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2 results

  • Chapter 1 - Physiology of Pregnancy

  • from Section 1
  • Edited by Olutoyin A. Olutoye
  • Book:
    Anesthesia for Maternal-Fetal Surgery
    Published online:
    19 November 2021
    Print publication:
    11 November 2021, pp 1-16

  • Summary

    The pregnant patient may present for fetal intervention at any time from the second trimester until near delivery. Physiological changes of pregnancy occur in every organ system in a dynamic fashion, with changes occurring to different degrees at specific periods during gestation. The maternal-fetal anesthesiologist must be familiar with expected changes. The decrease in diastolic pressure and mean arterial pressure, which nadir in the second trimester, often need to be addressed during mid-gestation fetal interventions. Other changes may need to be addressed earlier than typically expected during pregnancy. For example, the pregnant patient’s airway is characterized by mucosal edema and the need for a smaller than expected endotracheal tube. This is typically of concern at the time of delivery or non-obstetric surgery if endotracheal intubation is required. As the majority of fetal intervention procedures are performed during the mid-gestation period, the maternal-fetal anesthesiologist is often faced with managing the pregnant airway, not uncommonly in rapidly changing situations as planned sedation may be converted to general anesthesia for a variety of reasons during the procedure. All the physiologic changes of pregnancy are important to keep in mind as one approaches the clinical care of the pregnant patient.

  • Postpartum depression and perceived stress among Tunisian parturient

  • N. Messedi, L. Aribi, W. Bouattour, F. Khanfir, F. Charfeddine, K. Chaaben, J. Aloulou
  • Journal:
    European Psychiatry / Volume 64 / Issue S1 / April 2021
    Published online by Cambridge University Press:
    13 August 2021, p. S694
    • Article
      • You have access
      • Open access
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  • Introduction

    The postpartum depressions (PPD), rank first postpartum complications and therefore pose a public health problem by their frequencies and their adverse consequences.

    Objectives

    To detect the depression among a Tunisian parturient, to evaluate their perceived stress and to study the link between these entities

    Methods

    A cross-sectional, analytical study of 40 first week postpartum women hospitalized in the gynecology department in Hedi Cheker hospital in Sfax-Tunisia, during the month of September 2019. We used the Arab version of Edinburgh Postnatal Depression Scale (EPDS) and the Cohen perceived stress scale (PSS).

    Results

    The average age of the participants was 31.07 years old. The Parturient have a rural origin in 62.5% of cases, they have a secondary school level in 52.5% of cases. There were exaggerated sympathetic signs in 52.5% of the cases. An organic pathologies were present during pregnancy in 47.5%. The postpartum period was simple in 77.5% of cases. For the post-natal period, 90% of parturient were going to receive help of a family member. EPDS: the average score was5.35 and the risk of developing a PPD was 20%. PSS we found that life represents a perpetual threat in 27% of cases. The factors correlated with the PPD were: a high level of perceived stress (p < 0.00) and organic pathology during pregnancy (p=0.02).

    Conclusions

    Our study shows that the risk of postpartum depression is high among Tunisian parturient and it is associated with high level of stress, because of this a precocious screening is necessary.

    Disclosure

    No significant relationships.