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PubMed1982

Psychotic disorders after childbirth in Nigerian women.

Fifty-seven consecutive cases of psychotic disorders arising within one year of childbirth and presenting over a two-year-period were studied prospectively. There was a preponderance of primigravidae. In 18% a family history of psychiatric disorders was obtained; 39% had suffered from previous psychotic episodes; 35% had suffered from obstetric complications; in 9% there was poor psychological adjustment to pregnancy. The majority (65%) was schizophrenic. Onset of symptoms in half the cases was within one month of delivery. The majority of cases (60%) presented in hospital within one month of onset of symptoms; there was a significant association between delay in arrival in hospital and prior treatment by religious or traditional healers. The immediate prognosis in terms of clinical recovery of the women was good. However, 53% ceased breast-feeding; seven of the children died, while another seven became physically ill. Eleven husbands left their wives. The implications of these findings are discussed.

Adult↗
PubMedDate not supplied

Progressive systemic sclerosis and postpartum renal failure complicated by peripheral gangrene.

A patient with progressive systemic sclerosis (PSS) complicated by accelerated hypertension, postpartum renal failure and gangrene in all 4 extremities is presented. Pregnancy seldom has a significant effect upon the course of PSS unless there is renal involvement. Four previously reported cases of PSS with postpartum renal failure are reviewed. In our case, sepsis, shock, retained placenta, propranolol therapy and disseminated intravascular coagulation may have contributed to the development of renal failure and symmetrical peripheral gangrene.

Adult↗
PubMed1981

[Clinical pathological analysis of peripartum maternal mortality (author's transl)].

All maternal deaths which occurred in relation to labour at the Department of Obstetrics and Gynaecology, University Hospital, Graz, between 1963 and 1978 were reviewed and analysed. 24 mothers died over this 15-year period. The maternal death rate was 0.34 per thousand. In all cases a post mortem examination was performed. The youngest woman was 19, the oldest 42 years old. Most of the decreased mothers were primiparae. The main cause of maternal death was post-partum haemorrhage, followed by infection of the uterus especially after Caesarean section. Three mothers died of liver distrophy. The remaining causes were eclampsia (2 cases); pulmonary artery embolism after Caesarean section (2 cases); irreversible shock from amniotic fluid and air embolism (one case each); uraemia due to glomerulo- or pyelonephritis (one case each); malignant melanoma (one case). It is demonstrated that special risk factors are advanced maternal age, low social status and lack of antenatal care.

Adult↗
PubMedDate not supplied

[Mother-child hospitalization].

The authors think, that psychological perturbations in women during the period immediately preceding and following childbirth brings about deepseated personality changes that will determine the future relationship between the mother and her child and all subsequent children. Hospitalization of the mother and child together is resorted to in three types of case: for the classic post-partum psychosis, for psychotic mothers showing serious personality troubles, and for early deviations in the mother-child relationship. For most children the alternative is being taken into care, or being placed in the hands of a series of mother-substitutes. Joint hospitalization allows a relationship to be established in a satisfactory environment, allows the mother-child relationship to be maintained, or a means of separation arranged if it should prove necessary. This practice opens new horizons in research into the psychology of mothers and the child's development in the earliest time of life. It should be possible to organize hospitalization of this type within the structure of the general hospital, and include it in the long-term treatment both of the mother and the child.

Female↗