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Antepartum Depression

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141. 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

142. Umbilical Cord Prolapse

to the woman (possibly with her companions in labour) at a mutually convenient time. After obstetric emergencies, women can be psychologically affected by postnatal depression, post- traumatic stress disorder or fear of further childbirth. Women with cord prolapse and those who undergo urgent transfer to hospital might be particularly vulnerable to emotional problems. 67 5.2 Training All staff involved in maternity care should receive training in the management of obstetric emergencies including (...) (37 weeks or more). Cochrane Database Syst Rev 2006;(1):CD005302. 30. Ezra Y , Strasberg SR, Farine D. Does cord presentation on ultrasound predict cord prolapse? Gynecol Obstet Invest 2003;56:6–9. 31. Kinugasa M, Sato T, Tamura M, Suzuki H, Miyazaki Y , Imanaka M. Antepartum detection of cord presentation by transvaginal ultrasonography for term breech presentation: potential prediction and prevention of cord prolapse. J Obstet Gynaecol Res 2007;33:612–8. 32. Phelan JP , Boucher M, Mueller E

2014 Royal College of Obstetricians and Gynaecologists

143. Miscarriage

of miscarriage? Grief, anxiety, and/or depression will be experienced by many women following pregnancy loss. About 20% of women who experience a miscarriage become symptomatic for depression and/or anxiety. In most of these women, symptoms persist for 1–3 years, impacting their quality of life and subsequent pregnancies [ ]. These reactions tend to be most intense in the 4–6 weeks after the miscarriage [ ; ; ; ]. Grief following miscarriage is comparable in nature, intensity, and duration to grief reactions (...) if the woman: Is at increased risk of haemorrhage (such as her pregnancy is in the late first trimester), or Has had a previous adverse and/or traumatic experience associated with pregnancy (such as stillbirth, miscarriage, or antepartum haemorrhage), or Is at increased risk from the effects of haemorrhage (such as she had a coagulopathy or is unable to have a blood transfusion), or Has an infection. If the bleeding and pain settle (suggesting complete miscarriage), the woman will be advised to take

2018 NICE Clinical Knowledge Summaries

144. Diabetes distress is associated with adverse pregnancy outcomes in women with gestational diabetes: a prospective cohort study. (PubMed)

diabetes distress (OR 4.70, p = .02) and parity (OR 0.21, p = .02) but not antepartum depressive symptoms were related to adverse pregnancy outcomes.Diabetes distress is likely in women with GDM and our findings suggest an association between both diabetes distress, parity and adverse pregnancy outcomes in women with GDM. This warrants replication and further research into the underlying mechanisms explaining the impact of diabetes distress in GDM and potential interventions to reduce distress. (...) Diabetes distress is associated with adverse pregnancy outcomes in women with gestational diabetes: a prospective cohort study. Around 12% of pregnant women develop gestational diabetes mellitus (GDM), which is associated with increased health risks for both mother and child and pre- and postpartum depression. Little is known about the relationship of GDM with diabetes-specific emotional distress (diabetes distress). The aims of this study are to assess the prevalence of diabetes distress

2019 BMC Pregnancy and Childbirth

145. Transgender men, pregnancy, and the "new" advanced paternal age: A review of the literature. (PubMed)

to transgender individuals, especially transgender men during pregnancy, as well as research that addresses evidence-based practice remain limited. In this review, we discuss obstetrical issues for transgender men who are ≥35 years old, termed the "new" advanced paternal age. We review preconception care and focus on fertility issues, the impact of stopping gender-affirming hormonal treatment, and age-appropriate health maintenance. We review antepartum and postpartum care, including labor and delivery (...) , monitoring for perinatal depression, contraception, and chest feeding. Finally, we conclude with suggestions for areas for further research and study.Copyright © 2019 Elsevier B.V. All rights reserved.

