Mind Matters

Total Page:16

File Type:pdf, Size:1020Kb

Mind Matters MIND MATTERS Vol. 20 No. 3 | Spring 2018 a RANZCOG publication The College 5 From the President Steve Robson Vol. 20 No. 3 Spring 2018 9 From the CEO Alana Killen O&G Magazine Advisory Group Dr Gillian Gibson Fellows Rep, New Zealand 11 Leaders in focus Dr Bernadette White Fellows Rep, VIC Dr William Milford Young Fellows Rep, QLD Kirsten Connan with Marilyn Clarke Dr John Schibeci Diplomates Rep, NSW Dr Brett Daniels Fellows Rep, TAS Dr Fiona Langdon Trainees Rep, WA Mind matters 14 Editorial O&G Magazine Editors Brett Daniels Rachel Corkery Lisa Westhaven 15 Perinatal mental health: an area of specialty Layout and Production Editor Renée Miller, Hettie Dubow & Klara Szego Rachel Corkery 18 Schizophrenia and psychotic disorders Designer Megan Galbally & Caroline Crabb Shay Colley Whitehart 21 Perinatal depression and anxiety Editorial Communications Rebecca Hill, Rosalind Powrie & Anne Sved Williams O&G Magazine Advisory Group RANZCOG 254–260 Albert Street 24 Antidepressants in pregnancy East Melbourne, VIC 3002 Australia Lyndall White (t) +61 3 9417 1699 (e) [email protected] 26 Eating disorders in adolescents and young women Advertising Sales Danielle Pogos & Michele Yeo Bill Minnis Minnis Journals 29 Substance misuse and dependence in pregnancy (t) +61 3 9836 2808 Helen Winrow & Nicholas Walker (e) [email protected] 32 Personality disorders in clinical practice Jonathon Tremain Louise Newman Tremain Media (t) +61 2 9988 4689 (e) [email protected] 34 Psychosomatic disorders Bharat Visa, Yasaman Rezaei Adli & Louise Newman Printer Southern Colour 36 Postpartum psychosis: a practical management (t) +61 3 8796 7000 guide for obstetricians O&G Magazine authorised by Ms Alana Killen Marie-Paule Austin © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). All rights reserved. No part of this 39 Mental health and pelvic pain publication may be reproduced or copied in Susan Evans & Tiffany Brooks any form or by any means without the written permission of the publisher. The submission of articles, news items and letters is encouraged. 42 Birth trauma and post-traumatic stress disorder Debra Creedy & Jenny Gamble For further information about contributing to O&G Magazine visit: ogmagazine.org.au 44 Finding meaning in bad news: critical The statements and opinions expressed in articles, conversations in medicine letters and advertisements in O&G Magazine are Catherine Campbell those of the authors and, unless specifically stated, are not necessarily the views of RANZCOG. 46 Are mothers convicted of infanticide mentally ill? Although all advertising material is expected to Anne Buist conform to ethical and legal standards, acceptance does not imply endorsement by the College. 48 PMT, PMS and PMDD: is there a difference? ISSN 1442-5319 Martien Snellen, Josephine Power & Gaynor Blankley Cover art ©RANZCOG 50 Menopause and mental health Annabelle Brennan 52 Obstetricians and mental health: more than RANZCOG Regional Committees delivering babies New Zealand Dr Celia Devenish Chair Vijay Roach Jane Cumming Manager Level 6 Featherson Tower 54 Mental health in medical practitioners 23 Waring Taylor Street/ PO Box 10611 Paula Fernandez & Alana Gilbee Wellington 6011, New Zealand (t) +64 4 472 4608 (f) +64 4 472 4609 (e) [email protected] Women’s health Australian Capital Territory 56 World Contraception Day: LARC in focus Dr John Hehir Chair Catriona Melville & Kirsten Black Lee Dawson Executive Officer (e) [email protected] 60 New guidelines for care during pregnancy New South Wales Debra Thoms A/Prof Gregory Jenkins Chair Lee Dawson Executive Officer 61 Comparing maternal mortality in the UK and Australia Suite 2, Ground Floor, 69 Christie Street St Leonards, NSW 2065 Gerald Lawson (t) +61 2 9436 1688 (f) +61 2 9436 4166 (e) [email protected] 66 Case report: antenatal management of anorexia nervosa Queensland Katherine Grove, Fiona Langdon, Shivanthi Senaratne, et al Dr William Milford Chair Sylvia Williamson Executive Officer 69 Case report: a brain in the pelvis: anti-NMDA-receptor Unit 22, Level 3, 17 Bowen Bridge Road encephalitis and ovarian teratoma HERSTON, Qld 4006 (t) +61 7 3252 3073 Myriam Girgis & Unine Herbst (e) [email protected] 72 Case report: acute abdomen in the third trimester South Australia/Northern Territory Dr Amita Singla Chair Sarah Luthy, Leeanne Panisi & Briley Pinau Tania Back Executive Officer Level 1, 213 Greenhill Road 74 The leg-up Eastwood 5063 