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Antepartum Depression

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181. Multiple gestation associated with infertility therapy: a committee opinion

of preterm birth (cerebral palsy, retinopathy, and bronchopulmonary dysplasia) and those of fetal growth restriction (polycythemia, hypoglycemia, and necrotizing enterocolitis). To what extent multiple gestation itself may affect neurobehavioral development in the absence of these complications isnotclear. Physical, emotional, and?nancial stresses increase the incidence of depression and anxiety disorders among mothers rearing twins and higher-order multiples (57). The incidence of behavioral problems (...) : a meta-analysis. Obstet Gynecol 2004;103:551–63. 39. D’Alton ME, Mercer BM. Antepartum management of twin gestation: ultrasound. Clin Obstet Gynecol 1990;33:42–51. 40. Torok O, Lapinski R, Sala?a CM, Bernasko J, Berkowitz RL. Multifetal pregnancyreductionisnotassociatedwithanincreasedriskofintrauterine growth restriction, except for very-high-order multiples. Am J Obstet Gynecol 1998;179:221–5. 41. Evans MI, Britt DW. Fetal reduction. Semin Perinatol 2005;29:321–9. 42. BlondelB,KoganMD,AlexanderGR

2012 Society for Assisted Reproductive Technology

183. Pharmacokinetics of Quetiapine Across Pregnancy and Postpartum

. Condition or disease Intervention/treatment Bipolar Disorder Drug: Quetiapine Detailed Description: Bipolar Disorder (BD) and Schizophrenia (SCHZ) in pregnancy are associated with pregnancy complications and increased maternal mortality due to physiological and psychosocial changes independent of SGA use. Untreated BD and SCHZ have been associated with an increased risk of placental abnormalities, antepartum hemorrhage, preterm birth, pre-eclampsia, low birth-weight, intrauterine growth retardation (...) -delivery and banked for later analysis Cerebrospinal Fluid (CSF) Quetiapine and 7-N-desalkyquetiapine Concentrations [ Time Frame: CSF to be obtained within 10 minutes of the epidural placement during labor ] Scores on Depression assessment, Inventory of Depression Symptomatology- Self Report (IDS-SR) [ Time Frame: Participants will complete these assessments an average of every 10 weeks from the time they enter the study, up to 12 weeks postpartum ] To determine if there is a pattern of increasing

2016 Clinical Trials

184. Chloroprocaine 3%

and /or formulations ingredients; ascertained or presumptive hypersensitivity to the amide and ester-type anaesthetics Diseases: significant history of renal, hepatic, gastrointestinal, cardiovascular, respiratory, skin, haematological, endocrine or neurological diseases that may interfere with the aim of the study; ascertained psychiatric diseases, eclampsia, antepartum haemorrhage, sepsis, blood coagulation disorders, insulin dependent diabetes mellitus, terminal kidney failure Medications: Medication known (...) : September 29, 2016 Last Update Posted: January 30, 2019 Last Verified: January 2019 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: Yes Additional relevant MeSH terms: Layout table for MeSH terms Pharmaceutical Solutions Anesthetics Ropivacaine Chloroprocaine Procaine Central Nervous System Depressants Physiological Effects of Drugs Anesthetics, Local Sensory System Agents Peripheral Nervous System Agents

2016 Clinical Trials

185. Relationship Between Postpartum Mood Disorders and Delivery Experience

birth at the University of Michigan Speaks English without translator Live pregnancy not desiring termination Smartphone owner Woman whose delivery date is >28 weeks gestational age Exclusion Criteria: History of previous postpartum depression (PPD) or posttraumatic stress disorder (PTSD) from a birth experience Non-English speaker requiring a translator Patients who have a fetus with major fetal anomalies Positive screening at 28 weeks antepartum for Edinburgh Postnatal Depression Scale (EPDS (...) Kountanis, University of Michigan Study Details Study Description Go to Brief Summary: The purpose of this study is to evaluate potential risk factors for developing postpartum depression or posttraumatic stress disorder during the first year postpartum in patients who have no preexisting history of PTSD or PPD. Condition or disease Postpartum Period Depression Stress Disorders, Post-Traumatic Detailed Description: It is theorized that poor pain control during labor and cesarean delivery, non-elective

2016 Clinical Trials

186. Postoperative Cesarean Delivery Pain Relief; Diclofenac Versus Bupivacaine

conditions: CPD, fail induction of labor, antepartum hemorrhage without hypovolemic shock, dystocia, previous cesarean section and active labor, malpresentation in labor, macrosomic presentation in labor Pregnant women more than 20 years of age Gestational age more than 37 week Cesarean section under regional or general anesthesia Ability to communicating, writing and reading Thai language Exclusion Criteria: Inability to communicating or writing or reading Thai language Contraindicated to bupivacaine (...) Numbers: RJBUPI First Posted: February 1, 2017 Last Update Posted: October 10, 2017 Last Verified: October 2017 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Additional relevant MeSH terms: Layout table for MeSH terms Bupivacaine Diclofenac Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Sensory System Agents Peripheral Nervous System Agents Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Anti

