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Antepartum Depression

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121. Intrapartum care for healthy women and babies

Preterm labour or preterm prelabour rupture of membranes Placental abruption Anaemia – haemoglobin less than 85 g/litre at onset of labour Confirmed intrauterine death Induction of labour Substance misuse Alcohol dependency requiring assessment or treatment Onset of gestational diabetes Malpresentation – breech or transverse lie BMI at booking of greater than 35 kg/m 2 Recurrent antepartum haemorrhage Small for gestational age in this pregnancy (less than fifth centile or reduced growth velocity (...) rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 89Previous complications Stillbirth/neonatal death with a known non-recurrent cause Pre-eclampsia developing at term Placental abruption with good outcome History of previous baby more than 4.5 kg Extensive vaginal, cervical, or third- or fourth-degree perineal trauma Previous term baby with jaundice requiring exchange transfusion Current pregnancy Antepartum bleeding of unknown

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

122. Light Therapy for Depression During Pregnancy

to neonatal intensive care, and cognitive, emotional and behavioural disturbances.Treatment of antepartum depression requires careful judgement to minimise risk to the foetus. Pharmacological treatment is an option, but all antidepressants cross the placenta, and both practitioners and patients are concerned about possible teratogenicity, pre- and perinatal adverse effects for the infant, as well as negative effects on long-term development. Thus, psychiatric medication use for depression in pregnancy may (...) Official Title: A Randomised, Double-blind, Placebo-controlled Study of Light Therapy for Antepartum Depression Study Start Date : October 2004 Actual Primary Completion Date : October 2008 Actual Study Completion Date : October 2008 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: Bright light therapy Early morning white light @ 7,000 lux for 60 minutes daily (4.2 x 10^5 lux-min) for 5 weeks Other: Light

2010 Clinical Trials

123. Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh. (PubMed)

Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh. There is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. There is no research on the association between maternal mental disorders and LBW in Bangladesh. This study aims to investigate (...) the independent effect of maternal antepartum depressive and anxiety symptoms on infant LBW among women in a rural district of Bangladesh.A population-based sample of 720 pregnant women from two rural subdistricts was assessed for symptoms of antepartum depression, using the Edinburgh Postpartum Depression Scale (EPDS), and antepartum anxiety, using the State Trait Anxiety Inventory (STAI), and followed for 6-8 months postpartum. Infant birth weight of 583 (81%) singleton live babies born at term (≥ 37 weeks

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2010 BMC Public Health

124. Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. (PubMed)

suicidal ideation was reported by 2.6% (49). Among patients with probable major depression, 29.5% (28) reported current suicidal ideation. Psychosocial stress (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.21-1.36), domestic violence (OR 3.45; 95% CI 1.46-8.12), chronic medical conditions (OR 3.05; 95% CI 1.63-5.69), and race (Asian: OR 5.81; 95% CI 2.55-13.23; or African American: OR 2.98; 95% CI 1.24-7.18) each significantly increased the odds of probable antepartum major depressive disorder (...) Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. To estimate the prevalence of major and minor depression, panic disorder, and suicidal ideation during pregnancy while also identifying factors independently associated with antenatal depressive disorders.In this prospective study, participants were 1,888 women receiving ongoing prenatal care at a university obstetric clinic from January 2004 through January 2009. Prevalence of psychiatric disorders

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2010 Obstetrics and Gynecology

125. Risk factors for depressive symptoms during pregnancy: a systematic review. (PubMed)

Risk factors for depressive symptoms during pregnancy: a systematic review. The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the English-language literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and > or =1 risk factors. For each risk factor, 2 blinded, independent reviewers evaluated the overall trend (...) of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate

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2010 American journal of obstetrics and gynecology

126. Committee opinion no. 453: Screening for depression during and after pregnancy. (PubMed)

Committee opinion no. 453: Screening for depression during and after pregnancy. Depression is very common during pregnancy and the postpartum period. At this time, there is insufficient evidence to support a firm recommendation for universal antepartum or postpartum screening. There are also insufficient data to recommend how often screening should be done. There are multiple depression screening tools available for use.