Nicole Woodrow & Vinay Rane (t) +61 8 8274 3735 (f) +61 8 8271 5886 (e) [email protected] 76 Q&A: endometrial sampling in general practice Tasmania Natasha Trpkovska & Sue Tutty Dr Lindsay Edwards Chair Lisa Del Din Executive Officer 78 From the editor’s desk College House 254–260 Albert Street Caroline de Costa East Melbourne, Vic 3002 (t) +61 3 9412 2998 80 Journal Club (e) [email protected] Brett Daniels Victoria Dr Charlotte Elder Chair The College Lisa Del Din Executive Officer College House 81 College Statements update 254–260 Albert Street East Melbourne, Vic 3002 Yee Leung (t) +61 3 9412 2998 (e) [email protected] 81 Notice of deceased Fellow Western Australia Dr Robyn Leake Chair 82 RANZCOG 2018 Provincial Fellows/WA/SA/NT RSM Carly Moorfield Executive Officer 44 Kings Park Road PO Box 1645, West Perth, WA 6872 83 FRANZCOG Advanced Training Modules (t) +61 8 9322 1051 (f) +61 8 6263 4432 Michael Permezel (e) [email protected] The Royal Australian and New Zealand 84 Queen’s Birthday Honours Awards College of Obstetricians and Gynaecologists College House 254–260 Albert Street 85 Letters to the Editor East Melbourne, Vic 3002 Margaret Sparrow, Carol Shand & Lisa Rasmussen (t) +61 3 9417 1699 (f) +61 3 9417 0672 (e) [email protected] (w) www.ranzcog.edu.au 86 Obituaries Vol. 20 No. 3 Spring 2018 | 3 From the President THE COLLEGE Prof Steve Robson President This issue of O&G Magazine addresses the vitally important subject of mental health. As usual, the editorial team have brought together an outstanding group of experts to write. It is difficult to overstate the importance of mental health and it is gratifying to see such a detailed examination of so many clinical conundrums in this issue. O&G Magazine, in its current format, has been going strong for 15 years now and each issue seems to be better and more informative than the last. FIGO The International Federation of Gynaecology and Prof Steve Robson with American College of Obstetrics (FIGO) will seem a remote and somewhat Obstetricians and Gynecologists (ACOG) President, peripheral organisation to many of you. The College Dr Lisa Hollier. was successful in bidding for the FIGO scientific and clinical meeting for 2021. FIGO’s meeting is held every three years and will be hosted in Rio de Janeiro, RANZCOG 2018 Annual Scientific Meeting Brazil, in October of this year. The next meeting On a local scale, the RANZCOG 2018 ASM is set will be in Sydney in 2021. The FIGO congress is the to run in Adelaide in September. For the first time, largest global women’s health scientific meeting. our Indigenous Women’s Health Meeting is being FIGO’s member organisations (of which RANZCOG held at the same time. The pre-meeting workshops is one) comprise nearly every national obstetrics and look to be excellent and the Adelaide organising gynaecology society in the world. committee are hoping to top the programs of recent meetings in Perth and Auckland. I hope as many of It is a great honour for our College to host you as possible will have the opportunity to travel this meeting, but with that honour comes to South Australia for what looks to be a fantastic considerable responsibility. I am chairing the local College event. organising committee and will continue to do so in my capacity as College past-President. I have met Ministerial Advisory Committee on with the FIGO President-elect, Prof Carlos Fuchtner Out-of-Pocket Costs of Bolivia, and arrangements for FIGO Sydney 2021 The Ministerial Advisory Committee on Out- are well underway. On behalf of the College and the of-Pocket Costs was set up by Health Minister local organising group, we are intending to arrange Greg Hunt in response to public concerns about the best FIGO meeting yet! I hope that all of you are transparency with regards to out-of-pocket costs able to make time for this event in your diaries. in private healthcare. The group is chaired by the Vol. 20 No. 3 Spring 2018 | 5 THE COLLEGE Prof Steve Robson with FIGO President-elect, Dr Carlos Fuchtner (left), and Society of Obstetricians and Gynaecologists of Canada (SOGC) past-President, Dr Andre Lalonde (right). Chief Medical Officer and has representatives from been incredibly rewarding. I hope I can impress upon the procedural colleges, the Australian Medical you what an honour it has been to work with so Association (AMA), private health insurers and many RANZCOG Councillors and Board colleagues private hospital groups. We are working towards a over 12 tumultuous years. It