Consequenties van een bipolaire stoornis en gebruik van stemmingsstabilisatoren voor het beleid rond zwangerschap

– For patients with a bipolar disorder who are pregnant or consider pregnancy, the following issues are of importance:

– Genetic counselling: genetic vulnerability is virtually certainly the basis of the occurrence of a bipolar disorder.

– Medication: discontinuation of the medication may lead to recurrence; continuation may cause intoxications in the woman and her child and congenital anomalies in the child.

– Alternatives to mood stabilizers can be applied; electroconvulsive therapy is a possibility as is medication with antidepressants, antipsychotics and benzodiazepines during acute episodes of mood disorder.

– Precautions for mother and child if mood-stabilizing treatment is continued: use sustained-release preparations, regularly check blood levels and thyroid function, administer vitamin K if necessary, perform ultrasonoscopyexamination of amniotic fluid, have the child delivered in hospital.

– Management of the newborn child: observation, determination of blood levels, regular checks of thyroid function, if necessary administration of vitamin K.