Part 12 book “Beckmann and ling’s obstetrics and gynecology” has contents: Neurologic and psychiatric disorders, sexually transmitted infections, reproductive cycles, amenorrhea and abnormal uterine bleeding, premenstrual syndrome and premenstrual dysphoric disorder, gestational trophoblastic neoplasia, vulvar and vaginal disease and neoplasia, and other contents. | CHAPTER 25 Neurologic and Psychiatric Disorders This chapter deals primarily with APGO Educational Topic Areas: TOPIC 17 MEDICAL AND SURGICAL COMPLICATIONS OF PREGNANCY TOPIC 29 ANXIETY AND DEPRESSION Students should be able to identify how pregnancy affects the natural history of various neurologic and mood disorders and how a preexisting neurologic and mood disorder affects maternal and fetal health. They should be able to outline a basic approach to evaluation and management of neurologic and mood disorders in pregnancy. CLINICAL CASE You are seeing a new patient who is at 14 weeks of gestation with her first pregnancy. She informs you that she has had significant depression for some years. When she has tried stopping her antidepressant medications, her symptoms became severe and on two occasions required hospital admission. Her psychiatrist discussed continued use of a selective serotonin reuptake inhibitor in pregnancy, and together they decided she should remain on such medications. In discussing general obstetric care, you counsel her on depression and management during pregnancy. INTRODUCTION Headaches are common in reproductive aged women and are therefore encountered during pregnancy, particularly in the first trimester. Depression and anxiety are seen quite frequently in the pregnant population, as they are in the general population. Postpartum depression 544 (PPD) is an important entity that must be appreciated by anyone caring for patients during and after delivery. Other specific neurologic and psychiatric disorders are also seen, albeit less frequently, but they pose challenges for those providing obstetric care to patients with these conditions. NEUROLOGIC DISORDERS Headaches Hormonal changes are thought to influence headaches in women in pregnancy, the postpartum period, and at other reproductive system changes throughout life. Headaches are especially common in pregnancy, particularly in the first trimester. In pregnant women presenting .
