Abstrait

The carmentis protocol: A new method for preventing postpartum depression from preconceive age to puerperium.

Mangiapane E*, Compagno GR, Cusimano D, Saputo E, Severino M, Vitrano F, Lumia C

The Postpartum Depression (PPD) or Postnatal Depression (PND) is one of the different configurations that the psychological suffering of the woman takes in puerperium. PPD is the most common psychic abnormality of childbirth, and it may cause adverse effects on the health and quality of life of the new mother, as well as the child and the partner; it is distinguished from maternity blues (a minor disorder that disappears after a few weeks from birth), from puerperal psychosis (a pathology that requires psychiatric treatment) and from traumatic neurosis (the perception of childbirth as a real trauma). The etiology of PPD focuses on specific risk factors, related to both the genetic and hereditary heritage and the biological variability of women, and to psychological components or social influences. Obstetric factors are no less important, detectable from the remote and close anamnesis of the pregnant women, but also any significant experiences during labor or childbirth. The main objective of this research, especially for health policy, is therefore to develop effective preventive strategies, which allow early detection of patients with significant risk factors. To date, there are methods of high statistical precision screening, which are administered already in term pregnancies or in the immediate postpartum. Screening tools must be able to establish the right timing of action and women acceptability and for this reason it is proposed a new method that includes three different moments of screening and prevention: pre-conceptional age, pregnancy and postpartum (The Carmentis Protocol). It is required the multidisciplinary intervention of several figures that rotate symbiotically in the birth path in its entirety: midwives, first of all, in collaboration with clinical psychologists. The PPD deserves to be focused for its scientific relevance, as the bearer of a constellation of symptoms that need to be recognized and treated, in order to restore the well-being of the dyad first and of the triad afterwards. Prevention is better than cure, acting against the PPD means satisfying a need for the health of the whole society.