Objective:Real-world data on perinatal mental health screening and psychiatric care linkage in regional obstetric populations are limited. This study evaluated screening positivity rates for anxiety and depression during pregnancy and the postpartum period and assessed psychiatric service utilization in a regional Korean obstetric setting. Methods:Pregnant and postpartum women who visited an obstetric clinic between December 2021 and January 2023 were examined in this retrospective, single-center study. Anxiety and depression were evaluated using the Korean versions of the Beck Anxiety Inventory and Edinburgh Postnatal Depression Scale (EPDS). Screening assessments were categorized according to the gestational stage (first, second, and third trimesters) and postpartum period. Results:Of the 445 women included in this study, 235 underwent at least one screening assessment during pregnancy. Among them, 33.2% and 17.9% screened positive for anxiety and depression, respectively, at least once. All 445 women completed the postpartum screening, and 23.6% and 22.9% screened positive for anxiety and depression, respectively. In the exploratory multivariable analysis, neonatal birth weight <1.5 kg remained associated with positive postpartum EPDS screening results. Among the women referred for psychiatric evaluation, only 10.6% attended an initial psychiatric consultation. Conclusion:Positive anxiety and depression screening results were identified during routine perinatal care, whereas psychiatric service utilization remained low. These findings highlight the gap between anxiety and depression screening and psychiatric care linkage, supporting the need for integrated perinatal mental health referral systems.

Listeria monocytogenes is a pathogen responsible for food poisoning and severe infections, primarily affecting pregnant women, the elderly, neonates, and immunocompromised individuals. Listeriosis can manifest as gastroenteritis, bacteremia, meningitis, encephalitis, and cerebral abscesses. In pregnant women, it can lead to complications such as chorioamnionitis, preterm labor, and fetal death. The bacterium can cross the placenta, resulting in generalized infection or meningitis in neonates. Besides the potential for missed diagnosis, Listeria monocytogenes infection can be fatal; however, it is preventable through careful attention to food safety and hygiene practices. This review examines listeriosis, with a particular focus on its impact on pregnant women and neonates.

Out-of-hospital cardiac arrest in pregnancy is extremely rare. In this case report, a 43-year-old female patient at 24.0 weeks of gestation collapsed outside her home after cardiac arrest. The paramedics performed cardiopulmonary resuscitation with defibrillation for ventricular fibrillation. Spontaneous circulation was achieved after 19 minutes. The fetus was stable during postarrest care. The patient exhibited high blood pressure with seizure-like symptoms for 2 days afterwards, which resolved with magnesium sulfate. She gradually recovered and returned to her daily activities while on treatment with beta blockers for cardiomyopathy and premature ventricular contractions until delivery. At 37.2 weeks of gestation, she underwent elective Cesarean section under spinal anesthesia. The baby weighed 2.55 kg and did not present with any complications. Here, we report a case of successful full-term delivery in a patient who underwent cardiopulmonary resuscitation for sudden cardiac arrest during the second trimester of pregnancy.

INTRODUCTION:Struma ovarii (SO) is a rare ovarian mature teratoma which is composed of 50% or more thyroid tissues. Malignant transformation is reported to occur in less than 5% of all cases, and it leads to 5-6% metastatic disease. The most common type is a papillary carcinoma. However, follicular carcinoma of arising from SO is extremely rare.CASE PRESENTATION:A 23-year-old nullipara complained of right lower abdominal pain. CT scan revealed a large complex cystic and solid mass in pelvic cavity with moderate amount ascites with peritoneal thickening and omental infiltration. We performed a right salpingo-oophorectomy and surgical staging.CLINICAL DISCUSSION:It was diagnosed with follicular carcinoma, stage IA. After the multidisciplinary team meeting, we decided not to conduct additional treatment, including total thyroidectomy followed by radioiodine treatment and T4 therapy because thyroid tests were normal findings.CONCLUSION:There is still no established treatment consensus for follicular carcinoma of SO patients. The choice for a conservative or radical approach depends on the doctor. However, conservative surgery could be considered for low risk, early stage patients who have childbearing potential.

