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Fulltext Antidepressant-Like Properties of Fish Oil on Postpartum Depression-Like Rats Model: Involvement of Serotonergic System

Abdul Aziz NU, Chiroma SM, Mohd Moklas MA, Adenan MI, Ismail A, Hidayat Baharuldin MT

Brain Sci, 2020 Oct 13;10(10).
PMID: 33066310 DOI: 10.3390/brainsci10100733

Pathophysiology of postpartum depression (PPD) has been associated with many factors, such as neuroendocrine, neuroinflammation and neurotransmitter changes. Fish oil (FO) improves PPD both in humans and animals. However, little is known with regards to its pharmacology on a PPD-like rat model. Hence, the current study aimed at investigating the effects of FO on a PPD-like rat model. Female rats were induced with PPD-like symptoms and then randomly divided into six groups (n = 6) for two experimental protocols. Protocol 1 consisted of PPD-like rats (2 mL distilled water), PPD-like + FO (9 g/kg/d) and PPD-like + Fluoxetine (FLX) (15 mg/kg/d) groups of rats, whereas Protocol 2 consisted of PPD-like rats (2 mL distilled water) + PCPA (p-chlorophenylalanine) 150 mg/kg, PPD-like + FO (9 g/kg/d) + PCPA 150 mg/kg and PPD-like + FLX (15 mg/d) + PCPA 150 mg/kg groups of rats, respectively. All treatments were administered orally for 10 days postpartum, except PCPA, which was given intraperitoneally. Prior to euthanasia, the antidepressant-like effect of the FO was evaluated using the forced swimming test (FST) and open field test (OFT) on day 10 postpartum. Biochemical analysis of serotonin, serotonin metabolite and serotonin turnover from their prefrontal cortex and hippocampus were also measured. The results showed that FO decreased immobility time and increased swimming time significantly, but not climbing time in FST. Further, it also decreased serotonin metabolite and turnover significantly in the hippocampus of the PPD-like rats. In contrast, administration with PCPA reversed all the outcomes. The antidepressant-like effects of FO were found to be similar with that of FLX. Thus, it can be concluded that FO exerts its antidepressant-like effects in PPD-like rats through modulation of serotonergic system.

Matched MeSH terms: Postpartum Period
Antenatal depressive symptoms and breastfeeding: a prospective cohort study

Yusuff AS, Tang L, Binns CW, Lee AH

Breastfeed Med, 2015 Jul-Aug;10(6):300-4.
PMID: 26090921 DOI: 10.1089/bfm.2015.0069

INTRODUCTION: Globally many women suffer from depression during pregnancy. This study investigated the impact of antenatal depressive symptoms on the duration of breastfeeding up to 6 months among women in Sabah, Malaysia.
SUBJECTS AND METHODS: A prospective cohort study of 2,072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation and followed up at 1, 3, and 6 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Cox regression analyses were performed to determine the relationship between antenatal EPDS scores and cessation of breastfeeding before 6 months postpartum.
RESULTS: In total, 1,078 (52%) women with complete information on breastfeeding duration were included in the final sample. Approximately 99% of mothers were breastfeeding at discharge, and 87% of them continued to breastfeed at 6 months postpartum. Women with an antenatal EPDS score of 8 or above were twice more likely to stop breastfeeding before 6 months (adjusted hazards ratio=1.95; 95% confidence interval, 1.26, 3.01) than those who scored less than 4 on the EPDS.
CONCLUSIONS: Depressive symptoms during pregnancy appeared to be associated with early breastfeeding cessation for mothers residing in Sabah.

Matched MeSH terms: Postpartum Period
Adult giant hydronephrosis diagnosed in the second trimester of pregnancy: A case report and literature review

Ramly F, Mohamad NAN, Zahid AZM, Kasim NM, Teh KY

Case Rep Womens Health, 2021 Jan;29:e00275.
PMID: 33304832 DOI: 10.1016/j.crwh.2020.e00275

Adult giant hydronephrosis in a normally sited kidney is unusual during pregnancy. The most frequent cause is congenital obstruction at the ureteropelvic junction. Ultrasound accompanied by magnetic resonance imaging (MRI) are valuable in reaching the diagnosis, especially when clinical assessment of an abdominal mass is inconclusive regarding aetiology. We report a case of giant hydronephrosis in a woman who presented at 23 weeks of gestation with abdominal distension. She was managed conservatively. Unfortunately, the pregnancy was complicated by severe pre-eclampsia at 32 weeks of gestation, necessitating delivery via emergency caesarean section. She had a smooth postpartum recovery, and subsequently standard imaging was performed before nephrectomy. The literature and previously reported cases of giant hydronephrosis in pregnancy are reviewed.

