Increased bone resorption and decreased bone formation occur in preeclampsia in both mother and fetus, being more pronounced in the latter. The increased osteoclastic activity in preeclampsia may be attributed to increased RANKL induced by increased interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and transforming growth factor beta2 (TGF-beta2) production.
Use of the sutured Lippes Loop for immediate postpartum insertion was evaluated in 100 volunteers at the Kasr-el-Aini Hospital in Cairo. The intrauterine devices were inserted manually immediately after delivery of the placenta. There was an expulsion rate of 1.2 per 100 women at three months, one case of infection requiring treatment and one removal because of bleeding. One woman became pregnant and expelled the Loop. The two major problems associated with the use of an intrauterine device, high expulsion rate and perforation, were overcome by hand insertion of the Loop.
Background: Depression during pregnancy occurs more often than most people realize. Early detection of depression during pregnancy is critical because depression can adversely affect birth outcome and neonatal health. Mental health care during pregnancy is a serious public health issue. Objectives: to estimate the prevalence of antepartum depression and its effects on pregnancy outcome; among pregnant women in the last trimester,living in rural Egypt. Methods: the first part of the study was cross sectional; to assess the prevalence of antepartum depression. This was followed by a prospective part to detect the effects of antepartum depression on the outcome of pregnancy. The sample size was 300 consented women. A structured interview questionnaire was designed including socio-demographic and economic data, obstetric history, and neonatal information. Hamilton Rating Scale was used to detect the prevalence and level of Depression Results: 68.7% of sampled women suffered from antepartum depression. The incidence of low birth weight was (4%), and about one fifth of babies were admitted in NICU in the first month. Death in first month of life was (3%). The only significant predictor of unfavorable birth outcome using logistic regression was depression level. Females with severe depression were 9.43 at higher risk to have unfavorable birth outcome than normal ones. Also females with moderate depression had 1.4 higher risk to have unfavorable birth outcome than females without depression. Conclusion: (68.7%) of women suffered from depression during pregnancy. Increasing level of depression was significantly associated with adverse birth outcome.
Key Words: depression, pregnancy, mental health, ANC, neonatal health.
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