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2010 Obstetrics and Gynecology

128. WHO guidelines on the management of health complications from female genital mutilation

for preventing and treating obstetric complications in women living with type III FGM (strong recommendation; very low-quality evidence). R-2 Either antepartum or intrapartum deinfibulation is recommended to facilitate childbirth in women living with type III FGM (conditional recommendation; very low-quality evidence). R-3 Deinfibulation is recommended for preventing and treating urologic complications – specifically recurrent urinary tract infections and urinary retention – in girls and women living (...) with type III FGM (strong recommendation; no direct evidence). BP-1 Girls and women who are candidates for deinfibulation should receive adequate preoperative briefing (Best practice statement). BP-2 Girls and women undergoing deinfibulation should be offered local anaesthesia (Best practice statement). MENTAL HEALTH R-4 Cognitive behavioural therapy (CBT) should be considered for girls and women living with FGM who are experiencing symptoms consistent with anxiety disorders, depression or post

2016 World Health Organisation Guidelines

129. Hypertensive disorders of pregnancy

discussion with a consultant obstetrician • Treatment is recommended during the antepartum, intrapartum and within the first 24 hours postpartum for preeclampsia with evidence of central nervous system dysfunction • Symptoms or signs have poor positive and negative predictability for eclampsia • Refer to Appendix D: Magnesium Sulfate protocol Suggested indications to commence • Eclampsia • Severe preeclampsia, defined in the Magpie Trial 28 as: o sBP greater than or equal to 170 mmHg or dBP greater than (...) . Table 15. Eclampsia Aspect Considerations Goals of treatment 1 • Terminate the seizure • Prevent recurrence • Control hypertension • Prevent maternal and fetal hypoxia Context • There are no reliable clinical markers that predict eclampsia • Hypertension and proteinuria may be absent prior to the seizure 1 • Seizures may occur antepartum, intrapartum or postpartum usually within 24 hours of birth 1 • Reported incidence of eclampsia varies. In Australia in singleton pregnancies, the incidence

2016 Queensland Health

130. Guidelines for Weight Gain During Pregnancy: A Focused Practice Question

not included in the systematic review Types of Studies included Systematic review & literature review ? RCTs, Prospective cohort, retrospective cohort and case-control studies Outcomes Included Maternal outcomes Antepartum period: abnormal glucose metabolism and gestational diabetes, maternal discomforts in pregnancy, hyperemesis, hypertensive disorders, gallstones. Intrapartum period: premature rupture of membranes, preterm labour, postterm pregnancy, induction of labour, length of labour, mode (...) of delivery, vaginal birth after caesarean, vaginal lacerations, shoulder dystocia, cephalopelvic disproportion, complications of labour and delivery. Postpartum period: lactation, weight retention, premenopausal breast cancer, postpartum depression and maternal mortality. Birth outcomes: preterm birth, birthweight, low birthweight, macrosomia, large for gestational age, small for gestational age, apgar scores. Infant outcomes: perinatal mortality, birth defects, breastfeeding initiation and maintenance

2016 Peel Health Library

132. Neonatal resuscitation

· Abnormal fetal presentation · Prolapsed cord · Prolonged first or second stage of labour · Precipitate labour · Antepartum haemorrhage (e.g. abruption, placenta praevia, vasa praevia) · Meconium in the amniotic fluid · Narcotic administration to mother within 4 hours of birth · Assisted vaginal birth–forceps or vacuum (ventouse) · Maternal general anaesthesia Queensland Clinical Guideline: Neonatal resuscitation Refer to online version, destroy printed copies after use Page 10 of 38 3 Preparation (...) Babies born to febrile women (temperature greater than 38 °C) are at increased risk of death, perinatal respiratory depression, neonatal seizures and cerebral palsy 1 · Induced hypothermia for hypoxic ischaemic encephalopathy (HIE): o Refer to Queensland Clinical Guideline: Hypoxic ischaemic encephalopathy (HIE) 3 · Do not apply hot water bottles or heat packs/stones directly to a baby and only use to warm linen when no other means available Delayed cord clamping 1,5,11 · Insufficient evidence

