Previous induced abortion and ante-natal depression in primiparae: preliminary report of a survey of mental health in pregnancy

1978 ◽  
Vol 8 (4) ◽  
pp. 711-715 ◽  
Author(s):  
R. Kumar ◽  
Kay Robson
Keyword(s):  
Mental Health ◽  
Preliminary Report ◽  
Previous History ◽  
First Trimester ◽  
Induced Abortion ◽  
Depression And Anxiety ◽  
History Of ◽  
Expectant Mothers ◽  
Clinically Significant ◽  
In Pregnancy

SynopsisOne hundred and nineteen primiparae, who were routinely attending ante-natal clinics, were interviewed repeatedly between the 12th and 36th weeks of their pregnancies. The incidence of depression was highest in the first trimester and, overall, about a fifth of the sample was found to be suffering from clinically significant neurotic disturbances. In a proportion of these expectant mothers there was an association between depression and anxiety early in pregnancy and a previous history of induced abortion; this phenomenon may reflect a reactivation of mourning which was previously suppressed.

Progestogens for treatment and prevention of pregnancy disorders

2010 ◽  
Vol 3 (3) ◽  
Author(s):  
Adolf E. Schindler
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
First Trimester ◽  
Study Groups ◽  
Treatment And Prevention ◽  
Maternal Immune System ◽  
Hydroxyprogesterone Caproate ◽  
History Of ◽  
Threatened Abortion ◽  
In Pregnancy

AbstractProgesterone appears to be the dominant hormone not only establishing a proper secretory endometrial development but also adequate decidualization to establish pregnancy and sustain pregnancy development. Progesterone is the natural immunoregulator to control the maternal immune system and not to reject the allogeneic fetus. There are two sources of progesterone: corpus luteum first and placenta later. Three progestogens can be used in pregnancy: (i) progesterone (per os, intravaginal and intramuscular), (ii) dydrogesterone (per os), and (iii) 17α-hydroxyprogesterone caproate (intramuscular). There are three indications, for which these progestogens can be clinically used either for treatment or prevention: (i) first trimester threatened and recurrent (habitual) abortion, (ii) premature labor/premature birth, and (iii) pre-eclampsia (hypertension in pregnancy). The available data are limited and only partially randomized. In threatened abortion the use of progesterone, dydrogesterone and 17α-hydroxyprogesterone caproate leads to a significant improved outcome, when at the time of threatened abortion a viable fetus has been ascertained by ultrasound. For prevention of recurrent abortion there are also some data indicating a significant effect compared with women without progestogen treatment. Prevention of preterm birth by progestogens (progesterone vaginally, orally and 17α-hydroxyprogesterone caproate intramuscularly) was significantly effective. The main study groups include pregnant women with a previous history of premature birth. However, also in women with shortened cervix use of progesterone seems to be helpful. The studies done so far in women with risk factors for pre-eclampsia or established pre-eclampsia were based on parenteral progesterone application. However, new studies are urgently needed.

scholarly journals A study of feto-maternal outcome in bleeding per vaginum in first trimester of pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1191
Author(s):  
Jaydeep J. Bhatu ◽  
Darshil S. Prajapati
Keyword(s):  
Vaginal Bleeding ◽  
Local Population ◽  
Previous History ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Maternal Complications ◽  
History Of ◽  
Threatened Abortion ◽  
Degree Of Association ◽  
In Pregnancy

Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

scholarly journals Improving Mental Health in Pregnancy for Refugee Women: Protocol for the Implementation and Evaluation of a Screening Program in Melbourne, Australia (Preprint)

2019 ◽  
Author(s):  
Jacqueline Anne Boyle ◽  
Suzanne Willey ◽  
Rebecca Blackmore ◽  
Christine East ◽  
Jacqueline McBride ◽  
...  
Keyword(s):  
Mental Health ◽  
Postnatal Depression ◽  
Screening Program ◽  
Routine Care ◽  
Perinatal Mental Health ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Refugee Women ◽  
Health Disorders ◽  
In Pregnancy

BACKGROUND Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is one of the leading causes of maternal mortality postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program’s feasibility and acceptability to women and health care providers (HCPs). OBJECTIVE The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). METHODS This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. RESULTS The recruitment is complete, and data collection and analysis are underway. CONCLUSIONS It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/13271

Gender-related differences in mental health of Canadian Armed Forces members during the COVID-19 pandemic

2021 ◽  
pp. e20210012
Author(s):  
Kerry Sudom ◽  
Eva Guérin ◽  
Jennifer E. C. Lee
Keyword(s):  
Mental Health ◽  
Armed Forces ◽  
The State ◽  
Depression And Anxiety ◽  
Family Status ◽  
Health Issues ◽  
Demographic Groups ◽  
Canadian Armed Forces ◽  
Regular Force ◽  
Clinically Significant

Lay Summary The challenges associated with the coronavirus disease 2019 (COVID-19) pandemic have the potential to not only adversely affect mental health in general, but also to emphasize and widen disparities in mental health across demographic groups. In particular, research suggests that women have been disproportionately affected by the pandemic psychologically, socially, and economically. However, the state of mental health in the Canadian Armed Forces (CAF) during the pandemic and the impacts of gender on mental health outcomes are currently unknown. This study uses data collected early in the pandemic to examine the state of mental health of CAF Regular Force members and the impacts of gender and family status. Although most members were doing well, a notable minority were experiencing mental health issues at potentially clinically significant levels, with women more likely to experience depression and anxiety than men and women with children less likely to experience functional impairment as a result of their symptoms. The findings provide a snapshot of the mental health of Regular Force members during the pandemic and suggest the importance of considering gender and family situation in understanding mental health.

scholarly journals A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India

2017 ◽  
Vol 7 (1) ◽  
pp. 266
Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Care Hospital ◽  
History Of ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.

