Screening of prenatal depression and anxiety among antenatal women and their association with fear of Coronavirus disease during the COVID-19 pandemic in Coastal Karnataka, India

Background: A vulnerable population like pregnant mothers may have several concerns and anxieties about the impact of coronavirus disease 2019 (COVID-19) infection on pregnancy outcomes and the unborn fetus. However, there is no definitive information on the effect of COVID‐19 on the mental health of pregnant women in our population. We aimed to study the prevalence of depression, anxiety, and COVID-19 related anxiety among antenatal women during the COVID-19 pandemic.Methods: This was a cross-sectional study performed on all antenatal women irrespective of their trimester. Depression, anxiety and COVID-19 related anxiety were assessed using Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and COVID-19 Anxiety Syndrome scale respectively.Results: 381 antenatal women responded to the questionnaire. Though the prevalence of clinically significant anxiety and depression was 1.3% and 1%, 74% of them had subsyndromal anxiety and 80.6% had subsyndromal depression. Those with significant anxiety scores had higher COVID-19 anxiety. In contrast, those with significant depression had lower COVID-19 anxiety. Antenatal women who feared of various complications in pregnancy due to COVID-19 (like preterm birth, anomalous baby, fetal growth restriction, fear of getting infected with Coronavirus) had significantly higher COVID-19 anxiety.Conclusions: The prevalence of clinically significant anxiety and depression was 1.3% and 1%. However, three fourth of the participants suffered from subsyndromal anxiety and depression. Therefore, there is a need to identify antenatal women with subsyndromal anxiety and depression and provide psychosocial support to them during the crisis. Good communication, reassurance, providing care and support to pregnant women should be prioritized during the COVID-19 pandemic to avoid increased levels of anxiety and depression.

Transverse limb defect: a case report

Transverse limb defects are a relatively rare problem (3.5-6.9/10000 births) with a fairly low prenatal detection rate (55%). The possible etiology for this condition could be as part of a genetic condition or amniotic band syndrome. The detection rate can be improved with the use of careful anatomical survey during anomaly scan. In this case report, transverse limb defect was detected in the second trimester.

Total Laparoscopic Hysterectomy with Prior Uterine Artery Ligation at Its Origin

We compared the duration of surgery, blood loss, and complications between patients in whom both uterine arteries were ligated at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom ligation was done after cornual pedicle. Using a prospective study in a gynecologic laparoscopic center, a total of 52 women who underwent TLH from June 2013 to January 2014 were assigned into two groups. In group A, uterine arteries were ligated after the cornual pedicles as done conventionally. In group B, TLH was done by ligating both uterine arteries at the beginning of the procedure. All the other pedicles were desiccated using harmonic scalpel or bipolar diathermy. Uterus with cervix was removed vaginally or by morcellation. The indication for TLH was predominantly dysfunctional uterine bleeding and myomas in both groups. In group A, the average duration of surgery was 71 minutes, when compared to 60 minutes in group B (P<0.001). In group A, the total blood loss was 70 mL, when compared to 43#x2009;mL in group B (P value < 0.001). There were no major complications in both groups. To conclude, prior uterine artery ligation at its origin during TLH reduces the blood loss and surgical duration as well as the complications during surgery