Pregnancy in the severely mentally ill patient as an opportunity for global coordination of care

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 07/2013; 210(1). DOI: 10.1016/j.ajog.2013.07.029
Source: PubMed


Although obstetricians commonly care for pregnant patients with psychiatric disorders, little has been written about the implications of managing a pregnancy during a prolonged psychiatric hospitalization for severe mental illness. Multidisciplinary care may optimize obstetric and psychiatric outcomes. We describe a 27 week G1P0 severely mentally ill patient admitted after a suicide attempt. She exhibited intermittently worsening depression and anxiety throughout a two month inpatient psychiatric hospitalization, during which her psychiatric and obstetric providers collaborated regarding her care. We review recommendations for antepartum and intrapartum management of the acutely suicidal and severely mentally ill patient, and in particular, the evidence that a multidisciplinary coordinated approach to planning can maximize patient physical and mental health and facilitate preparedness for delivery.

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