would be impossible to transparency model that will hopefully assist women achieve anything as College President without the and their family doctors in selecting appropriate support of many people. I should give a special thank care. As with other Government endeavours, I am you to Kylie Grose and Eleanor Bonikowski for the concerned that a heavy-handed response will either amazing job they do in keeping things running in the do little to solve the problem, or potentially make office of the President and CEO. I would like to wish things worse. The work of this group is ongoing and incoming President, Dr Vijay Roach, and his Board all I will report back to you later in the year, when I am the best for what will be, no doubt, a very memorable allowed to speak publicly.
Recommended publications
  • Concealed Or Denied Pregnancy
    Concealed or denied pregnancy Finlay F1, Marcer H1, Baverstock A2 1Child Health Department, Newbridge Hill, Bath BA1 3QE 2Paediatric Department, Musgrove Park Hospital, Taunton TA1 5DA Review Article Word Count 2,491 References 21 Concealed or denied pregnancy Finlay F, Marcer H, Baverstock A Introduction A 23 year old lady presented in labour with a concealed pregnancy. An ambulance was called to her home but unfortunately the baby died following complications secondary to delivery. ‘Rapid Response Procedures’ were set in motion and subsequent actions focused on appropriate physical and psychological care for the mother, along with multi agency safeguarding discussions. On reflection this case posed some interesting and challenging questions including -How common is a concealed pregnancy? What are the characteristics of women who have a concealed pregnancy? What are the risks/outcomes for the mother and the baby? And perhaps the biggest dilemma, what is the appropriate response from health professionals when a concealed or denied pregnancy is suspected? Due to the challenges we faced in managing this case we undertook a literature review to try to answer some of these questions Literature review Definitions A concealed pregnancy is described as one in which a woman knows that she is pregnant but does not tell anyone, or those who are told collude and conceal the fact from health professionals. A denied pregnancy is when a woman is unaware of, or unable to accept the fact that she is pregnant. Although the woman may be intellectually aware that she is pregnant she may continue to think, feel and behave as though she is not.
    [Show full text]
  • Toward a Phenomenology of Unwanted Pregnancy
    Being Torn: Toward a Phenomenology of Unwanted Pregnancy CAROLINE LUNDQUIST In Pregnant Embodiment: Subjectivity and Alienation, Iris Marion Young describes the lived bodily experience of women who have “chosen” their pregnancies. In this essay, Lundquist underscores the need for a more inclusive phenomenology of preg- nancy. Drawing on sources in literature, psychology, and phenomenology, she offers descriptions of the cryptic phenomena of rejected and denied pregnancy, indicating the vast range of pregnancy experience and illustrating substantial phenomenological differences between “chosen” and unwanted pregnancies. It is crucial . that women take seriously the enterprise of finding out what we do feel, instead of accepting what we have been told we must feel. —Adrienne Rich In Pregnant Embodiment: Subjectivity and Alienation, Iris Marion Young draws from sources in literature, psychology, and phenomenology to provide an account of the lived bodily experience of pregnancy.1 Young limits her analysis to women in “technologically sophisticated Western societies,” who have chosen pregnancy, where by “chosen,” she intends “either an explicit decision to become pregnant or at least a choosing to be identified with and positively accepting of it [preg- nancy],” while acknowledging that throughout human history, most women have not chosen their pregnancies in this sense (2005, 47). Young’s revolution- ary work paves the way for a more comprehensive phenomenology of pregnancy, one that gives voice to the multitudes of women who have not chosen their pregnancies, even in the limited sense she describes. In this piece, I underscore Hypatia vol. 23, no. 3 (July–September 2008) © by Caroline Lundquist Caroline Lundquist 137 the need for a phenomenology of pregnancy that is inclusive of the experiences of those other women—the women whose voices we find conspicuously absent from contemporary discourse on pregnancy and abortion.
