Obstetrics and Gynecology
KAVITHA NAGANDLA; Keeran Rajandram; Khaisro Ali Shah; Kathy Anne Rani A/P Arulraj; Lee Huang Ming; Joanne Wong Mei Jye
Articles in Press, Accepted Manuscript, Available Online from 23 January 2024
Abstract
Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant ...
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Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant concern during the pandemic. This systematic review aims to synthesise the current scientific evidence on the impact of the COVID-19 pandemic on perinatal mental health and its associated risk factors.
Materials & Methods: The review used a structured process based on JBI and PICOS strategy and searched three databases for studies published between July 2020 to December 2022 that measured specific mental health outcomes using validated measures. The PRISMA guideline was followed for the study selection process.
Results: Among the total 45 articles that have been included, the prevalence of depression and anxiety was found to be moderate to severe in pregnant and/or postpartum women during the pandemic, with a significantly higher level compared to prior to the pandemic. Additionally, pregnant and/or postpartum who tested positive for COVID-19 were more vulnerable to anxiety and depression. Furthermore, perinatal women with pre-existing mental illness showed further deterioration during the pandemic, and lastly, pregnant and/or postpartum women had higher levels of anxiety and depression compared to non-pregnant women.
Conclusions: This systematic review finds a significant increase in depression and anxiety among pregnant women during the COVID-19 pandemic, with risk factors such as unemployment and poor social support. Healthcare professionals should establish treatment plans to prevent adverse mental outcomes for this vulnerable population.
Obstetrics and Gynecology
Khor Chun Kit; Christine Na Sin Ee; Jackie Wong Kee Hung; Aiswaryaa Devi A/P Tambi Selvam; Chan Sue Vern; Lee Lionel; Hussein Akl; Kavitha Nagandla
Volume 8, Issue 2 , March and April 2023, , Pages 105-112
Abstract
Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. ...
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Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. This systematic review aims to assess the efficacy of levonorgestrel-releasing intrauterine device as medical management in women who have adenomyosis.Materials & Methods: We searched PubMed, Cochrane and Scopus databases from January 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosis of adenomyosis. Main outcome measures in the study are menstrual blood loss (milliliters), pain score measured in 10 cm-visual analogue scale, and uterine volume.Results: Pooled results from meta-analysis showed that after LNG-IUD treatment for adenomyosis, there is significant reduction in dysmenorrhoea, measured using Visual Analogue Scale after 6 months (Standardized Mean Difference (SMD): 3.68; Cl: 2.11-5.25) , 12 months (SMD: 4.23; CI: 2.99-5.48), 24 months (SMD: 4.69; CI: 3.40-5.97) and 36 months (SMD: 4.01; CI: 3.57-4.45); significant reduction in menstrual bleeding after 6 months (SMD: 2.52; CI: 1.15-3.89), 12 months (SMD: 3.43; CI: 1.64-5.22) and 24 months (SMD: 3.57; CI: 1.88-5.26); significant reduction in uterine volume after 6 months (SMD: 0.49; CI: 0.04-0.93), 12 months (SMD: 0.80; CI: 0.11-1.48) and 24 months (SMD: 0.86; CI: 0.15-1.58).Conclusion: LNG-IUS is an effective method in alleviating the symptoms of adenomyosis. It is a valuable long-term alternative for the treatment of adenomyosis for young and perimenopausal women in terms of dysmenorrhoea and heavy menstrual bleeding.