Antidepressant use in Alzheimer's disease patients: results of the REAL.FR cohort

2009 ◽  
Vol 22 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Christophe Arbus ◽  
Virginie Gardette ◽  
Eric Bui ◽  
Christelle Cantet ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Previous History ◽  
Natural Setting ◽  
Antidepressant Prescription ◽  
History Of ◽  
Antidepressant Use ◽  
Clinically Significant ◽  
History Of Depression

ABSTRACTBackground: Psychotropic medication is widely prescribed in clinical practice for the management of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, there have been few pharmaco-epidemiological studies or studies conducted in a natural setting on the real use of antidepressants in AD. The aim of this survey was to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription.Methods: REAL.FR is a four-year, prospective, multi-center study. Baseline data including demographic characteristics, clinical variables and drug intake were obtained. Depressive symptoms were determined using the Neuropsychiatric Inventory (NPI).Results: A total of 686 AD patients were included. Antidepressant treatment was prescribed for 34.8% of patients. Clinically significant depressive symptoms (NPI ≥ 4) were observed in 20.5% of the total population. Although depressed subjects were significantly more likely to be treated with antidepressants than non-depressed subjects (p<0.0001), only 60% of depressed subjects overall were prescribed an antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression.Conclusions: The available data on antidepressant efficacy in BPSD other than depression (in particular, agitation, aggression and, occasionally, psychotic symptoms) do not influence prescription choices. Depressive symptoms may be taken more seriously in the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time.

scholarly journals Suicide due to fear of COVID-19, in pregnancy, lead to Neonatal malformations: A case report

2021 ◽  
Author(s):  
Javad Boskabadi ◽  
Saeed Kargar-Soleiman abad ◽  
shahrokh mehrpishe ◽  
Elham Pishavar ◽  
Roya Farhadi
Keyword(s):  
Mental Health ◽  
Case Report ◽  
Antipsychotic Drugs ◽  
First Trimester ◽  
Limited Data ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations

scholarly journals DETECTION OF HYPOTHYROIDISM IN EARLY PREGNANCY: UNIVERSAL SCREENING

2020 ◽  
pp. 1-4
Author(s):  
Manpreet Kour ◽  
Taranjeet Kour
Keyword(s):  
Pregnant Women ◽  
Previous History ◽  
First Trimester ◽  
Normal Serum ◽  
Systemic Review ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
History Of ◽  
Adverse Pregnancy ◽  
Hypothyroid Patients

Background: Thyroid dysfunction is one of the most common endocrine disorders in women of childbearing (1), second only to diabetes mellitus.The aim of this systemic review was to determine whether an increased maternal TSH level and normal serum T4 levels, as seen in SCH, could also be associated with pregnancy complications. Methods: This study was conducted in Nobel hospital,Pune January 2015 to July 2016 in all the pregnant women attending antenatal clinic in their first trimester of pregnancy. Data was collected on a pre-designed, pre-tested study proforma which includes socio-demographic information of patients, detailed clinical history and examinations of pregnant women and babies. Blood samples were taken under all aseptic precautions and were sent to laboratory of the institute for routine investigations and thyroid profile. Patients were followed up till delivery and babies were followed up till discharge from the hospital. Results:This study was conducted in 220 patients in obstetrics and gynaecology department in Noble Hospital, Pune. Out of 220 cases,198 cases were euthyroid, 13 cases were subclinical hypothyroid and 9 cases were overt hypothyroid. Hypothyroidism was found in 22(10%) of pregnant women in their first trimester. Out of which, 13(5.91%) had subclinical hypothyroidism and 9(4.09%) had overt hypothyroidism. Majority of the patients 45.45% were in age group of 26-30years. 90.91% of hypothyroid patients had regular cycles and 9.09% had irregular cycles. Hypothyroidism was equally distributed between primi and multigravida patients. 31.82% of hypothyroid patients had previous history of abortions and 68.18% had no such history.18.18% of hypothyroid patients had history of infertility and 31.82% had no history of infertility. Anti-TPO was present in 9.09% and none of euthyroid patients. Maternal and Fetal complications were found more in hypothyroid patients than euthyroid patients. Conclusion: Most of the patients in our study who have subclinical thyroid disease are asymptomatic, so screening is the most convenient method to identify such patients. Follow-up of abnormal TSH values with FT3 and FT4 may yield valuable results which could enable us for therapeutic intervention and may go a long way in preventing adverse pregnancy outcomes.

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