Cesarean deliveries account for 20.7% of all deliveries in France, according to the latest perinatal survey. At Nice University Hospital, the C-section rate over the last 5 years is around 19%. Caesarean section patients are at greater risk of developing symptoms of anxiety, stress and depression. The post-operative period is also more painful, and there is a positive correlation between immediate post-operative pain and the risk of developing chronic pelvic pain. Numerous attempts to reduce these symptoms have been evaluated, including music therapy, relaxation techniques, acupressure and the use of preoperative melatonin. Virtual reality has demonstrated its effectiveness in reducing pain and anxiety in other disciplines, notably pediatric surgery and neurosurgery. In particular, several trials have demonstrated a reduction in anxiety in the paediatric population and, for pelvic procedures under local anaesthetic, during prostate biopsies or hysteroscopy in consultation, with a reduction in anxiety and pain respectively. It has been used to provide information by showing a film about the caesarean section procedure, and has been shown to be effective in terms of patient satisfaction, but without being able to demonstrate a significant reduction in anxiety (p=0.06). The use of virtual reality during the entire peri- and intra-operative management process (maternity stay, patient transfer to the operating room, locoregional anesthesia procedure and during the operation) has not been studied in the context of cesarean section.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
20
Adherence to the use of the virtual reality headset will be reported by a percentage of use at each stage of care.
CHU Nice - Hôpital de l'Archet 2
Nice, Alpes-Maritimes, France
Evaluate the feasibility of a pathway involving the use of virtual reality from patient admission to the cesarean section.
Rate of acceptance of the use of the virtual reality headset during each stage of care (on admission to the maternity ward, in the delivery room before transfer to the operating room, at the patient's request in the caesarean section room after birth (in the absence of skin-to-skin contact with the newborn).
Time frame: 18 months
Assessing patients' pain throughout the treatment process
The patient's pain will be assessed according to a VAS from 0 to 100.
Time frame: 18 months
Evaluate patient anxiety throughout treatment
The patient's anxiety will be assessed using a VAS from 0 to 100.
Time frame: 18 months
Evaluate patient satisfaction throughout the care process
Patient satisfaction will be assessed according to 2 closed questions: "Would you recommend this service to someone close to you? "If you were to have another caesarean section, would you want this care again?
Time frame: 18 months
Evaluation of the impact on the course of surgery and the post-operative period
The impact on the course of surgery and the post-operative period will be assessed by Total operative time (in minutes).
Time frame: 18 months
Evaluation of the impact on the course of surgery and the post-operative period
The impact on the course of surgery and the post-operative period will be assessed by Amount of blood loss (in mL).
Time frame: 18 months
Evaluation of the impact on the course of surgery and the post-operative period
The impact on the course of surgery and the post-operative period will be assessed by the occurrence of nausea/vomiting during the operation.
Time frame: 18 months
Evaluation of the impact on the course of surgery and the post-operative period
The impact on the course of surgery and the post-operative period will be assessed by the time between the end of the caesarean section and the patient's first rising (in hours).
Time frame: 18 months
Evaluation of the impact on the course of surgery and the post-operative period
The impact on the course of surgery and the post-operative period will be assessed by Time from end of caesarean section to first micturition (in hours).
Time frame: 18 months
Assessing the impact on newborns by APGAR
The newborn's condition at birth will be assessed by APGAR at 1 minute of life.
Time frame: 18 months
Assessing the impact on newborns by APGAR
The newborn's condition at birth will be assessed by APGAR at 5 minutes of life.
Time frame: 18 months
Assessing the impact on newborns by APGAR
The newborn's condition at birth will be assessed by APGAR at 10 minutes of life.
Time frame: 18 months
Assessing the impact on newborns
The newborn's condition at birth will be assessed by pH at the cord.
Time frame: 18 months
Assessing the impact on newborns
The newborn's condition at birth will be assessed by lactates at the cord (in mmol/L).
Time frame: 18 months
Evaluation of the medical team's satisfaction after surgery
The surgeon's satisfaction based on a VAS from 0 to 100 at the end of the procedure and the anesthetist's satisfaction based on a VAS from 0 to 100 at the end of the procedure.
Time frame: 18 months
Assessment feasibility
Completion rate of evaluation questionnaires
Time frame: 18 months
Evaluation of study refusals
Refusal rate and Reason for refusal to participate (if patient wishes to justify refusal)
Time frame: 18 months
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