Suicidality among pregnant women in Brazil: prevalence and risk factors.

Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55%. The overall CSR was 23.53%, distributed across risk levels of low (12.55%), moderate (1.18%), and high (9.80%). Our rates approximate those found in another Brazilian study (18.4%). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95% confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95% CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95% CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.

Postpartum depression: A systematic review of the genetics involved.

Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.

Determinaçäo ecográfica antenatal das características do amnio e do corion na gestaçäo gemelar / Antenatal ecographic determination of the characteristics of amnion and corion of twin gestation

Os autores descrevem os resultados da análise da correlaçäo da visualizaçäo ultra-sonográfica da membrana amniótica e medida de sua espessura superior a 2mm com a corionicidade e amniocidade das gestaçöes gemelares. Encontram uma correlaçäo satisfatória e acreditam ser essa medida de grande utilidade no estudo ultra-sonográfico das gestaçöes gemelares.

Insuficiência congênita da tricúspide aspectos clínicos ultra-sonográficos e anátomo-patológicos / Congenital tricuspid insufficiency clinical ultrasonographic and anatomo-pathological aspects

A insuficiência congênita da tricúspide é anomalia cardíaca rara e que pode se manifestar no período neonatal precoce com cardiomegalia e insuficiência cardíaca congestiva grave. É relatado caso em que essas manifestaçöes foram detectadas através de ultra-sonografia realizada na 38ª semana de gestaçäo e no qual a necrópsia evidenciou as alteraçöes valvulares características.

Trombastenia de Glanzmann e gravidez: relato de caso / Glanzmann's thrombasthenia and pregnancy: a case report

Os autores relatam um caso extremamente raro de paciente com diagnóstico de Trombastenia de Glanzmann, prévio a gravidez. Paciente de 25 anos, branca, primigesta, proveniente de Divinópolis, Minas Gerais, foi acompanhada durante o período pré-natal, parto e puerpério no Serviço de Assistência à Gestaçäo Alto Risco do Hospital das Clínicas da UFMG. O período pré-natal transcorreu sem complicaçöes. A mesma teve o parto espontâneo. No pós parto imediato desenvolveu grande hematoma no local da episotomia com resoluçäo espontânea em duas semanas sob tratamento clínico. A gestaçäo aumenta o risco de sangramento maciço no parto e a transfusäo de plaquetas pode ser ineficaz em alguns casos