Matched MeSH terms: Postpartum Period
Women's perspectives towards traditional and complementary medicine used to conceive, during pregnancy and the postpartum period

Shaukat Ali R, Gnanasan S, Farooqui M

Complement Ther Clin Pract, 2018 Feb;30:109-115.
PMID: 29389469 DOI: 10.1016/j.ctcp.2017.12.009

OBJECTIVES: This study aims to explore pregnant and postpartum women's understanding of the meaning of traditional and complementary medicine (T&CM) and how that may affect their T&CM use.
METHODS: A cross-sectional study was conducted using self-administered questionnaires. Data collected from 374 women were analysed and represented via descriptive statistics.
RESULTS: Out of the 374 participants, 285 (76.2%) reported using at least one type of T&CM to conceive, during pregnancy or in the postpartum period. The majority of the participants identified that T&CM is all about plants or natural products without chemicals or drugs (n = 267, 71.4%, p postpartum period even though they are aware that there is insufficient evidence on its safety and efficacy. Therefore, further studies are needed in order to gain sufficient clinical evidence that could be used to structure better guidelines for T&CM practices and services in Malaysia.

Matched MeSH terms: Postpartum Period*
Patrescence in Southern Thailand: cosmological and social dimensions of fatherhood among the Malay-Muslims

Merli C

Cult Health Sex, 2011 Dec;13 Suppl 2:S235-48.
PMID: 21409659 DOI: 10.1080/13691058.2011.558592

This paper examines fatherhood among the Malay Muslims of Southern Thailand (representing a minority at the national level, but constituting the majority population in the region). Traditional practices related to birth and the postpartum period are upheld as a marker of ethnic and religious identity by such groups. Building on the concept of patrescence as 'becoming a father', proposed by Dana Raphael, the data presented show how the process of assuming fatherhood develops during pregnancy and continues after birth through a series of ritual practices in which a man contributes to female postpartum practices. The medicalisation of birth in synergy with recent literalist interpretations of Islam has impacted on these practices, making it difficult to comply with the ritual burial of the afterbirth, which constitutes the cosmological and physical anchoring of individual and ethnic identity to the soil.

Matched MeSH terms: Postpartum Period
Fulltext Dengue Maculopathy with Foveolitis in a Postpartum Female

Kan KW, Sylves P, Nik-Ahmad-Zuky NL, Shatriah I

Cureus, 2017 Dec 13;9(12):e1942.
PMID: 29468098 DOI: 10.7759/cureus.1942

Dengue fever is common in the tropics and its clinical manifestations and complications are well-known. However, dengue-related ocular complications are rare. Here we present a postpartum female who complained of bilateral central scotoma, at five days after the clinical diagnosis of dengue fever. The ocular examination was suggestive of dengue maculopathy and foveolitis. She was treated with a combination of intravenous methylprednisolone and immunoglobulin. The final visual recovery was good.

Matched MeSH terms: Postpartum Period
Early screening of baby blues based on Android applications: First-week postpartum

Sarli D, Gunawan I, Novinaldi, Poddar S

Enferm Clin, 2020 06;30 Suppl 5:129-132.
PMID: 32713551 DOI: 10.1016/j.enfcli.2019.11.038

Postpartum depression (PPD) is quite large, where there are 1 in 25 postpartum women experiencing PPD who still report symptoms of PPD after six months. The highest risk of experiencing PPD is more experienced by primiparas detected in 10-19 postpartum days. For PPD to not adversely affect the mother and baby, initial screening is needed to prevent the occurrence of PPD by using an Android-based EPDS application. The research objectives are an early screening of baby blues based on Android application and to determine the factors influence of baby blues. Participants download EPDS apps to make it easier for participants to screen the baby blues at the beginning of the first week after giving birth. On fourth week, the mothers refill EPDS apps screening to compare the results of screening the first week with fourth week using the Dependent T-test. In this study also analyzed the factors that influence the baby blues such as education, employment, parity, and age using the ANOVA Test. The study sample was the first-week postpartum mothers with a total sample of 64 people. The average EPDS screening results in the first week were 6.64, with a standard deviation of 2.57. The screening results on fourth week are 6.70, with a standard deviation of 2.53. The results of statistical tests obtained p-value 0.208; it can conclude that there was no difference in the results of screening tests in the first week with the fourth week. PPD events occur mostly in primiparas and women aged <20 years with p-value 0.001, while in education p-value 0.596 and employment-value 0.784. It recommended for pregnant women and health workers to do screening in the first week of postpartum so that it can detect PPD early.