2016 Clinical Practice Guidelines Portal

133. Neonatal resuscitation

· Abnormal fetal presentation · Prolapsed cord · Prolonged first or second stage of labour · Precipitate labour · Antepartum haemorrhage (e.g. abruption, placenta praevia, vasa praevia) · Meconium in the amniotic fluid · Narcotic administration to mother within 4 hours of birth · Assisted vaginal birth–forceps or vacuum (ventouse) · Maternal general anaesthesia Queensland Clinical Guideline: Neonatal resuscitation Refer to online version, destroy printed copies after use Page 10 of 38 3 Preparation (...) Babies born to febrile women (temperature greater than 38 °C) are at increased risk of death, perinatal respiratory depression, neonatal seizures and cerebral palsy 1 · Induced hypothermia for hypoxic ischaemic encephalopathy (HIE): o Refer to Queensland Clinical Guideline: Hypoxic ischaemic encephalopathy (HIE) 3 · Do not apply hot water bottles or heat packs/stones directly to a baby and only use to warm linen when no other means available Delayed cord clamping 1,5,11 · Insufficient evidence

2016 Clinical Practice Guidelines Portal

134. Interventions for preventing or reducing domestic violence against pregnant women. (PubMed)

, one study, 271 women, very low quality). Finally, the risk for low birthweight (< 2500 g) did not differ between groups (RR 0.74, 95 % CI 0.41 to 1.32, 306 infants, low quality).There were few statistically significant differences between intervention and control groups for depression during pregnancy and the postnatal period. Only one study reported findings for neonatal outcomes such as preterm delivery and birthweight, and there were no clinically significant differences between groups. None (...) of the studies reported results for other secondary outcomes: Apgar score less than seven at one minute and five minutes, stillbirth, neonatal death, miscarriage, maternal mortality, antepartum haemorrhage, and placental abruption.There is insufficient evidence to assess the effectiveness of interventions for domestic violence on pregnancy outcomes. There is a need for high-quality, RCTs with adequate statistical power to determine whether intervention programs prevent or reduce domestic violence episodes

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2014 Cochrane

135. Maternal, pregnancy and neonatal outcomes following IVF pregnancies

of ectopic pregnancy after ART 37 Table 3b: Risk factors for ectopic pregnancy in ART 38 Table 4a: Pregnancy loss after ART incidence 41 Table 4b: Risk factors for pregnancy loss after ART 42 Table 5a: Incidence of antepartum haemorrhage in ART pregnancies 48 Table 5b: Risk factors for antepartum haemorrhage in ART pregnancies 50 Table 6a: Incidence of hypertensive disorders in ART pregnancies 52 5 MATERNAL, PREGNANCY AND NEONATAL OUTCOMES FOLLOWING IVF: A RAPID REVIEW | SAX INSTITUTE Table 6b: Risk (...) 19: Incidence of thromboembolic disease in ART pregnancies 122 Table 20: Incidence of maternal mortality in ART pregnancies 126 Table 21: Incidence of maternal hospitalisation in ART pregnancies 128 Table 22: Incidence of ICU admission in ART pregnancies 130 Table 23a: Incidence of postpartum depression in ART pregnancies 131 Table 23b: Risk factors for postpartum depression in ART pregnancies 133 Table 24: Incidence of long term maternal morbidity in ART pregnancies 134 6 MATERNAL, PREGNANCY

2015 Sax Institute Evidence Check

136. Parent-infant Psychotherapy for Improving Parental and Infant Mental Health: A Systematic Review

. another PIP, video-interaction guidance, psychoeducation, counselling or cognitive behavioural therapy (CBT)), two of these studies included a control group in addition to an alternative treatment group. Samples included women with postpartum depression, anxious or insecure attachment, maltreated, and prison populations. We assessed potential bias (random sequence generation, allocation concealment, incomplete outcome data, selective reporting, blinding of participants and personnel, blinding (...) -up, or both, for the primary outcomes of parental depression (both dichotomous and continuous data); measures of parent-child interaction (i.e. maternal sensitivity, child involvement and parent engagement; infant attachment category (secure, avoidant, disorganised, resistant); attachment change (insecure to secure, stable secure, secure to insecure, stable insecure); infant behaviour and secondary outcomes (e.g. infant cognitive development). The results favoured neither PIP nor control

