Is polycystic ovary syndrome a risk factor for depression and anxiety?: a cross-sectional study

OBJECTIVE

The objective of this study was to learn more about the prevalence and pathophysiology of depression and anxiety that may be caused by polycystic ovary syndrome and to make plans for taking necessary precautions for this vulnerable group.

METHODS

This case-control study was conducted between January 2022 and October 2022. A total of 120 women with polycystic ovary syndrome and 143 controls were included in the study. All healthy volunteers and women with polycystic ovary syndrome were evaluated using self-administered questionnaires and physical examination. Anthropometric data such as weight and height and laboratory value were documented.

RESULTS

There was no significant difference between the groups in terms of demographic characteristics. When the Hospital Anxiety and Depression Scale scores of both groups were compared, both depression and anxiety scores were found to be significantly higher in women with polycystic ovary syndrome compared with the control group (OR: 3.319, 95%CI, 1.563-7.047, p<0.001 and OR: 3.238, 95%CI, 1.659-6.315, p<0.001). In the Hospital Anxiety and Depression Scale questionnaire, the rate of irregular menstruation and Ferriman-Gallwey score were statistically significant in women with polycystic ovary syndrome with high depression and anxiety scores. While serum LH levels and LH/FSH ratios were significantly different in women with polycystic ovary syndrome with high depression scores, serum LH, LH:FSH ratios, and serum total testosterone levels were found significant in women with polycystic ovary syndrome with high anxiety scores.

CONCLUSION

It is clear that depression and anxiety are more common in patients with polycystic ovary syndrome than in healthy women. Our findings support previous recommendations regarding routine screening for depression and anxiety in this population.

Predictive value of prenatal ultrasound in foetal intraabdominal cystic lesions and evaluation of perinatal outcomes: a single-centre study results

The prenatal diagnosis of intra-abdominal cystic lesions is relatively common and it can be due to a wide variety of clinical conditions. The aims of this study were to determine the accuracy of the prenatal ultrasound in identifying the aetiology of foetal intra-abdominal cysts and to describe the prenatal and postnatal outcomes. This study is a retrospective analysis of 137 foetuses diagnosed with intraabdominal cysts during the prenatal period, except those originating from the urinary system, conducted from April 2015 to August 2018. Among 137 intraabdominal cysts identified as antenatal, ovarian cysts had the highest rate of prenatal diagnosis. The most frequently misdiagnosed pathologies were gastrointestinal system obstructions with 6 cases. There were 129 (94.2%)cases of intraabdominal cysts born alive. Intrabdominal cystic lesions resolved spontaneously in 23(16.8%) cases in the intrauterine period and 28 cases within 12 (20.4%) months after birth during follow-up. Postpartum surgical treatment was performed in 44 (%32.1) cases. The overall neonatal mortality was 21/137 (15.3%),with no death in the intrauterine period; 8(5.8%) of these were death following termination of pregnancy, 6(4.4%) were postpartum, and 7(5.1%) were post-surgical death. Postnatal results of intraabdominal cysts are variable. Therefore, individual assessing and managing each case is of clear benefit due to cyst's variable course. IMPACT STATEMENTWhat is already known on this subject? The prenatal diagnosis of intra- abdominal cystic lesions is relatively common and prenatal ultrasound is the main screening tool. The diagnosis of a foetal intra-abdominal cyst might represent a diagnostic and management dilemma due to the wide variety of potential diagnosis.What the results of this study add? The accuracy of prenatal ultrasound in identifying the origin of a foetal intra-abdominal cyst seems to be high with detailed ultrasonographic examinations and the perinatal outcome of these foetuses is favourable in most of them.What the implications are of these findings for clinical practice and/or future research? Regardless of the cyst's origin, it should be kept in mind that prenatal and postnatal clinical courses can be variable in each case, and every pregnant woman with a foetus with an intraabdominal cyst must be managed individually in every aspect.

