Postpartum
Postpartum
K E PA N I T E R A A N K L I N I K S M F I L M U K E S E H ATA N P E R E M P U A N
R S U D D R D O R I S S Y LVA N U S
FA K U LTA S K E D O K T E R A N
U N I V E R S I TA S PA L A N G K A R AYA
PA L A N G K A R AYA
2020
DEFINISI
• Baby blues atau maternity blues atau postpartum blues adalah fase dari
kestabilan emosi setelah melahirkan, ditandai dengan episode sering
menangis, lekas marah, kebingungan, penurunan konsentrasi dan
kecemasan.
Manjunath NG, Vankatesh G, Rajanna. Postpartum Blue is Common in Socially and Economically Insecure Mothers. Indian Journal Of 3
Comunnity Medicine. 2011 Jul-Sep; 36(3): 231–233.
ETIOLOGI DAN FAKTOR RISIKO
FAKTOR
PERUBAHAN
PSIKOSOSIAL
BIOLOGIS
FAKTOR RISIKO
YANG TERKAIT
DENGAN
GANGGUAN
POSTPARTUM
Brummelte S and Galea LAM. Postpartum depression: Etiology, treatment and consequences for maternal care. 4
Hormone And Behavior. Volume 77, January 2016, Pages 153-166
PATOFISIOLOGI
GENETIK
NEUROINFLAMASI
LINGKUNGAN
HORMON
Corticotropine Releasing Hormone (CRH) diproduksi oleh trofoblas, fetal membrane, dan desidua, diregulasi
oleh steroid, ↓ kadarnya karena pengaruh progesteron
Plasental CRH dan maternal CRH merangsang hipofisis anterior untuk meningkatkan ACTH, sehingga
merangsang sekresi maternal kortisol dari korteks adrenal
Manjunath NG, Vankatesh G, Rajanna. Postpartum Blue is Common in Socially and Economically Insecure Mothers. 11
Indian Journal Of Comunnity Medicine. 2011 Jul-Sep; 36(3): 231–233.
KRITERIA DIAGNOSIS
Rai S, Pathak A, Sahrma I. postpartum psychiatric disorders: Early diagnosis and management. Indian Journal Of 12
Comunnity Medicine. 2015 Jul; 57(Suppl 2): S216–S221
EPDS
KUISIONNER
13
INTERPRETASI EPDS
Cox, J.L., Holden, J.M., and Sagovsky, R.. Detection of postnatal depression: Development of the 10- 15
itemEdinburgh Postnatal Depression Scale. British Journal of Psychiatry. 1987.150:782-6
TATALAKSANA
Manjunath NG, Vankatesh G, Rajanna. Postpartum Blue is Common in Socially and Economically Insecure Mothers. 16
Indian Journal Of Comunnity Medicine. 2011 Jul-Sep; 36(3): 231–233.
NON-FARMAKOLOGI
• Pendidikan psikoedukasi dan dukungan emosional
• Dukungan keluarga, teman dan psikoedukasi tentang baby
blues
• Meminimalkan gangguan tidur pasien pada malam hari
17
Cunningham, et al. 2016. Obstetri Williams. Edisi 23. Jakarta: EGC.
FARMAKOLOGI
ANTIDEPRESAN→ SSRIs
ANTIPSIKOTIK
LITHIUM KARBONAT
BENZODIAZEPINE
The CANMAT Depression Work Group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016
Clinical Guidelines for the Management of Adults with Major Depressive Disorder. Can J Psychiatry. 2016 Sep; 18
61(9): 540–560.
FARMAKOKINETIK SSRI
Stahl,S.M. Stahl’s Essential Psychopharmacology : Neuroscientific Basis and Practical Application 4 th Ed. New York : 19
Cambridge University Press.2013.p.284-290
FARMAKOKINETIK SSRI
Stahl,S.M. Stahl’s Essential Psychopharmacology : Neuroscientific Basis and Practical Application 4 th Ed. New York : 20
Cambridge University Press.2013.p.284-290
PROGNOSIS
Manjunath NG, Vankatesh G, Rajanna. Postpartum Blue is Common in Socially and Economically Insecure Mothers. 21
Indian Journal Of Comunnity Medicine. 2011 Jul-Sep; 36(3): 231–233.