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The puerperium

Published online by Cambridge University Press:  10 October 2008

William Dunlop
William Dunlop*
Affiliation:
Professor and Head of Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, UK.
*
Professor W Dunlop, Department of Obstetrics and Gynaecology, Princess Mary Maternity Hospital, Newcastle upon Tyne NE2 3BD, UK.
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Extract

The puerperium is a time of substantial maternal risk. Within recent years, crude maternal mortality rates of 8.9/100,000 total births have been reported from England and Wales and of 6.6/100,000 from Sweden. Maternal deaths are considerably more likely to follow delivery than to precede it (Table 1). The risks associated with caesarean section are particularly noteworthy: death rates have been reported to be as much as 12 times greater than those following vaginal delivery.

Type
Articles
Information
Fetal and Maternal Medicine Review , Volume 1 , Issue 1 , January 1989 , pp. 43 - 60
Copyright
Copyright © Cambridge University Press 1989

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References

1Department of Health and Social Security. Report on confidential enquiries into maternal deaths in England and Wales 1979–1981. Her Majesty's Stationery Office, 1986.Google Scholar
2Hogberg, U.Maternal deaths in Sweden, 1971–1980. Acta Obstet GynecolScand 1986; 65: 161–67.CrossRefGoogle ScholarPubMed
3Moldin, P, Hökegård, KH, Nielsen, TF. Cesarean section and maternal mortality in Sweden 1973–1979. Acta Obstet Gynecol Scand 1984; 63: 7–11.CrossRefGoogle ScholarPubMed
4Herbert, WNP.Complications of the immediate puerperium. Clin Obstet Gynecol 1982; 25: 219–32.CrossRefGoogle ScholarPubMed
5Klug, PW.Die Bedeutung der Sonographie im frühen Puerperium. Geburtsh u Frauenheilkd 1984; 44: 425–27.CrossRefGoogle ScholarPubMed
6Lückert, G, Domke, N, Löffler, F.Sonographische Untersuchungen der physiologischen Involution des Uterus im Wochenbett. Zentralbl Gynäkol 1984; 106: 681–85.Google Scholar
7Lipinski, JK, Adam, AH.Ultrasonic prediction of complications following normal vaginal delivery. J Clin Ultrasound 1981; 9: 17–19.CrossRefGoogle ScholarPubMed
8Macfarlane, A, Mugford, M.Birth Counts. London: Her Majesty's Stationery Office, 1984: 245. Table A7.32(a).Google Scholar
9Reading, AE, Sledmere, CM, Cox, DN, Campbell, S. How women view postepisiotomy pain. Br Med J 1982; 284: 243–46.CrossRefGoogle ScholarPubMed
10Isager-Sally, L, Legarth, J, Jacobsen, B, Bostofte, E.Episiotomy repair – immediate and long-term sequelae. A prospective randomized study of three different methods of repair. Br J Obstet Gynaecol 1986; 93: 420–25.CrossRefGoogle ScholarPubMed
11Reading, AE.A comparison of the McGill Pain Questionnaire in chronic and acute pain. Pain 1982; 13: 185–92.CrossRefGoogle ScholarPubMed
12Sleep, J, Grant, A.Relief of perineal pain following childbirth: a survey of midwifery practice. Midwifery 1988; 4: 118–22.CrossRefGoogle ScholarPubMed
13White, CA, Koonitz, FP.Beta-hemolytic streptococcus infections in postpartum patients. Obstet Gynecol 1973; 41: 27–32.Google Scholar
