Psychological Outcome of Women with Morbidly Adherent Placenta Following Hystrectomy: Prospective Matched Case-control Study

Abstract

Placenta accreta (Morbidly adherent placenta) is a condition in which all or part of the placenta is adherent to the uterine wall because of myometrial invasion by chorionic villi. It may occur when there is either a primary deficiency of or a secondary damage to chorionic villi or Nitabuch’s layer. Women often consider the uterus to be a sexual organ, and the controller and regulator of important physiological functions in the body, as well as the source of youth, energy, activity, and a symbol of child-bearing capacity. There are three broad subsets of psychological symptoms. These are: anxiety and depression attributed to the operation, sexual dysfunction (presenting as diminished libido, pain, dyspareunia or anxiety surrounding sexual activity) and reactions related to perceptions of feminity and low self-esteem. Women who report inadequate social supports, marital discord or dissatisfaction, or recent negative life events, such as a death in the family, financial difficulties, or loss of employment, are more likely to experience postpartum depression. However, there has been no apparent, consistent association between obstetric factors and risk for postpartum depression. However, recent data suggest certain adverse perinatal outcomes are associated with increased symptoms of depression and postpartum depression. Women can also experience depression during pregnancy. Peripartum depression refers to depression occurring during pregnancy or after childbirth. The use of the term peripartum recognizes that depression associated with having a baby often begins during pregnancy. Up to 85% of women experience postpartum affective instability. Rapidly fluctuating mood, tearfulness, irritability, and anxiety are common symptoms. Symptoms peak on the fourth or fifth day after delivery and last for several days, but they are generally time-limited and spontaneously remit within the first 2 postpartum weeks.Symptoms do not interfere with a mother's ability to function and to care for her child. The study included 120 subjects divided into 3 groups including Group A which included 40 women who underwent caesarean hysterectomy, Group B which included women who underwent lower segment caesarean section and Group C which included 40 women who underwent spontaneous vaginal delivery with inclusion and exclusion criteria. All patients who delivered from 4 to 6 months ago, will be subjected to fulfill Questionnaire after obtaining informed consent from the patients who are invited to participate in the research.