Matched MeSH terms: Postpartum Period
Fulltext Antidepressant-Like Effect of Lipid Extract of Channa striatus in Postpartum Model of Depression in Rats

Abdul Shukkoor MS, Baharuldin MTHB, Mat Jais AM, Mohamad Moklas MA, Fakurazi S, Basir R

Evid Based Complement Alternat Med, 2017;2017:1469209.
PMID: 29317891 DOI: 10.1155/2017/1469209

Postpartum depression affects 15% of women. Channa striatus, a freshwater fish, is consumed in local Malay population as a rejuvenating diet during postpartum period. This study evaluated the antidepressant-like effect of lipid extract of C. striatus fillet and its mechanism of action in female Sprague-Dawley rats in postpartum model of depression. The rats were ovariectomized and treated with high dose of progesterone and estradiol benzoate for 23 days to have hormone-simulated pregnancy. The day 24 and afterwards were considered as the postpartum period. During the postpartum period, lipid extract was administered at 125, 250, and 500 mg/kg through intraperitoneal route for 15 days. Fluoxetine (10 mg/kg) was used as the positive control. On postpartum day 15, the animals were tested in forced swimming test (FST) and open field test (OFT) followed by biochemical analysis. Withdrawal of hormone administration during the postpartum period induced depressive-like behavior in FST. Administration of lipid extract reversed that depressive-like behavior at 125, 250, and 500 mg/kg in FST. In OFT, it decreased the exploratory activity. The mechanism of the antidepressant-like effect may be mediated through the decrease in plasma corticosterone, increase in plasma oxytocin, and decrease in nuclear factor-kappa B in prefrontal cortex of rats.

Matched MeSH terms: Postpartum Period
Fulltext The Effect of Channa striatus (Haruan) Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

Ab Wahab SZ, Abdul Kadir A, Nik Hussain NH, Omar J, Yunus R, Baie S, et al.

Evid Based Complement Alternat Med, 2015;2015:849647.
PMID: 26101537 DOI: 10.1155/2015/849647

Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain (p = 0.814) and WES (p = 0.160) between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p = 0.014 and p < 0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient's satisfaction and is safe for human consumption.

Matched MeSH terms: Postpartum Period
Fulltext Clinical effects of thai herbal compress: a systematic review and meta-analysis

Dhippayom T, Kongkaew C, Chaiyakunapruk N, Dilokthornsakul P, Sruamsiri R, Saokaew S, et al.

Evid Based Complement Alternat Med, 2015;2015:942378.
PMID: 25861373 DOI: 10.1155/2015/942378

Objective. To determine the clinical effects of Thai herbal compress. Methods. International and Thai databases were searched from inception through September 2014. Comparative clinical studies investigating herbal compress for any indications were included. Outcomes of interest included level of pain, difficulties in performing activities, and time from delivery to milk secretion. Mean changes of the outcomes from baseline were compared between herbal compress and comparators by calculating mean difference. Results. A total of 13 studies which involved 778 patients were selected from 369 articles identified. The overall effects of Thai herbal compress on reducing osteoarthritis (OA) and muscle pain were not different from those of nonsteroidal anti-inflammatory drugs, knee exercise, and hot compress. However, the reduction of OA pain in the herbal compress group tended to be higher than that of any comparators (weighted mean difference 0.419; 95% CI -0.004, 0.842) with moderate heterogeneity (I (2) = 58.3%, P = 0.048). When compared with usual care, herbal compress provided significantly less time from delivery to milk secretion in postpartum mothers (mean difference -394.425 minutes; 95% CI -620.084, -168.766). Conclusion. Thai herbal compress may be considered as an alternative for osteoarthritis and muscle pain and could also be used as a treatment of choice to induce lactation.