14Gibbs, RS, DeCherney, AH, Schwarz, RH.Prophylactic antibiotics in cesarean section: a double-blind study. Am J Obstet Gynecol 1972; 114: 1048–53.CrossRefGoogle ScholarPubMed
15Sweet, RL, Ledger, WJ.Puerperal infectious morbidity: a two-year review. Am J Obstet Gynecol 1973; 117: 1093–100.CrossRefGoogle ScholarPubMed
16Depalma, RT, Cunningham, FG, Leveno, KJ, Roark, ML.Continuing Investigation of women at high risk for infection following cesarean delivery: three-dose perioperative antimicrobial therapy. Obstet Gynecol 1982; 60: 53–59.Google ScholarPubMed
17Weissberg, SM, Edwards, NL, O'Leary, JA.Prophylactic antibiotics in cesarean section. Obstet Gynecol 1971; 38: 290–93.Google ScholarPubMed
18Chapman, ST.Bacterial infections in pregnancy. Clin Obstet Gynaecol 1986; 13: 397–416.CrossRefGoogle ScholarPubMed
19Wallace, RJ, Alpert, S, Browne, K,Juey-Shin, LL, McCormack, WM.Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever. Obstet Gynecol 1978; 51: 181–85.Google ScholarPubMed
20Beeley, L.Drugs and breast feeding. Clin Obstet Gynaecol 1986; 13: 247–51.CrossRefGoogle ScholarPubMed
21Davies, PA, Gothefors, L. In: Bacterial infections in the fetus and newborn infant, Philadelphia: WB Saunders Company, 1984: 210.Google Scholar
22Scholefield, JH, Duncan, JL, Rogers, K.Review of a hospital experience of breast abscesses. Br J Surg 1987; 74: 469–70.CrossRefGoogle ScholarPubMed
23Robson, SC, Boys, RJ, Dunlop, W, Hunter, S.Haemodynamic changes during early human pregnancy: an M-mode and Doppler echocardiographic study. Br Heart J 1987; 57: 584–85.Google Scholar
24Robson, SC, Dunlop, W, Hunter, S.Haemodynamic changes during the early puerperium. Br Med J 1987; 294: 1065.CrossRefGoogle ScholarPubMed
25Robson, SC, Hunter, S, Moore, M, Dunlop, W.Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol 1987; 94: 1028–39.CrossRefGoogle ScholarPubMed
26Robson, SC, Boys, RJ, Hunter, S, Dunlop, W. Maternal hemodynamics after normal delivery and delivery complicated by postpartum hemorrhage. Obstet Gynecol (in press).Google Scholar
27Matsunaga, T.Studies on maternal hemodynamics during normal pregnancy: correlation between maternal hemodynamics and fetal growth. Nippon Sanka Fujinka Gakkai Zasshi 1984; 36: 795–804.Google ScholarPubMed
28Fortuin, NJ, Hood, WP, Sherman, ME, Craige, E.Determination of left ventricular volume by ultrasound. Circulation 1971; 44: 575–84.CrossRefGoogle Scholar
29Maruta, S.The observation of the maternal hemodynamics during labor and cesarean section. Nippon Sanka Fujinka Gakkai Zasshi 1982; 34: 776–84.Google ScholarPubMed
30Boys, RJ, Dunlop, W, Hunter, S, Robson, SC.Serial changes in maternal cardiac dimensions and function before and during normal human pregnancy. J Physiol 1988; 403: 84.Google Scholar
31Ishimatsu, J.Studies of maternal hemodynamics during normal pregnancy: measurement of left ventricular performance and septal wall thickness by echocardiography. Nippon Sanka Fujinka Gakkai Zasshi 1983; 35: 2359–67.Google ScholarPubMed
32Robson, SC, Hunter, S, Dunlop, W.Left atrial dimension during early puerperium. Lancet 1987; 2: 111–12.CrossRefGoogle ScholarPubMed
