a rare complication of pregnancy, occurring from the sixth month of pregnancy until six months postnatally (usually within six weeks of delivery). It can follow pre-eclampsia. It is characterized by palpitations, dyspnoea, oedema (peripheral and central), and impaired exercise tolerance. The diagnosis is confirmed on echocardiography. It has a high mortality and morbidity. Treatment of heart failure, anticoagulation, and in some cases immunosuppressant therapy is required; in some cases heart transplantation may be considered.
Also called postnatal DEPRESSION, this is the state of depression that may affect women soon after they have given birth. The condition often occurs suddenly a day or so after the birth. Many women suffer from it and usually they can be managed with sympathetic support. If, however, the depression – sometimes called ‘maternal blues’ – persists for ten days or more, mild ANTIDEPRESSANT DRUGS are usually e?ective. If not, psychiatric advice is recommended. (See PREGNANCY AND LABOUR.)... puerperal depression
a familial condition affecting the heart, characterized by unexplained thickening (hypertrophy) of the wall of the left ventricle. In many cases this is an incidental finding and patients have a good outcome. However, more severely affected patients may suffer chest pain, tachyarrhythmia (see arrhythmia), heart failure, and sudden death. In some cases there is focal thickening of muscle around the left ventricular outflow tract (asymmetric septal hypertrophy, ASH), and this can result in restriction of blood flow to the body (hypertrophic obstructive cardiomyopathy, HOCM). The diagnosis is made by electrocardiography, echocardiography, and cardiac *magnetic resonance imaging. Usually drug treatment is sufficient to control symptoms, but some patients require cardiac *catheterization or surgical treatment. Those deemed at highest risk of sudden death may require an *implantable cardiovertor defibrillator.... hypertrophic cardiomyopathy
a *psychosis that is triggered by childbirth and usually arises in the first two weeks after giving birth. It affects 1 in 200 women; those suffering from bipolar affective disorder or schizophrenia or those who have a history of puerperal psychosis are at particularly high risk. The symptoms develop very rapidly and the patient needs to be hospitalized, ideally in a mother and baby psychiatric unit to avoid separation; most patients respond well to *antipsychotic medication.... puerperal psychosis
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