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Journal of the American College of... Aug 2011Peripartum cardiomyopathy is a pregnancy-associated myocardial disease characterized by the development of heart failure due to marked left ventricular systolic... (Review)
Review
Peripartum cardiomyopathy is a pregnancy-associated myocardial disease characterized by the development of heart failure due to marked left ventricular systolic dysfunction. Although the disease is relatively uncommon, its incidence is increasing, and it can be associated with important and lasting morbidity and with mortality. Peripartum cardiomyopathy seems to affect women in different parts of the world but with considerable differences in clinical presentation. The purposes of this review are to describe the clinical profile of peripartum cardiomyopathy in the United States and to provide recommendations for the diagnosis and the management of this disease.
Topics: Cardiomyopathies; Female; Heart Transplantation; Humans; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Outcome; Prognosis; Puerperal Disorders; Ventricular Function, Left
PubMed: 21816300
DOI: 10.1016/j.jacc.2011.03.047 -
Journal of Perinatology : Official... 2002Examine frequency, timing, and reasons for maternal postpartum rehospitalizations and acute care visits 1 year postpartum after a high-risk pregnancy.
OBJECTIVE
Examine frequency, timing, and reasons for maternal postpartum rehospitalizations and acute care visits 1 year postpartum after a high-risk pregnancy.
STUDY DESIGN
Secondary analysis of data collected during a randomized clinical trial of advanced practice nurses gives transitional care for women with high-risk pregnancies. The 171 women were primarily African American, never married, Medicaid eligible, diagnosed with pregestational diabetes (20), gestational diabetes (23), either diagnosed (48) or at risk (44) for preterm labor, and chronic hypertension (36).
RESULTS
Of the total rehospitalizations (17%) and acute care visits (32%), over one third occurred in the first 8 weeks postpartum. Chronic hypertensives and gestational diabetics had the highest rate of rehospitalization and proportion of acute care visits. Six women were rehospitalized for subsequent pregnancies.
CONCLUSION
Women with high-risk pregnancies have continued high health care resource use over the first postpartum year demonstrating the need for more intensive patient education and follow-up to improve outcomes and reduce resource use.
Topics: Adult; Diabetes, Gestational; Female; Hospitalization; Humans; Incidence; Obstetric Labor, Premature; Postpartum Period; Pregnancy; Pregnancy, High-Risk; Puerperal Disorders
PubMed: 12368974
DOI: 10.1038/sj.jp.7210796 -
Bulletin of the World Health... 1983
Review
Topics: Adult; Depressive Disorder; Female; Humans; Male; Menstruation Disturbances; Mothers; Postpartum Period; Pregnancy; Psychophysiology; Psychotic Disorders; Puerperal Disorders; Sexual Behavior; Sexual Dysfunction, Physiological; Sterilization, Reproductive
PubMed: 6349843
DOI: No ID Found -
Medicine Nov 2023Posterior reversible encephalopathy syndrome (PRES) is a rare complication commonly associated with headache and acute changes in blood pressure that results from a...
RATIONALE
Posterior reversible encephalopathy syndrome (PRES) is a rare complication commonly associated with headache and acute changes in blood pressure that results from a variety of causes, culminating in vasogenic cerebral edema in the occipital and parietal lobes of the brain.
PATIENT CONCERNS
We report here a woman who suffered from headache, generalized tonic-clonic seizures, and cortical blindness in the late postpartum period.
DIAGNOSES
Posterior reversible encephalopathy syndrome.
INTERVENTIONS
The patient was treated with amlodipine besylate tablets for hypertension, dehydration with mannitol and glycerin fructose, and antispasmodic treatment with sodium valproate and oxcarbazepine.
OUTCOMES
On day 2, the patient became conscious, headache and vision improved. One week later, symptoms and signs disappeared, blood pressure returned to normal, and brain MRI lesions disappeared in re-examination.
LESSONS
Eclampsia associated with PRES is reversible in most cases, but it is a serious and potentially life-threatening obstetric emergency. If adequate treatment is provided in a timely manner, most women will make a full recovery. Attention needs to be paid to timely and adequate treatment, as well as appropriate follow-up and support for patients with PRES.
Topics: Pregnancy; Humans; Female; Eclampsia; Posterior Leukoencephalopathy Syndrome; Postpartum Period; Brain Diseases; Puerperal Disorders; Headache
PubMed: 37960797
DOI: 10.1097/MD.0000000000035867 -
Endocrine Reviews Oct 2001Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of... (Review)
Review
Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of the thyroid. The prevalence ranges from 5-7%. We discuss the role of antibodies (especially thyroid peroxidase antibodies), complement, activated T cells, and apoptosis in the outbreak of postpartum thyroiditis. Postpartum thyroiditis is conceptualized as an acute phase of autoimmune thyroid destruction in the context of an existing and ongoing process of thyroid autosensitization. From pregnancy an enhanced state of immune tolerance ensues. A rebound reaction to this pregnancy-associated immune suppression after delivery explains the aggravation of autoimmune syndromes in the puerperal period, e.g., the occurrence of clinically overt postpartum thyroiditis. Low thyroid reserve due to autoimmune thyroiditis is increasingly recognized as a serious health problem. 1) Thyroid autoimmunity increases the probability of spontaneous fetal loss. 2) Thyroid failure due to autoimmune thyroiditis-often mild and subclinical-can lead to permanent and significant impairment in neuropsychological performance of the offspring. 3) Evidence is emerging that as women age subclinical hypothyroidism-as a sequel of postpartum thyroiditis-predisposes them to cardiovascular disease. Hence, postpartum thyroiditis is no longer considered a mild and transient disorder. Screening is considered.
