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  • Depression with postpartum onset: a prospective cohort study in women undergoing elective cesarean section in Brasilia, Brazil

    Rev Bras Ginecol Obstet. 2013;35(3):130-135

    Summary

    Depression with postpartum onset: a prospective cohort study in women undergoing elective cesarean section in Brasilia, Brazil

    Rev Bras Ginecol Obstet. 2013;35(3):130-135

    DOI 10.1590/S0100-72032013000300007

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    PURPOSE: It was to determine the prevalence of depressive symptoms in a sample of puerperal women from Brasília, Brazil, distinguishing cases with onset after delivery from those already present during pregnancy. METHODS: A prospective cohort study with convenience sampling of patients submitted to elective cesarean section at two private hospitals. As an instrument for assessing depressive symptoms, the Edinburgh Postnatal Depression Scale with cutoff >13 was applied shortly before delivery and four to eight weeks after childbirth. RESULTS: Among the 107 women who completed the study, 11 (10.3%) had significant depressive symptoms during pregnancy and 12 (11.2%) during the postpartum period. Among the 12 patients with postpartum symptoms, 6 had symptoms during pregnancy, so that 5.6% of the sample had postpartum onset of depression. The higher overall frequency of depression was significantly among single women than among married women (p=0.04), a fact mainly due to a higher frequency of single women experiencing persistent depressive symptoms both before and after delivery (p=0.002). The risk of depression was not influenced by age, parity or educational level. CONCLUSION: Women with depression identified during the postpartum period comprise a heterogeneous group, in which symptoms may have started before pregnancy, during pregnancy or after childbirth. In this sample, half of the postpartum depression cases already presented symptoms during late pregnancy. Since depression can arise before and after childbirth, it may have different etiologies and, therefore, a different response to treatment, a possibility that should be considered by clinicians and researchers.

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  • Case Report

    Severe familial hypertriglyceridemia during pregnancy

    Rev Bras Ginecol Obstet. 2001;23(6):397-402

    Summary

    Case Report

    Severe familial hypertriglyceridemia during pregnancy

    Rev Bras Ginecol Obstet. 2001;23(6):397-402

    DOI 10.1590/S0100-72032001000600009

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    Severe hypertriglyceridemia during pregnancy rarely occurs but it frequently produces complications, such as acute pancreatitis, a serious health risk both for the mother and the fetus. The treatment of a patient who had had acute pancreatitis due to hypertriglyceridemia (triglyceridemia = 5100 mg/dl) two months before fecundation is presented in this paper. During gestation, bezafibrate was substituted for 3.0 g omega-3 fatty acids (14% eicosapentaenoic and 11.13% docosahexaenoic acids). With this therapy, the triglyceride levels were maintained below 800 mg/dl, which is considered to be the safe limit to avoid acute pancreatitis. No complication occurred during pregnancy, the patient delivered vaginally (40 weeks), and the newborn (3075 g) did not present any morphological alterations. We conclude that an adequate diet and the use of omega-3 fatty acids were effective in preventing acute pancreatitis in this pregnant woman with serious hypertriglyceridemia. This therapeutic approach may be used alternatively to other treatments currently utilized for familial hypertriglyceridemia in pregnancy.

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    Severe familial hypertriglyceridemia during pregnancy

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