33Robson, SC, Dunlop, W, Moore, M, Hunter, S.Combined Doppler and echocardiographic measurement of cardiac output: theory and application in pregnancy. Br J Obstet Gynaecol 1987; 94: 1014–27.CrossRefGoogle ScholarPubMed
34Sperry, KL.Myocardial infarction in pregnancy. J Forensic Sci 1987; 32:1464–70.CrossRefGoogle ScholarPubMed
35Iffy, L, TenHove, W, Frisoli, G.Acute myocardial infarction in the puerperium in patients receiving bromocriptine. Am J Obstet Gynecol 1986; 155: 371–72.CrossRefGoogle ScholarPubMed
36Feldman, HN.Myocardial infarction in the puerperium. Am J Obstet Gynecol 1987; 157: 515–16.CrossRefGoogle ScholarPubMed
37Walters, BNJ, Thompson, ME, Lee, A, de Swiet, M.Blood pressure in the puerperium. Clin Sci 1986; 71: 589–94.CrossRefGoogle ScholarPubMed
38Davidson, NMcD.Blood pressure in the puerperium. Clin Sci 1987; 73: 239.CrossRefGoogle ScholarPubMed
39Jenkins, DM, Soltan, MH.Plasma prolactin and puerperal blood pressure. Br J Obstet Gynaecol 1980; 87: 597–99.CrossRefGoogle ScholarPubMed
40Butters, L, McCabe, R.The influence of breast and bottle feeding on blood pressure. Midwifery 1988; 4: 130–32.CrossRefGoogle ScholarPubMed
41Landesman, R, Miller, MM.Blood volume changes during the immediate post-partum period. Obstet Gynecol 1963; 21: 40–48.Google Scholar
42Taylor, DJ, Phillips, P, Lind, T.Puerperal haematological indices. Br J Obstet Gynaecol 1981; 88: 601–606.CrossRefGoogle ScholarPubMed
43Walters, BNJ, Walters, T.Hypertension in the puerperium. Lancet 1987; 2: 330.CrossRefGoogle ScholarPubMed
44Crawford, JS, Lewis, M, Weaver, JB.Hypertension in the puerperium. Lancet 1987; 2: 693–94CrossRefGoogle ScholarPubMed
45Wilkes, RG, Bryson, THL, Kent, A.Hypertension in the puerperium. Lancet 1987; 2: 1089.CrossRefGoogle ScholarPubMed
46Kaemmerer, H, Rapp, K, Wagner, HH.Ultraschalluntersuchung des Pfortaderstromgebietes im Puerperium. Rontgenblatter 1985; 38: 244–47Google ScholarPubMed
47MacLennan, FM, MacDonald, AF, Campbell, DM.Lung water during the puerperium. Anaesthesia 1987; 42: 141–47.CrossRefGoogle ScholarPubMed
48Groenendij, kR, Trimbos, JBMJ,Wallenburg, HCS.Hemodynamic measurements in preeclampsia: preliminary observations. Am J Obstet Gynecol 1984; 150: 232–36.CrossRefGoogle Scholar
49Hankins, GDV, Wendel, GD, Cunningham, FG, Leveno, KJ.Longitudinal evaluation of hemodynamic changes in eclampsia. Am J Obstet Gynecol 1984; 150: 506–12.CrossRefGoogle ScholarPubMed
50Cotton, DB, Lee, W, Huhta, JC, Dorman, KF.Hemodynamic profile of severe pregnancy-induced hypertension. Am J Obstet Gynecol 1988; 158: 523–29.CrossRefGoogle ScholarPubMed
51Benedetti, TJ, Quilligan, EJ.Cerebral edema in severe pregnancy-induced hypertension. Am J Obstet Gynecol 1980; 137: 860–62.CrossRefGoogle ScholarPubMed
52Zinaman, M, Rubin, J, Lindheimer, MD.Serial plasma oncotic pressure levels and echoencephalography during and after delivery in severe pre-eclampsia. Lancet 1985; 1: 1245–47.CrossRefGoogle ScholarPubMed
53Pritchard, JA.Changes in the blood volume during pregnancy and delivery. Anesthesiology 1965; 26: 393–99.CrossRefGoogle ScholarPubMed
54Editorial. Postpartum fluid retention. Lancet 1979; 1: 960–61.Google Scholar
