Prevalence of positive depression screen among post miscarriage women- A cross sectional study

Background: Miscarriages are a common pregnancy complication affecting about 10–15% of pregnancies. Miscarriages may be associated with a myriad of psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10–20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression. We set out to determine the prevalence of positive depression screen among women who have experienced a miscarriage at the Aga Khan University hospital, Nairobi. Methods: The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic review at the gynecology clinics at Aga Khan University Hospital, Nairobi. The Edinburgh postpartum depression scale was used to screen for depression in the patients. Prevalence was calculated from the percentage of patients achieving the cut –off score of 13 over the total number of patients. Results: A total of 182 patients were recruited for the study. The prevalence of positive depression screen was 34.1% since 62 of the 182 patients had a positive depression screen. Moreover, of the patients who had a positive depression screen, 21(33.1%) had thoughts of self-harm. Conclusion: A positive depression screen is present in 34.1% of women in our population two weeks after a miscarriage. Thoughts of self-harm are present in about a third of these women (33.1%) hence pointing out the importance of screening these women using the EPDS after a miscarriage

Prevalence of Positive Depression Screen among Post Miscarriage Women at The Aga Khan University Hospital

Introduction: Miscarriages are a common pregnancy complication affecting about 10-15% of pregnancies. Miscarriages may be associated with a myriad psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10-20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression. Objective: To determine the prevalence of positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi. Methods: The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic review at the gynecology clinics at Aga Khan University Hospital, Nairobi. The Edinburgh postnatal depression scale was used to screen for depression in the patients. Prevalence was calculated from the percentage of patients achieving the cut –off score of 13 over the total number of patients. Secondary analysis was done using Univariate and multivariate analysis to compare clinical variables between the screen - positive and screen - negative women in order to delineate the potential pattern of association between the two among the study subjects. Results: A total of 182 patients were recruited for the study. The prevalence of positive depression screen was 34.1% since 62 of the 182 patients had a positive depression screen. Univariate analysis revealed that education level (p=0.039) and mode of conception (p=0.005) impacted on the outcome of the depression screen. In multivariate analysis, multiple factors impacted on the depression screen and these included: age (p=0.009), education level (p=0.001), gestation at miscarriage (p=0.04), marital status (p=0.043), prior miscarriage (p=0.011) and mode of conception (p=0.03). Moreover, of the patients who had a positive depression screen, 21(33.1%) had thoughts of self-harm. Conclusion: A positive depression screen is present in 34.1% of women in our population 2 weeks after a miscarriage. More so, factors that seem to impact on the positive depression screen include a younger age, a lower education level, an older gestational age at miscarriage, being single, an assisted mode of conception and a prior miscarriage. Thoughts of self-harm are present in about a third of these women (33.1%) hence pointing out the importance of screening these women using the EPDS after a miscarriage

Successful Pregnancy Outcome after Open Strassman Metroplasty for Bicornuate Uterus

Introduction. Müllerian duct anomalies represent a group of congenital malformations that result from failure to complete bilateral paramesonephric duct elongation, fusion, canalization, or septal resorption. These anomalies are rare in the general population with a bicornuate or didelphys uterus being among the common ones. Bicornuate uterine malformations are of clinical significance due to their adverse reproductive outcomes. Metroplasty has been shown to improve reproductive outcomes of bicornuate uterine malformations. We document a case of bicornuate uterus that was managed with Strassman metroplasty and a subsequent successful pregnancy outcome. Case. A Black African lady was seen with a history of six prior miscarriages. Her diagnostic workup revealed a bicornuate uterus for which she had a Strassman metroplasty performed. She later conceived and was followed up to term with a successful live birth. Conclusion. Strassman metroplasty is a rare procedure in Sub-Saharan Africa and this case seeks to add to the body of knowledge on surgical management of Müllerian duct anomalies specifically bicornuate uterus in this region. This case report aims to increase the awareness of Müllerian duct abnormalities specifically bicornuate uterus in cases of recurrent miscarriages and highlight the diagnostic strategies to investigate and to demonstrate management options in low resource settings