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Without treatment, postpartum depression can resolve spontaneously or become chronic depression Maternal hemodynamic status may need to be supported with fluid resuscitation or blood product transfusion. Risk of recurrence is about 1 in 3 to 4

Other potential psychiatric disorders in the postpartum period include anxiety and, rarely, postpartum psychosis. Uterine rupture (rare) amniotic fluid embolism postpartum hemorrhage placenta accreta uterine inversion some complications are emergencies that require delivery to be expedited with operative vaginal delivery or cesarean delivery Urinary tract infections (cystitis and pyelonephritis) mastitis postpartum depression postpartum hypertensive disorders (postpartum preeclampsia or postpartum hypertension) postpartum physiologic changes clinical parameters within the first 24 hours after delivery, pulse rate begins to decrease, and temperature may be slightly elevated.

Endocrine changes have been implicated, but the specific cause is unknown.

Patients presenting for psychiatric care occasionally have undiagnosed general medical disorders that are not the cause of their psychiatric symptoms but nonetheless require evaluation and treatment Such disorders may be unrelated (eg, hypertension, angina) or caused by the psychiatric disorder (eg, undernutrition due to lack of motivation to eat resulting from chronic schizophrenia) or its. Therapeutic drug selection and response depend upon the indication, characteristics of the drug (eg, efficacy, safety profile, route of administration, route of elimination, dosing frequency, cost), and characteristics of the patient (eg, age, sex, comorbidities, other medications, and sometimes weight, race, genetic factors, or current or planned pregnancy) Analgesia and anesthesia options for labor and delivery include neuraxial, locoregional, parenteral analgesia, and general anesthesia

Neuraxial methods (eg, epidural or spinal anesthesia) are typically preferred (1). Obstetric and gynecologic history are often considered a distinct part of the medical history This history includes past medical history related to reproductive and overall gynecologic health, including pregnancies, medical conditions, medications, and procedures. Postpartum depression postpartum depression postpartum depression is depressive symptoms that last > 2 weeks after delivery and meet criteria for major depression.

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