2019 Maturitas

146. Pre-conception - advice and management

planning a pregnancy; and managing women who are underweight prior to conception. New sections on rheumatological conditions and inflammatory bowel disease have also been added. Creation of a general section on mental health issues that incorporates previous information on depression, bipolar disorder, and psychosis and schizophrenia. Minor changes to the management recommendations on alcohol advice; managing a woman with diabetes planning to conceive; referral of women with asthma for preconception

2017 NICE Clinical Knowledge Summaries

147. Use of Antidepressants in Breastfeeding Mothers

Database Syst Rev 2007;(3):CD006309. 40. Brandon AR, Freeman MP. When she says ‘‘no’’ to med- ication: Psychotherapy for antepartum depression. Curr Psychiatry Rep 2011;13:459–466. 41. Cuijpers P, Brannmark JG, van Straten A. Psychological treatment of postpartum depression: A meta-analysis. J Clin Psychol 2008;64:103–118. 42. O’Hara MW, Schlechte JA, Lewis DA, et al. Prospective study of postpartum blues. Biologic and psychosocial fac- tors. Arch Gen Psychiatry 1991;48:801–806. 43. Dekker JJ, Koelen (...) and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Background P ostpartum depression (PPD) (sometimes referred to as pregnancy-related mood disorder) is one of the most common and serious postpartum conditions, affecting 10–20% of mothers within the ?rst year of childbirth. 1 Studies have found that up to 50% of women with PPD are undiagnosed. 2 Risk factors

2015 Academy of Breastfeeding Medicine

148. Gestational diabetes mellitus

• There is limited evidence or consensus regarding specific antepartum tests or their frequency 54 • Monitoring type and frequency is influenced by the presence of other pregnancy complications (e.g. antepartum haemorrhage, preeclampsia, fetal growth restriction) as well as severity of maternal hyperglycaemia 24 • Fetal abdominal circumference (AC) greater than or equal to 75% for gestational age, measured at 29 to 33 weeks gestation, correlates with an increased risk for birth of an LGA infant 55 Fetal growth (...) for glycaemic management o Addition of pharmacologic therapy 3.3 Psychosocial support Table 14. Psychosocial support Aspect Consideration Context • Emotional well-being is an important part of diabetes care and self- management 8 • Rapport between the woman and the health care provider can enhance compliance 56 • Barriers to effective treatment response in women with GDM include depression, eating disorders, stress and anxiety 57 Information and education • Individualise the approach to management. Take

2015 Queensland Health

149. Obesity in pregnancy

associated with obesity in pregnancy Pre-pregnancy BMI is a greater determinant of healthy outcomes for the woman and her newborn than gestational weight gain (GWG). 1 The higher the pre-pregnancy BMI the greater the associated risk. Table 7. Risks of obesity in pregnancy Period Health risk Preconception • Infertility 13 • Pre diabetes (e.g. impaired fasting glucose or impaired glucose tolerance) • Type 2 Diabetes Antenatal • Antepartum stillbirth 14 • Miscarriage 1,15 • Maternal mortality 16 • Diabetes (...) (Gestational diabetes mellitus and Diabetes in Pregnancy ) 14 • Preeclampsia 14 • Obstructive sleep apnoea—may be related to adverse fetal outcomes 14 • Thromboembolic disease 14 • Cholecystitis 14 • Depression 4 • Difficulties with abdominal palpitation and obtaining adequate auscultation of fetal heart and cardiotocograph (CTG) • Suboptimal ultrasonography 5 • Diagnosis of congenital abnormality 17 • Preterm birth (PTB)—mostly associated with comorbidities 14,18 • Increased odds of dizygous twinning 19

