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Obstetrics and Gynecology Clinics of North America

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https://www.readbyqxmd.com/read/30092931/treatment-of-peripartum-mental-health-disorders-an-essential-element-of-prenatal-care
#1
EDITORIAL
Constance Guille, Roger B Newman
No abstract text is available yet for this article.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092930/pregnancy-an-opportune-time-to-evaluate-and-treat-mental-health-disorders
#2
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092929/psychosocial-aspects-of-fertility-and-assisted-reproductive-technology
#3
REVIEW
Jamie Stanhiser, Anne Z Steiner
Psychosocial aspects of fertility, infertility, and assisted reproductive technology (ART) can significantly impact patients' sense of self-identity and personal agency, mental well-being, sexual and marital relationships, reproductive efficiency, compliance with treatment, and pregnancy outcomes. Research is needed to understand how stress, anxiety, depression, mood disorders, and psychotropic medications impact fertility and infertility treatment. The psychosocial implications of ART on our society include a shift toward older maternal age at conception, the complexities of third-party reproduction, and consideration for the psychological and socioeconomic barriers to receiving care...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092928/the-unwelcome-guest-working-with-childhood-sexual-abuse-survivors-in-reproductive-health-care
#4
REVIEW
Phyllis M Florian
Health care providers (HCPs) are often poorly prepared to respond to childhood sexual abuse (CSA) survivors' needs in reproductive health care. With few protocols addressing the CSA survivor population, HCPs struggle with delivering interventions that meet professional standards of care within the systemic constraints of reproductive health care. To bridge the gap that exists when the unwelcome guest of CSA enters the reproductive health care arena, it is important to understand the psychological influences of trauma that affect CSA survivors, the symptoms or behavioral cues that are commonly revealed, and therapeutic approaches that can facilitate positive patient-provider experiences in health care...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092927/perinatal-intimate-partner-violence
#5
REVIEW
Christine K Hahn, Amanda K Gilmore, Rosaura Orengo Aguayo, Alyssa A Rheingold
This article reviews the prevalence and outcomes of perinatal intimate partner violence (IPV). Reported rates of perinatal IPV range from 3.7% to 9.0%. Perinatal IPV is associated with a multitude of mental and obstetric health outcomes that affect the mother and child. Perinatal medical providers have an opportunity to detect victims of IPV and facilitate services for this population. Screening, safety planning, and referral procedures are essential for addressing this public health problem.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092926/impact-of-pregnancy-loss-on-psychological-functioning-and-grief-outcomes
#6
REVIEW
Tonia M Cassaday
This article discusses the prevalence and timing of perinatal loss. The impact that perinatal grief has on psychological functioning is presented, including common grief reactions and the risk factors for complicated grief. The ways that perinatal grief is processed by each parent and the impact that it has on the relationships is also discussed. The role of the health care professional is outlined and the process for them to assist grieving parents is outlined in 5 steps. The screening process and treatment of grieving parents is also presented...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092925/treatment-of-perinatal-opioid-use-disorder
#7
REVIEW
Lisa Boyars, Constance Guille
Opioid agonist therapy is the standard of care for pregnant women with Opioid Use Disorder, but medication-assisted withdrawal from opioid agonist therapy is increasingly prevalent. We review available literature evaluating the risks and benefits of medication-assisted withdrawal. We highlight the importance of supporting women in making an informed treatment choice that is best for them. Although it is tempting to choose medication-assisted withdrawal to decrease the risk of newborn opioid withdrawal, we caution against this practice...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092924/management-of-attention-deficit-hyperactivity-disorder-during-pregnancy
#8
REVIEW
Allison S Baker, Marlene P Freeman
Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder affecting 3.2% of women. More women are taking psychostimulant medications, including during pregnancy. Although stimulant use does not appear to be associated with congenital malformations, there are inconsistent data about other obstetric risks, and no long-term neurodevelopmental data exist to inform clinical management decisions. This article summarizes the available data regarding perinatal exposure to psychostimulants...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092923/perinatal-sleep-problems-causes-complications-and-management
#9
REVIEW
Allison K Wilkerson, Thomas W Uhde
Changes in sleep are ubiquitous in the perinatal period and it is important to be able to determine when these changes are significant enough to indicate sleep deficiency associated with increased risk for poor maternal and infant outcomes. Guidelines for identifying sleep deficiency include insomnia symptoms, excessively shortened sleep duration, and perception of insufficient or nonrestful sleep. Causes and complicating factors related to such sleep problems have been well-documented and are used to tailor behavioral and pharmacologic treatments for women who are pregnant or in the early postpartum period...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092922/identification-and-treatment-of-peripartum-anxiety-disorders
#10
REVIEW
Katherine E Williams, Hristina Koleva