55Davison, JM, Vallotton, MB, Lindheimer, MD.Plasma osmolality and urinary concentration and dilution during and after pregnancy: evidence that lateral recumbency inhibits maximal urinary concentrating ability. Br J Obstet Gynaecol 1981; 88: 472–79.CrossRefGoogle ScholarPubMed
56Davison, JM, Dunlop, W.Changes in renal hemodynamics and tubular function induced by normal human pregnancy. Sem Nephrol 1984; 4: 198–207.Google Scholar
57Steegers, EAP, Hein, PR, Tan ACITL, Groeneveld, EAM, Jongsma, HW, Benraad, TJ.Plasma atrial natriureticpeptide (ANP) in late pregnancy and puerperium. Eur J Obstet Gynecol Reprod Biol 1987; 26: 213–17.CrossRefGoogle Scholar
58Rutherford, AJ, Anderson, JV, Elder, MG, Bloom, SR.Release of atrial natriuretic peptide during pregnancy and immediate puerperium. Lancet 1987; 1: 928–29.CrossRefGoogle ScholarPubMed
59Cugini, P, Centanni, M, Salandi, E et al. Inactive and active renins, aldosterone and cortisol in puerpera and newborn. Clin Exp Obstet Gynecol 1982; 9: 226–32.Google ScholarPubMed
60Oats, JN, Broughton Pipkin, F, Symonds, EM, Craven, DJ.A prospective study of plasma angiotensin-converting enzyme in normotensive primigravidae and their infants. Br J Obstet Gynaecol 1981; 88: 1204–10.CrossRefGoogle ScholarPubMed
61Dunlop, W.Serial changes in renal haemodynamics during normal human pregnancy. Br J Obstet Gynaecol 1981; 88: 1–9.CrossRefGoogle ScholarPubMed
62Dunlop, W. Changes in renal haemodynamics induced by human pregnancy. PhD Thesis, University of Newcastle upon Tyne, 1982.Google Scholar
63Davison, JM, Hytten, FE.Glomerular filtration during and after pregnancy. J Obstet Gynaecol Br Commonw 1974; 81: 588–95.CrossRefGoogle Scholar
64Davison, JM, Dunlop, W, Ezimokhai, M.24-hour creatinine clearance during the third trimester of normal pregnancy. Br J Obstet Gynaecol 1980; 87: 106–109.CrossRefGoogle ScholarPubMed
65Ezimokhai, M, Davison, JM, Philips, PR, Dunlop, W.Non-postural serial changes in renal function during the third trimester of normal human pregnancy. Br J Obstet Gynaecol 1981; 88: 465–71.CrossRefGoogle ScholarPubMed
66Dunlop, W, Davison, JM.The effect of pregnancy upon the renal handling of uric acid. Br J Obstet Gynaecol 1977; 84: 13–21.CrossRefGoogle ScholarPubMed
67Egwuatu, VE.Plasma urate, urea and creatinine levels during pregnancy and after the puerperium in normal primigravid Nigerians. Br J Obstet Gynaecol 1983; 90: 21–25.CrossRefGoogle ScholarPubMed
68Bailey, RR, Rolleston, GL.Kidney length and ureteric dilatation in the puerperium. J Obstet Gynaecol Br Commonw 1971; 78: 55–61.CrossRefGoogle ScholarPubMed
69Cietak, KA, Newton, JR.Serial quantitative maternal nephrosonography in pregnancy. Br J Radiol 1985; 58: 405–13.CrossRefGoogle ScholarPubMed
70Bonnar, J, McNicol, GP. Douglas, AS.Coagulation and fibrinolytic mechanisms during and after normal childbirth. Br Med J 1970; 2: 200–203.CrossRefGoogle ScholarPubMed
71Walker, JE, Gow, L, Campbell, DM, Ogston, D.The inhibition by plasma of urokinase and tissue activator-induced fibrinolysis in pregnancy and the puerperium. Thromb Haemostas 1983; 49: 21–23.Google ScholarPubMed