2016 Clinical Trials

187. Longitudinal course of ante- and postpartum generalized anxiety symptoms and associated factors in West-African women from Ghana and Côte d'Ivoire. (PubMed)

. The majority of women (79.8%) had consistent low anxiety symptoms, while 11.4% had elevated anxiety scores before and around childbirth that decreased gradually. 5.4% of women showed increasing anxiety symptoms over time. Few women (3.3%) had transient anxiety with elevated scores at three and 12 months postpartum. Risk factors for elevated anxiety levels around childbirth were antepartum depressive symptoms, higher levels of stress (economic, marital and social stress), lower child birth weight (...) /2010 and 03/2014. Anxiety symptoms were measured using the seven-item Generalized Anxiety Disorder scale (GAD-7) at three months antepartum and three, 12 and 24 months postpartum. Growth mixture modeling was applied to identify latent trajectory classes of anxiety. Multinomial logistic regression was used to investigate the associations of psychosocial, sociodemographic, obstetric and clinical characteristics with different trajectories.Four distinct trajectories of anxiety were identified

2016 Journal of Affective Disorders

188. Childhood Abuse and Suicidal Ideation in a Cohort of Pregnant Peruvian Women. (PubMed)

in this cohort was 71.8% and antepartum suicidal ideation was 15.8%. The prevalence of antepartum suicidal ideation was higher among women who reported experiencing any childhood abuse compared to those reporting none (89.3% vs 10.7%, P < .0001). After adjusting for potential confounders, including antepartum depression and lifetime intimate partner violence, those with history of any childhood abuse had a 2.9-fold (2.90, adjusted odds ratio; 95% confidence interval, 2.12-3.97) increased odds of reporting (...) ideation among pregnant women.A cross-sectional study was conducted among 2964 pregnant women attending prenatal clinics in Lima, Peru. Childhood abuse was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 scale. Logistic regression procedures were performed to estimate adjusted odds ratios and 95% confidence intervals adjusted for potential confounders.Overall, the prevalence of childhood abuse

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2016 American Journal of Obstetrics and Gynecology

189. Psychometric Evaluation of the Ford Insomnia Response to Stress Test (FIRST) in Early Pregnancy (PubMed)

% of the variance. The FIRST-S items showed good internal consistency (Cronbach α = 0.81). CFA results corroborated the one-factor structure finding from the EFA; and yielded measures indicating goodness of fit (comparative fit index of 0.902) and accuracy (root mean square error of approximation of 0.057). The FIRST-S had good construct validity as demonstrated by statistically significant associations of FIRST-S scores with sleep quality, antepartum depression and anxiety symptoms. Finally, results from IRT (...) exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency and construct validity were also assessed by evaluating the association between the FIRST-S with symptoms of depression, anxiety, and sleep quality. Item response theory (IRT) analyses were conducted to complement classical test theory (CTT) analytic approaches.The mean score of the FIRST-S was 13.8 (range: 9-33). The results of the EFA showed that the FIRST-S contained a one-factor solution that accounted for 69.8

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2016 Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

190. Neonatal Distress Causes

: SSICCCFIT s CNS Formula Intestinal Toxins IV. Causes: Immediate (follows delivery) Mnemonic: TAMM Asphyxia Medications Malformations Mnemonic: DATA Drugs Asphyxia Anomalies Specific Causes of peripartum distress Intrauterine Asphyxia Depressants and other Medications (maternal) or prescribed s Barbiturates s Cerebral edema Cerebral (rare) Congenital Anomalies or Malformations Prematurity Mechanical airway obstruction Parenchymal lung disease Neurologic disorders V. Risk Factors: Antepartum See causes

2018 FP Notebook

191. Peripartum Risk to the Fetus

Peripartum Risk to the Fetus Aka: Peripartum Risk to the Fetus From Related Chapters II. Indications intensity (e.g. continuous or intermittent monitoring) III. Risk Factors: Antenatal Fetal factors Abnormal umbilical artery velocimetry restriction Oligohydramnios Maternal factors Antepartum Maternal cardiac disease ( ) Maternal Morbid Maternal renal disease Maternal vascular disease IV. Risk Factors: Intrapartum Fetal factors Abnormal on Meconium stained amniotic fluid Maternal factors Hypertonic (...) Induced labor or augmented labor Intrauterine infection or (>42 weeks gestation) (<32 weeks gestation) Previous ceserean delivery Prolonged >24 hours (at term) Regional analgesia in labor V. Risk Factors: Specific Conditions and their associated risks Preterm delivery Asphyxia Blood Group Incompatibility ABO incompatibility or Fetal asphyxia Preterm (<38 weeks) or Postterm (>42 weeks) delivery Asphyxia ( ) Fetal Asphyxia Prematurity Neonatal Depression Hypovolemia VI. References Images: Related links

