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[Consequences of a bipolar disorder and use of mood stabilizers for its management during pregnancy]
E A Knoppert-van der Klein1, P Kölling, E M van Gent
1Psychiatrisch Ziekenhuis Endegeest, Jelgersmapolikliniek, Oegstgeest.
Unlabelled:
For patients with a bipolar disorder who are pregnant or consider pregnancy, the following issues are of importance: Genetic counselling: genetic vulnerability is virtually certainly the basis of the occurrence of a bipolar disorder.
Medication:
discontinuation of the medication may lead to recurrence; continuation may cause intoxications in the woman and her child and congenital anomalies in the child. Alternatives to mood stabilizers can be applied; electroconvulsive therapy is a possibility as is medication with antidepressants, antipsychotics and benzodiazepines during acute episodes of mood disorder. Precautions for mother and child if mood-stabilizing treatment is continued: use sustained-release preparations, regularly check blood levels and thyroid function, administer vitamin K if necessary, perform ultrasonoscopy/examination of amniotic fluid, have the child delivered in hospital. Management of the newborn child: observation, determination of blood levels, regular checks of thyroid function, if necessary administration of vitamin K.