A case of prepartum psychosis and infanticide

Bucove, Arnold D.

doi:10.1007/bf01563478

Cited by 11 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Psychosis during the perinatal period must be viewed in a broader context: leaving it untreated can cause harm to the mother through poor self-care, increased drug and alcohol use, non-attendance for obstetric care and impulsive acts [ 30 ]. In severe cases, there may be direct harm to the child through untreated maternal psychomorbidity, including neglect or even infanticide [ 68 , 69 ]. A 20-year study on puerperal psychosis in Austria found that out of 96 patients, six died from suicide, with three ‘extended suicide attempts’ leading to two cases of infanticide [ 70 ].…”

Section: Main Textmentioning

confidence: 99%

Sodium valproate in pregnancy: what are the risks and should we use a shared decision-making approach?

Macfarlane

Greenhalgh

2018

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundDespite significant teratogenic risks, sodium valproate is still widely prescribed in many countries to women of childbearing age, as a mood stabiliser in bipolar disorder and also in epilepsy. The UK has recently banned valproate use in women who are not in a pregnancy prevention programme. Whilst this ruling reflects prevailing clinical practice, it also highlights an ongoing debate about when (if ever) a woman who is or could become pregnant should be allowed to choose to take valproate.Main bodyWe review the benefits and harms of drugs available for bipolar disorder and epilepsy in women of childbearing age, with a particular focus on teratogenic risk. We speculate on hypothetical rare situations in which potential benefits of valproate may outweigh potential harms in such women. We also review the literature on shared decision-making – on which there is now a NICE guideline and numerous evidence-based decision tools. Drawing on previous work by experts in shared decision-making, we offer a list of ‘frequently asked questions’ and a matrix of options to support conversations with women about continuing or discontinuing the drug in (or in anticipation of) pregnancy. We also consider whether shared decision-making is an appropriate paradigm when considering whether to continue a teratogenic drug.ConclusionWe conclude that because valproate in pregnancy remains the subject of such debate, there is scope for further research – not only into the relative efficacy and safety of alternatives to it – but also into the dynamics of communication and shared decision-making in this situation.

show abstract

Section: Main Textmentioning

confidence: 99%

Sodium valproate in pregnancy: what are the risks and should we use a shared decision-making approach?

Macfarlane

Greenhalgh

2018

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…However, in one study it was found that schizophrenic women were not at higher risk for specific obstetric complications but were at greater risk of requiring interventions during delivery, including labor induction and assisted or cesarean delivery (56). If left untreated during pregnancy, schizophrenia-spectrum disorders can have devastating effects on both mother and child, with rare reports of maternal selfmutilation (57,58), denial of pregnancy resulting in refusal of prenatal care (59), and infanticide (60,61).…”

Section: Schizophrenia-spectrum Disordersmentioning

confidence: 99%