Prevalence and risk factors for postpartum depression among women seen at Primary Health Care Centres in Damascus.

BACKGROUND: In Syria, there are no previous studies on postpartum depression. The aim of this study is was identify the prevalence of postpartum depression and investigate its risk factors among Syrian women seen at the Primary Health Care Centres in Damascus. METHODS: This descriptive cross-sectional study was carried out between January and December 2017 in Damascus, Syria. Postpartum women seen at a convenience sample of the largest and well-utilized primary health care centres in Damascus were invited to participate in the study. The Arabic version of the validated Edinburgh Postnatal Depression Scale questionnaire was used to measure postpartum depression. A cut-off score of 13 was considered to indicate probable depression. RESULTS: Out of a total of 1105 women participated in this study, 28.2% had a score of 13 (probable Depression). The multivariate analysis showed that postpartum depression was significantly associated with a reported a health problem during last pregnancy (OR = 2.2; 95% confidence interval [CI]: 1.4-3.5); displacement (OR = 1.4; 95% confidence interval [CI]: 1.04-1.97); perceived exposure to a lot of life stressors (OR = 5.04; 95% confidence interval [CI]: 2.4-10.5); while antenatal care had a protective effect (OR = 0.52; 95% confidence interval [CI]: 0.36-0.75). CONCLUSIONS: The prevalence of postpartum depression among Syrian women in this study was relatively high, as compared to other Arab and Non-Arab countries. Displacement due to the Syrian crisis among other factors was associated with postpartum depression. Obstetricians and other professionals should be sensitized about the importance of screening for the problem for better management.

Interstitial ectopic pregnancy: A rare case report.

INTRODUCTION: Interstitial pregnancies are a rare form of ectopic pregnancy with life threatening consequences. Thus, the aim of this report is to shed light on the importance of early diagnosis for optimal outcomes. CASE PRESENTATION: Herein, we present a case of an interstitial ectopic pregnancy in a 31-year-old Syrian female who presented only with mild non-specific abdominal pain. The ultrasound showed a gestational sac in the right horn of the uterus non-communicating with the endometrial cavity suggesting an interstitial ectopic pregnancy. Cornual excision and salpingectomy were performed with laparotomy instead of laparoscopy due to resource-limited facilities. Follow-up with serum human chorionic gonadotropin ß-HCG continued until the hormone levels became undetectable. DISCUSSION: Interstitial ectopic pregnancies can present with non-classic symptoms. Ultrasonographic evaluation for lower abdominal pain in women at the first trimester is essential to detect interstitial ectopic pregnancies. CONCLUSION: Early diagnosis is key to prevent the life threatening progression of interstitial pregnancy, so this diagnosis should be kept in mind in women presenting with first trimester abdominal pain and/or vaginal bleeding.