2015 Queensland Health

151. SMFM State of Pregnancy Monograph

and/or fetal condition and the local resources. The discipline of MFM involves several pregnancy- related aspects, including: preconception care for women with medical or genetic risk factors or prior adverse pregnancy outcomes; antepartum care for pregnancies with medical, surgical, obstetric or fetal complications; labor and delivery and associated complications; obstetric complications; maternal medical complications; fetal evaluation for anomalies; fetal testing; gynecologic issues related to pregnancy (...) , there is very little information about the types of drugs for chronic conditions such as diabetes, depression or asthma among others. SMFM is working to gather interested organizations and federal agencies to engage in a collaborative effort to ensure that the effect of these types of drugs in pregnancy and lactation is known. This enormous public health PRECONCEPTION CARE Preconception evaluation of women to optimize maternal and perinatal outcomes. Examples include women with underlying illness, previous

2015 Society for Maternal-Fetal Medicine

152. Antenatal corticosteriods given to women prior to birth to improve fetal, infant, child and adult health

Chapter 14: Use of antenatal corticosteroids for women with specific risk factors for preterm birth 134 14.1 Women with a history of previous preterm birth 138 14.2 Women in preterm labour 151 14.3 Women with preterm prelabour rupture of membranes at risk of preterm birth 164 14.4 Women with chorioamnionitis at risk of preterm birth 180 14.5 Women with antepartum haemorrhage at risk of preterm birth 186 14.6 Women with a multiple pregnancy (twins and higher order) 198 14.7 Women with diabetes mellitus (...) in preterm labour – Repeat course of antenatal corticosteroids 372 Page 3 M17 Women with preterm prelabour rupture of membranes – Single course of antenatal corticosteroids 376 M18 Women with preterm prelabour rupture of membranes – Repeat antenatal corticosteroids .. 380 M19 Women with chorioamnionitis at risk of preterm birth – Single course of antenatal corticosteroids 384 M20 Women with chorioamnionitis at risk of preterm birth – Repeat antenatal corticosteroids 388 M21 Women with antepartum

2015 Clinical Practice Guidelines Portal

153. Choosing your model of care: A decision aid for pregnant women choosing their maternity care provider

midwife in labour Women who had an instrumental birth Women who felt in control during labour and birth Women who weren’t supported by a known midwife in labour Women who did not have an instrumental birth Women who did not feel in control during labour and birth 12Studies have found no difference between midwifery models of care and other models of care in: The chance of having antepartum haemorrhage (bleeding from your vagina during pregnancy) [3] The chance of a baby dying before, during and after (...) after birth [8] The chance of having a baby with a low birth weight (less than 2500g) [8] The chance of having a baby born prematurely (before 37 weeks pregnancy) [8] The chance of the baby having a low APGAR score (A score to assess a baby’s well-being after birth, a score lower than 7 means that a baby might need help breathing) [3] The chance of the baby having convulsions (fits) [8] The chance of having postnatal depression [8] The average length of a woman’s labour [8] The chance that a women

2015 EUnetHTA

154. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement

restriction (FGR) h Delivery Cesearean section/operative deliveries Small or large for gestational age (SGA/LGA), i preterm delivery (PTD), j anomalies detected by obstetrical screening Postpartum and neonatal/infancy Thromboembolism, postpartum depression, Lactation rates Anomalies detected after birth, neonatal intensive care unit admission, length of stay a A death of male or female parent or fetus/infant participating in trials should be reported. b OHSS (ovarian hyperstimulation syndrome

2014 Society for Assisted Reproductive Technology

155. Diagnosis and Treatment of Fetal Cardiac Disease

assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome (...) assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome (TTTS), lung masses, and vascular tumors, are highlighted. Experimental catheter-based intervention strategies to prevent the progression of disease in utero also are discussed

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2014 American Heart Association

