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PPD.pptx
- 1. Post-partum depression - A catastrophe that may ends into an irreversible catastrophe A case Report Dr Fahmida Rashid Swati Assistant Professor Chittagong Medical College Mail-dr.fahmidaswati@gmail.com
- 10. 3 Years later……
- 11. At 38 weeks- APH Stress
- 12. Labor Pain
- 15. 2nd Gravida 38 weeks pregnancy with APH due to placenta previa with H/O LSCS
- 16. LSCS
- 17. Entry- difficult Extensive Adhesion Prolong Surgery SAB converted to GA Asphyxiated Baby Delivered Stress
- 18. Placenta Acreta with invasion
- 19. Severely Asphyxiated Referred - NICU
- 20. After 4 hour baby died Trauma
- 21. On 6th POD
- 37. What was the cause of this suicide? Could it be Prevented? Should it be included in MMR?
- 38. Stillbirth defies the modern expectation of pregnancy. Prompts many complex emotional responses Grief reaction comparable to other types of bereavement (Chan, Lou, Arthur, Cao, Wu, Li & Lui, 2008:509)
- 39. Joyous birth ends in tragic death Potential to cause serious short-term and long-term psychological problems Mother have to deal with emotions surrounding birth and death simultaneously (Human, 2013: I)
- 40. Grief process is exacerbated by circumstances of loss Kirk, 1984:4 • Lack of memories of baby • Absence of “object” to mourn • Sense of biological failure • lack of validation from others • Uncertainty for future • Suffer parent, family and friends ,family's socio-economic environment
- 41. Post partum depression/ Psychosis After stillbirth (14.8%) When occur? up to 1 year, but commonly starts about 1– 3 weeks after childbirth. ACOG
- 42. What causes postpartum depression? Changes in hormone History of depression Fatigue Emotional factors Lifestyle factor ACOG
- 43. Marriage in Different cast Social factor 1st baby died Burn in childhood 2nd baby died Blamed by family after death of baby Cause of this case
- 44. Preventable? YES
- 45. Mental health Should be addressed as a part of all care plans NICE 2018 Should Provide culturally relevant information on mental health problems
- 46. Monitoring and contact women with mental health problem and those at risk who avoiding treatment Monitor in pregnancy and the postnatal. NICE 2018
- 47. If risk of self-harm or suicide: NICE 2018 Assess - social support Arrange help Inform professionals Advise woman, her partner, family /care giver.
- 48. How can we help? High-intensity psychological intervention Multiple session Focus on 're-living' Discuss option: photograph mementos seeing holding Follow-up appointment NICE 2018 Stillborn
- 49. American Pregnancy Association & ACOG Routinely screen for symptoms support of others who have had a similar experience. At least once during perinatal period
- 50. Where OGSB standing today? Are we taking care of our women's mental health ? Isn't it the right time to take initiative by us ? LETS START TALKING