Emotional impact of severe post-partum haemorrhage on women and their partners: an observational, case-matched, prospective, single-centre pilot study Aude Ricbourg a, *, Christelle Gosme b , Etienne Gayat b,c,d , Chloe´ Ventre b , Emmanuel Barranger a,c , Alexandre Mebazaa b,c,d a Department of Obstetrics and Gynaecology, Hoˆpital Lariboisie`re AP-HP, 2 rue Ambroise Pare´, 75010 Paris, France b Department of Anaesthesiology and Intensive Care Medicine, Hoˆpital Lariboisie`re AP-HP, 2 rue Ambroise Pare´, 75010 Paris, France c University Paris Diderot, Paris, France d UMR-942, INSERM, Paris, France Introduction Postpartum haemorrhage (PPH) is the most common cause of maternal morbidity or mortality. Medical and technical progress permit an improvement of the outcome of the women health but it seems that the psychological impact of PPH is underestimated. Initially described by American men who served in the Vietnam War, post-traumatic stress disorder (PTSD) is a reaction to an event, either personally experienced or witnessed, that involves an actual or a threat of death or serious injury or a threat to the physical integrity of oneself or others [1]. The prevalence of PTSD as result of childbirth is as high as 1.5% of women [2]. Women who experienced a high level of obstetrics intervention and dissatis- faction of their intrapartum care seem to more likely develop trauma symptoms in postpartum [3]. The knowledge that psychological health may have an impact on a newborn’s affective and cognitive development highlights the importance of assessing the psychological impact of PPH on women. This observational, case/control, prospective, single-centre study sought to estimate the number of women and their partners who experience PTSD in the context of PPH. Additionally, we also studied post-partum depression and the impact of PPH on the mother/child relationship. Therefore, we used the following psychological scales that are described in the literature and are approved by scientific societies: Impact of Event Scale-Revised (IESR) to assess PTSD [4–9], Edinburgh Post Natal Depression Scale (EPDS) to assess post-natal depression [10] and Mother-Infant European Journal of Obstetrics & Gynecology and Reproductive Biology 193 (2015) 140–143 A R T I C L E I N F O Article history: Received 6 May 2015 Accepted 30 July 2015 Keywords: Post-partum haemorrhage Post-traumatic stress disorder Postnatal depression A B S T R A C T Objective: This observational, matched-control, prospective, single-centre study sought to estimate the emotional impact of post-partum haemorrhage (PPH) on women and their partners, including its influences on post-traumatic stress disorder (PTSD), postpartum depression and the mother/child relationship. Study design: All consecutive women who were admitted for PPH from December 2010 through December 2011 and their partners were screened for eligibility. Emotional impact was assessed using three self-reported questionnaires (Impact of Event Scale- Revised to assess PTSD, Edinburgh Post Natal Depression Scale to assess post-natal depression and Mother-Infant Bonding Scale to assess the relationship between mother and child). Each PPH patient was matched with a control woman for whom the delivery was not complicated by PPH. Results: The results showed (a) that women with PPH and their partners were more likely to report symptoms related to PTSD compared with controls, (b) that women with PPH were less likely to suffer from postnatal depression and (c) that there was no difference in the mother/child relationship between women with PPH and controls. Conclusion: PPH is associated with a high incidence of PTSD-related symptoms in both women and their partners. PTSD in the context of PPH is likely an under-recognised phenomenon by health care professionals. ß 2015 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +33 1 49 95 62 23; fax: +33 1 49 95 6215. E-mail address: aude.ricbourg@lrb.aphp.fr (A. Ricbourg). Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology jou r nal h o mep ag e: w ww .elsevier .co m /loc ate/ejo g rb http://dx.doi.org/10.1016/j.ejogrb.2015.07.020 0301-2115/ß 2015 Elsevier Ireland Ltd. All rights reserved.