2018 FP Notebook

192. Family Practice Notebook Updates

blocks (landmarks, visualize fluid dispersion) is not a contraindication to Be aware of and precalculate toxic dose levels Dilute anesthetic to lower concentrations and higher volumes for best effect (psych, pharm, depression) risk in (treat with s) QRS prolongation may also occur with (treat with serial doses of bicarbonate) (psych, pharm, depression) Some drugs we do not identify as s include , St. Johns Wort, Selegeline May cause in or when taking tyramines; treat with phentolamine (alpha (...) , hemeonc) Incidental and persistent have replaced late presentations (palpable , flank pain, ) (gi, peds, ) (ORS) is preferred in moderate dehydration and well described protocols can avoid IV fluids in most cases Half-strength apple juice followed by preferred fluids is more effective than ORS in mild dehydration due to (ob, antepartum) Excluding is top priority in pregnancy of unknown location level <6 is consistent with non-viable pregnancy should be seen on by 1800 to 3000 (psych, behavior

2018 FP Notebook

193. Striae Gravidarum

Gravidarum , Striae Albicantes , Stretch Marks of Pregnancy II. Epidemiology : 90% of pregnant women by third trimester III. Risk Factors Non-caucasian IV. Physiology Related to with pregnancy Deep collagen deposits break apart Also associated with increased ACTH secretion Affects connective tissue V. Signs Red, pink, or purple depressed atrophic bands, streaks Distribution (occurs in areas of higher fat) Buttocks s s Arms Regress after delivery Residual white streaks remain (Striae Albicantes) VI (...) . Management: Antepartum Minimal evidence of benefit of any topical in pregnancy Combination products with possible benefit Tocopherol, s, panthenol, hyaluronic acid Centella asiatica, alpha-tocopherol, collagen-elastin Unclear safety in pregnancy VII. Management: Postpartum Typical course is for striae to fade postpartum Topical Indicated if striae in early stages (still red) May reduce residual changes Do not use concurrently in pregnancy or System retinoids have been used d dye laser at 585 nm VIII

2018 FP Notebook

194. Suicidal Ideation in Pregnancy: An Epidemiologic Review (PubMed)

and suicidal ideation. Of the 57 included articles, 20 reported prevalence, 26 reported risk factors, 21 reported consequences of antepartum suicidal ideation, and 5 reported on screening measures. Available evidence indicates that pregnant women are more likely than the general population to endorse suicidal ideation. Additionally, a number of risk factors for antepartum suicidal ideation were identified including intimate partner violence, <12-year education, and major depressive disorder (...) . There is a need for enhanced screening for antepartum suicidal ideation. The few screening instruments that exist are limited as they were primarily developed to measure antepartum and postpartum depression. Given a substantial proportion of women with suicidal ideation that does not meet clinical thresholds of depression and given the stress-diathesis model that shows susceptibility to suicidal behavior independent of depressive disorders, innovative approaches to improve screening and detection

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2016 Archives of women's mental health

195. Suicidal Ideation During the Postpartum Period (PubMed)

Depression Scale and from the Patient Health Questionnaire.Two percent of participants presented with SI during the first 6 months postpartum. In bivariate analyses, race/ethnicity, nativity, insurance, and language were significantly correlated with SI 3 weeks, 3 months, and 6 months postpartum. Screening positive for depression (p = 0.0245) and anxiety (0.0454), assessed 1-2 days postpartum, was significantly correlated with later SI in bivariate analyses, as were antepartum complications (p = 0.001 (...) ), depressive history (0.001), and self-efficacy (0.045). In adjusted models, antepartum complications (OR = 4.681, 95% CI = 1.99-10.99) and depressive history (OR-3.780, 95% CI = 1.514-9.441) were significantly associated with later postpartum SI. Heightened self-efficacy reduced the odds of later SI (p = 0.050).Findings suggest that SI among a relatively healthy group of new mothers occurs with some frequency. Mothers with a history of depression and antepartum complications may be at increased risk.

