Federico Prefumo

Objective: To assess risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic using Mind-COVID, a prospective cross-sectional study that compares outcomes in middle-income economies and high-income economies. Methods: A total of 7102 pregnant women from 12 high-income economies and nine middle-income economies were included. The web-based survey used two standardized instruments, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Result: Pregnant women in high-income economies reported higher PHQ-9 (0.18 standard deviation [SD], P < 0.001) and GAD-7 (0.08 SD, P = 0.005) scores than those living in middle-income economies. Multivariate regression analysis showed that increasing PHQ-9 and GAD-7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ-9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD-7 scores were associated with a pregnancy-related complication, fear of adverse outcomes in children related to COVID-19, and feeling of burden related to finances. Conclusions: According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.

Twin reversed arterial perfusion (TRAP) sequence is a unique complication of monochorionic multiple pregnancy in which an acardiac twin with multiple morphological anomalies and without a complete cardiovascular system is perfused by a structurally normal co-twin (the pump twin). 1 The acardiac twin is not viable, but it endangers the pump twin, causing an increased risk of congestive heart failure, intrauterine growth restriction (IUGR), preterm premature rupture of membranes (pPROM) and preterm delivery. The main goals in TRAP sequence management are preserving the survival of the pump twin and approaching a term delivery. If a conservative management is

• In una gravidanza a basso rischio è raccomandata un’ecografia di screening nel primo trimestre e una nel secondo trimestre.
• La donna deve essere informata su scopi, implicazioni e limiti delle indagini ecografiche.
• In Italia vengono eseguite in media cinque ecografie ostetriche per ogni parto.
• Attualmente, non sono previsti o raccomandati in Italia programmi di controllo della qualità degli screening ecografici in gravidanza.