Fetal intracranial hemorrhage: prenatal sonographic diagnosis criteria and postnatal outcomes

Objective

This study aimed to provide sufficient knowledge of prenatally diagnosed fetal intracranial hemorrhage (ICH) defining the ultrasound (US) examination results, the contribution of fetal magnetic resonance imagination (MRI) to the diagnosis, and the pregnancy outcomes from our series of fetal ICH cases.

Material and methods

This retrospective observational study included eleven fetuses who were diagnosed as having ICH from April 2016 to August 2020. The data regarding the medical records, prenatal US and MRI findings, treatments applied, and prognosis of fetal ICH cases were collected from the hospital database and analyzed.

Results

Fetal ICHs were grade 3 in 6 cases, and grade 4 in the remaining 5 cases. The mean gestational age at diagnosis was 30.2 weeks. Nine (81.8%) of the cases were diagnosed in the third trimester and two (18.2%) were diagnosed in the second trimester. Fetal cranial MRI was performed in 7/11 cases following ultrasonographic diagnosis. The fetal MRI confirmed the fetal ICH diagnosis and previous US findings regarding location and grade in all cases. Five patients (45.5%) diagnosed with grade 3 (n=1) and grade 4 (n=4) ICH underwent pregnancy termination. Of the remaining 6 cases, one case (9.1%) diagnosed with grade 3 fetal ICH resulted in an IUFD. Four cases classified as grade 3 fetal ICH and one case with grade 4 fetal ICH were born alive at term.

Conclusion

The clinical manifestations of fetal ICH are diverse and have a wide spectrum of severity and prognostic implications. Fetal ICH cases were mainly detected in the third trimester, with a minority detected in the second trimester. These cases can be safely diagnosed and graded with US examination, but the underlying etiology frequently cannot be determined. Fetal cranial MRI might aid in the diagnosis confirmation and combined use with the US provide appropriate counseling to the parents.

Evaluation of psychological resilience and anxiety levels of patients with hyperemesis gravidarum diagnosis and comparison with healthy pregnant women

Objective:

To compare the psychological resilience and anxiety levels of patients diagnosed with hyperemesis gravidarum (HG) and healthy pregnant women.

Materials and Methods:

A sociodemographic data form and the Resilience scale for Adults (RSA) and the State-Trait Anxiety Inventory (STAI) were administered. The sociodemographic data form was completed by the physician, and the RSA and STAI were completed by the participant. The sample of the study consisted of 60 pregnant women with HG and hospitalized and 97 healthy voluntary pregnant women with similar characteristics to the research group without any pregnancy complications. Data were evaluated using descriptive statistical analyses, the independent samples t-test, the Mann-Whitney U test and Pearson’s correlation analysis.

Results:

The age range was 18-42 years for HG group and 20-43 years for control group. The average age of the HG group was 28.17±5.96 years and that of the control group was 29.45±5.83 years. There was no statistically significant difference between the groups in terms of pregnancy week. Regarding the prevalence of state and trait anxiety between the groups, it was found that 66.7% of the HG group had a high level of trait anxiety and 51.7% had a high level of state anxiety. It was found that 61.9% of the control group had a high level of trait anxiety and 38.1% had a high level of state anxiety. There was no difference between the healthy pregnant group and the HG group in terms of anxiety (p=0.125). It was found that there was a significant difference between the groups in terms of only sub-dimensions of RSA, which were perception of self (U=2385.00, p=0.044) and perception of future (U=2350.50, p=0.030). The perception of self and perception of future scores of the healthy control group were higher.

Conclusion:

There was no difference between the healthy pregnant group and the HG group in terms of anxiety. It was observed that the HG group had a lower perception of self and future. Apart from the usual increase in anxiety levels during pregnancy, HG accompanied by stubborn nausea and vomiting does not create an extra psychological burden, either as a cause or a result.

Evaluating the effects of the COVID-19 pandemic on the physical and mental well-being of obstetricians and gynecologists in Turkey

Objective

To apply online surveying to assess the general physical and mental well‐being of obstetricians/gynecologists (OB/GYNs) working in COVID‐19 designated hospitals in Turkey.

