COVID-19 Tanılı Gebede Postpartum Kaygı Düzeyi: İki Olgu Sunumu

Yıl 2020, , 297 - 301, 31.12.2020

Ayşe Çuvadar , Handan Özcan , Mehmet Gürkan Arıkan , Sinan Ateş

https://doi.org/10.38108/ouhcd.773462

Cited By: 12

Öz

Amaç: Çalışmanın amacı SARS-CoV-2'nin neden olduğu yeni korona virüs hastalığı (COVID-19) tanısı alan ve sezeryan ile doğum yapmış olan iki olguda kaygı durumlarını belirlemektir.
Olgu 1: Otuz sekiz yaşında, 38+1 gebelik haftasında olan ve COVID-19 tanısı alan gebe kliniğimize yatırıldı. COVID-19 tedavisi ve sezeryan operasyonu gerçekleştirilen hastaya postoperatif dönem tedavisi uygulandı ve bakımı yapıldı. Annenin 14 gün izolasyon sonunda bebeği ile teması sağlandı. Doğum sonrasında bebek yenidoğan yoğun bakım ünitesinde izole edilerek anne ile teması önlendi. Annenin ‘Durumluluk ve Sürekli Kaygı Envanteri’ ile kaygı düzeyi belirlendi. Hastanın durumluluk kaygı durumu orta düzey ve sürekli kaygı düzeyi ise yüksek olarak saptandı.
Olgu 2: Yirmi iki yaşında, 39+5 gebelik haftasında olan hasta, öksürük ve ateş şikayetleri ile hastanemize başvuru yaptı. PCR test sonucu pozitif çıkan hasta COVID-19 tanısı ile kliniğimize yatırıldı. Sezeryan olan hastaya postoperatif dönem tedavisi uygulandı ve bakımı yapıldı. 1. olguda olduğu gibi bebek yenidoğan yoğun bakım ünitesinde 14 gün izole edildi. Hastanın durumluluk kaygı düzeyi düşük ve sürekli kaygı düzeyi ise orta düzey olarak saptandı.
Sonuç: COVID-19’un maternal ve fetal etkileri için kanıtlar halen yetersizdir. Çalışmada da bilinmezlik durumu, annenin bebeğini görememesi, emzirememesi, dokunamaması gibi durumlar postpartum dönemde kadınların kaygılarını artırmaktadır. Sağlık profesyonellerinin bu dönemde anneye destek olmaları (annenin bebeğini görmesini ve bebeğinin beslenmesine katılmasını sağlama, kaygı durumu yüksek olanlara psikolojik destek sağlama gibi faktörler) önemlidir.

Anahtar Kelimeler

COVID-19, gebe, kaygı

Teşekkür

Tüm yazarlar özetin çevirisi için Yeter Çuvadar'a teşekkür eder.

Level of Postpartum Anxiety in Pregnant Woman Diagnosed with COVID-19: Presentation of Two Cases

Öz

Objective: The objective of the study is to determine the levels of anxiety in two cases who were diagnosed with the novel corona virus disease (COVID-19) caused by SARS-CoV-2 and delivered via c-section.
Case 1: A pregnant who was at the age of thirty eight and at 38w, 1d and had diagnosed with COVID-19, was admitted to our clinic. The patient who was given COVID-19 treatment and underwent a c-section operation, was given postoperative treatment and care. The mother was in contact with her baby after 14 days of isolation. The newborn was isolated in neonatal intensive care unit to prevent contact with the mother. The mother’s level of anxiety was determined using ‘State-Trait Anxiety Scale’. The state anxiety level of the patient was found to be moderate while trait anxiety level of her was high. In the end of an isolation period of 14 days, the mother was allowed to contact the baby.
Case 2: The patient was at the age of twenty two and at 39w, 5d and gestation applied to our hospital with the complaints of cough and fever. With a positive result of PCR test, the patient was admitted to our clinic with a diagnosis of COVID-19. She delivered via c-section followed by postoperative treatment and care. As is in the Case 1, the baby was isolated in the neonatal intensive care unit for 14 days. The patient’s state anxiety level is low and her trait anxiety level is moderate.
Conclusion: The evidences on the maternal and foetal effects of COVID-19 are still scarce. In the study, the factors such as the uncertainty, the mothers’ inability to see, breastfeed and touch the baby etc increase anxiety in women who are in postpartum period. The support to be given by the healthcare professionals in this period (enabling the mother to see her baby and participate in her baby’s feeding, providing psychological support to those who have high level of anxiety) is vital.