    [Show full text]
  • Schizophrenia Around the Time of Pregnancy: Leveraging Population- Based Health Data and Electronic Health Record Data to Fill Knowledge Gaps Clare L
    BJPsych Open (2020) 6, e97, 1–7. doi: 10.1192/bjo.2020.78 Review Schizophrenia around the time of pregnancy: leveraging population- based health data and electronic health record data to fill knowledge gaps Clare L. Taylor, Trine Munk-Olsen, Louise M. Howard and Simone N. Vigod Background for rare outcomes that would be difficult to study in clinical Research in schizophrenia and pregnancy has traditionally been research. Advanced pharmaco-epidemiological methods have conducted in small samples. More recently, secondary analysis been used to address confounding in studies of antipsychotic of routine healthcare data has facilitated access to data on large medications in pregnancy, to provide data about the benefits numbers of women with schizophrenia. and risks of treatment for women and their care providers. Aims Conclusions To discuss four scientific advances using data from Canada, Use of these data has advanced the field of research in schizo- Denmark and the UK from population-level health registers and phrenia and pregnancy. Future developments in use of elec- clinical data sources. tronic health records include access to richer data sources and use of modern technical advances such as machine learning and Method supporting team science. Narrative review of research from these three countries to illustrate key advances in the area of schizophrenia and Keywords pregnancy. Schizophrenia; pregnancy; information technologies; epidemi- Results ology; perinatal psychiatry. Health administrative and clinical data from electronic medical records have been used to identify population-level and clinical Copyright and usage cohorts of women with schizophrenia, and follow them longitu- © The Author(s) 2020. Published by Cambridge University Press dinally along with their children.
    [Show full text]
  • A Systemic Explanation of Denial of Pregnancy Fitting Clinical
    A systemic explanation of denial of pregnancy fitting clinical observations and previous models Patrick Sandoz Institut FEMTO-ST, Universite´ de Franche-Comte,´ UMR CNRS 6174, Besanc¸on, France ABSTRACT Introduction: The etiology of denial of pregnancy remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. s Furthermore, the involvement of mother-fetus interactions cannot result only from psychology causes t in the mother. Although instructive, the few available evolutionary and systemic explanations proposed n remain insufficient. This article synthesizes and extends previous knowledge within a systemic model i which is fully compatible with clinical observations. r Methods: A systemic intrapersonal conflict theory opposing primitive, evolutionary-inherited forces to P psycho-sociological forces embodied across individual’s childhood is developed. e Results: As members of a social species, human beings have a dual character of independent organisms r and of social group members that is a source of customized intrapersonal conflicts. Authors explain denial P of pregnancy as a standby-in-tension response to such an unresolved intrapersonal conflict between for- and against-pregnancy forces. As long as the woman’s brain is unable to renounce one option in favor of the other, denial of pregnancy offers a standby-in-tension means to postpone conflict resolution. It may thus be considered as temporarily adaptive response. Conclusions: The proposed systemic psycho-evolutionary explanation of denial of pregnancy is fully consistent with clinical observations. It brings into agreement the previously reported models with the advantage of being more synthetic. It is thus compatible with a large diversity of causative events in accordance with the actual life story of each woman concerned.