72Kruithof, EKO, Tran-Thang, C, Gudinchet, A et al. Fibrinolysis in pregnancy: a study of plasminogen activator inhibitors. Blood 1987; 69: 460–66.CrossRefGoogle ScholarPubMed
73Dalaker, K.Clotting factor VII during pregnancy, delivery and puerperium. Br J Obstet Gynaecol 1986; 93: 17–21.CrossRefGoogle ScholarPubMed
74Dahlman, T, Hellgren, M, Blombäck, M.Changes in blood coagulation and fibrinolysis in the normal puerperium. Gynecol Obstet Invest 1985; 20: 37–44.CrossRefGoogle ScholarPubMed
75Greer, IA.Thrombo-embolic problems in pregnancy. Fetal Medicine Review 1989; 1: 79–103.CrossRefGoogle Scholar
76Aaro, IA, Juergens, JL.Thrombophlebitis associated with pregnancy. Am J Obstet Gynecol 1971; 109: 1128–33.CrossRefGoogle ScholarPubMed
77Treffers, PE, Huidekoper, BL, Weenink, GH, Kloosterman, GJ.Epidemiological observations of thrombo-embolic disease during pregnancy and in the puerperium, in 56,022 women. Int J Gynaecol Obstet 1983; 21: 327–31.CrossRefGoogle Scholar
78Bolan, JC.Thromboembolic complications of pregnancy. Clin Obstet Gynecol 1983; 26: 913–22.CrossRefGoogle ScholarPubMed
79Editorial. Thromboembolism in pregnancy. Br Med J 1979; 1: 1661.CrossRefGoogle Scholar
80Howie, PW.Anticoagulants in pregnancy. Clin Obstet Gynaecol 1986; 13: 349–63.CrossRefGoogle ScholarPubMed
81Orme, ML'E, Lewis, PJ, de Swiet, M, Serlin, MJ, Sibeon, R, Baty, JD, Breckenridge, AM.May mothers given warfarin breast-feed their infants? Br Med J 1977; 1: 1564–65.CrossRefGoogle ScholarPubMed
82Powley, JM, Doran, FSA.Galvanic stimulation to prevent deep-vein thrombosis. Lancet 1973; 1: 406–407.CrossRefGoogle ScholarPubMed
83Powley, JM.Prophylaxis against postoperative pulmonary embolism. Lancet 1978; 1: 261–62.CrossRefGoogle Scholar
84Lao, TT, de Swiet, M, Letsky, E, Walters, BNJ.Prophylaxis of thromboembolism in pregnancy: an alternative. Br J Obstet Gynaecol 1985; 92: 202–206.CrossRefGoogle ScholarPubMed
85Saleh, AA, Bottoms, SF, Welch, RA, Ali, MM, Mariona, FG, Mammen, EF.Preeclampsia, delivery, and the hemostatic system. Am J Obstet Gynecol 1987; 157: 331–36.CrossRefGoogle ScholarPubMed
86Younker, D, Jones, MM, Andewala, J, Citrin, A, Joyce, TH.Maternal cortical vein thrombosis and the obstetric anesthesiologist. Anesth Analg 1986; 65: 1007–12.CrossRefGoogle ScholarPubMed
87Srinivasan, K.Cerebral venous and arterial thrombosis in pregnancy and puerperium. A study of 135 patients. Angiology 1983; 34: 731–46.CrossRefGoogle ScholarPubMed
88Srinivasan, K.Ischemic cerebrovascular disease in the young. Two common causes in India. Stroke 1984; 15: 733–35.CrossRefGoogle Scholar
89Jain, S, Maheshwari, MC.Cerebrovascular diseases: a review of the Indian experience in the last 35 years. Neuroepidemiology 1986; 5: 1–16.CrossRefGoogle ScholarPubMed
90Solal-Céligny, P, Tertian, G, Fernandez, H et al. Pregnancy and paroxysmal nocturnal hemoglobinuria. Arch Intern Med 1988; 148: 593–95.CrossRefGoogle ScholarPubMed
91Morishita, H, Higuchi, K, Nakago, K et al. Hypothalamic function in women during the first month post-partum. Acta Endocrinol 1984; 105: 145–48.Google ScholarPubMed
