Diagnosis and treatment of bipolar disorder in pregnant women

Donald M. Hilty, Rosemary H. Kelly, Robert E Hales

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Bipolar disorder is relatively rare in obstetrics and gynecology (ob/gyn) practice compared with depressive and anxiety disorders, but there is a high risk for poor outcomes for patients and their offspring. Ob/Gyn physicians are assuming increasing responsibility for the care of these patients in today's managed care environment, working independently or in collaboration with a psychiatrist. The clinical presentation of bipolar patients may include mania and/or depression, in addition to more minor mood fluctuations that accompany the emotional and physical changes of pregnancy. The key issue in the differential diagnosis is to rule out medical, surgical, medication, and substance etiologies of mania that are potentially reversible. Indications for routine, urgent, and emergent referrals to a psychiatrist are reviewed. Treatment for bipolar women considering pregnancy includes prepregnancy planning education, involving the patient, family, psychiatrist, ob/gyn physician, and maternal-fetal medicine specialist. Treatment for pregnant bipolar women includes an individualized risk/benefit assessment regarding medication, monitoring levels and adherence to medication if it is used, ongoing patient education, and collaboration between the ob/gyn physician, maternal-fetal medicine specialist, and psychiatrist. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)105-112
Number of pages8
JournalPrimary Care Update for Ob/Gyns
Volume7
Issue number3
DOIs
StatePublished - May 2000

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ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Nursing(all)

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