2015 Campbell Collaboration

137. Caesarean section

individual CS. [new 2011] [new 2011] 1.4.4 1.4.4 Preoper Preoperativ ative testing and prepar e testing and preparation for CS ation for CS 1.4.4.1 Pregnant women should be offered a haemoglobin assessment before CS to identify those who have anaemia. Although blood loss of more than 1000 ml is infrequent after CS (it occurs in 4–8% of CS) it is a potentially serious complication. [2004] [2004] 1.4.4.2 Pregnant women having CS for antepartum haemorrhage, abruption, uterine rupture and placenta praevia (...) ] 1.7.1.8 Healthcare professionals caring for women who have had a CS should inform women that after a CS they are not at increased risk of difficulties with breastfeeding, depression, post-traumatic stress symptoms, dyspareunia and faecal incontinence. [2004] [2004] 1.7.1.9 While women are in hospital after having a CS, give them the opportunity to discuss with healthcare professionals the reasons for the CS and provide both verbal and printed information about birth options for any future pregnancies

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

138. [Effect of maternal antepartum psychological therapy upon early infant temperament]. (PubMed)

[Effect of maternal antepartum psychological therapy upon early infant temperament]. To find out whether there was any change in early infant temperament after mothers had received group psychological therapy on depression and anxiety during pregnancy period.A total of 800 subjects meeting the inclusion criteria, without the exclusion criteria and willing to sign the informed consent were recruited randomly from Shanghai International Peace Maternity & Child Health Hospital in their l6th-20th (...) weeks of pregnancy. They were randomized into the therapy group and the control group by the doll randomization table. Women in the therapy group would have a group psychological therapy for 6 times, 1.5 hours each time, while the control group not. The group psychological therapy included therapist introduction and participatory discussion. The therapy concerned the antepartum and postpartum depression, the risk factors concerned with antepartum and postpartum depression, antepartum and postpartum

2009 Zhonghua yi xue za zhi Controlled trial quality: uncertain

139. Population and Public Health Prenatal Care Pathway

Health and Adjustment to Pregnancy ? ? ? ? ? ? ? 26 Perinatal Depression and Anxiety ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 29 While every attempt has been made to ensure that the information contained herein is clinically accurate and current, Perinatal Services BC acknowledges that many issues remain controversial, and therefore may be subject to practice interpretation? © Perinatal Services BC, 2014 Perinatal Services BC West Tower, Suite 350 555 West 12th Avenue Vancouver, BC Canada V5Z 3X7 Tel: 604-877

2014 British Columbia Perinatal Health Program

140. Best Practice Guidelines for Mental Health Disorders in the Perinatal Period

, with the right strategy and a coordinated approach, it can be detected early and effectively treated. Most women need the support of health professionals, family and friends to seek assistance for a mental health disorder.17 Mental Health Disorders in the Perinatal Period 3.0 Perinatal Depression 3.1 Education and Prevention 3.1.1 What is Perinatal Depression? Perinatal depression (PND) is a term used to describe a major depressive episode during pregnancy (also referred to as the antepartum or antenatal (...) Best Practice Guidelines for Mental Health Disorders in the Perinatal Period Best Practice Guidelines for Mental Health Disorders in the Perinatal Period BC Reproductive Mental Health Program & Perinatal Services BC March 2014BEST PRACTICE GUIDELINES FOR MENTAL HEALTH DISORDERS IN THE PERINATAL PERIOD (2014) is a manual for healthcare clinicians who care for women during their reproductive years. This guidance describes best practices for the care of women with depression, anxiety disorders

2014 British Columbia Perinatal Health Program

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