92Jeppsson, S, Rannevik, G, Kullander, S.Studies on the decreased gonadotropin response after the administration of LH/FSH-releasing hormone during pregnancy and the puerperium. Am J Obstet Gynecol 1974; 120: 1029–34.CrossRefGoogle Scholar
93Messenis, IE, Souvatzoglou, A, Vrontakis, M, Stefos, T, Charitopoulou, R, Lolis, DE.Relationships between serum prolactin levels and follicle stimulating hormone response to luteinizing hormone-releasing hormone during early puerperium. Acta Endocrinol 1983; 104: 143–47.Google Scholar
94DeLa Lastra, M, Llados, C.Luteinizing hormone content of the pituitary gland in pregnant and nonpregnant women. J Clin Endocrinol Metab 1977; 44: 921–23.CrossRefGoogle Scholar
95Liu, JH, Park, KH.Gonadotropin and prolactin secretion increases during sleep during the puerperium in nonlactating women. J Clin Endocrinol Metab 1988; 66: 839–45.Google ScholarPubMed
96Ishizuka, B, Quigley, ME, Yen, SSC.Postpartum hypogonadotrophinism: evidence for increased opioid inhibition. Clin Endocrinol 1984; 20: 573–78.CrossRefGoogle ScholarPubMed
97Grossman, A, West, S, Williams, J, Evans, J, Rees, LH, Besser, GM.The role of opiate peptides in the control of prolactin in the puerperium, and TSH in primary hypothyroidism. Clin Endocrinol 1982; 16: 317–20.CrossRefGoogle ScholarPubMed
98Lodico, G, Stopelli, I, Delitala, G, Maioli, M.Effects of naloxone infusion on basal and breast-stimulation-induced prolactin secretion in puerperal women. Fertil Steril 1983; 40: 600–603.CrossRefGoogle ScholarPubMed
99Hennart, P, Delogne-Desnoeck, J, Vis, H, Robyn, C.Serum levels of prolactin and milk production in women during a lactation period of thirty months. Clin Endocrinol 1981; 14: 349–53.CrossRefGoogle ScholarPubMed
100Vemer, HM, Rolland, R.The dynamics of prolactin secretion during the puerperium in women. Clin Endocrinol 1981; 15: 155–63.CrossRefGoogle ScholarPubMed
101Vemeer, HM, Rolland, R.The influence of exogenous oestradiol benzoate on the pituitary responsiveness to LHRH during the puerperium in women. Clin Endocrinol 1982; 16: 251–58.CrossRefGoogle Scholar
102Bohnet, HG, Kato, K.Prolactin secretion during pregnancy and puerperium: response to metoclopramide and interactions with placental hormones. Obstet Gynecol 1985; 65: 789–92.Google ScholarPubMed
103Melis, GB, Fruzzetti, F, Paoletti, AM et al. Pharmacological activation of gamma-aminobutyric acid-system blunts prolactin response to mechanical breast stimulation in puerperal women. J Clin Endocrinol Metab 1984; 58: 201–205.CrossRefGoogle ScholarPubMed
104Polatti, F, Branbilla, A, Mandelli, B, Forgione, A.Can pharmacologic hyperprolactinaemia and breast-suction induce lactation in women with normal menstrual cycles? Clin Exp Obstet Gynecol 1984; 11: 123–25.Google ScholarPubMed
105Martin, RH, Oakey, RE.The role of antenatal oestrogen in post-partum human lactogenesis: evidence from oestrogen-deficient pregnancies. Clin Endocrinol 1982; 17: 403–408.CrossRefGoogle ScholarPubMed
106Kauppila, A, Chatelain, P, Kirkinen, P, Kivinen, S, Ruokonen, A.Isolated prolactin deficiency in a woman with puerperal alactogenesis. J Clin Endocrinol Metab 1987; 64: 309–12.CrossRefGoogle Scholar
107Yen, SSC, Lein, A. Mammals: man. In: Lamming, GE, ed. Marshall's physiology of reproduction, fourth edition, Edinburgh: Churchill Livingstone, 1984: 713–88.Google Scholar
