tailieunhanh - Critical Care Obstetrics part 71

Critical Care Obstetrics part 71 provides expert clinical guidance throughout on how you can maximize the chances of your patient and her baby surviving trauma. In this stimulating text, internationally recognized experts guide you through the most challenging situations you as an obstetrician are likely to face, enabling you to skillfully:Recognize conditions early-on which might prove life threatening, Implement immediate life-saving treatments in emergency situations, Maximize the survival prospects of both the mother and her fetus | Acute Psychiatric Conditions in Pregnancy assistance. In addition besides inpatient psychiatric hospitalization other treatment options may offer psychiatric stabilization such as partial hospital programs intensive outpatient programs substance abuse treatment individual or family therapy and psychotropic medications. A multimodality treatment plan is best achieved through collaboration between psychiatry social work obstetrics and gynecology and medicine services. Although there is not definite evidence that antidepressant medication specifically reduces suicidality in MDD antidepressants are the mainstay treatment for reducing depressive symptoms. There is also not compelling evidence that mood stabilizers antipsychotics or benzodiazepines acutely reduce suicidality in psychiatric disorders whereas lithium has been demonstrated to reduce suicide and suicide attempts in bipolar disorder 87 . Suicidality during pregnancy and postpartum Completed suicides are less prevalent in pregnancy 95 96 and the postpartum period 38 96 compared to non-puerperal times in a woman s life. Adolescents may not have lower suicide rates than older postpartum women 38 . Results from a Danish cohort reported that suicide risk increased 70-fold in the first year after giving birth in the presence of a psychiatric disorder 97 . An examination of perinatal maternal deaths in the United Kingdom in 1997-99 suggested that suicide was the leading cause of maternal death was increased in women with psychiatric and substance abuse disorders and was more likely to be a violent death compared to the suicides of men and nonchildbearing women 98 . Other studies confirm that although suicide rates may be lower during pregnancy and the postpartum period perinatal women complete suicide by more violent and lethal means than when not perinatal 94 . Lindahl and colleagues have suggested that when assessing suicidality in the pregnant or postpartum woman specific inquiry should be made about reasons for