There has been no machine learning study with a rich collection of clinical, sonographic markers to compare the performance measures for a variety of newborns’ weight-for-height indicators. This study compared the performance measures for a variety of newborns’ weight-for-height indicators based on machine learning, ultrasonographic data and maternal/delivery information. The source of data for this study was a multi-center retrospective study with 2949 mother–newborn pairs. The mean-squared-error-over-variance measures of five machine learning approaches were compared for newborn’s weight, newborn’s weight/height, newborn’s weight/height2 and newborn’s weight/hieght3. Random forest variable importance, the influence of a variable over average node impurity, was used to identify major predictors of these newborns’ weight-for-height indicators among ultrasonographic data and maternal/delivery information. Regarding ultrasonographic fetal biometry, newborn’s weight, newborn’s weight/height and newborn’s weight/height2 were better indicators with smaller mean-squared-error-over-variance measures than newborn’s weight/height3. Based on random forest variable importance, the top six predictors of newborn’s weight were the same as those of newborn’s weight/height and those of newborn’s weight/height2: gestational age at delivery time, the first estimated fetal weight and abdominal circumference in week 36 or later, maternal weight and body mass index at delivery time, and the first biparietal diameter in week 36 or later. These six predictors also ranked within the top seven for large-for-gestational-age and the top eight for small-for-gestational-age. In conclusion, newborn’s weight, newborn’s weight/height and newborn’s weight/height2 are more suitable for ultrasonographic fetal biometry with smaller mean-squared-error-over-variance measures than newborn’s weight/height3. Machine learning with ultrasonographic data would be an effective noninvasive approach for predicting newborn’s weight, weight/height and weight/height2.

Introduction: Uterine myoma occurs in 1.6-2% of pregnancies. Most myomas during pregnancy are asymptomatic, but 10-20% may develop complications. The most common complication is abdominal pain, usually caused myoma degeneration or torsion of a pedunculated myoma. Case presentation: A 40-year-old pregnant woman was transferred with severe left upper abdominal pain with suspicion of left ovarian torsion at 32 weeks of gestation. Magnetic resonance imaging (MRI) demonstrated a 9.8 cm-sized oval mass abutting the uterine fundus, suggesting subserosal myoma with degeneration. She was admitted for pain control, and the pain was relieved in a few days with conservative management. Two years later, she revisited our hospital for the treatment. Total laparoscopic hysterectomy with bilateral salpingectomy was performed. A 6-cm isolated solid mass adhering to the omentum in the pelvic cavity was observed intraoperatively. The trace on the anterior wall of the uterus was considered to be a broken pedicle that had initially connected the mass. Clinical discussion: In our case, the patient had severe abdominal pain, and ultrasound and MRI findings suggested subserosal myoma degeneration. A retrospective diagnosis of torsion was made following the surgery, which was assumed to cause the pain during pregnancy, and that an amputation occurred during or after the pregnancy. Conclusion: Diagnosis is based on clinical manifestations and radiologic examination, however, it is usually difficult to diagnose preoperatively, especially among pregnant women who have diagnostic test limitations. Therefore, if a pregnant woman with a myoma complains of abdominal pain, various possibilities should be considered

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Loop electrosurgical excision procedure (LEEP) is commonly performed for the management of cervical intraepithelial neoplasia. Although LEEP is considered to be a relatively simple procedure, several unexpected complications have been reported in the literature. Herein, we report a case of hemoperitoneum caused by uterine perforation following LEEP. Blood collection in pelvic cavity and two small defects of the uterus were confirmed by diagnostic laparoscopy. The defects were sutured and the patient recovered well after the operation.