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2016 Journal of Women's Health

196. Maternity Care Pathway

Additional Care This pathway is designed for all pregnant women, most of whom are healthy. Women with the following conditions in the current pregnancy may require additional care or services or referral to a specialist: Cardiac disease, including hypertension • Renal disease • Endocrine disorders or pre-existing diabetes • Psychiatric disorders • Haematological disorders • Autoimmune disorders • Pharmacological therapy (anti-depressants, • anticonvulsants etc.) History of infertility or assisted (...) for testing and treatment for GBS • Normal birth • 54 Preparation for labour (including latent phase) and birth including the woman’s preferences, recognition of the • signs of active labour and coping with pain Variations from normal birth and possible interventions • 14 British Columbia Perinatal Health Program Labour support and doula • 55 care On-call arrangements, when and who to call when in labour • Postnatal self-care, awareness of ‘baby blues’ and postnatal depression • Procedure/Test

2010 British Columbia Perinatal Health Program

197. Late Intrauterine Fetal Death and Stillbirth

associated antepartum conditions include congenital malformation, congenital fetal infection, antepartum haemorrhage, pre-eclampsia and maternal disease such as diabetes mellitus. 3,4 The common causes of intrapartum death include placental abruption, maternal and fetal infection, cord prolapse, idiopathic hypoxia–acidosis and uterine rupture. 3,4 Transplacental infections associated with IUFD include cytomegalovirus 30 (Evidence level 2+), syphilis 31–34 (Evidence level 1+) and parvovirus B19 34,35 (...) and preoperative assessment should be cancelled. 8. Psychological and social aspects of care 8.1 What psychological problems can follow late IUFD? Carers must be alert to the fact that mothers, partners and children are all at risk of prolonged severe psychological reactions including post-traumatic stress disorder but that their reactions might be very different. Perinatal death is associated with increased rates of admission owing to postnatal depression. 139 Unresolved normal grief responses can evolve

2010 Royal College of Obstetricians and Gynaecologists

198. Addyi - Flibanserin

that flibanserin compared unfavorably with available selective serotonin reuptake inhibitors (SSRIs) as a treatment for depression and abandoned further development for depression. However, in Phase 2 trials, flibanserin appeared to have outperformed both placebo and SSRIs in maintaining sexual function in subjects with major depression. 6 This finding underscored the 2002 BI decision to pursue development of flibanserin as a treatment of female HSDD. 2 West SL, D’Aloisio AA, Agans RP, Kalsbeek WD, Borisov NN (...) that significant safety concerns, including syncope/hypotension, CNS depression, DDIs, and accidental injuries, could not be offset by numerically small treatment effects shown in the three clinical trials. While the third clinical trial (already ongoing at the time of the first CR letter) did assess FSFI- desire as a pre-specified co-primary endpoint, FDA’s concerns that the FSFI-desire domain may not be optimal to assess sexual desire were not adequately addressed. On September 27, 2013, FDA issued a second

2015 FDA - Drug Approval Package

199. Clinical practice guideline for the management of women who report decreased fetal movements

the amniotic sac. This environment cushions the baby from injury and plays an important role in fetal development. Antenatal Occurring before birth; concerned with the care and treatment of the unborn baby and pregnant woman. Antepartum Before the onset of labour. Apgar score A system to assess the status of the baby after birth. The Apgar score is based on the following five variables: heart rate, respiratory effort, muscle tone, reflex irritability and colour with a maximum score is 10. The Apgar score (...) with severe neonatal depression or fetal growth restriction. Importantly, a significant reduction in perinatal mortality was shown (OR 0.51, 95%CI 0.32-0.81). Another study of 489 women with DFM 74 demonstrated that women with DFM, but no other pregnancy risk factor, did not require further follow-up once the CTG and the amniotic fluid volume were confirmed normal. An ultrasound scan was performed to assess amniotic fluid volume in women with DFM and revealed a 3.7 times greater likelihood of a diminished

2010 Clinical Practice Guidelines Portal

200. Chinese Herbal Medicine and Micronized Progesterone for Threatened Miscarriage RCT

of gestation ] Number of patients who have a pregnancy loss before 20 weeks of gestation Pregnancy loss rate [ Time Frame: After 20 weeks of gestation ] Number of patients who have a pregnancy loss after 20 weeks of gestation Serum Progesterone Level [ Time Frame: Up to 1 years ] Units: ng/ml Pregnancy-induced hypertension [ Time Frame: Up to 1 years ] Diabetes [ Time Frame: Up to 1 years ] The number of participants with diabetes Antepartum haemorrhage [ Time Frame: Up to 1 years ] The number (...) of participants with antepartum haemorrhage Preterm birth [ Time Frame: Up to 1 years ] Preterm birth rate Postdate delivery [ Time Frame: Up to 1 years ] Postdate delivery rate Preeclampsia [ Time Frame: Up to 1 years ] The number of participants with Preeclampsia Intrauterine Growth Retardation [ Time Frame: Up to 1 years ] Intrauterine Growth Retardation Rate Small for gestational age infant [ Time Frame: Up to 1 years ] The number of small for gestational age infant Stillbirth [ Time Frame: Up to 1 years

2015 Clinical Trials

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