Matched MeSH terms: Postpartum Period
The hospital factor on breast feeding failure

Rajakumar MK

Family Practitioner, 1977;2:67-68.

Preliminary findings of a survey on the influences of institutional facilities on mothers in the post-partum period in hospital that affect breast-feeding were reported. It was observed that although advice on breast-feeding is now given, there is a conflict between advice and practice so that the advice has been ritualistic. There is a lack of follow-up on advice, and the mother is not helped and encouraged to breast-feed and to overcome her initial disappointment and difficulties. It was also pointed out that the artificial milk-food industry exercises a negative influence through maternity ward staff by provision of milk samples to maternity units and by visits of their sales staff to the mothers. It was emphasised that the hospital factor could be an important cause of failure of the mother to breast-feed.

Matched MeSH terms: Postpartum Period
Timing of return to work and women's breastfeeding practices in urban Malaysia: A qualitative study

Sulaiman Z, Liamputtong P, Amir LH

Health Soc Care Community, 2018 01;26(1):48-55.
PMID: 28560792 DOI: 10.1111/hsc.12460

Nearly half of the working population in Malaysia are women, and with only a short period of maternity leave, they may struggle to achieve the recommended 6 months of exclusive breastfeeding. The aim of this paper was to explore the relationship between the timing of return to work and beliefs and breastfeeding practices among women in urban Malaysia. A qualitative inquiry based on a phenomenological framework and multiple methods was used: face-to-face interview, participant diary and researcher field notes. Data collection took place in Penang and the Klang Valley, Malaysia, from March to September 2011. Eligible participants were purposely identified at randomly selected recruitment sites. A thematic analysis method was used to develop the typologies and categories of the findings. A total of 40 working women with a mean age of 32 years (SD 3.4) were interviewed and 15 participated in the diary writing. Most women (75%) returned to work between 2 and 3 months. Only 10% returned to work 4 months or later postpartum, and 15% had an early return to work (defined here as less than 2 months). The women fell into three groups: Passionate women with a strong determination to breastfeed, who exclusively breastfed for 6 months; Ambivalent women, who commenced breastfeeding but were unable to sustain this after returning to work; and Equivalent women, who perceived formula feeding as equally nutritious as breast milk. Although longer maternity leave was very important for Ambivalent women to maintain breastfeeding, it was not as important for the Equivalent or Passionate women. In conclusion, returning earlier was not an absolute barrier to continuing breastfeeding. Instead, a woman's beliefs and perceptions of breastfeeding were more important than the timing of her return to work in determining her ability to maintain breastfeeding or breast milk feeding.

Matched MeSH terms: Postpartum Period/psychology
Serum FGF-21 and FGF-23 in association with gestational diabetes: a longitudinal case-control study

Mosavat M, Omar SZ, Sthanshewar P

Horm Mol Biol Clin Investig, 2020 Mar 13;41(2).
PMID: 32167928 DOI: 10.1515/hmbci-2019-0060

Background Fibroblast growth factors (FGFs); FGF-21 and FGF-23, have been proposed to be associated with metabolic syndrome. However, data on the role of these peptides in gestational diabetes mellitus (GDM) are limited. Therefore, this study was designed to assess the association of serum FGF-21 and FGF-23 with the risk of GDM. Furthermore, we evaluated the circulation of these peptides in pregnancy and post-puerperium. Materials and methods Fifty-three pregnant subjects with GDM and 43 normal glucose tolerance (NGT) pregnant women participated in this study. Serum FGF-21 and FGF-23 were measured during pregnancy and post-puerperium. Results FGF-21 and FGF-23 were low in GDM compared to NGT during pregnancy. There were no significant differences in the level of these peptides post-puerperium. Using logistic regression, FGF-23 [odds ratio (OR) 0.70 (95% confidence interval [CI]: 0.50-0.96)] was inversely associated with GDM, so a 1-μg/mL decrease in FGF-23 levels was associated with a 1.4-fold increased risk of developing GDM and this remained statistically significant after adjustment for confounders [adjusted OR (aOR) 0.70 (95% CI: 0.50-0.98)]. There was no association of FGF-21 with the development of GDM risk. Conclusions Lower FGF-23 concentrations could be involved in the pathophysiology of GDM. FGF-21, even though associated with metabolic risk factors in pregnancy, may not be a fundamental factor in GDM.

