Experiences of pregnant women with hypertensive disorders admitted to critical care units and motherchild separation in three institutions in Ecuador, during the Covid-19 pandemic (2020)

Norma Agustina Conforme Delgado, Martha Cecilia Daquilema Sánchez, Jorge Leodan Cabrera Olvera, Maricelys Jiménez Barrera, Jorge Luis Rodríguez Díaz
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Abstract

Objectives: Hospitalization in critical care areas has compromised the well-being of the mother-child bond during childbirth and the postpartum period. Therefore, it is necessary to describe the experiences of pregnant women with hypertensive disorders admitted to the intensive care unit.

Material and methods: A qualitative research study with a phenomenological design, involving a sample of ten participants with a history of hypertensive disorders during pregnancy, admitted to critical care. Using snowball sampling and data saturation, information was gathered through semi-structured interviews following informed consent. Data were analyzed with open coding a posteriori using Colaizzi's method and complemented by MAXQDA 2022 software.

Results: Six categories emerged: 1) consequences of hypertensive disorders in pregnant women in intensive care units; 2) positive aspects during perinatal care; 3) emotions and suffering due to the loss of the newborn; 4) impact of critical conditions on the mother-newborn relationship; 5) lack of resources for timely therapeutic interventions in perinatal care, and 6) lack of assertive communication by healthcare personnel.

Conclusions: Maternal morbidity and mortality caused by hypertensive disorders require high complexity care in specialized institutions to reduce life-threatening risks, leading to disrupted early bonding and separation of the mother-child dyad, as well as negative feelings in the mothers. This situation results in a painful experience for the family. Therefore, healthcare professionals must develop strategies to ensure the preservation of the emotional bond, which can be compromised in critical care areas.

[2019冠状病毒病大流行期间(2020年),厄瓜多尔三家机构中患有高血压的孕妇被送入重症病房,母婴二胎分离的经历]。
目标:重症监护病房的住院损害了分娩和产后母子关系的健康,因此有必要描述重症监护病房中患有高血压的孕妇的经历。材料与方法:现象学设计的定性研究,包括10名有妊娠高血压病史的重症监护参与者。通过雪球抽样和信息饱和,在接受知情同意的情况下,通过应用半结构化访谈获得信息。分析采用Colaizzi方法进行后开编码;与MAXQDEA 2022项目相辅相成。结果:采用了6个类别:(1)重症监护病房中孕妇高血压的后果;(2)围产期护理的积极方面;3)失去新生儿的情绪和痛苦;(4)恶劣环境对母婴关系的影响;5)围产期护理中缺乏及时治疗的资源,6)卫生保健人员缺乏自信的沟通。结论:由高血压引起的孕产妇发病率和死亡率需要在专门机构中进行高度复杂的护理,以减少生命危险,从而导致过早脱离依恋和母子二人组分离,以及母亲的负面情绪;这给家庭带来了痛苦的经历;因此,卫生工作者必须制定战略,确保在关键地区建立情感联系。
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