Topics: Adult; Female; Humans; Postnatal Care; Pregnancy; Pregnancy Complications; Prenatal Care; Puerperal Disorders; Thyroiditis; Thyroiditis, Autoimmune
PubMed: 11588143
DOI: 10.1210/edrv.22.5.0441 -
Kidney International Dec 2018
Topics: Acute Kidney Injury; Adult; Female; Humans; Kidney Cortex Necrosis; Magnetic Resonance Imaging; Puerperal Disorders; Renal Dialysis; Tomography, X-Ray Computed
PubMed: 30466570
DOI: 10.1016/j.kint.2018.07.005 -
BMJ Open Mar 2019Research into what constitutes the best and most effective care for women with an acute severe postpartum mental disorder is lacking. The effectiveness and... (Comparative Study)
Comparative Study
Protocol for a quasi-experimental study of the effectiveness and cost-effectiveness of mother and baby units compared with general psychiatric inpatient wards and crisis resolution team services (The ESMI study) in the provision of care for women in the postpartum period.
INTRODUCTION
Research into what constitutes the best and most effective care for women with an acute severe postpartum mental disorder is lacking. The effectiveness and cost-effectiveness of psychiatric mother and baby units (MBUs) has not been investigated systematically and there has been no direct comparison of the outcomes of mothers and infants admitted to these units, compared with those accessing generic acute psychiatric wards or crisis resolution teams (CRTs). Our primary hypothesis is that women with an acute psychiatric disorder, in the first year after giving birth, admitted to MBUs are significantly less likely to be readmitted to acute care (an MBU, CRTs or generic acute ward) in the year following discharge than women admitted to generic acute wards or cared for by CRTs.
METHODS AND ANALYSIS
Quasi-experimental study of women accessing different types of acute psychiatric services in the first year after childbirth. Analysis of the primary outcome will be compared across the three service types, at 1-year postdischarge. Cost-effectiveness will be compared across the three service types, at 1-month and 1-year postdischarge; explored in terms of quality-adjusted life years. Secondary outcomes include unmet needs, service satisfaction, maternal adjustment, quality of mother-infant interaction. Outcomes will be analysed using propensity scoring to account for systematic differences between MBU and non-MBU participants. Analyses will take place separately within strata, defined by the propensity score, and estimates pooled to produce an average treatment effect with weights to account for cohort attrition.
ETHICS AND DISSEMINATION
The study has National Health Service (NHS) Ethics Approval and NHS Trust Research and Development approvals. The study has produced protocols on safeguarding maternal/child welfare. With input from our lived experience group, we have developed a dissemination strategy for academics/policy-makers/public.
Topics: Cost-Benefit Analysis; Crisis Intervention; Delivery of Health Care; Female; Hospitals, Psychiatric; Humans; Maternal-Child Health Centers; Mental Disorders; Observational Studies as Topic; Patient Care Team; Postnatal Care; Pregnancy; Puerperal Disorders; Treatment Outcome
PubMed: 30904867
DOI: 10.1136/bmjopen-2018-025906 -
American Family Physician Aug 2002
Topics: Adult; Anticonvulsants; Antihypertensive Agents; Diagnosis, Differential; Eclampsia; Female; Humans; Labetalol; Magnesium Sulfate; Phenytoin; Pregnancy; Puerperal Disorders; Treatment Outcome
PubMed: 12182515
DOI: No ID Found -
Malawi Medical Journal : the Journal of... Jun 2019This is a brief review of puerperal (post-partum) psychosis and contains a case report of Donkin Psychosis, an unusual form which is associated with pre-eclampsia, from... (Review)
Review
This is a brief review of puerperal (post-partum) psychosis and contains a case report of Donkin Psychosis, an unusual form which is associated with pre-eclampsia, from Queen Elizabeth Central Hospital in Blantyre, Malawi. It includes considerations for treatment of Donkin Psychosis, in particular. It is the first reported case of Donkin Psychosis from Africa, to our knowledge.
Topics: Adult; Blood Pressure; Eclampsia; Female; Humans; Postpartum Period; Pregnancy; Pregnancy Complications; Psychotic Disorders; Puerperal Disorders
PubMed: 31452852
DOI: 10.4314/mmj.v31i2.11 -
Journal de Gynecologie, Obstetrique Et... Oct 2007The aim of this article is to review clinical and epidemiological data on pre- and postnatal anxious and depressive disorders. To this end, we systematically analysed... (Review)
Review
The aim of this article is to review clinical and epidemiological data on pre- and postnatal anxious and depressive disorders. To this end, we systematically analysed definitions, prevalence, risk factors and obstetrical consequences of perinatal disorders, as reported in seminal as well as more recent publications. We report and discuss the most consensual results about anxious and depressive disorders of pregnancy and the postpartum, with special emphasis on maternity blues, postpartum depression and postpartum psychosis. Reviewed data confirm that the perinatal period is a time of high risk for the onset or exacerbation of several anxious or depressive disorders, which are likely to impede the normal progress of pregnancy or the child's development. The potential severity of bipolar disorders and puerperal psychosis is highlighted by the fact that they heavily contribute to maternal mortality. The specificity of perinatal disorders, their impact on public health, the extensive research and mounting knowledge in that field, provide ample justification for the recognition of perinatal psychiatry as a distinct branch of psychiatry.
Topics: Anxiety Disorders; Female; Humans; Maternal Mortality; Mood Disorders; Pregnancy; Pregnancy Complications; Puerperal Disorders; Risk Factors
PubMed: 17616264
DOI: 10.1016/j.jgyn.2007.06.003