Managing psychosis in pregnancy.
OBJECTIVE
This article provides an introduction to the complex issues surrounding the management of women who have a history of psychosis and who become pregnant. Balancing the mental wellbeing of the woman and the safety and wellbeing of the baby is a complex task for both the expectant mother and the health professionals involved in her care.


METHODS
Within this article the complexity of the issues will be outlined as a case report of a woman with a history of psychotic related disorders, who was also pregnant.


METHODS
The woman was being case managed by a Mental Health Service in Victoria, Australia, and was included on the National Register of Antipsychotic Medications in Pregnancy Register (NRAMP) recently established at the Alfred Psychiatry Research Centre (APRC).


RESULTS
The profile of women with a history of previous mental illness, and who are pregnant, often includes a poor psychosocial history and involvement with child protection agencies with regard to custody of the children. Well meant but poorly coordinated decisions by health professionals result in sub-optimal outcomes for both mother and infant.


CONCLUSIONS
There is a need for the exploration of the management and experiences of women who have a history of psychosis and who are pregnant. This case example highlights the complexity of issues surrounding the management of this vulnerable group of women and their babies.
McCauley-Elsom
Kay
K
School of Nursing and Midwifery, Monash University, McMahon's Road, Frankston, Vic. 3199, Australia. Kay.McCauley@med.monash.edu.au
Kulkarni
Jayashri
J
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D019090:Case Management; D002655:Child Custody; D003299:Cooperative Behavior; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007400:Interprofessional Relations; D000077152:Olanzapine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy*; D011644:Puerperal Disorders / Q000175:diagnosis; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine