Prenatal depression leading to postpartum psychosis.

Postpartum psychosis is a mood disorder occurring up to 3 months after delivery. Incidence is one to two women every 1,000 live births. If not detected and appropriately treated in time, it may have detrimental effects on both the mother and her baby. We report a case of puerperal psychosis in a patient with a history of depression. We have also reviewed the relevant literature discussing prediction, management and differential diagnosis of postpartum psychosis. We emphasise the importance of early detection and provision of care to all women at risk of mental illness by multidisciplinary team, including GPs, obstetricians, midwives and perinatal mental health professionals.

The role of recombinant activated Factor VII in major obstetric haemorrhage: the Farnborough experience.

Major obstetric haemorrhage is one of the commonest causes of maternal mortality and morbidity worldwide. It may result in coagulopathy and diffuse pelvic or vaginal bleeding. Correction of coagulopathy when administering Factor VII may be crucial to the management of selected cases. We report the use of recombinant activated factor in three cases of massive obstetric haemorrhage. Prolonged international normalised ratio, activated partial thromboplastin time, and reduced fibrinogen were the trigger to use rFVIIa. It was effective to halt the process of coagulopathy, secure haemostasis and improve laboratory parameters in all three patients. We review the relevant literature and discuss its indications, the potential benefits and possible complications. Recombinant activated Factor VII is a potential haemostatic agent in massive obstetric haemorrhage. Its successful use has been reported in post-surgical bleeding and consumptive coagulopathy. It may abolish the need for hysterectomy, which has a devastating effect on the patient future fertility and psychological well-being.

Spectral properties of (5-phenyl-1,3,4-oxadiazol-2-yl)-7-hydroxycoumarin (POHC).

The electronic absorption, emission and excitation spectra of POHC were measured in different solvents and are affected by solvent polarity. The fluorescence quantum yield of POHC decreases with increasing Richardt and Dimorth solvent parameter (E(T)) value of the solvent. In dilute solutions POHC is almost totally present in its protonated nitrogen tautomer form. The deprotonation is a reversible process. A shoulder in the absorption spectra at approximately 473 nm indicates the presence of a portion of the tautomer (s) that disappears on lowering the temperature. Molecular oxygen acts as a quencher with quenching rate constant of 1.8 x 10(10) M(-1) s(-1) in DMF. Energy transfer from POHC to rhodamine 6G in ethanol was also studied. POHC is relatively photostable in ethanol (phic approximately 1.7 x 10(-4)). Quantum chemical calculations were carried out and correlated to experimental observations.