108Lewis, PR, Galvin, PM, Short, RV.Salivary oestriol and progesterone concentrations in women during late pregnancy, parturition and the puerperium. J Endocr 1987; 115: 177–81.CrossRefGoogle ScholarPubMed
109Spies, HG, Chappel, SC. Mammals: nonhuman primates. In: Lamming, GE, ed, Marshall's physiology of reproduction, fourth edition, Edinburgh: Churchill Livingstone, 1984: 659–712.Google Scholar
110Zuppa, A, Tornesello, A, Perrone, PAG et al. Parità e quantità di latte materno da suzione prodotta nei primo quattro giorni del puerperio. Pediatr Med Chir 1986; 8: 389–91.Google Scholar
111Houston, MJ, Howie, PW, McNeilly, AS.Factors affecting the duration of breast feeding: 1. Measurement of breast milk intake in the first week of life. Early Hum Dev 1983; 8: 49–54.CrossRefGoogle ScholarPubMed
112Salariya, EM, Easton, PM, Cater, JI.Duration of breast-feeding after early initiation and frequent feeding. Lancet 1978; 2: 1141–43.CrossRefGoogle ScholarPubMed
113Houston, MJ, Howie, PW, Smart, L, McArdle, T, McNeilly, AS.Factors affecting the duration of breast feeding: 2. Early feeding practices and social class. Early Hum Dev 1983; 8: 55–63.CrossRefGoogle ScholarPubMed
114Dostálová, L.Vitamin status during puerperium and lactation. Ann Nutr Metab 1984; 28: 385–408.Google ScholarPubMed
115Okamura, T, Takeuchi, T, Nishii, O, Yaginuma, T, Kawana, T.Effects of low-caloric diet in puerperium on prolactin, TSH, estradiol and milk secretion. Nippon Sanka Fujinka Gakkai Zasshi 1987; 39: 2059–65.Google ScholarPubMed
116Kauppila, A, Kivinen, S, Ylikorkala, O.A dose response relation between improved lactation and metoclopramide. Lancet 1981; 1: 1175–77.CrossRefGoogle ScholarPubMed
117Ylikorkala, O, Kauppila, A, Kivinen, S, Viinikka, L.Sulpiride improves inadequate lactation. Br Med J 1982; 285: 249–51.CrossRefGoogle ScholarPubMed
118Barguño, JM, delPozo, E,Cruz, M, Figueras, J.Failure of maintained hyperprolactinaemia to improve lactational performance in late puerperium. J Clin Endocrinol Metab 1988; 66: 876–79.CrossRefGoogle ScholarPubMed
119Joint Formulary Committee. In: British national formulary, Volume 16, London: British Medical Association and The Pharmaceutical Press, 1988; 32–36.Google Scholar
120Schmidt, D, Canger, R, Avanzini, G et al. Change of seizure frequency in pregnant epileptic women. J Neurol Neurosurg Psychiatry 1983; 46: 751–55.CrossRefGoogle ScholarPubMed
121Bardy, AH.Incidence of seizures during pregnancy, labor and puerperium in epileptic women: a prospective study. Acta Neurol Scand 1987; 75: 356–60.CrossRefGoogle ScholarPubMed
122Landon, MJ, Kirkley, M.Metabolism of diphenylhydantoin (phenytoin) during pregnancy. Br J Obstet Gynaecol 1979; 86: 125–32.CrossRefGoogle ScholarPubMed
123Bardy, AH, Hiilesmaa, VK, Teramo, KAW.Serum phenytoin during pregnancy, labor and puerperium. Acta Neurol Scand 1987; 75: 374–75.CrossRefGoogle Scholar
124Knott, C, Williams, CP, Reynolds, F.Phenytoin kinetics during pregnancy and the puerperium. Br J Obstet Gynaecol 1986; 93: 1030–37.CrossRefGoogle ScholarPubMed
