Background: Mood and anxiety issues are the main mental health complaints of women during pregnancy and the postpartum period. Services targeting such women can reduce perinatal complications related to psychiatric difficulties. This quality assurance project aimed to examine changes in mood and anxiety symptoms in pregnant and postpartum women referred to the Women's Health Concerns Clinic (WHCC), a specialized outpatient women's mental health program. Methods: We extracted patient characteristics and service utilization from electronic medical records of women referred between 2015 and 2016. We also extracted admission and discharge scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Results: Most patients accessed the WHCC during pregnancy (54%), had a diagnosis of major depressive disorder (54.9%), were prescribed a change in their medication or dose (61.9%), and accessed psychotherapy for perinatal anxiety (30.1%). There was a significant decrease in EPDS scores between admission and discharge (t(214) = 11.57; p = .000; effect size d = .86), as well as in GAD-7 scores (t(51) = 3.63; p = .001; effect size d = .61). A secondary analysis showed that patients with more severe depression and anxiety symptoms demonstrated even greater effect sizes. Conclusions: Changes in EPDS and GAD-7 scores indicate that the WHCC is effective in reducing mood and anxiety symptoms associated with the perinatal period. This project highlights the importance of quality assurance methods in evaluating the effectiveness of clinical services targeting perinatal mental health, in order to inform policy and funding strategies.
Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assisted conception. We present a 31-year-old gestational carrier who presented with suprapubic and pelvic pain at 6 weeks and 2 days' gestation. An ultrasound scan demonstrated an empty uterus and a complex mass in the left adnexa. Operative laparoscopy was performed and an ovarian pregnancy was found and treated. We believe this to be the first report of ovarian pregnancy after IVF in a gestational carrier. Appropriate counselling of surrogate mothers is of utmost importance as the risk of ectopic pregnancy is increased by using assisted reproduction technology. Although ovarian pregnancy still remains a rare event, the possibility of this condition should always be considered.
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