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Vascular Medicine (London, England) Jun 2015Postpartum reversible cerebral vasoconstriction syndrome (PPRCVS) is a rare but serious cause of headache that occurs in the early postpartum period. The rarity of this... (Review)
Review
Postpartum reversible cerebral vasoconstriction syndrome (PPRCVS) is a rare but serious cause of headache that occurs in the early postpartum period. The rarity of this disorder has limited the current literature to single case reports and small, observational case series. The lack of familiarity with PPRCVS may contribute to mismanagement of these unique patients and lead to poor outcomes. To address current gaps in the understanding of PPRCVS, this review and data analysis characterizes the demographics, presentation, clinical course, management and prognosis of PPRCVS and provides a general review of the epidemiology, pathophysiology and diagnosis to assist clinicians who may care for patients with this rare disorder.
Topics: Cerebral Arteries; Cerebrovascular Disorders; Constriction, Pathologic; Diagnosis, Differential; Female; Humans; Puerperal Disorders; Syndrome
PubMed: 25835347
DOI: 10.1177/1358863X14567976 -
Biological Psychiatry Dec 1995Seven women with histories of puerperal psychosis and four with histories of puerperal major depression were consecutively treated with high-dose oral estrogen...
Seven women with histories of puerperal psychosis and four with histories of puerperal major depression were consecutively treated with high-dose oral estrogen immediately following delivery. None of the women had histories of nonpuerperal affective disorder, and all women were affectively well throughout the current pregnancy and at delivery. Despite the high risk for recurrent illness in this population, only one woman developed relapse of postpartum affective disorder. All others remained entirely well and required no treatment with psychotropic medications during the 1 year follow-up period. This low rate of relapse, 9% compared to an expected 35-60% without prophylaxis, suggests that oral estrogen may stem the rapid rate of change in estrogen following delivery, thereby preventing the potential impact on dopaminergic and serotonergic neuroreceptors. It is hypothesized that the rapid rate of change of estrogen after delivery creates an "estrogen withdrawal state." This may be a critical factor in driving acute puerperal affective psychosis and early-onset puerperal major depression.
Topics: Administration, Oral; Adult; Depression, Postpartum; Dose-Response Relationship, Drug; Drug Administration Schedule; Estrogen Replacement Therapy; Estrogens; Estrogens, Conjugated (USP); Female; Follow-Up Studies; Humans; Infusions, Intravenous; Personality Inventory; Pilot Projects; Pregnancy; Psychiatric Status Rating Scales; Psychotic Disorders; Puerperal Disorders; Recurrence; Risk Factors
PubMed: 8750040
DOI: 10.1016/0006-3223(95)00063-1 -
Bailliere's Clinical Obstetrics and... Dec 1989
Review
Topics: Depressive Disorder; Female; Humans; Puerperal Disorders
PubMed: 2700146
DOI: 10.1016/s0950-3552(89)80068-9 -
Journal of Psychopharmacology (Oxford,... Jun 2003Neuroendocrine challenge tests of hypothalamic dopamine receptor function in the early postpartum period suggest that the sensitivity of these receptors is increased in... (Comparative Study)
Comparative Study
Neuroendocrine challenge tests of hypothalamic dopamine receptor function in the early postpartum period suggest that the sensitivity of these receptors is increased in women with a history of bipolar disorder after childbirth. We tested the hypothesis that, in women predisposed to bipolar disorder in the puerperium, hypothalamic dopamine receptor function is more sensitive to changes in circulating ovarian hormone concentrations than in women without such histories. Eight fully recovered and drug-free women who had had at least one episode of bipolar illness following childbirth were compared with nine normal controls. Growth hormone (GH) responses to apomorphine (APO 0.005 mg s.c.) were measured in the early follicular phase, when plasma concentrations of ovarian hormones are low, and in the mid-luteal phase, when they are relatively high. The recovered bipolar subjects and the controls did not differ from each other in their follicular and midluteal oestrogen and progesterone concentrations. In the midluteal phase, both groups had increased oestrogen and progesterone levels. The recovered bipolar subjects did not differ from controls in baseline concentrations of GH in either of the menstrual phases. The APO-GH responses of the two groups did not differ in the follicular phase, but in the midluteal phase, when female sex steroids are relatively increased, the recovered group had significantly enhanced APO-GH responses [MANOVA for repeated measures: (i) area under the curve, group by phase effect: p < 0.04; (ii) GH peak rise after APO, group by phase effect: p < 0.056] and the responses were not related to concurrent measures of mood. The results of this small study of women predisposed to bipolar disorder in the puerperium shows an increased dopaminergic receptor sensitivity in the luteal phase of the menstrual cycle. It suggests that their dopaminergic systems have increased sensitivity to changes in circulating female sex steroids. This may be aetiologically relevant to the pathogenesis of puerperal bipolar disorder.
Topics: Adult; Dopamine; Estrogens; Female; Follicular Phase; Human Growth Hormone; Humans; Hypothalamus; Luteal Phase; Menstrual Cycle; Progesterone; Psychotic Disorders; Puerperal Disorders; Radioimmunoassay; Receptors, Dopamine
PubMed: 12870568
DOI: 10.1177/0269881103017002009 -
Women and Birth : Journal of the... Feb 2017Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder. (Observational Study)
Observational Study
BACKGROUND
Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.
AIM
Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.
METHODS
This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3-5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.
FINDINGS
Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13-5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05-1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06-38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09-0.77) and life in a city (odds ratio 0.29; confidence interval 0.09-0.94).
