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Antenatal Depression In A High-Risk Pregnancy

Tze-Ern Chua, Jemie Wang, Helen Chen


Objective: This case report highlights antenatal depression as a common condition with potentially grave outcomes if left untreated. However, treatment options can be limited by the need to protect the fetus from medication-induced side effects. Methods: We report a young female obstetric patient who was carrying twins conceived through assisted reproduction, and her pregnancy was complicated by placenta previa major and repeated antepartum hemorrhages, which necessitated multiple admissions and strict bed rest. She became intensely depressed and anxious, developed suicidal ideation and refused examinations that were necessary to her physical health. She was referred to a psychiatrist and was given low-dose medication, supportive counseling, and case management. Results: She responded well to treatment, showing marked improvement in her mood and cooperation with obstetric care. Her twins were delivered at 35 weeks’ gestation in good health. Her progress was maintained into the postpartum period. Conclusions: This case of antenatal depression was successfully treated using a combination of medication, case management and psychological support. It adds to evidence that this illness benefits from early identification and is highly treatable. ASEAN Journal of Psychiatry, Vol. 15 (1): January – June 2014: 86-89.


Antenatal Depression; Antidepressants; Psychiatric Case Management

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