    [Show full text]
  • Can Denial of Pregnancy Be a Denial Of
    Psychiatria Danubina, 2013; Vol. 25, Suppl. 2, pp 113–117 Conference paper © Medicinska naklada - Zagreb, Croatia CAN DENIAL OF PREGNANCY BE A DENIAL OF FERTILITY? A CASE DISCUSSION Adèle Struye, Nicolas Zdanowicz, Chady Ibrahim & Christine Reynaert Medicine Faculty, Université Catholique de Louvain, Psychopathology and Psychosomatic Unit Hospital Universitary Center Mont-Godinne, Yvoir, Belgium SUMMARY Background: For many years, several cases of neonaticide resulting from a denial of pregnancy were reported in the press. Recently, a case of neonaticide made headlines in Belgium: a woman realised that she was pregnant during childbirth. A few minutes after the delivery, the baby was asphyxiated to death. In the obstetric history of the patient, we note six pregnancies, of which three births were given to anonymous adoption. Mrs D. was not able to explain why she was not using any method of contraception despite all of her pregnancies. Many questions need to be asked in order to further understand denial of pregnancy. Do these women understand the link between sexual intercourse and the potential of pregnancy? Which women are more at risk of denying their pregnancy? Is there a certain personality profile at risk? Methods: In the following article, we report the case of Mrs D. who presented to the consultation of the clinic of CHU Mont- Godinne (Belgium). We will also discuss the literature available on the online databases (PubMed, PsycArticles, PsycInfo and Cairn.info) using the following keywords: denial of pregnancy, neonaticide, contraception. Results: In the results of retrospective studies, we notice that indeed most women who have had a denial of pregnancy were not using any method of contraception.
    [Show full text]
  • Pre Birth Guidance
    1 North Yorkshire and City of York Safeguarding Children Partnership Safeguarding Unborn Babies - Pre Birth Guidance Title Safeguarding Unborn Babies – Pre – Birth Guidance Version 2.0 Date 02-03-20 Author Elaine Wyllie, Designated Nurse Safeguarding Children Karen Hedgley, Designated Nurse Safeguarding Children Danielle Johnson, Head of Safeguarding, NYCC Children’s Social Care Rose Howley Interim Group Manager, MASH, Assessment, Immediate Response / Edge of Care Safeguarding Team York Teaching Hospital NHS Foundation Trust Safeguarding Team South Tees Teaching Hospitals NHS Foundation Trust Safeguarding Team Harrogate and District NHS Foundation Trust Update and Approval Process Version Group/Person Date Comments 1.0 NYSCB Executive 31/12/2014 Baseline version for approval 2.0 NYSCP Practice 14/02/2020 Reviewed and updated practice Development Subgroup guidance circulated to PDS membership for approval 3.0 CYSCP Business Group Feburary 2020 Electronically circulated to the Buisness Group for comment and approval 4.0 NYSCP Practice 02/03/2020 PDS approved updated guidance Development Subgroup 5.0 CYSCP Business Group March 2020 Buisness Group approved the updated guidance Issue Date March 2020 Review Date March 2022 Reviewing Officer CYSCP Buisness Unit 2 Contents 1. Aim of this Guidance .............................................................................. 4 2. Introduction ........................................................................................... 4 3. Identification of Need and Risk During Pregnancy ................................
    [Show full text]
  • Suspicious Perinatal Death and the Law: Criminalising Mothers Who Do Not Conform
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Middlesex University Research Repository Suspicious perinatal death and the law: criminalising mothers who do not conform Emma Milne A thesis submitted for the degree of Doctor of Philosophy Department of Sociology University of Essex 2017 Acknowledgements ii Acknowledgements There are a number of people who have made this PhD possible due to their impact on my life over the course of the period of doctoral study. I would like to take this opportunity to offer my thanks. First and foremost, my parents, Lesley and Nick Milne, for their constant love, friendship, care, commitment to my happiness, and determination that I will achieve my goals and fulfil my dreams. Secondly, Professor Jackie Turton for the decade of encouragement, support (emotional and academic) and friendship, and for persuading me to start the PhD process in the first place. To Professor Pete Fussey and Dr Karen Brennan, for their intellectual and academic support. A number of people have facilitated this PhD through their professional activity. I would like to offer my thanks to all the court clerks in England and Wales who assisted me with access to case files and transcripts – especially the two clerks who trawled through court listings and schedules in order to identify two confidentialised cases for me. Professor Sally Sheldon, and Dr Imogen Jones who provided advice in relation to theory. Ben Rosenbaum and Jason Attermann who helped me decipher the politics of abortion in the US. Michele Hall who has been a constant source of support, information and assistance.
