Farias Ryan, Hartnett Janice
University of Connecticut Obstetrics and Gynecology, USA.
Case Rep Obstet Gynecol. 2022 Apr 12;2022:3143601. doi: 10.1155/2022/3143601. eCollection 2022.
Catatonia during pregnancy is rare and presents unique challenges due to the potential ramifications to mom and baby of the overall disease state and of potential treatment options. The purpose of this case report is to highlight the complexities in the workup and management of a catatonic patient with concurrent acute obstetric concerns requiring urgent intervention. We report a case of acute catatonia due to underlying major depressive disorder in a patient who presented in spontaneous preterm labor, with a twin pregnancy of unknown chorionicity with no known prenatal care. She underwent an extensive workup with no significant findings on lumbar puncture, brain MRI, metabolic labs, and EEG. After exclusion of several acute underlying conditions, a presumptive diagnosis of catatonia secondary to exacerbation of underlying major depressive disorder was made. She was transferred to an inpatient psychiatric facility postdelivery and treated with a course of lorazepam, aripiprazole, and escitalopram with good effect.
妊娠期紧张症较为罕见，由于整体疾病状态以及潜在治疗方案对母婴可能产生的影响，会带来独特的挑战。本病例报告的目的是强调对一名患有紧张症且同时存在需要紧急干预的急性产科问题的患者进行检查和管理时的复杂性。我们报告一例因潜在的重度抑郁症导致急性紧张症的病例，患者出现自然早产，怀有双胎妊娠，绒毛膜性不明，且未进行过产前检查。她接受了全面检查，腰椎穿刺、脑部磁共振成像、代谢实验室检查和脑电图检查均未发现明显异常。在排除了几种急性潜在疾病后，初步诊断为潜在重度抑郁症加重继发紧张症。产后她被转至住院精神科机构，接受了一个疗程的劳拉西泮、阿立哌唑和艾司西酞普兰治疗，效果良好。