125Lander, CM, Livingstone, I, Tyrer, JH, Eadie, MJ.The clearance of anticonvulsant drugs in pregnancy. Clin Exp Neurol 1981; 17:71–78.Google ScholarPubMed
126Korn-Lubetzki, I, Kahana, E, Cooper, G, Abramsky, O.Activity of multiple sclerosis during pregnancy and puerperium. Ann Neurol 1984; 16: 229–31.CrossRefGoogle ScholarPubMed
127Kendell, RE, McGuire, RJ, Connor, Y, Cox, JL.Mood changes in the first three weeks after childbirth. J Affective Disord 1981; 3: 317–26.CrossRefGoogle ScholarPubMed
128Yalom, ID, Lunde, DT, Moos, RH, Hamburg, DA.Post partum blues syndrome. Arch Gen Psychiat 1968; 18: 16–27.CrossRefGoogle ScholarPubMed
129Levy, V.The maternity blues in post-partum and post-operative women. Br J Psychiatry 1987; 151: 368–72.CrossRefGoogle ScholarPubMed
130Gard, PR, Handley, SL, Parsons, AD, Waldron, G.A multivariate investigation of postpartum mood disturbance. Br J Psychiatry 1986; 148: 567–75.CrossRefGoogle ScholarPubMed
131Stein, GS.The pattern of mental change and body weight change in the first post partum week. J Psychosomat Res 1980; 24: 165–71.CrossRefGoogle ScholarPubMed
132Stein, G, Morton, J, Marsh, A, Hartshorn, J, Ebeling, J, Desaga, U.Vasopressin and mood during the puerperium. Biol Psychiatry 1984; 19: 1711–17.Google ScholarPubMed
133Carroll, BJ.The dexamethasone suppression test for melancholia. Br J Psychiatry 1982; 140: 292–304.CrossRefGoogle ScholarPubMed
134Greenwood, J, Parker, G.The dexamethasone suppression test in the puerperium. Aust NZ J Psychiatry 1984; 18: 282–84.CrossRefGoogle ScholarPubMed
135Banovac, K, Kekić, M, Bzik, Lj, Skreb, F, Sekso, M.Reduced active thyroid hormone levels after delivery. J Endocrinol Invest 1981; 4: 271–74.CrossRefGoogle ScholarPubMed
136Tolino, A, de Conciliis, B, Montemagno, U.Thyroid hormones in the human pregnancy. Acta Obstet Gynecol Scand 1985; 64:557–59.CrossRefGoogle ScholarPubMed
137Fung, HYM, Kologlu, M, Collison, K et al. Postpartum thyroid dysfunction in Mid Glamorgan. Br Med J 1988; 296: 241–44.CrossRefGoogle ScholarPubMed
138Neugebauer, R.Rate of depression in the puerperium. Br J Psychiatry 1983; 143: 421–22.CrossRefGoogle ScholarPubMed
139Cox, JL, Connor, Y, Kendell, RE.Prospective study of the psychiatric disorders of childbirth. Br J Psychiatry 1982; 140: 111–17.CrossRefGoogle ScholarPubMed
140Cox, JL, Connor, YM, Henderson, I, McGuire, RJ, Kendell, RE.Prospective study of the psychiatric disorders of childbirth by self report questionnaire. J Affective Disord 1983; 5: 1–7.CrossRefGoogle ScholarPubMed
141Saks, BR, Frank, JB, Lowe, TL, Berman, W, Naftolin, F, Cohen, DJ.Depressed mood during pregnancy and the puerperium: clinical recognition and implications for clinical practice. Am J Psychiatry 1985; 142: 728–31.Google ScholarPubMed
142Kendell, RE, Chalmers, JC, Platz, C.Epidemiology of puerperal psychoses. Br J Psychiatry 1987; 150: 662–73.CrossRefGoogle ScholarPubMed
143Davidson, J, Robertson, E.A follow-up study of post partum illness, 1946–1978. Acta Psychiatr Scand 1985; 71: 451–57.CrossRefGoogle ScholarPubMed
144Riley, DM, Watt, DC.Hypercalcemia in the etiology of puerperal psychosis. Biol Psychiatry 1985; 20: 479–88.CrossRefGoogle ScholarPubMed