Methods

A prospective survey‐based study using an online survey platform. Three hundred participants working at COVID‐19 designated hospitals in Turkey identified from a hospital database were sent a link to the survey by email between April 29 and May 20, 2020.

Results

A total of 253 OB/GYNs (31 consultants and 222 residents) completed the survey, for a response rate of 84.3%. Of respondents, 191 (76.4%) were anxious about coming into contact with pregnant women infected with COVID‐19. 74.4% stated that they were afraid of getting sick. 64.8% reported that they had fallen into despair at times because of the pandemic. 66.5% stated that their family lives were affected. 72.4% started living separately from their families because of the pandemic.

Conclusion

Despite the difficulties in patient care during the pandemic, OB/GYNs continued providing for their patients, which reflected positively on their perceptions of the profession. The importance of trust in the national healthcare system, presence of adequate PPE, finding a suitable coping mechanism, and family support were essential for Turkish OB/GYNs during the COVID‐19 pandemic.

ClinicalTrials.gov identifier: NCT04327531.

Turkish obstetricians/gynecologists reported anxiety and stress caused by the current situation and future implications of the COVID‐19 pandemic.

Turkish obstetricians/gynecologists reported anxiety and stress caused by the current situation and future implications of the COVID‐19 pandemic.

Maternal serum TXNDC5 levels and thiol/disulfide homeostasis in preeclamptic pregnancies

Objective: To investigate thiol/disulfide homeostasis (TDH) and thioredoxin domain-containing 5 (TXNDC5) level in early and late-onset preeclampsia.Material and methods: In this cross-sectional study, 24 pregnant women with early-onset preeclampsia and 26 pregnant women with late-onset preeclampsia were compared with 30 pregnant women with no obstetric complications. The serum TXNDC5 levels and thiol/disulfide homeostasis were measured.Results: Serum TXNDC5 levels were significantly higher in the early-onset and late-onset preeclampsia groups compared with the control group (p < .05). Native thiol and total thiol levels were significantly lower in the early-onset and late-onset preeclampsia groups than control group. The disulfide levels were found as significantly high in early preeclamptic patients compared to control group (p < .05). The highest levels of TXNDC5 and the lowest levels of native thiol and total thiol were found in early-onset preeclampsia group. No significant difference was found between the patients with early onset and late onset preeclampsia regarding TXNDC5 levels and thiol/disulfide homeostasis (p > .05).Conclusion: Serum TXNDC5 levels were significantly higher in patients with early-onset and late-onset preeclampsia. The dynamic thiol/disulfide homeostasis was impaired in favor of the oxidized state in patients with preeclampsia.

Why do multiparous women with a history of vaginal delivery give birth by cesarean section?

OBJECTIVE

A cesarean section (C-section) is performed to deliver a baby through the mother's abdomen. In recent years, the rate of incidences requiring a C-section is steadily increasing all over the world. Advanced maternal age, chronic health problems, multiple pregnancies as a result of the development of assisted reproductive technologies, and an insufficient supplementary health network can be considered as the reasons why mothers and obstetricians prefer a C-section. Our study aimed to identify the risk factors for the need of C-section in women with a history of vaginal delivery.

MATERIAL AND METHODS

238 multiparous women with a history of vaginal birth at 37-42 gestational weeks were enrolled in our study. 110 women had underwent C-section. Control group was chosen randomly from women giving birth by vaginal route.

RESULTS

Overall, 238 multiparous women with a history of vaginal delivery at 37-42 gestational weeks were enrolled in our study. The history of operative delivery, that of labor induction and presence of meconium and the indication of admission to the delivery room were different between groups. A lower Bishop score and biophysical profile, smaller gestational period, and lower birth weight were associated with the group requiring a C-section, whereas older age and a long time interval from the previous birth were associated with the group not requiring a C-section.

CONCLUSION

A strategy involving either labor induction or not could be individualized for each patient to eliminate the risk factors for adverse outcomes. To identify criteria for the standardization of labor management, further studies are needed.