Anxiety disorders in the peripartum period are common and frequently overlooked. They can present de novo or as exacerbations of generalized anxiety disorder, obsessive compulsive disorder, panic disorder and social anxiety disorder, or posttraumatic stress disorder. Calculating a score on the Edinburgh postnatal depression scale is a useful method of screening for these disorders while also screening for perinatal depression. Treatment includes psychotherapy, specifically cognitive behavioral therapy, and antidepressants, the choice of which should be balanced between the severity of symptoms and impact of functioning, risks of untreated illness, and the risks associated with the use of medications in pregnancy and lactation...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092921/recognizing-and-managing-postpartum-psychosis-a-clinical-guide-for-obstetric-providers
#11
REVIEW
Lauren M Osborne
Postpartum psychosis is a psychiatric emergency that affects 1 to 2 per 1000 women. Key clinical features include mood fluctuation, abnormal thoughts or behaviors, and confusion. Women with a history of bipolar disorder are at heightened risk, as are first-time mothers; current research on the causes focuses on biological triggers, such as immune dysregulation. Women with postpartum psychosis require inpatient hospitalization and should be treated with lithium, antipsychotics, and benzodiazepines.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092920/complementary-health-practices-for-treating-perinatal-depression
#12
REVIEW
Nafisa Reza, Kristina M Deligiannidis, Elizabeth H Eustis, Cynthia L Battle
This article provides a focused review of the evidence for several complementary health approaches (ie, omega-3 fatty acids, folate, vitamin D, selenium, zinc, magnesium, B vitamins, physical activity, yoga) in the treatment of perinatal depression. There is evidence that some of these treatments may be reasonable to consider in women during pregnancy or the postpartum period. However, there are little data on the comparative safety and efficacy of these relative to traditional treatments (eg, psychotherapy, pharmacotherapy)...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092919/pharmacologic-treatment-of-perinatal-depression
#13
REVIEW
Mary C Kimmel, Elizabeth Cox, Crystal Schiller, Edith Gettes, Samantha Meltzer-Brody
This review provides information about medications used to treat perinatal depression, including guidance around when to use certain medications and when to consult a mental health provider. For each group of medications, including selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, mirtazapine, bupropion, lithium, atypical antipsychotics, and lamotrigine, the risks and benefits of treatment during pregnancy and lactation are reviewed, and unique qualities of each medication...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092918/treatment-of-peripartum-bipolar-disorder
#14
REVIEW
Crystal T Clark, Katherine L Wisner
Bipolar disorder affects women throughout their childbearing years. During the perinatal period, women with bipolar disorder are vulnerable to depressive episode recurrences and have an increased risk for postpartum psychosis. Perinatal screening is critical to identify women at risk. Although medications are the mainstay of treatment, the choice of pharmacotherapy must be made by the patient based on a risk-benefit discussion with her physician. For optimal dosing in pregnancy, therapeutic drug monitoring may be required to maintain effective drug concentrations...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747739/medical-disorders-in-pregnancy
#15
EDITORIAL
Erika Peterson, Judith U Hibbard
No abstract text is available yet for this article.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747738/team-based-care-of-pregnant-women-with-challenging-medical-disorders
#16
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747737/thromboprophylaxis-in-pregnancy
#17
REVIEW
Diana Kolettis, Sabrina Craigo
Venous thromboembolism is a leading cause of maternal morbidity and mortality worldwide. Identifying women who are at greatest risk for venous thromboembolism, and managing their pregnancies with appropriate thromboprophylaxis is essential to decreasing this life-threatening condition. Those at greatest risk are patients with thrombophilias, a personal or family history of venous thromboembolism, and those undergoing cesarean delivery. Current international guidelines on thromboprophylaxis vary in details, but all strategies rely on risk factor identification and thromboprophylaxis for the highest risk patients...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747736/infections-in-pregnancy-and-the-role-of-vaccines
#18
REVIEW
Kimberly B Fortner, Claudia Nieuwoudt, Callie F Reeder, Geeta K Swamy
Pregnant women are at risk for infection and may have significant morbidity or mortality. Influenza, pertussis, zika, and cytomegalovirus produce mild or asymptomatic illness in the mother, but have profound implications for her fetus. Maternal immunization can prevent or mitigate infections in pregnant women and their infants. The Advisory Committee of Immunization Practices recommends 2 vaccines during pregnancy: inactivated influenza, and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis during pregnancy...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747735/seizures-in-pregnancy
#19
REVIEW
Kassie J Bollig, Daniel L Jackson
Seizures are among the most serious neurologic complications encountered in pregnancy. This review provides a foundation for the initial diagnosis, evaluation, classification, and management of seizures during pregnancy.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747734/hypertensive-disorders-in-pregnancy
#20
REVIEW
Amelia L M Sutton, Lorie M Harper, Alan T N Tita
Hypertensive disorders of pregnancy are a heterogeneous group of conditions that include chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension. These disorders account for a significant proportion of perinatal morbidity and mortality nearly 10% of all maternal deaths in the United States. Given the substantial health burden of hypertensive disorders in pregnancy, there is increasing interest in optimizing management of these conditions. This article summarizes the diagnosis and management of each of the disorders in the spectrum of hypertension in pregnancy and highlights recent updates in the field...
June 2018: Obstetrics and Gynecology Clinics of North America
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