Acute Psychiatric Crisis in Obstetrics



Though pregnancy is joyful for most of women, many biological and psychosocial changes may make vulnerable to psychiatric episode in an otherwise normal or in preexisting controlled disease. Many pregnancies occur unexpectedly while women are receiving treatment with medications for psychiatric disorders. Many women may consider stopping medication abruptly after learning they are pregnant, but for many women, this may carry substantial risks making them vulnerable to acute psychiatric episode during pregnancy causing harm to themselves and the fetus or neonate.

Although studies suggest that some medications may be used safe during pregnancy, research on effects of prenatal exposure to psychotropic medications is still incomplete. This chapter summarizes in short the various types of psychiatric illness which may present as acute emergency for an obstetrician.


Bipolar Disorder Anxiety Disorder Hyperemesis Gravidarum Nephrogenic Diabetes Insipidus Acute Psychosis 
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Further Reading

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    National Institute of Mental Health (US). The numbers count: mental disorders in America. Bethesda: NIMH/NIH Publication; 2008. Available at: Accessed 12 Jan 2012.Google Scholar
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    Chrousos GP, Torpy DJ, Gold PW. Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: clinical implications. Ann Intern Med. 1998;129:229–40.CrossRefPubMedGoogle Scholar
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    Yim IS, Glynn LM, Dunkel-Scheter C, et al. Risk of postpartum depressive symptoms with elevated corticotrophin-releasing hormone in human pregnancy. Arch Gen Psychiatry. 2009;66:162–9.CrossRefPubMedPubMedCentralGoogle Scholar
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    Robertson E, Grace S, Wallington T, et al. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–95.CrossRefPubMedGoogle Scholar
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    Lorenzetti V, Allen NB, Fornito A, et al. Structural brain abnormalities in major depressive disorder: a selective review of recent MRI studies. J Affect Disord. 2009;117:1–17.CrossRefPubMedGoogle Scholar
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    Belmaker RH, Agam G. Major depressive disorder. N Engl J Med. 2008;358:55–68.CrossRefPubMedGoogle Scholar
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    Sacher J, Wilson AA, Houle S, et al. Elevated brain monoamine oxidase A binding in the early postpartum period. Arch Gen Psychiatry. 2010;67:468–74.CrossRefPubMedGoogle Scholar
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    Doornbos B, Fekkes D, Tanke MA, et al. Sequential serotonin and noradrenalin associated processes involved in postpartum blues. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:1320–5.CrossRefPubMedGoogle Scholar
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    Practice Bulletin ACOG. Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2008;111:1001–19.CrossRefGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyDMIMS(DU)WardhaIndia

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