Anahtar Kelimeler

COVID-19, pregnant woman, anxiety

Kaynakça

• Aydemir Ö, Köroğlu E. (2000). Psikiyatride Kullanılan Klinik Ölçekler. Hekimler Yayın Birliği, Ankara, s.153-63.
• Bacanlı H, İlhan T, Aslan S. (2009). Beş faktör kuramına dayalı bir kişilik ölçeğinin geliştirilmesi: sıfatlara dayalı kişilik testi (SDKT), Türk Eğitim Bilimleri Dergisi, 7(2), 261-279.
• Centers for Disease Control and Prevention. (CDC). (2020). Considerations for Inpatient Obstetric Healthcare Settings. 2020. (Erişim Tarihi: 15.04.2020) https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html
• Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W et al. (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet, 395(10226), 809-815.
• Chua M, Lee J, Sulaiman S, Tan H. (2020). From the frontline of COVID-19–How preparedare we as obstetricians: a commentary. International Journal of Obstetrics and Gynaecology, 127(7), 1471-528.
• COVID-19 (SARS-COV-2 Enfeksiyonu Rehberi) Bilim Kurulu Çalışması 2020. Erişim Tarihi: 15.04.2020, https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf?type=file. 1-154
• Liang H, Acharya G. (2020). Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstetricia Gynecologica Scandinavica, 99, 439–442.
• Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K. et al. (2020). Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study, Clinical Infectious Diseases, 71 (16), 2035-2041.
• Li W, Yang Y, Liu Z, Zhao Y, Zhang Q, Zhang L et al. (2020). Progression of Mental Health Services during the COVID-19 Outbreak in China. International Journal of Biological Sciences, 16(10), 1732–1738.
• Liu R, Han H, Liu F, Lv Z, Wu K, et al. (2020). Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb, Clinica Chimica Acta, 505, 172-175.
• Liu S, Yang L, Zhang C, Xiang YT, Liu Z, Hu S et al. (2020). Online Mental Health Services in China During The COVID-19 Outbreak. Lancet Psychiatry, 7, 1-2.
• Melender HL. (2002). Experiences of Fears Associated with Pregnancy and Childbirth: A Study of 329 Pregnant Woman. Birth, 29(2), 101-111.
• National Institutes of Health (NIH). (2020). COVID-19. Erişim Tarihi: 15.04.2020, https://www.nih.gov/health-information/coronavirus.
• Öner N, Le Compte A. (1985). Durumluluk Süreklilik Kaygı Envanteri El Kitabı. Boğaziçi Yayınları, No:133, İstanbul, s.28.
• Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y. et al. (2020). ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound in Obstetrics & Gynecology, 55(5), 700-708.
• World Health Organization (WHO). (2020). Mental Health and Psychosocial Considerations During The COVID-19 Outbreak. 2020. (Erişim Tarihi: 15.04.2020). WHO/2019-nCoV/MentalHealth/2020.1.
• WHO. (2019). Novel Coronavirus (2019-nCoV) situation rep orts. Erişim Tarihi: 15.04.2020, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.
• Yue L, Han L, Li Q, Zhong M, Wang J, Wan Z et al. (2020). Anaesthesia and infection control in cesarean section of pregnant women with coronavirus disease 2019 (COVID-19). Journal of Clinical Anesthesia, 66(109908), 2384.