The effect of bleeding stress during cesarean section in patients undergoing spinal: a review study
The effect of bleeding stress during cesarean section in patients undergoing spinal: a review study
Mohammad amin Masoumi,1,*zeinab sadat moosavifard,2
1. BSc in Nursing, Department of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran. 2. Department of Nursing, Faculty of nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran.
Introduction: Cesarean section is one of the most common surgeries in the world. The rate of cesarean section in the world is equal to 15-20% and in Iran is equal to 40%. In cesarean section, 1000-750 cc is considered normal bleeding. Surgery is a stressful situation that triggers psychological and physiological reactions. A mother who goes to the operating room for a cesarean section is stressed because of the unfamiliar environment, the vague sounds of the monitor, the noise of other patients and operating room staff, the fear of the outcome or complications of the operation, and the anesthesia, the baby's health. Especially when spinal anesthesia is performed, because the patient is conscious and feels the surrounding stimuli during the operation, it is more stressful.
Methods: This review study was designed and performed to introduce and evaluate the effect of stress on bleeding during cesarean section. Materials and Methods: All data were obtained by referring to the authoritative scientific databases of Google Scolar, SID, Pubmed, Science Direct, Scopus and with the keywords Stress, Bleeding during surgery, Bleeding, Cesarean section, Spinal anesthesia. A systematic review was conducted in the period 2000-2009.
Results: In humans, one of the systems that responds to stress is the immune system. Under stress, increased cortisol decreases levels of proinflammatory cytokines and IL and α-TNF. Cortisol reduces immune cells at the wound site by stopping the proliferation and differentiation of immune cells, altering gene expression, and reducing cell adhesion. In cesarean sections, repair occurs in four stages: homeostasis, inflammation, proliferation, and tissue deformation. In the homeostasis stage, the immune system plays an important role in repair by producing pro-inflammatory cytokines. Stress can delay wound healing and prolong bleeding by reducing these cytokines. The majority of cesarean section patients undergo spinal anesthesia and are awake until the last moment due to special conditions and to prevent damage to the fetus, and they are not even injected with hypnotics. Therefore, these patients suffer a lot of stress. Researchers' clinical experiences show that patients with high stress tend to bleed more during a cesarean section.
Conclusion: Given that cesarean section is very stressful for the mother and can indirectly increase bleeding during cesarean section, so measures to reduce patients' stress seem necessary. Today, nurses use non-invasive, uncomplicated methods to minimize patient anxiety, including providing information about the patient's procedure, hand massage, aromatherapy, and music therapy.