Prophylactic Lithium in Puerperal Psychosis

1991 ◽  
Vol 158 (3) ◽  
pp. 393-397 ◽  
Author(s):  
D. E. Stewart ◽  
J. L. Klompenhouwer ◽  
R. E. Kendell ◽  
A. M. Van Hulst
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Lithium Carbonate ◽  
Controlled Study ◽  
Third Trimester ◽  
Psychotic Illness ◽  
Puerperal Psychosis ◽  
The Third ◽  
Larger Sample

At three centres, 21 women at high risk for puerperal psychosis were given prophylactic lithium carbonate late in the third trimester of pregnancy or immediately after delivery. Only two of the women had a recurrence of their psychotic illness while on prophylactic lithium. One woman given lithium during third trimester had an unexplained stillbirth. Although a larger sample in a carefully controlled study is still required, there now seems to be grounds for the use of prophylactic lithium immediately after delivery in women not breastfeeding who have previously suffered from either puerperal psychosis or bipolar disorder.

scholarly journals Fetal Myocardial Performance Index in the Third Trimester of Pregnancy: Feasibility and Reproducibility of Conventional Spectral Doppler versus Spectral Tissue Doppler Technique

2019 ◽  
Author(s):  
Lea M. Porche ◽  
Elena Sinkovskaya ◽  
Rachel D. Seaman ◽  
Hadiza Galadima ◽  
Letty Romary ◽  
...  
Keyword(s):  
High Risk ◽  
Performance Index ◽  
Tissue Doppler ◽  
Myocardial Performance Index ◽  
P Value ◽  
Myocardial Performance ◽  
Completion Rates ◽  
Third Trimester ◽  
The Third ◽  
Spectral Doppler

Abstract Objective This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population. Study Design This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks’ gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients. Results Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (68/79, 86% vs. 42/79, 53.2%), p-value <0.01. In obese subjects (n = 50) LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (37/50, 74% vs. 26/50, 52%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (40/50, 80% vs. 25/50, 50%), p-value <0.01. intraclass correlation coefficient for all modalities ranged between 0.73 and 0.93, except for LV conventional spectral Doppler intraobserver variability which was 0.22. Conclusion Tissue Doppler had statistically higher completion rates than conventional spectral Doppler, including the obese subgroup, with evidence of strong reproducibility in the third trimester.

scholarly journals A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome

2014 ◽  
Vol 6 (3) ◽  
pp. 139-143 ◽  
Author(s):  
Hema Dhumale ◽  
Yeshita Pujar ◽  
Komal Gurunath Revankar
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Low Risk ◽  
Controlled Study ◽  
Third Trimester ◽  
Randomized Controlled ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
And Control

ABSTRACT Objective To assess the role of routine third trimester ultrasound in low-risk pregnancy on antenatal interventions and perinatal outcome. Design Randomized controlled study. Setting KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum. Subjects A total of 290 low-risk pregnant women between 34 and 37 weeks attending antenatal clinic and fulfilling inclusion criteria were allotted using computer-generated randomization numbers into study and control groups. Intervention In study group, third trimester ultrasound was performed to assess fetal growth, amniotic fluid index (AFI), malpresentations, and late onset fetal anomalies. In control group, no routine ultrasound was performed, unless indicated by clinical suspicion during subsequent visits. High-risk fetuses identified were managed as per the standard protocol. All women were followed to assess antenatal interventions, intrapartum events and perinatal outcome. Results Detection of high-risk fetuses antenatally in study and control groups was 17.25 and 2.07% respectively. This difference was statistically significant (p = —0.0001). Rates of antenatal interventions among study and control were 24.8 and 4.44% respectively. Prevalence of small for gestational age (SGA) fetuses among study and control was 6.9 vs 11.03% respectively. This difference was not statistically significant (p = —0.253). There was no statistical difference in adverse intrapartum events, cesarean section rate for nonreassuring cardiotocography (CTG), low Apgar score and neonatal intensive care unit (NICU) admissions among study and controls. Conclusion Routine third trimester ultrasound is a logical solution for detection of high-risk fetuses in low-risk pregnancies which would otherwise be missed by clinical examination. However, this leads to an increase in antenatal interventions without significantly influencing the perinatal outcome. How to cite this article Revankar KG, Dhumale H, Pujar Y. A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):139-143.

scholarly journals Development of Gastrointestinal Function: Risk Factors for Necrotizing Enterocolitis

