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Results for “Puerperal Disorders”

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PubMed1991

Puerperal psychiatric disorders in Nigerian women.

Forty-two cases of psychiatric disorders occurring within six-months of childbirth and seen over a 15-month period were studied retrospectively. The majority of the cases were less than 30 years old, married and primiparous. There was a preponderance of schizophrenic over other psychiatric syndromes. The onset of illness in the majority (71.4%) was after the first two weeks of post-partum. The implication of this for postnatal clinical assessment was discussed. There was no significant difference in the mean length of admission of the major diagnostic groups. The outcome was satisfactory in 76.2% of them.

Adolescent↗
PubMed1981

The social and obstetric correlates of psychiatric admission in the puerperium.

Computer linkage of obstetric and psychiatric record systems made it possible to identify all women resident in the city of Edinburgh who had given birth to live or stillborn children in 1971-7 and to study (a) the distribution of psychiatric admissions relative to the time of childbirth and (b) the correlates of psychiatric admission in the first 90 days after childbirth. Having a first baby, being unmarried and undergoing Cesarean section were all associated with an increased risk of admission; twin births, perinatal death and maternal age were not. It is difficult to account for these and other established relationships purely in psychological or purely in somatic terms, suggesting that influences of both kinds are probably involved in the genesis of puerperal disorders.

Adolescent↗
PubMed2003

Menstrual cycle effects on hypothalamic dopamine receptor function in women with a history of puerperal bipolar disorder.

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.

Adult↗
PubMed2006

[Puerperal complications in nulliparous women delivered by section caesarean: pair study].

AIM: Research frequency of puerperal disorders in nulliparous women who had cesarean section in University Hospital Mostar in year 2004 and given results compared with nulliparus women who had vaginal mode of delivery. PATIENTS AND METHODS: Research included 119 nulliparous women who had C-section in year 2004 (Tested group) and 119 nulliparous women who had vaginal mode of delivery (control group) taking in count time of delivery (first next one in delivery room protocol) and age (+/- 2 years). We analyzed type of puerperal disorders and their frequency in these groups and made comparison among them. RESULTS: Frequency of puerperal disorders in nulliparous women delivered by cesarean section is higher increased compared with nulliparous women who had vaginal mode of delivery (chi2=15,015; p<0,001). In tested group was found significantly higher frequency of anemia (chi2=8,895; p=0,003) and puerperal fever (chi2=8,333; p=0,004). Higher risk of puerperal disorders in nulliparous women who had cesarean section was confirmed by odds ratio which was 4,183. CONCLUSION: Higher incidence of puerperal disorders in nulliparous women who had cesarean section is confirmation of higher risks for women with operative mode of delivery which is concerning due to increased trend of cesarean sections in our country and in the world.

Adolescent↗
PubMed1991

[Role of electroshock therapy in puerperal mental disorders].

Ten cases of psychotic patients requiring electroconvulsivotherapy (ECT) are reported during pregnancy and puerperium. The interest and the safety of ECT are confirmed. ECT is principally indicated in severe cases and in typical or atypical mood disorders.

Adult↗
PubMed1991

[Treatment of puerperal mental disorders and dysfunctioning of the early mother-child relation at the maternity of the General Hospital Center of Charleville-Mźières].

The psychiatric care of the motherhood disorders and of their consequences over the early mother-child relation has become necessary from P.C. Racamier's writings and after studies about maltreated young children. Maltreatment has been defined by us in a broad sense, that is to say from marked cruelties to neglect, including various forms of aggressiveness and rejection. The Maternity Hospital, as a structure, has been considered as a well-suited place because nearly all the future mothers of the department are delivered there. The work undertaken for one year at Charleville-Mézières Maternity Hospital is clinically described, with its advantages and its difficulties, revealing the increasing need of a correctly trained multidisciplinary staff, even specialized, which could ensure psychiatric care over a period long enough to be effective.

Female↗
PubMed2000

Molecular genetic studies of bipolar disorder and puerperal psychosis at two polymorphisms in the estrogen receptor alpha gene (ESR 1).

A number of lines of evidence point to the possible involvement of estrogen pathways in the pathophysiology of bipolar disorder in general and puerperal psychosis in particular. There is strong evidence from clinical, follow-up, and genetic studies to support the hypothesis that most cases of puerperal psychosis are manifestations of an affective disorder diathesis with a puerperal trigger and that genes influence susceptibility to both diathesis and trigger. The nature of the trigger is unknown but in view of the abrupt onset at a time of major physiological change it is widely believed that biological, probably hormonal, mechanisms are of paramount importance, with estrogen receiving the most attention to date. We have undertaken a case control association study of bipolar disorder and puerperal psychosis at two known polymorphisms within the estrogen receptor alpha gene (ESR 1) in a sample of 219 unrelated bipolar probands and 219 controls. We could exclude these polymorphisms from an important contribution to susceptibility to bipolar disorder with a high level of confidence. We found no support for the hypothesis that they contribute specific susceptibility to the puerperal trigger, but due to the small numbers of puerperal probands (n = 26) no firm conclusions can be drawn regarding their involvement in puerperal psychosis. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:850-853, 2000.

Adult↗
PubMed1992

Schizoaffective disorders with and without onset in the puerperium.

The premorbid and sociodemographic features, long-term course and long-term outcome (on average 23.8 resp. 26.8 years after onset of illness) were compared in 30 female schizoaffective patients with onset of their illness during the puerperium and 60 female schizoaffective patients with onset at other times. The majority of premorbid and sociodemographic variables as well as course parameters were similar in the two groups. Most of the few differences (in age at first manifestation, marital state at onset, presence of stable heterosexual relationship before onset, acuteness of onset, presence of life events) are closely connected with the inclusion and exclusion criteria applied for the puerperal disorders (exclusion of patients with preexisting illness or psychiatric symptoms during pregnancy, inclusion only if onset was within 6 weeks of parturition). The puerperal schizoaffective disorders began more frequently with a schizomanic episode and less frequently with a schizodepressive episode than did the non-puerperal schizoaffective disorders, a finding which perhaps reflected the "pathoplastic" role of the puerperium on psychotic disorders. Several significant differences were found regarding the long-term outcome (frequency of persistent alterations, level of global functioning and disability, non-achievement of the expected social development, loss of autarky), confirming earlier findings that puerperal disorders generally have a better outcome than other psychotic disorders.

Adolescent↗