    [Show full text]
  • Nursing Care of the Family During Pregnancy 191
    C HAPTER Nursing Care of the Family7 during Pregnancy DEITRA LEONARD LOWDERMILK LEARNING OBJECTIVES • Describe the process of confirming pregnancy • Identify the typical nursing assessments, and estimating the date of birth. diagnoses, interventions, and methods of • Summarize the physical, psychosocial, and evaluation in providing care for the pregnant behavioral changes that usually occur as the woman. mother and other family members adapt to • Discuss education needed by pregnant women pregnancy. to understand physical discomforts related to • Discuss the benefits of prenatal care and pregnancy and to recognize signs and problems of accessibility for some women. symptoms of potential complications. • Outline the patterns of health care used to • Examine the impact of culture, age, parity, and assess maternal and fetal health status at number of fetuses on the response of the the initial and follow-up visits during family to the pregnancy and on the prenatal pregnancy. care provided. KEY TERMS AND DEFINITIONS birth plan A tool by which parents can explore multifetal pregnancy Pregnancy in which more their childbirth options and choose those that than one fetus is in the uterus at the same are most important to them time; multiple gestation couvade syndrome The phenomenon of Nägele’s rule One method for calculating the expectant fathers’ experiencing pregnancy-like estimated date of birth, or “due date” symptoms pelvic tilt (rock) Exercise used to help relieve low cultural prescriptions Practices that are expected back discomfort during
    [Show full text]
  • Her Body, My Baby: Surrogate Motherhood and Fetal
    HER BODY, MY BABY: SURROGATE MOTHERHOOD AND FETAL ABDUCTIONS IN THE UNITED STATES SINCE ROE VS. WADE by Sandra Reineke, Ph.D. Associate Professor of Political Science and Women’s Studies University of Idaho [email protected] Do not cite without permission by the author. 2 In their political campaigns for reproductive rights in the 1970s and 1980s, feminists in the United States and elsewhere made the female body a central focus in their quest for equal citizenship. Their political demands were perhaps best encapsulated in the famous campaign slogan “My Body Belongs to Me,” which activists used to raise public awareness about women’s lack of reproductive freedom mirrored as it was in societal equations of womanhood with motherhood. Around the same time, the invention and development of in-vitro fertilization and related medically assisted reproductive practices include “third-party reproduction,” such as egg donation and surrogate motherhood, soon pointed towards the political limitations of the feminist claim to equal bodily integrity as science and medicine began to move human reproduction outside of women’s bodies (Petchesky 1995). To date feminist theorists and activists remain divided about the pros and cons of assisted reproductive technologies (ARTs). Generally, speaking, “liberal” feminists have argued that ARTs broaden women’s reproductive choices, while “difference” or “cultural” feminists claim that science and medicine increasingly pathologize and control women’s bodies and thus women’s reproductive decisions (Shanley 1993; Reineke 2008). At the basis of the current academic and public debates in the United States and elsewhere about third-party reproduction and related medical technologies, lie the theoretical insights of the French philosopher and writer Simone de Beauvoir, who demonstrated in her path breaking study Le Deuxième sexe (1949), how patriarchal body politics control women’s reproductive lives through gendered expectations about women’s role in society as mothers.
    [Show full text]
  • Delusion of Denial of Pregnancy a Case Report
    Asian Journal of Psychiatry 45 (2019) 72–73 Contents lists available at ScienceDirect Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp Letter to the Editor Delusion of denial of pregnancy: A case report T 1. Introduction evaluation for pregnancy, ECT was considered. Foetal monitoring was started and she was administered 6 effective ECTs. After receiving 6 Denial of pregnancy is a rare phenomenon, which can be associated ECTs, she started showing improvement in symptoms, but would refuse with negative maternal and fetal outcomes in the form of refusal to to accept her pregnancy. At 39th week of pregnancy, she developed accept antenatal care, precipitous delivery, fetal abuse, postpartum labour pains, but had to undergo lower section caesarean section emotional disturbances in the mother and neonaticide (Jenkins et al., (LSCS), in view of non-progression of labour. She gave birth to a female 2011; Miller, 1990). Denial of pregnancy in the delusional form is child weighing 3040 g. Started accepting her baby and would breast rarely reported. In our literature search, we could only find few case feed her. However, within a week, her symptoms worsened, stopped reports reporting delusional denial of pregnancy (Kuppili et al., 2017; caring for the baby and stopped feeding. As a result, she received 7 Miller, 1990; Slayton and Soloff, 1981; Walloch et al., 2007). In this more ECTs, with which showed significant improvement in her symp- case report, we discuss denial of pregnancy in a patient diagnosed with toms (reduction of PANSS from 90 to 57). However, within 2 weeks of schizophrenia and review the existing literature on the topic.
