The Predictive Performance of Depressive Symptoms in the Second Trimester of Gestation for Postnatal Depressive Symptoms in a Primary Care Setting.

Purpose: The aim of this study was to determine and quantify the predictive performance of depressive symptoms in the second trimester for postnatal depressive symptoms and to raise awareness of psychosocial problems. Methods: This was a prospective longitudinal study. The experimental group comprised Chinese women who completed the Edinburgh Postnatal Depression Scale (EPDS) two times (once during the second trimester and once at 6-8 weeks postdelivery) at Fong Son Tong Health Center (CSSL), Macau. Descriptive statistics were used to analyze the collected data. The predictive performance was determined using paired t-tests and receiver operating characteristic curves. The control group was a pre-existing group that had only completed the EPDS at 6-8 weeks postdelivery. Finally, postnatal depressive symptoms (EPDS score ≥12) were compared between the experimental and control groups. Results: In the experimental group, a total of 160 women completed the EPDS during the second trimester, and 137 (85.6%) completed the EPDS at 6-8 weeks postdelivery. The EPDS score in the second trimester was positively correlated with the score at 6-8 weeks postdelivery. The optimal threshold value of the EPDS score in the second trimester is ≥7. Compared with the control group, there was statistical significance in the detection of postnatal depressive symptoms in the experimental group. Conclusions: Screening for possible depressive symptoms in the second trimester and actively following up with at-risk women in the postnatal period may be an effective strategy for improving postnatal mental health outcomes.

New sonographic feature (C-sign) to improve the prenatal accuracy of jejunal atresia.

OBJECTIVES: To describe a new sonographic feature of the C-sign for prenatal diagnosis of jejunal atresia and evaluate its role in prenatal jejunal atresia, particularly preceding bowel dilatation and polyhydramnios. METHODS: This was a retrospective study from a tertiary maternal hospital. Patients with prenatal sonographic examination and confirmed small bowel atresia postdelivery were included. All sonographic images were reviewed by two senior sonographers. Comparison of sonographic images between prenatal jejunal and ileal atresia using the C-sign resembles the shape of the entire duodenum and other traditional sonographic features. The control group without bowel atresia was assessed for the presence of the C-sign. RESULTS: The C-sign and combined bowel dilatation with polyhydramnios were more frequent in jejunal atresia than ileal atresia, but the C-sign can be used to detect jejunal atresia earlier. The C-sign can be more likely to diagnose jejunal atresia in persisting bowel dilatation and polyhydramnios. The C-sign was not reported in any of the control fetuses. CONCLUSION: The C-sign is a new sonographic feature that can be used to improve the prenatal accuracy and early detection of jejunal atresia. However, further prospective validation is needed.

Prenatal diagnosis of midgut volvulus with jejunal atresia by ultrasonography.

Prenatal midgut volvulus is difficult to diagnose, and it is particularly difficult to evaluate the degree of rotation, which may be related to prognosis. We present a rare case of prenatal midgut volvulus with a 720° rotation around the superior mesenteric artery diagnosed based on ultrasonography, and jejunal atresia was noted at the same time. This condition was supported by prenatal magnetic resonance imaging and the subsequent postnatal operation. To the best of our knowledge, there is no previous literature describing similar ultrasound findings in the prenatal period. Recognition of the color Doppler ultrasound imaging findings can help elucidate the relationship among the twisted vessels of midgut volvulus during the prenatal examination.