CONCLUSION
Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice.
Topics: Adult; Anxiety Disorders; Croatia; Delivery, Obstetric; Depression; Depression, Postpartum; Female; Humans; Longitudinal Studies; Neuroticism; Odds Ratio; Parturition; Postpartum Period; Predictive Value of Tests; Pregnancy; Puerperal Disorders; Risk Factors; Stress Disorders, Post-Traumatic; Surveys and Questionnaires
PubMed: 27421663
DOI: 10.1016/j.wombi.2016.06.007 -
Nihon Rinsho. Japanese Journal of... May 1994Depression following childbirth (postpartum depression) is a common psychiatric illness of women, postpartum. We review Japanese and English literature on postpartum... (Review)
Review
Depression following childbirth (postpartum depression) is a common psychiatric illness of women, postpartum. We review Japanese and English literature on postpartum depression. Problems with definition, study design and validity of the diagnosis prevented comprehensive understanding whether postpartum depression is a distinct subtype of endogenous depression. In general, postpartum depression seems to be the same illness as depression at other times in life. The biological and psycho-social pathogenetic factors, unique to the puerperal period, are not yet known. Clinicians caring for women and infants should learn to screen their patients for this multifactorial (genetic, temperamental, and environmental) disorder, and try to integrate a multidisciplinary (pharmaco-, psycho-, socio-, familial) approach.
Topics: Depressive Disorder; Female; Humans; Puerperal Disorders; Stress, Psychological
PubMed: 8007401
DOI: No ID Found -
Revue Des Maladies Respiratoires Dec 2013Cardiopulmonary exercise testing (CPET) is the examination of choice to understand mechanisms responsible for dyspnea in patients without significant medical history.... (Review)
Review
Cardiopulmonary exercise testing (CPET) is the examination of choice to understand mechanisms responsible for dyspnea in patients without significant medical history. The three observations illustrate the major interest of the CPET in this frequent situation in clinical practice. A 68-year-old man who has severe dyspnea in her leisure time hiking in the mountains, a 25-year cyclist presenting disabling dyspnea follow competitors racing neo-professional cyclists, and a 37-year woman who developed a persistent dyspnea, 6 months after delivery. In these three situations, CPET determined the disorder responsible for the symptoms without increasing the diagnostic tests.
Topics: Adult; Aged; Bicycling; Dyspnea; Exercise Test; Exercise Tolerance; Female; Humans; Male; Puerperal Disorders; Sports
PubMed: 24314709
DOI: 10.1016/j.rmr.2013.09.012 -
Journal of Affective Disorders Sep 2005
Topics: Bipolar Disorder; Cross-Sectional Studies; Depression, Postpartum; Depressive Disorder, Major; Female; Follow-Up Studies; Humans; Psychophysiology; Psychotic Disorders; Puerperal Disorders; Remission, Spontaneous; Risk Factors
PubMed: 15996747
DOI: 10.1016/j.jad.2005.05.002 -
Journal of Dairy Science Sep 1988Incidence, predisposing factors, and implications of various reproductive disorders (dystocia, twinning, stillbirth, retained placenta, cystic ovaries, anovulation,... (Review)
Review
Incidence, predisposing factors, and implications of various reproductive disorders (dystocia, twinning, stillbirth, retained placenta, cystic ovaries, anovulation, infections of the reproductive tract, metritis, and abnormal health status) are reviewed as to their inter-relationships and collective impact on reproductive performance, milk yield and predisposition to other diseases or disorders in the periparturient dairy cow. All reproductive disorders reviewed reviewed reduce reproductive performance either directly or indirectly. Concurrent milk yield was reduced marginally in a few studies as a consequence of twinning, retained placenta, cystic ovaries, metritis, or other uterine disorders, and in cows with an abnormal health status. There is strong evidence for associated losses in milk yield following surgical delivery of a stillborn calf. We conclude that most periparturient disorders occur as a complex, rather than as a single abnormality. Cows with one disorders are at increased risk for other disorders, including metabolic ones. In contrast, actual milk yield or potential for high production generally does not predispose cows to increased risk for any of the reproductive disorders. The literature suggests that prophylactic measures to prevent occurrence of the one disorder might decrease the risk and incidence of other related disorders, either directly or indirectly.
Topics: Animals; Cattle; Cattle Diseases; Female; Genital Diseases, Female; Pregnancy; Puerperal Disorders
PubMed: 3053814
DOI: 10.3168/jds.S0022-0302(88)79846-X -
Duodecim; Laaketieteellinen... 2015Various mental disorders are encountered at the maternal clinic. Pregnancy predisposes to some mental disorders, most commonly depressive and anxiety disorders. The... (Review)
Review
Various mental disorders are encountered at the maternal clinic. Pregnancy predisposes to some mental disorders, most commonly depressive and anxiety disorders. The recognition of substance use disorders during pregnancy is very important, but difficult owing to the associated disgrace. An eating disorder with an onset preceding the pregnancy may cause problems for growth and development of the fetus and should thus be identified early enough. The rare but severe postpartum psychosis may often break out only after discharge from the maternity hospital. Drug therapy during pregnancy requires careful consideration and clear-cut reasoning.
Topics: Feeding and Eating Disorders; Female; Humans; Mental Disorders; Pregnancy; Pregnancy Complications; Puerperal Disorders; Substance-Related Disorders
PubMed: 26237899
DOI: No ID Found