Puerperium

The list of grounds for exemption from a prescription charge in the United Kingdom is extensive. The social grounds are low income, children below the age of 16 years, people in full-time education up to 19 years of age, pregnant women and women in the puerperium following either a live or still birth, old age (women over 60, men over 65, but since October 1995 men over 60) and war pensioners. 

Lactation Detectable amounts of progestins enter the milk of mothers receiving these agents. The effect on the nursing infant has not been determined. Medroxyprogesterone does not adversely affect lactation and may increase milk production and duration of lactation if given in the puerperium. 

Gracious, B.L. and Wisner, K.L. (1997) Phenelzine use throughout pregnancy and the puerperium a case report, review of the literature, and management recommendations. Depression Anxiety 6 124-128. 

O Hara, M.W. (1986) Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry 43 569— 573. 

Williams, K.E. and Koran, L.M. (1997) Obsessive-complusive disorder in pregnancy, the puerperium, and the premenstruum. J Clin Psychiatry 58 330-334. 

Wisner, K.L. and Perel,J.M. (1988) Psychopharmacologic agents and electroconvulsive therapy during pregnancy and the puerperium. In Cohen, R.L., ed. Psychiatric Consultation in Childbirth Settings. New York Plenum, pp. 165-206. 

Angelica grosserrata Maxim. Fu Shen (root) Angelic, linoleic, oleic, palmitic, stearic acids.50 Antispasmodic, diaphoretic, diuretic. Treat apoplexy, swellings, catarrh, dropsy, headache, leprosy, puerperium. 

Eupatorium chineme L. var. simplicifolium (Malcino) Kitam. E. lindleyanum DC E. japonicum Thunb. Zi Lan (Thorowort) (whole plant) Cumarin, O-cumaric acid, lactones, rhymohydroquinone, volatile oil, euparin, bornyl acetate, dimethyl thymohydroquinone, linalool.48 Sedative in disturbances of pregnancy and puerperium. Carminative, diuretic, vermifuge. 

Oral misoprostol 400 micrograms has been compared with placebo in the routine management of the third-stage of labor. In this study shivering was a specific adverse effect of oral misoprostol in the puerperium (19 versus 5% RR = 3.69 95% Cl = 2.05, 6.64) (14). 

Shinkoda H, Matsumoto K, Park,YM. Changes in sleep-wake cycle during the period from late pregnancy to puerperium identified through the wrist actigraph and sleep logs. Psychiatry Clin Neurosci 1999 53 133-135. 

Makletsova (USSR, 1979) examined 162 pregnant women occupationally exposed to Zineb and found an increased risk of abortion, delivery complications and puerperium. Controls were 148 pregnant women. Zielhuis (ref. 116, p. 32) found the data inconclusive because of the absence of dose information and a relatively high incidence of pregnancy and delivery complications in the controls. 

Hellgren M, Johansson S, Eriksson UG, et al, The oral direct thrombin inhibitor, ximelagatran, an alternative for anticoagulant treatment during the puerperium and lactation. Bjog 2005 I 12 579-583. 

Cantu C, Barinagarrementeria F (1993) Cerebral venous thrombosis associated with pregnancy and puerperium. Review of 67 cases. Stroke 24 1880-1884... 

All natural ergot alkaloids possess these six principal effects to a greater or lesser degree. The vasoconstrictor effect and the contractile effect on the smooth muscle of the uterus are the most important peripheral effects. The latter accounts for the classical indication of the ergot alkaloids in obstetrics where they are used to treat post partum hemorrhage and to accelerate uterine involution in the puerperium. The wide-... 

Retamal P, Cantillano V. Tratamiento de la enfermedad bipolar durante el embarazo y puerperio. [Treatment of bipolar disorder during pregnancy and puerperium period. A case report.] Rev Medical Chil 2001 129(5) 556-60. 

Thrombosis in the dural sinuses or cerebral veins is much less common than cerebral arterial thromboembolism. It causes a variety of clinical syndromes, which often do not resemble stroke (Bousser and Ross Russell 1997). While ischemic arterial stroke and cerebral venous thrombosis share some causes (Southwick et al. 1986), others are specific to cerebral venous thrombosis (Table 29.1). A particularly high index of suspicion is required in women on the oral contraceptive pill (Saadatnia and Tajmirriahi 2007) and in the puerperium. In the past, cerebral venous thrombosis was strongly associated with otitis media and mastoiditis, lateral sinus thrombosis or otitic hydrocephalus, but the most common causes are now pregnancy and the puerperium, which cause 5-20% of the cerebral venous thrombosis in the developed world, the oral contraceptive pill, malignancy, dehydration, inflammatory disorders and hereditary coagulation disorders. No cause is found in around 20% of cases. 

Sims EAH, Krantz KE. Serial studies of renal function during pregnancy and the puerperium in normal women. J Clin Invest 1958 37 1764-74. 

Maes M, Verkerk R, Bonaccorso S, Ombelet W, Bosmans E, Scharpe S (2002) Depressive and anxiety symptoms in tlie early puerperium ai e related to increased degradation of ti yptophan into kynurenine, a phenomenon wliich is related to immune activation. Life Sci 71 1837-1848. 

Dahlman TC. Osteoporotic fractures and the recurrence of thromboembolism during pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with heparin. Am J Obstet Gynecol 1993 168(4) 1265-70. 

Shnider SM. Serum chlonesterase activity during pregnancy, labor and the puerperium. Anesthesiology 1965 26 335-9. 

Robson N, Robertson 1, Whittaker M. Plasma cholinesterase changes during the puerperium. Anaesthesia 1986 41(3) 243-9. 

Gerhardt A, Scharf RE, Beckmann MW, Struve S, Bender HG, PiUny M, et al. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Engl J Med 2000 342 374-80. 

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