Psychological Outcome of Women with Morbidly Adherent Placenta Following Hystrectomy: Prospective Matched Case-control Study
Authors: El-Shalakany Amr Hassan , El-Din Adel Shafik Salah , ElSehrawy Tarek Mohamed Kamel , Ragab Mostafa Ramadan Bakry 
Published: October 2021

Abstract

Background
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.

Aim of the work
The purpose of this study is to investigate the risk of postoperative psychiatric disorders of depression, anxiety outcomes and sexual dysfunctions and self esteem disturbance in women with morbidly adherent placenta following hysterectomy.

Methods
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.

Results
Self-esteem was statistically signifciantly highest in cases underwent CS with no statistical significant difference between CH and VD. Anxiety was non- statistically significantly most frequent in CH and least frequent in VD. Depression was non- statistically signifciantly most frequent in CH and least frequent in VD. Severe depression was statistically signifciantly most frequent in VD and least frequent in CH. Different dysfunctions were statistically significantly highest in CH research group. Desire, Arousal, Lubrication and pain dysfunctions were statistically significantly lowest in VD group. Orgasm and Satisfaction dysfunctions were signifciantly lowest in CS group. Analyzing the current research data results and considering previous research efforts in female sexual dysfunctions in correlation to obstetric clinical scenarios reveal that the female sexual normal activity is a critical issue when affected could result in serious sequale not only affecting the female as regards self-esteem and psychiatric health status but could affect the male partner due to reduced sexual functional capacity, future research efforts are recommended to be multi-centric in fashion taking in consideration more detailed aspects particularly the male partner satisfaction from sexual activities with his female counterpart after cesarean, vaginal deliveries.

Conclusion
Analyzing the current research data results and considering previous research efforts in female sexual dysfunctions in correlation to obstetric clinical scenarios reveal that the female sexual normal activity is a critical issue when affected could result in serious sequale not only affecting the female as regards self-esteem and psychiatric health status but could affect the male partner due to reduced sexual functional capacity, future research efforts ere recommended to be multicentric in fashion taking in consideration more detailed aspects particularly the male partner satisfaction from sexual activities with his female counterpart after cesarean, vaginal deliveries.