Puerperal pathology

An Sist Sanit Navar. 2009;32 Suppl 1:169-75.

[Puerperal pathology].

[Article in Spanish]


Servicio de Obstetricia y Ginecología, Hospital Virgen del Camino, Pamplona, 31008, Spain. bbezares@hotmail.com


The puerperium is the period from the end of labour to the appearance of the first menstruation. The possible pathologies that can occur in this period of time are the most frequent cause of maternal mortality even in our setting. The pathology of lactation includes failure of breastfeeding, cracks in the nipple, mammary ingurgitation and puerperal mastitis. Puerperal infection is a frequent obstetric complication although clinical guidelines for prophylaxis have considerably reduced its incidence. The vascular pathology of the puerperium includes clinical features of great seriousness, representing one of the main causes of maternal mortality. These include deep vein thrombosis, of which pulmonary thromboembolism is the most serious complication. It does not appear that a psychiatric pathology is more frequent in the puerperium than in other periods of life, but the clinical features related to this period are described, such as “blues”, puerperal depression and puerperal psychosis. Finally, other clinical features which although infrequent can constitute a medical emergency in the puerperium are: Sheehan’s syndrome, peripartum cardiomyopathy and postpartum thyroids.

[PubMed – indexed for MEDLINE]

Recurring short delirium with postpartum onset in two sisters.

Psychopathology. 1999 Nov-Dec;32(6):325-9.

Recurring short delirium with postpartum onset in two sisters.


Department of Psychiatry and Psychotherapy, University of Tübingen, Germany.


We report on a 30-year-old woman who twice developed a short postpartum psychosis with organic signs, but without obvious organic cause. Extensive investigations only yielded a state of moderate hypercoagulability. Her sister had developed similar signs and symptoms during her second puerperium and died 5 days after her delivery. We discuss the combination of various precipitating factors for postpartum psychosis, the possible impact of the findings on its cause and its classification.

Copyright 1999 S. Karger AG, Basel

Postpartum mania induced by Bromocriptine

[Postpartum mania induced by Bromocriptine: a case report].

[Article in French]


Service Universitaire de Psychiatrie, EA 3676, Université Victor Segalen Bordeaux 2, Hôpital Charles Perrens.


The postpartum period is a high-risk period for occurrence of mood disorders (depression, mania) particularly for women with a history of bipolar disorder. We report the case of a woman with a postpartum mania episode with psychotic features induced by bromocriptine. This case report highlights the need to systematically explore the personal history of pregnant women in search of mood disorder which may proscribe use of bromocriptine.

[PubMed – indexed for MEDLBromocriptine (Parlodel) is used to treat symptoms of hyperprolactinemia (high levels of a natural substance called prolactin in the body) including lack of menstrual periods, discharge from the nipples, infertility (difficulty becoming pregnant) and hypogonadism (low levels of certain natural substances needed for normal development and sexual function). Bromocriptine (Parlodel) may be used to treat hyperprolactinemia caused by certain types of tumors that produce prolactin, and may shrink these tumors. Bromocriptine (Parlodel) is also used alone or with other treatments to treat acromegaly (condition in which there is too much growth hormone in the body) and Parkinson’s disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance). Bromocriptine (Cycloset) is used with a diet and exercise program and sometimes with other medications to control blood sugar levels in people with type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Bromocriptine (Cycloset) is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated). Bromocriptine is in a class of medications called dopamine receptor agonists. It treats hyperprolactinemia by decreasing the amount of prolactin in the body. It treats acromegaly by decreasing the amount of growth hormone in the body. It treats Parkinson’s disease by stimulating the nerves that control movement. The way bromocriptine works to treat diabetes is not knownINE]


Postpartum psychosis

Postpartum psychosis

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Postpartum psychosis
Classification and external resources
Incidence of psychoses among Swedish first-time mothers
ICD10 F53.0f50
ICD9 Template:ICD9648.4

Postpartum psychosis (or puerperal psychosis) is a term that covers a group of mental illnesses with the sudden onset of psychotic symptoms following childbirth.

A typical example is for a woman to become irritable, have extreme mood swings and hallucinations, and possibly need psychiatric hospitalization. Often, out of fear of stigma or misunderstanding, women hide their condition.[1]

In this group there are at least a dozen organic psychoses, which are described under another heading “organic pre- and postpartum psychoses“.[2] The relatively common non-organic form, still prevalent in Europe, North America and throughout the world, is sometimes called puerperal bipolar disorder, because of its close link with manic depressive (bipolar) disorder;[3] but some of these mothers have atypical symptoms (see below), which come under the heading of acute polymorphic (cycloid) psychosis (schizophreniform in the US).[4] Puerperal mania was first clearly described by the German obstetrician Osiander in 1797,[5] and a literature of over 2,000 works has accumulated since then. These psychoses are endogenous, heritable illnesses with acute onset, benign episodic course and response to mood-normalizing and mood-stabilizing treatments. The inclusion of severe postpartum depression under postpartum psychosis is controversial: many clinicians would allow this only if depression was accompanied by psychotic features (see below).

The onset is abrupt, and symptoms rapidly reach a climax of severity. Manic and acute polymorphic forms almost always start within the first 14 days, but depressive psychosis may develop somewhat later.

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