (2.6%) cases resulted in maternal death and 199 (16.8%) cases resulted in postpartum complications. Women under 20 years of age (OR 2.03, 95% CI 1.50-2.75), who lacked formal education (OR 1.88, 95% CI 1.55-2.30), were unemployed (OR 1.94, 95% CI 1.57-2.41), were nulliparous (OR 2.11, 95% CI 1.83-2.43), did not receive antenatal care (OR 3.34, 95% CI 2.53-4.41) or received antenatal care in an informal healthcare setting (OR 8.18, 95% CI 4.41-15.14) were more likely to experience obstructed labour. Ineffective referral systems were identified as a major contributor to maternal death. Modifiable factors contributing to the prevalence of obstructed labour and associated adverse outcomes in Nigeria can be addressed through targeted policies and clinical interventions.

Status and predictors of readiness for hospital discharge in women with caesarean section: A latent profile analysis

BackgroundWomen undergoing caesarean section (CS) experience difficulties when preparing for discharge, and readiness for hospital discharge (RHD) may depend on individual characteristics. ObjectiveTo explore the status of RHD in women with CS, identify the latent classes of RHD, and analyse predictors from a bio-psycho-social perspective. MethodsA sample of 410 women with CS completed the following questionnaires on demographic and obstetric characteristics: Readiness for Hospital Discharge Study-New Mother Form (RHDS-NMF), Parents' Postnatal Sense of Security (PPSS), Quality of Discharge Teaching Scale (OB-QDTS), and Postpartum Support Questionnaire (PSQ). Latent profile analysis was used to identify the latent classes of RHD. Multiple logistic regression analysis was used to analyse the predictors. ResultsIn total, 96.6 % of women with CS reported discharge ready, and the score of RHDS-NMF was 136.09 ± 25.59. Three latent classes were identified as Low RHD (16.1 %), Moderate RHD (41.7 %), and High RHD (42.2 %). Primiparas (OR = 2.867 / 1.773; P = 0.012 / 0.033), emergency CS (OR = 3.134 / 2.470; P = 0.006 / 0.002), lower levels of PPSS (OR = 0.909 / 0.942; P = 0.009 / 0.013) and OB-ODTS (OR = 0.948 / 0.975; P < 0.001) were associated with Moderate and Low RHD. Lower PSQ predicted a higher probability of Low RHD (OR = 0.955; P = 0.038). ConclusionsThe perception of RHD by women in the study was inaccurate, with more than half not being classified as High RHD. Healthcare professionals can anticipate interventions for maternal well-being based on the characteristics of the different RHD classes.

Emergency Caesarean Section in a Patient with HELLP Syndrome and Intramural Myoma: A Case Report

Introduction: The syndrome of HELLP, often a complication of severe pre-eclampsia, is influenced by factors like multiparity, advanced maternal age, and potential genetic associations. Intramural Myoma have been linked to a 44% increased risk of hypertension in pregnant women, potentially contributing to the initiation and progression of pre-eclampsia, particularly due to their rapid expansion during pregnancy. This study reported a patient with intramural myoma and HELLP Syndrome in 35-36 weeks of gestation age. Case Presentation: A 40-year-old woman in her 35-36 weeks of gestation sought emergency care at General Hospital Dr. Saiful Anwar Malang due to escalating severe headaches. As a third-time expectant mother with a history of five antenatal visits, she presented with elevated blood pressure (219/110 mmHg), a BMI of 32 kg/m2, and various concerning findings, leading to a diagnosis of impending eclampsia, severe preeclampsia (HELLP syndrome), fetal distress, severe hypoalbuminemia, intrauterine growth restriction (IUGR), and other complications. The patient underwent an urgent cesarean section, revealing an intramural uterine myoma, followed by bilateral ligation of uterine arteries to address bleeding and myomectomy. Postoperatively, she received a magnesium sulfate infusion, her blood pressure stabilized at 143/92 mmHg and Hemoglobin 12,40 g/dl. Conclusion: Intramural myoma increases the risk of preeclampsia during pregnancy. Emergency C-section is an effective measure to address complications for both the mother and the baby, and bilateral ligation of uterine arteries can minimize surgical bleeding.

Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience.

(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (<100 copies/mL 2 occasions before or after pregnancy off ART). (2) Methods: A multi-centre, retrospective case series (1999-2021) comparing pre- and post-2012 when guidelines departed from zidovudine-monotherapy (ZDVm) as a first-line option. Demographic, virologic, obstetric and neonatal information were anonymised, collated and analysed in SPSS. (3) Results: A total of 49 live births were recorded in 29 women, 35 pre-2012 and 14 post. HIV infection was more commonly diagnosed in first reported pregnancy pre-2012 (15/35) compared to post (2/14), p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28/35) with pre-labour caesarean section (PLCS) (24/35). Post-2012 4/14 received ZDVm and 10/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11/35 deliveries pre-2012. During pregnancy, HIV was detected (> 50 copies/mL) in 14/49 pregnancies (29%) (median 92, range 51-6084). Neonatal ZDV post-exposure prophylaxis was recorded for 45/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates.

A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies.

This study investigated prospective relationships between the perception of threat to one's own life or to that of one's infant during childbirth and maternal childbirth-related posttraumatic stress symptoms (CB-PTSS) and probable childbirth-related posttraumatic stress disorder (CB-PTSD) in a community and a community and an emergency cesarean section (ECS) sample. Study samples included 72 mothers from a community sample and 75 mothers after emergency cesarean section. Perceived maternal and infant life threat were assessed at ≤1 week postpartum. Maternal CB-PTSS and probable CB-PTSD were assessed with validated questionnaires up to 6 months postpartum. Covariates were extracted from hospital records. Secondary data analysis with logistic and linear regressions was performed. Globally, mothers were significantly more likely to perceive their infant's life to be threatened, rather than their own. Both types of perceived threat were prospectively but differentially associated with maternal CB-PTSS and probable CB-PTSD at 4-6 weeks and 6 months postpartum. Statistical significance was set at p<0.05. The type of perceived threat differently influences maternal CB-PTSS and probable CB-PTSD up to 6 months postpartum. These results may be the basis for the development of a short screening instrument after traumatic childbirth in clinical settings. Future studies need to assess the psychometric properties and acceptability of such a brief screening tool.