การพยาบาลผู้คลอดที่เป็นโรคซึมเศร้าร่วมกับมีระยะการเบ่งคลอดยาวนาน: กรณีศึกษา

Abstract

Labor pain is a pain that causes great suffering to the mother. Especially long time of labor pain which will cause severe pain maybe result in complications and danger to the mother and the baby. Causing the mother to feel discouraged, resulting in fear and resulting in stress especially those who have depression before the stress will make the symptoms of the disease more severe and can cause danger to the mother and to the point of injuring herself and the child. Nurses in the labor room is an important role in assessing risks by observing behavioral and emotional changes to prevent complications that may occur including the role in helping to reduce feelings of pain, fear and anxiety. Depression screening using 2 question assessment (2Q) since the first step in the labor room is important if it is found that the mother has abnormal screening. Secondary questionnaire 9 questions (9Q) will be used for evaluate severity if the result is obtained with a severity more than the level, quickly coordinate the psychiatry team to help take care for the mother get to correct and appropriate psychological care. Resulting in mother having physical and mental readiness and can go through the labor process safety, both for the mother and the baby.

Outcome Case study: 31 years old Thai woman with primigravidarum was admitted in labor room from labor pain for 3 hours. Her gestational aged was 39 weeks. She was MDD patient who follow up with a psychologist at the Angthong hospital for 5 years. Sertraline was her medication and stop it during pregnancy. The outcome of 2Q was normal. Vacuum extraction was route of delivery with 2 hours and 29 minutes for 2nd stage of labor. During time of the 2nd stage, she was tried and discouraged. No complications, breastfeeding, can be sold back home, and stay in hospital for 3 days.

Conclusion In this study show that at the time of admission, pregnant women will be a screening of 2Q especially MDD patient for evaluation depressive mood and closed observation for behavioral change. Personal health care should have skill and knowledge in high risk pregnant women for decrease complication and good outcome.