Little is known about longitudinal changes of the first twin presentation in twin gestations. This is a retrospective cohort study including 411 women who were admitted consecutively and delivered live-born twins at 36 weeks of gestation or more. Longitudinal assessment of the first twin presentation was conducted during gestation and at birth in all cases. Gestational age at antenatal assessment was divided into two intervals: early-third trimester (28–31 weeks) and mid-third trimester (32–35 weeks). Fetal presentation was categorized as vertex or non-vertex. We analyzed change of fetal presentation between antepartum intervals and birth. First twin presentation at early-third trimester had the same presentation at birth in 87.6% (360/411) of the study population. In this ‘no change’ group, vertex presentation was seen in 95.6% (283/296) and non-vertex was seen in 67.0% (77/115) of cases. In total, 96.1% (395/411) of the study population maintained their presentation between mid-third trimester and birth. Vertex presentation was seen in 98.4% (310/315) and non-vertex was seen in 88.5% (85/96) of cases. When comparing vertex with non-vertex, vertex presentation during third trimester was a more reliable predictor of presentation at birth (p < .001). The only factor that contributed significantly to spontaneous version of the first twin during mid-third trimester and birth was a lower birth weight of the first twin compared with the second twin. In conclusion, first twin presentation with vertex during third trimester is not likely to change into non-vertex at birth. We concluded that vertex presentation in twin gestations at early- and mid-third trimester is very predictable. In contrast, a non-vertex first twin presentation is relatively unstable.

Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, which is characterized by a sudden cardiovascular collapse, respiratory failure, and disseminated intravascular coagulation (DIC). We report a case of sudden cardiac arrest due to an amniotic-fluid embolism which was successfully treated with veno-arterial extracorporeal membrane oxygenation (ECMO). A 32-year-old female at 39.1 weeks of gestation was scheduled for induction labor. During labor, a sudden generalized tonic-clonic seizure was developed followed by dyspnea and hypotension. An immediate vaginal delivery was performed, and the baby was healthy. Despite the appropriate cardiopulmonary resuscitation, she became hypoxemic and experienced recurrent cardiovascular collapse. ECMO was applied promptly, and the patient became stable rapidly and was discharged without any complications. ECMO seems to be a proper treatment option for catastrophic amniotic-fluid embolism.

Department of Obstetrics and Gynecology, Jeju National University Hospital, Jeju, Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Jeju National University College of Medicine and Graduate School of Medicine, Jeju, Department of Obstetrics and Gynecology, IlsanPaik Hospital, Inje University College of Medicine, Goyang, Korea Perinatology Vol. 29, No. 1, March, 2018 https://doi.org/10.14734/PN.2018.29.1.39 Original article Perinatology

Objective:The objective of this study was to estimate the prevalence for Chlamydia trachomatis infection in first trimester pregnancy inkorea.Methods:From March, 2013 to December, 2015, Chlamydia trachomatis screening test were performed on women who visited theoutpatient clinic for antenatal check. Specimens are taked from the endocervix or vagina and analysed by polymerase chainreaction. Medical records including age, parity, pregnancy outcome were reviewed.Results:Total 199 women were tested at first trimester pregnancy, of those tested women, 3.52% and 0% tested positive forchlaymydia and gonococcal infection. There were no significant difference between the infected and noninfected group. Duringthe same period, the prevalence of chlamydia in those who were diagnosed pelvic inflammatory disease was 9.6% (15/156).Conclusion:According to the current Centers for Disease Control and Prevention(CDC) guidelines, all pregnant women should be routinelyscreened for Chlamyidia trachomatis at the first prenatal visit. The reported Chlamydia prevalence in the united states in 2012was 3.5%, this prevalence is similar to our country. Therefore the screening and treatment of Chlamydia trachomatis arenecessary to prevention of obstetrical complication and neonatal infection.

Implanonⓡ is a single-rod subdermal contraceptive implant. It is usually located located and palpable around the insertion site,so it is easily inserted and removed. Most impalpable implanon is localized ultrasonography and magnetic resonance imaging.We report a patient whose implanon was undetected by ultrasonography and magnetic resonance imaging, but she pregnantand gave birth to a baby after insertion past five years.

Fibroma is a rare benign solid tumor of the vulva. In general, they appear as small, soft, and they are mostly located on theaxillae, lateral neck and inguinal lesion. We report a case of huge soft fibroma in the labium majus of a healthy, middle-agedwoman, and such fibroma on the labium majus are very rare.