156. Antidepressant Use During Pregnancy: Considerations for the Newborn Exposed to SSRIs/SNRIs

to serotonin reuptake inhibitors and benzodiazepines using population-based health data. Birth Defects Res B Dev Reprod Toxicol 2008;83(1):68-76. 10 Pedersen LH, Henriksen TB, Vestergaard M, Olsen J, Bech BH. Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study. BMJ 2009;339:b3569-b3575. 11 Chung TKH, Lau TK, Yip ASK, Chiu HFK, Lee DTS. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med (...) attention, such as depression and anxiety, are common during pregnancy. While there are risks to pharmaceutical treatment during pregnancy, untreated or incompletely managed depr ession also carries risks for the exposed newbor n. After car eful consideration of the risks and benefits of pharmaceutical treatment, many women and their caregivers decide to continue treatment with SSRIs/SNRIs during their pregnancy. While most newborns born to women who continue SSRI/SNRI treatment during pregnancy

2013 British Columbia Perinatal Health Program

157. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

Version 6.0 Clinical Manual Issue Date: January 2013 Part 1 - Clinical Guidelines Table of Contents 10 OBSTETRIC 1 10.1 Pre-term Labour and Tocolysis 1 10.2 Pre-Eclampsia 4 10.3 Eclampsia 6 10.4 Antepartum Haemorrhage 7 10.5 Post-Partum Haemorrhage 8 10.6 Epidurals In-Flight 10 10.7 Obstetric Trauma 11 11 PAEDIATRICS 1 11.1 Paediatric Upper Airway Obstruction 1 11.2 Gastroenteritis / Dehydration In Children 3 11.3 Neonate Retrievals 5 11.4 Intranasal Fentanyl 7 12 RESPIRATORY 1 12.1 Pulmonary Embolism (...) elevation = 1mm in 2 contiguous limb leads ? Persistent ST elevation = 2mm in 2 contiguous chest leads ? New left bundle branch block (LBBB) ? Changes consistent with posterior infarct (tall R in V1, deep anterior ST depression, ST elevation in V4 R) ? ECG changes of right ventricular infarct (ST elevation in leads aVR and V4R) NSTEMI Consistent history without ECG changes consistent with STEMI, plus positive troponin and positive creatine kinase (CK). Angina ? High Risk, (positive troponin but negative

2014 Clinical Practice Guidelines Portal

158. Investigation and Management Small-for-Gestational-Age Fetus

assessment of wellbeing with umbilical artery Doppler unless they develop specific pregnancy complications, for example antepartum haemorrhage or hypertension. However, they should be offered a scan for fetal size and umbilical artery Doppler during the third trimester. Serial ultrasound measurement of fetal size and assessment of wellbeing with umbilical artery Doppler should be offered in cases of fetal echogenic bowel. Abdominal palpation has limited accuracy for the prediction of a SGA neonate (...) need to be assessed on an individual basis. The evidence for an association with asthma, thyroid disease, inflammatory bowel disease and depression is less convincing. Studies report a weak or non–significant association with LBW but do not differentiate between the effect on SGA and preterm birth, and with confidence intervals [CIs] often crossing one. Therefore, if uncomplicated and adequately treated, these are not considered to be risk factors for a SGA fetus. 20,21 Maternal risk factors

2013 Royal College of Obstetricians and Gynaecologists

160. Clinical practice guideline for care in pregnancy and puerperium

of the evidence 344 B) Grading strength of the recommendations 345 Appendix 3. Tables 347 Appendix 4. Abbreviations 354 Appendix 5. Edinburgh Postnatal Depression Scale (EPDS) 355 Validated Spanish version (adapted from Garcia-Esteve 2003) 355 Bibliography 357CPG FOR CARE IN PREGNANCY AND PUERPERIUM 7 Presentation Documenting the variability in clinical practice, analyse its causes and adopt strategies aimed at eliminating it, have proven to be initiatives that promote safe and effective decision-making (...) . What are the tools with better performance in the detection of mental disorders during the puerperium? 80. Does the contact of the mother with other mother networks and support groups reduce the risk of mental problems and postpartum depression? Breastfeeding 81. What practices favour the establishment of breastfeeding during the puerperium? 82. What practices help to maintain breastfeeding during the puerperium? 83. What is the most appropriate treatment for the cracks in the nipple, breast

2014 GuiaSalud

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