Gracious B L, Wisner K L
Department of Psychiatry, Texas A&M University Health Science Center, Scott & White Clinic, Temple, USA.
Depress Anxiety. 1997;6(3):124-8.
Little is known about the use of monoamine oxidase inhibitors (MAOIs) during pregnancy and the postpartum period. We present a literature review with what we believe is the second case report of phenelzine exposure throughout pregnancy and the postpartum period. Potential indications for use and principles of the clinical management of the pregnant patient treated with an MAOI are also discussed and include: documenting informed consent, MAOI dose adjusting during pregnancy, monitoring of maternal and fetal outcome, and appropriate analgesia and anesthesia during labor and delivery. Our patient tolerated phenelzine well throughout her pregnancy but experienced recurring depressive symptoms during periods of significant weight gain requiring dose adjustment. Labor, delivery, and the perinatal period progressed without complication for our patient and her infant, in whom no congenital malformation was detected. Additional case reports and animal studies of MAOI use during gestation may help determine safety and refine clinical management guidelines.
关于在孕期和产后使用单胺氧化酶抑制剂（MAOIs）的情况，人们知之甚少。我们进行了一项文献综述，并呈现了我们认为的第二例在整个孕期及产后暴露于苯乙肼的病例报告。还讨论了使用MAOIs治疗的孕妇的潜在适应证及临床管理原则，包括：记录知情同意书、孕期调整MAOIs剂量、监测母婴结局，以及分娩期间适当的镇痛和麻醉。我们的患者在整个孕期对苯乙肼耐受性良好，但在体重显著增加需要调整剂量的期间出现了复发性抑郁症状。我们的患者及其婴儿的分娩、生产及围产期过程均无并发症，且未检测到婴儿有先天性畸形。关于孕期使用MAOIs的更多病例报告和动物研究可能有助于确定安全性并完善临床管理指南。