2004 ◽  
Vol 9 (2) ◽  
pp. 96-103
Author(s):  
David A. Clark ◽  
Amy L. Mitchell
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Premature Infant ◽  
Necrotizing Enterocolitis ◽  
Intestinal Tract ◽  
Intestinal Barrier ◽  
Gastrointestinal Function ◽  
Third Trimester ◽  
The Third ◽  
Limited Digestion

The intestinal tract of the fetus matures rapidly in the third trimester of the pregnancy. The premature infant has decreased intestinal motility, limited digestion, absorption and excretion, and poor intestinal barrier defense. These limitations place the infant at high risk for acute intestinal injury, necrotizing enterocolitis. This article reviews the development of the gastrointestinal tract in the fetus, the barriers to feeding the high risk, premature infant, and the most serious intestinal disease, necrotizing enterocolitis.

Elective cytogenetic amniocentesis in the third trimester for pregnancies with high risk factors

1999 ◽  
Vol 19 (8) ◽  
pp. 749-752 ◽  
Author(s):  
J. Shalev ◽  
I. Meizner ◽  
D. Rabinerson ◽  
R. Mashiach ◽  
D. Peleg ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Third Trimester ◽  
The Third ◽  
High Risk Factors

First trimester interleukin 8 levels are associated with postpartum relapse in multiple sclerosis

2009 ◽  
Vol 15 (11) ◽  
pp. 1356-1358 ◽  
Author(s):  
Rinze F Neuteboom ◽  
Evert Verbraak ◽  
Jane SA Voerman ◽  
Marjan van Meurs ◽  
Eric AP Steegers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Disease Activity ◽  
Serum Levels ◽  
First Trimester ◽  
Interleukin 8 ◽  
Disease Course ◽  
Third Trimester ◽  
The Third

Pregnancy has an ameliorating effect on multiple sclerosis (MS), but directly after delivery the risk of a relapse is increased. The pro-inflammatory chemokine interleukin 8 is associated with disease activity. We aimed to investigate whether pregnancy-induced fluctuations of interleukin 8 correlate with periods of enhanced and diminished disease activity. Thirty-six women with MS were prospectively studied before, during and after pregnancy. Serum levels of interleukin 8 were significantly decreased during the third trimester (p = 0.03). High first trimester serum levels of interleukin 8 were associated with a high risk of postpartum relapse (p = 0.007). These results help us to further understand the altered disease course during pregnancy.

Early predictive biomarkers for postpartum depression point to a role for estrogen receptor signaling

2014 ◽  
Vol 44 (11) ◽  
pp. 2309-2322 ◽  
Author(s):  
D. Mehta ◽  
D. J. Newport ◽  
G. Frishman ◽  
L. Kraus ◽  
M. Rex-Haffner ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Postpartum Depression ◽  
Expression Profiles ◽  
Predictive Biomarkers ◽  
Estrogen Signaling ◽  
Third Trimester ◽  
The Third ◽  
Genome Wide ◽  
A Genome

BackgroundPostpartum depression (PPD) affects approximately 13% of women and has a negative impact on mother and infant, hence reliable biological tests for early detection of PPD are essential. We aimed to identify robust predictive biomarkers for PPD using peripheral blood gene expression profiles in a hypothesis-free genome-wide study in a high-risk, longitudinal cohort.MethodWe performed a genome-wide association study in a longitudinal discovery cohort comprising 62 women with psychopathology. Gene expression and hormones were measured in the first and third pregnancy trimesters and early postpartum (201 samples). The replication cohort comprised 24 women with third pregnancy trimester gene expression measures. Gene expression was measured on Illumina-Human HT12 v4 microarrays. Plasma estradiol and estriol were measured. Statistical analysis was performed in R.ResultsWe identified 116 transcripts differentially expressed between the PPD and euthymic women during the third trimester that allowed prediction of PPD with an accuracy of 88% in both discovery and replication cohorts. Within these transcripts, significant enrichment of transcripts implicated that estrogen signaling was observed and such enrichment was also evident when analysing published gene expression data predicting PPD from a non-risk cohort. While plasma estrogen levels were not different across groups, women with PPD displayed an increased sensitivity to estrogen signaling, confirming the previously proposed hypothesis of increased sex-steroid sensitivity as a susceptibility factor for PPD.ConclusionsThese results suggest that PPD can be robustly predicted in currently euthymic women as early as the third trimester and these findings have implications for predictive testing of high-risk women and prevention and treatment for PPD.

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