Psychosocial and Obstetric Predictors of Depressive Symptomatology at Postpartum 4 Weeks / 대한산부인과학회지

OBJECTIVE: The aim of this study was to examine the psychosocial and obstetric predictors of depressive symptomatology at postpartum 4 weeks in Korea. METHODS: At their 1-week and 4-week postpartum visits, 61 postpartum women completed the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R). Data related to the psychiatric and obstetric characteristics, pregnancy and delivery related events were collected from the standardized medical records. 42 women with no history of pregnancy or delivery within the previous 6 months were selected as the control group. The postpartum group was divided into the depressive and non-depressive subgroups, according to their EPDS and BDI results at postpartum 4 weeks. RESULTS: Compared to the control group, the mean score of the BDI at postpartum 4 weeks was significantly higher in the postpartum group. The percentages of women having experienced severe emotional stress during pregnancy and of smokers and drinkers before pregnancy were significantly higher in the postpartum depressive subgroup (EPDS >or=10 and BDI >or=10) when compared to the postpartum non-depressive subgroup. The percentage of women having experienced depressive symptoms at postpartum 1 week was also significantly higher in the depressive subgroup. A depressive symptomatology at postpartum 1 week was identified as a significant risk factor for depressive symptoms at postpartum 4 weeks. CONCLUSION: The results of this study suggest that screening for depressive symptomatology in the immediate postpartum period might provide an effective means of detecting women at risk of developing postpartum depression in Korea. The finding that severe emotional stress experienced during pregnancy is associated with the development of postpartum depressive symptoms confirms the results of previous studies.

Psychosocial and Obstetric Factors associated with Postpartum Depressive Symptoms / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study is to examine the psychosocial and obstetric factors associated with postpartum depressive symptoms in Korea. METHODS: At the 1-week postpartum visit, 61 postpartum women completed Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), Stait-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R). Data related to psychiatric and obstetric characteristics, pregnancy and delivery related events were collected from standardized medical records. 42 women without a history of pregnancy or delivery within 6 months were selected as a control group. The postpartum group were divided into depressive and non-depressive group according to the EPDS and BDI results. RESULTS: Compared to the normal control group, mean scores of EPDS and BDI were significantly higher (por=10 and BDI >or=10) when compared to the postpartum non-depressive group. The psychosocial stress experienced during pregnancy was identified as a significant risk factor for postpartum depressive symptoms when multiple logistic regression analysis was performed after controlling for age and education level. CONCLUSION: These findings suggest that postpartum women in Korea have many psychiatric problems such as depressive mood and somatization which necessitate proper care and assessment during the early postpartum period. Stress management during pregnancy is also needed as a method of prevention against postpartum depression.

Laparoscopic Assisted Vaginal Hysterectomy: A Review of 500 Cases / 대한산부인과학회잡지

OBJECTIVES: To evaluate the effectiveness and the value of Laparoscopic Assisted Vaginal Hysterectomy, and to evaluate the possibility whether to replace abdominal hysterectomy to LAVH. METHOD: A retrospective study of the surgical procedure was performed by one team with one experienced laparoscopist. The operations were carried out in a private hospital, where operative laparoscopic set was available. All 500 patients underwent LAVH from March 1998 to March 1999 at the department of Obstetrics and Gynecology, Eun hospital. Patients were required hysterectomy for uterine fibroid, chronic pelvic pain and carcinoma in situ of cervix,. etc. RESULTS: The average operating time was 56.4+/-11.8 minutes, and the mean estimated postoperative hemoglobin loss was 0.62+/-1.0 g/dL. The mean uterine weight was 223.9+/-129.7 gram (range from 60gram to 800gram). The most common pathologic finding was adenomyosis(59.6%),and the second most pathologic findig was uterine fibroid(47%). No serious complications occured, but 3 vault hematoma cases occured. The combined procedures were salpingoophorectomy, adhesiolysis, and anterior or posterior colporrhaphy, etc. CONCLUSIONS: LAVH that has been possible to replace abdominal hysterectomy, may be valuable for gynecologic uterine diseases, but the experience is important for laparoscopic surgery. The learning curve influences the results of surgery and incidence of complications. Therefore the procedure may only be carried out by experienced laparoscopists, then the maximum value and advantages of laparoscopic surgery can be obtained. Our experience indicates that LAVH is to reduce almost all incidence of abdominal hysterectomy(0.4%)