Murugesan Manisha, Ganjekar Sundarnag, Thippeswamy Harish, Desai Geetha, Chandra Prabha S
Midlands Partnership Foundation Trust Shropshire, UK.
Dept. of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2024 Sep 9:02537176241273921. doi: 10.1177/02537176241273921.
Managing psychiatric emergencies during pregnancy is often challenging, as the safety of both the mother and the unborn fetus needs to be considered. This study aimed to examine the nature of psychiatric emergencies in pregnancy, their management, and clinical outcomes in women presenting to a psychiatry emergency room (ER).
Charts of perinatal women consulting psychiatry ER between January 2016 and June 2021 were reviewed for the nature of the psychiatric emergency, pregnancy details, psychiatric symptoms, sociodemographic information, medical comorbidities, clinical diagnosis, and care plan.
Among 286 perinatal women who attended psychiatry ER, 57 (19.9%) patients were pregnant. Over half ( = 30, 52.6%) women were multiparous and in their second trimester ( = 29, 50.9%). Bipolar disorder ( = 22, 38.6%) was the most common diagnosis. Agitation/aggression ( = 34, 59.6%) was the most common reason for visiting ER, with risk of self-harm ( = 14, 24.6%) and risk of harm to the fetus ( = 7, 12.3%) being other reasons. Emergency psychotropic medications were used in 32 (56.1%) women, with the use of haloperidol in combination with promethazine ( = 12, 37.5%) or lorazepam ( = 8, 25%) being the most common.
One-fifth of women in the perinatal period presenting to the ER were pregnant. Agitation and aggression were the most common reasons. Parenteral medications were commonly used, and more than a fifth required inpatient care, emphasizing the seriousness of risk.
孕期处理精神科急症往往具有挑战性，因为需要同时考虑母亲和未出生胎儿的安全。本研究旨在探讨孕期精神科急症的性质、处理方式以及在精神科急诊室就诊的女性患者的临床结局。
回顾了2016年1月至2021年6月期间在精神科急诊室就诊的围产期女性的病历，内容包括精神科急症的性质、妊娠细节、精神症状、社会人口学信息、合并症、临床诊断和护理计划。
在286名到精神科急诊室就诊的围产期女性中，57名（19.9%）患者处于孕期。超过半数（n = 30，52.6%）为经产妇，且处于孕中期（n = 29，50.9%）。双相情感障碍（n = 22，38.6%）是最常见的诊断。激动/攻击行为（n = 34，59.6%）是就诊急诊室最常见的原因，自我伤害风险（n = 14，24.6%）和对胎儿的伤害风险（n = 7，12.3%）是其他原因。32名（56.1%）女性使用了紧急精神药物，最常用的是氟哌啶醇联合异丙嗪（n = 12，37.5%）或劳拉西泮（n = 8，25%）。
到急诊室就诊的围产期女性中有五分之一处于孕期。激动和攻击行为是最常见的原因。常用注射药物，超过五分之一的患者需要住院治疗，这凸显了风险的严重性。
