Postpartum Depression

SUMMARY

Postpartum depression is a common and treatable clinical syndrome which effects up to fifty percent of all women and which can best be considered as a triad of disorders. Postpartum blues, postpartum affective disorders or major depressions, and postpartum psychosis have distinct symptoms with corresponding implications for social work interventions and treatment strategies. The role of prevention can be pivotal in terms of reducing negative impacts of psychological problems after birth and minimizing adverse consequences for the new baby and all family members.     

Postpartum thyroiditis

Postpartum thyroiditis is a disorder which is morphologically similar to Hashimoto's thyroiditis, but differs clinically. The disorder presents with a transient period of thyrotoxicosis which may be so mild that it is clinically missed. Many of these patients subsequently develop hypothyroidism which also spontaneously resolves. Documentation that the hypothyroidism is transient would be necessary to establish the diagnosis. There is a proclivity for this disorder to develop in the postpartum period. Two patients are presented with this disorder, one with a transient hypermetabolic state and one with a transient hypothyroid state.     

3剂良方：睡觉 说话 运动 赶走新妈妈的产后抑郁

产后抑郁是指从开始分娩至产后一段时间内出现的失眠．郁闷,易伤感、哭泣、烦躁不安、易疲劳等情绪异常。其发生率为产后妇女的20％-50％。以轻症患者为主。     

Postpartum haemorrhage

Postpartum haemorrhage can be either primary (within 24 hours of delivery) or secondary (within the following weeks). This article reviews the factors that may help anticipation of postpartum haemorrhage, and looks at issues involved in the management and treatment of women with this condition.     

Maternal Postpartum Diet and Postpartum Depression: A Systematic Review

Maternal and Child Health Journal - Compelling evidence from observational studies shows that dietary patterns play a role in the development of depression and depressive symptoms in the general...     

The Association between Postpartum Practice and Chinese Postpartum Depression: Identification of a Postpartum Depression-Related Dietary Pattern

Conflicting results of Chinese traditional postpartum practices have aroused concerns over their health effects. The role of postpartum practices in postpartum depression (PPD) is still a matter of discussion, especially from a dietary practice point of view. The current study was designed to (1) explore the association between postpartum practices and PPD, (2) to identify the dietary pattern related to PPD, and (3) to identify the possible pathways among postpartum practices and PPD. This study is part of the YI Study, which was a cross-sectional study conducted in 10 cities in China. Data for 955 postpartum women were used in the current analysis. The Edinburgh Postnatal Depression Scale (EPDS-10) was used to evaluate PPD with a cutoff value of 9. Postpartum practice was based on the participants’ self-reported practices. Individual practices were recorded and categorized as dietary and non-dietary practices. The dietary pattern was identified based on the food intake frequencies of 25 food groups using the method of reduced rank regression. Structural equation modeling was used to explore the potential pathways between postpartum practices and PPD. The current study observed significant associations between postpartum practices and PPD (Adjusted OR = 1.41, 95% CI: 1.04–1.90). A similar trend was also found between dietary postpartum practices and PPD (Adjusted OR = 1.39, 95%CI: 1.03–1.88) but not for non-dietary practices and PPD (Adjusted OR = 1.26, 95%CI: 0.92–1.75). A PPD-related dietary pattern was identified with the characteristics of a high intake of meat and eggs and a lower intake of vegetables, mushrooms, and nuts. This dietary pattern was significantly associated with a higher chance of adhering to postpartum practice (Adjusted OR = 1.26, 95% CI: 1.10–1.44). Based on the pathway analysis, this study also observed the association between postpartum practices and PPD, and the association between dietary practices and PPD were both mediated by sleep quality. In conclusion, this study demonstrated that a substantial proportion of women in modern China experience traditional postpartum Chinese practices and that either overall or dietary-related postpartum practices are associated with a higher risk of PPD. The current dietary practices in postpartum rituals may play an important role in developing PPD. A culturally embedded, science-based dietary guideline is required to help women to achieve both physical and psychological health in the postpartum period.     

Postpartum and interval mini-laparotomy

Dr. Dassenaike in Colombo, Sri Lanka, has developed a technique for minilaparotomy that is most suitable for postpartum procedures and can be performed in less than 5 minutes with provisions for quick anesthesia and without special equipment. The procedure can be performed under spinal or local anesthesia and as interval sterilization. Under good conditions up to 8 operations can be done in an hour. Dr. Dassenaike has described the preoperative procedure, induction of anesthesia, and operating procedure, especially the procedure for delivering the uterine tube in both postpartum and interval procedures.     

Postpartum depression: a review

Postpartum depression is a disorder that is often unrecognized and undertreated. Many psychosocial stressors may have an impact on the development of postpartum depression. The greater risk of postpartum depression is a history of major depression and those who have experienced depression during past pregnancies. Untreated maternal depression can have a negative effect on child development, mother-infant bonding, and risk of anxiety or depressive symptoms in infants later in life. Management of postpartum depression is a vital part of adequate medical care. The obstetrician and pediatrician can serve important roles in screening for and treating postpartum depression. To prevent adverse outcomes associated with depression and its impact on the child, it is important that all health care professionals and nurse practitioners are aware of specific signs and symptoms, appropriate screening methods, and proper treatment. This review article covers major traits of postpartum depression.     

Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period

Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.     

Postpartum depression: a metasynthesis

Postpartum depression has been described as a dangerous thief that robs mothers of the love and happiness they expected to feel toward their newborn babies. Even though the number of qualitative studies on postpartum depression is increasing, knowledge development will be impeded unless the rich understandings gleaned from these studies are synthesized. Using Noblit and Hare's 1988 approach, the author conducted a metasynthesis of 18 qualitative studies on postpartum depression. Four overarching themes emerged that reflected four perspectives involved in postpartum depression: (a) incongruity between expectations and the reality of motherhood, (b) spiraling downward, (c) pervasive loss, and (d) making gains. Implications for clinical practice and theory development are addressed.