Resilience and psychological distress in pregnant women during quarantine due to the COVID-19 outbreak in Spain: a multicentre cross-sectional online survey.

PURPOSE: To examine the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women during the confinement due to the COVID-19 outbreak in Spain. MATERIALS AND METHODS: Between 15 April and 14 May 2020, a multicentre cross-sectional survey was performed to study depression, anxiety and resilience in a sample of Spanish pregnant women during the lockdown set up by the Government in response to COVID-19 pandemic outbreak. We designed an anonymous online self-administered questionnaire (https://bit.ly/34RRpq1) that included the Spanish validated versions of the Edinburgh Postpartum Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Connor-Davidson Resilience 10-items Scale (CD-RISC-10). RESULTS: A total of 514 pregnant women completed the survey. 72.8% had been confined < 40 days and 27.2% between 41 and 60 days. 182 (35.4%) participants scored over 10, with 21.3% scoring over 13 (75th Percentile) in depressive symptoms rates. We found high trait and anxiety scores, with 223 (43.4%) and 227 (44.2%) pregnant women scoring over the trait and state mean scores. Neither depression, anxiety or resilience levels showed any significant correlation with the length of confinement. We found low CD-RISC-10 scores. CONCLUSIONS: We found a high prevalence of depression and anxiety symptoms during the quarantine, although we did not find an increased prevalence of psychological distress according to length of home confinement. Resilience correlated negatively with depression and anxiety.

Incontinencia urinaria 6 meses tras parto. Factores de riesgo asociados / Urinary incontinence since 6 months after delivery. Associated risk factors

Este estudio permite aproximarnos a la incidencia de incontinencia urinaria de esfuerzo a los 6 meses postparto en nuestro medio, lo que puede ser útil para proponer una actuación tanto a nivel de atención primaria como hospitalaria para poder disminuir el impacto que los posibles factores de riesgo ejercen, como por ejemplo un buen programa de entrenamiento de la musculatura pélvica con ejercicios de Kegel podría reducir la aparición de esta patología, de esta forma, se podría minimizar la morbilidad que sufren estas pacientes. Handa y cols. (21) concluyó que las pacientes que presentaban incontinencia urinaria o anal presentaban un moderado o alto impacto negativo en su vida diaria tras encuestar a 759 pacientes. Para finalizar, se concluye que existen diferentes evidencias en cuanto a los factores de riesgo asociados a la aparición de incontinencia urinaria postparto. El tipo de parto no tiene relación estadísticamente significativa con la aparición de esta sintomatología. No obstante, al existir literatura a favor y en contra de esta hipótesis se precisan más estudios que permiten concluir que vía del parto es la menos favorable para presentar incontinencia urinaria. Los autores, admiten que se podrían inferir más datos si se aumenta el número de pacientes evaluadas (AU)

This study allows us to approach the incidence of stress urinary incontinence at 6 months postpartum in our setting, which may be useful to propose a performance at both primary and hospital care levels, in order to reduce the impact that possible risk factors exert, such as for example, a good pelvic muscle training program with Kegel exercises could reduce the onset of this pathology, thus minimizing the morbidity of these patients. Handa et al. (21) concluded that patients with urinary incontinence or anal had a moderate or high negative impact in their daily lives after surveying 759 patients. Finally, we conclude that there is different evidence regarding the risk factors associated with the occurrence of postpartum urinary incontinence. The type of delivery has no statistically significant relationship with the appearance of this symptomatology. However, because there is literature for and against this hypothesis, more studies are needed to conclude that the way of delivery is the least favorable for presenting urinary incontinence. The authors admit that more data could be evidenced by increasing the number of patients evaluated (AU)

Cefalocentesis intraparto: una alternativa en fetos con holoprosencefalia / Intrapartum cephalocentesis: an alternative in foetuses with holoprosencephaly

Paciente secundigesta, cesárea anterior, 39 semanas de gestación, feto con holoprosencefalia alobar. Dado el diámetro biparietal estimado (117 mm) y el mal pronóstico de dicha patología, se optó por la cefalocentesis intraparto con una aguja para epidural, con el fin de lograr el parto por vía vaginal. Realizada la cefalocentesis intraparto se finaliza el parto mediante forceps. El neonato, de 3.990 g, presenta Apgar 9/10, PH 7,37 y supervivencia durante dos días. Por tanto, podríamos considerar que la cefalocentesis intraparto constituye una opción que se ha de considerar para el manejo de la holoprosencefalia alobar (AU)

We report the case of a woman at 39 weeks of pregnancy with her second child and a previous caesarean section, whose fetus had alobar holoprosencephaly. Given the estimated biparietal diameter of the foetus (117 mm) and the poor prognosis of this disease, we carried out an intrapartum cephalocentesis using a needle for epidural puncture to achieve a vaginal delivery. After the cephalocentesis, the delivery was completed by forceps. The birthweight was 3,990 g, with an Apgar score of 9/10, and PH 7.37. The neonate survived two days. Therefore, intrapartum cephalocentesis can be considered a reasonable option for the management of alobar holoprosencephaly ( AU)