Psychological impact of abnormally invasive placenta: an underestimated and hidden morbidity

J Basic Clin Physiol Pharmacol. 2022 Apr 8;33(5):649-653. doi: 10.1515/jbcpp-2021-0384. eCollection 2022 Sep 1.

Abstract

Objectives: To evaluate anxiety and psychological impact of abnormally invasive placenta (AIP) diagnosis during pregnancy.

Methods: A cross-sectional survey study was performed to assess the psychological response of pregnant women with an antenatally AIP diagnosis. The psychological impact was measured through a visual analogue scale (VAS) for anxiety, which ranged from 0 (not at all anxious) to 100 (extremely anxious) and was referred to three questions: (1) How anxious were you the first time they counselled you about AIP?; (2) How anxious were you the day of the planned cesarean delivery in terms of morbidity/mortality?; (3) How anxious were you in terms of future sexual activities?

Results: 48 singleton pregnancies that underwent planned cesarean hysterectomy for AIP, met the inclusion criteria and were surveyed for the study. Mean VAS was 41.6 ± 25.6, with 47.9% of women with VAS >50 for question 1 (p=0.015). Mean VAS was 52.9 ± 19.1, with 75.0% of women with VAS >50 for question 2 (p=0.02). Mean VAS was 49.6 ± 20.4, with 83.3% of women with VAS >50 for question 3 (p=0.006).

Conclusions: More than half of pregnant women with an antenatally AIP diagnosis reported a high VAS score regarding anxiety, in particular when morbidity/mortality and long-term consequences on sexual activities were analyzed. Our findings could be used to formulate timely psychological interventions to improve mental health and psychological resilience in women with AIP.

Keywords: accrete; anxiety; cesarean delivery; depression; placenta; postpartum hemorrhage; previa.

MeSH terms

  • Cesarean Section / adverse effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Morbidity
  • Placenta
  • Placenta Accreta* / diagnosis
  • Pregnancy
  • Retrospective Studies