    [Show full text]
  • Morbidly Obese Woman Unaware of Pregnancy Until Full-Term and Complicated by Intraamniotic Sepsis with Pseudomonas
    Hindawi Publishing Corporation Infectious Diseases in Obstetrics and Gynecology Volume 2007, Article ID 51689, 3 pages doi:10.1155/2007/51689 Case Report Morbidly Obese Woman Unaware of Pregnancy until Full-Term and Complicated by Intraamniotic Sepsis with Pseudomonas H. Muppala,1 J. Rafi,2 and I. Arthur3 1 Department of Obstetrics and Gynaecology, Royal Albert Edward Infirmary, Wigan Lane, Wigan WN1 2NN, Lancashire, UK 2 Department of Obstetrics and Gynaecology, Delaunays Road, Crumpsall M8 5RB, Manchester, UK 3 Women’s Health Directorate, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR, Lancashire, UK Correspondence should be addressed to H. Muppala, [email protected] Received 18 September 2007; Accepted 30 November 2007 A 32-year-old Caucasian woman of body mass index (BMI) 46 presented with urinary symptoms to accident and emergency (A&E). Acute pyelonephritis was the diagnosis. Transabdominal scan revealed a live term fetus. Both the partners were unaware of the ongoing pregnancy until diagnosed. She underwent emergency cesarean under general anaesthesia (GA) for nonreassuring CTG, severe chorioamnionitis, and moderate preecclampsia. A live male baby weighing 4400 grams delivered in poor condition. Placental tissue on culture exhibited scanty growth of pseudomonas aeruginosa. Chorioamnionitis due to pseudomonas is rare, with high neonatal morbidity and mortality. It is mostly reported among preterm prelabor rupture of membranes (PPROM). Educating the community especially morbidly obese women if they put on excessive weight or with irregular periods should seek doctor’s advice and exclude pregnancy. For the primary care provider, it is of great importance to exclude pregnancy in any reproductive woman presenting with abdominal complaints.
    [Show full text]
  • AMA Journal of Ethics® November 2016, Volume 18, Number 11: 1067-1069
    AMA Journal of Ethics® November 2016 Volume 18, Number 11: 1065-1163 Transgender Health and Medicine From the Editor Transgender Medicine in the Path to Progress and Human Rights 1067 Cameron R. Waldman Ethics Cases How Should Physicians Refer When Referral Options Are Limited for Transgender Patients? 1070 Commentary by Elizabeth Dietz and Jessica Halem Should Mental Health Screening and Psychotherapy Be Required Prior to Body Modification for Gender Expression? 1079 Commentary by Timothy F. Murphy Should Psychiatrists Prescribe Gender-Affirming Hormone Therapy to Transgender Adolescents? 1086 Commentary by Cary S. Crall and Rachel K. Jackson Podcast Providing Supportive and Affirming Care to Transgender Patients: An Interview with Dr. Aron Janssen The Code Says The AMA Code of Medical Ethics’ Opinions Related to Discrimination and Disparities in Health Care 1095 Danielle Hahn Chaet State of the Art and Science What’s in a Guideline? Developing Collaborative and Sound Research Designs that Substantiate Best Practice Recommendations for Transgender Health Care 1098 Madeline B. Deutsch, Asa Radix, and Sari Reisner AMA Journal of Ethics, November 2016 1065 Policy Forum Affirmative and Responsible Health Care for People with Nonconforming Gender Identities and Expressions 1107 Kristen L. Eckstrand, Henry Ng, and Jennifer Potter Transgender Reproductive Choice and Fertility Preservation 1119 Khadija Mitu Transgender Rights as Human Rights 1126 Tia Powell, Sophia Shapiro, and Ed Stein Medicine and Society Understanding Transgender and Medically Assisted Gender Transition: Feminism as a Critical Resource 1132 Jamie Lindemann Nelson Medical Narrative Lessons from a Transgender Patient for Health Care Professionals 1139 Ryan K. Sallans Second Thoughts Informed Consent in the Medical Care of Transgender and Gender- Nonconforming Patients 1147 Timothy Cavanaugh, Ruben Hopwood, and Cei Lambert Correspondence Response to “Ethical and Clinical Dilemmas in Using Psychotropic Medications During Pregnancy” 1156 Jennifer Piel, Suzanne B.
    [Show full text]