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The context of birth
Published in Helen Baston, Midwifery, 2020
Following the expulsion of the placenta and for the next six weeks is the postnatal period, also known as the puerperium. During this time the woman’s reproductive system body returns to its near pre-pregnancy state, give or take some stretch marks, scars and excess weight. The length of time her body takes to recover will depend on her mode of birth, pre-pregnancy fitness, age and parity.
Eicosanoids and Hypertension in Pregnancy
Published in Murray D. Mitchell, Eicosanoids in Reproduction, 2020
Scott W. Walsh, Valerie M. Parisi
Preeclampsia is characterized by the development of hypertension (maternal systemic arterial blood pressure ≥ 140/90 mmHg) and proteinuria (urinary protein >0.3 g/d) generally accompanied by edema during pregnancy or in the early puerperium in women who were normotensive before the pregnancy.1,4–7 Blood pressure usually returns to normotensive levels within 10 d following parturition. The etiology of preeclampsia is not known but it is likely due, in part, to a decreased production of a vasodilator.
Psychiatric disorders
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
The risk of post-partum depression in women with a history of depression is about 25%.6 Women with a history of severe post-partum depression may benefit from prophylactic antidepressants in the third trimester or the early puerperium. Although neonatal toxicity may occur due to antidepressant exposure in late pregnancy, this is often outweighed by the risks to the mother of stopping treatment before delivery.
The role of neuropeptide Y, orexin-A, and ghrelin in differentiating unipolar and bipolar depression: a preliminary study
Published in Nordic Journal of Psychiatry, 2022
Mehmet Ünler, İrem Ekmekçi Ertek, Nigar Afandiyeva, Mustafa Kavutçu, Nevzat Yüksel
Conditions that could affect sleep and appetite, thereby affecting neuropeptide levels, were determined as exclusion criteria. The exclusion criteria were as follows: (a) mental illness other than generalized anxiety disorder (because depression is known as the most common comorbidity in patients with generalized anxiety disorder); (b) major neurological diseases such as narcolepsy, epilepsy, cerebrovascular diseases; (c) serious chronic illnesses which are thought to affect sleep and appetite such as; diabetes, chronic renal failure, obstructive sleep apnea, active cancer diagnosis, etc.; (d) patients with hypothyroidism who are not in the euthyroid state as a result of routine blood tests in the last 3 months; (e) endocrine disorders such as Cushing’s disease, panhypopituitarism, Addison’s disease, polycystic ovary syndrome, etc.; (f) those who use drugs such as steroids, and oral contraceptives; (g) morbid obesity; (h) a history of severe head trauma with loss of consciousness or a history of neurosurgical surgery; (i) a history of gastrointestinal surgery; (j) pregnancy and puerperium. During the study, the patients continued their routine treatment, and only 11 patients in the UP group were not receiving treatment for the last 1 week.
Management of pregnant women with antiphospholipid antibodies
Published in Expert Review of Clinical Immunology, 2019
Amelia Ruffatti, Maria Favaro, Antonia Calligaro, Alessandra Zambon, Teresa Del Ross
Due to hormonal and clotting changes, puerperium is a critical thrombophilic period, thus, heparin thromboprophylaxis should be extended for at least 6 weeks after delivery in APS patients. According to some studies women with purely obstetric APS continue to have long-term risk for thrombosis mainly affecting arterial cerebral vessels. The finding by one of these studies [110] showed that LDA reduced the rate of vascular events from 59% to 10% and suggested that life-long LDA treatment could be prescribed to all women with purely obstetric APS. However, in one report [111] LAC positivity was a risk factor for developing long-term thrombosis in these women, thus life-long LDA treatment could be prescribed to purely obstetric APS women with one or more risk factors for thrombosis.
Pain and stress after vaginal delivery: characteristics at hospital discharge and associations with parity
Published in Journal of Obstetrics and Gynaecology, 2020
Vincenzo Zanardo, Matteo Parotto, Valeria Manghina, Lara Giliberti, Francesca Volpe, Lorenzo Severino, Gianluca Straface
Since the psychological distress analysed in this study reflects what would be present in the first post-discharge days when mother–infant contact is almost exclusive, these data extend the well-known clinical significance of peri-partum psychological distress in pregnancy, labour and puerperium to the post-discharge period as a critical feature of primiparae women post-delivery. If a certain amount of emotional distress is normal when considering the events surrounding first childbirth and the onset of lactation, women whose experience are at the high end of range for psychological distress may be at greater risk also for adverse breastfeeding outcomes (Dewey 2001) and occurrence and severity of symptoms of postpartum depression (Mori et al. 2015).