Matched MeSH terms: Postpartum Period/blood
Fulltext Case report : Actinomyces naeslundii complicating preterm labour in a trisomy-21 pregnancy

Ong HC, Ling AC, Ng DS, Ng RX, Wong PL, Omar SFS

IDCases, 2021;23:e01051.
PMID: 33532241 DOI: 10.1016/j.idcr.2021.e01051

Preterm birth is a global concern with considerable morbidity and mortality. Intrapartum infection is a known cause of preterm birth and Actinomyces infection is one of the infections contributing to preterm birth. We report a case of preterm birth of a trisomy-21 neonate to a mother with positive Actinomyces naeslundii from an intra-operative placental swab sample and discussed the relationship of this bacteria and preterm delivery, and the role of postpartum antibiotics use in this case.

Matched MeSH terms: Postpartum Period
Fulltext Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis

Chua WC, Mazlan MZ, Ali S, Che Omar S, Wan Hassan WMN, Seevaunnantum SP, et al.

IDCases, 2017;9:91-94.
PMID: 28725564 DOI: 10.1016/j.idcr.2017.05.002

We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures. A consensus was reached for extensive wound debridement to remove the source of infection; however, this approach was abandoned due to the patient's hemodynamic instability and the extremely high risks of surgery. Both the high vaginal swab and blister fluid culture revealed Group A beta hemolytic streptococcus infection. Intravenous carbapenem in combination with clindamycin was given. Other strategies attempted for streptococcal toxic removal included continuous veno-venous hemofiltration and administration of intravenous immunoglobulin. Unfortunately, the patient's condition worsened, and she succumbed to death on day 7 of hospitalization.

Matched MeSH terms: Postpartum Period
Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.

Matched MeSH terms: Postpartum Period
Fulltext Successful pregnancy "during" pedicled transverse rectus abdominis musculocutaneous flap for breast reconstruction with normal vaginal delivery

Chai SC, Umayaal S, Saad AZ

Indian J Plast Surg, 2015 5 21;48(1):81-4.
PMID: 25991893 DOI: 10.4103/0970-0358.155276

A transverse rectus abdominis myocutaneous (TRAM) flap is a popular choice for breast reconstruction. Pregnancies in women following a TRAM flap present concerns regarding both safety and the integrity of the abdominal wall. We report a case of a patient who was pregnant during immediate breast reconstruction with pedicled TRAM flap and had a successful spontaneous vaginal delivery. We also conducted a literature review using PubMed on pregnancy post TRAM flap, type of reconstruction, timing of pregnancy after TRAM flap, complication, and mode of delivery, which are summarised in this report. We concluded that patients may have safe pregnancies and normal deliveries following TRAM flap breast reconstruction regardless of the time frame of pregnancy after the procedure. Therefore, TRAM flaps can continue to be a reconstruction option, even in women of childbearing age.

Matched MeSH terms: Postpartum Period
Fulltext Relationship between obstetric risk factors and postnatal depression in Malaysian women

Abdul Kadir A, Mohammad Daud MN, Yaacob MJ, Nik Hussain NH

International Medical Journal (Tokyo), 2009;16:101-6.

Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. © 2009 Japan International Cultural Exchange Foundation.

Matched MeSH terms: Postpartum Period
Fulltext Reliability and validity of the malay version of Edinburgh Postpartum Depression Scale (EPDS) when administered to postpartum mothers at two points in time

Nursazila Asikin MA, Siti Norhani S, Nur Arzuar AR, Azam OE

International Medical Journal Malaysia, 2019;18:65-72.

Introduction: Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period.
Materials and Methods: This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman's correlation. The data were analyzed using SPSS version 20 and R 3.4.2.
Results: The Cronbach's alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach's alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1-30 days: Spearman's rho = 0.65, p < 0.01; 31-120 days: Spearman's rho = 0.73, p < 0.01).
Conclusion: The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS. © 2019 Default.
Study site: Klinik Kesihatan, Perak, Malaysia

Matched MeSH terms: Postpartum Period
Fulltext A retrospective review of 25 cases of lethal fetal anomalies

Dalia, F.A., Hamizah, I., Zalina, N., Yong, S.L., Mokhtar, A.

International Medical Journal Malaysia, 2016;15(1):19-23.
MyJurnal

Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
(32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
terminated at early trimester. A new direction is needed in our local practice.

Matched MeSH terms: Postpartum Period

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