depression postpartum

7/25/2019 Depression Postpartum

1/15

KATHERINE L. WISNER, M.D., BARBARA L. PARRY, M.D., AND CATHERINEM. PIONTEK, M.D.

POSTPARTUM DEPRESSION

Journal Readin

Ole! " Erna Wa#iPe$%i$%in " Dr. To$$& Her$an'&a!, S(.K)

RS. S&a$'udin, SH Ko#a Su*a%u$i


2/15

Masalah Klinis

De(re'i (o'#(ar#u$ +- ani#a (o'# (ar#u$a#au + " / ani#a (o'# (ar#u$

A$eri*a 'eri*a#

Kela!iran 0 )u#a1#a!un

+12)u#a1#a!un $enala$i anuan ini.


3/15

Defnisi

De(re'i (o'#(ar#u$ adala! #erda(a#n&a li$a darie)ala &an #er3an#u$ dala$ Ta%el +, dan 'ala!'a#un&a !aru' %eru(a $ood de(re'i a#au (er!a#ian$enurun a#au *e'enanan dala$ a*#i4i#a'

$enurun.


4/15

Ta%el +. 5e)ala De(re'i Ma&or denan on'e# (a'3a $ela!ir*anDe(re'i $a&or dide6ni'i*an denan #erda(a#n&a li$a dari e)ala

%eri*u#, 'ala! 'a#un&a !aru' $ood de(re'i a#au (er!a#ian

$enurun a#au *e'enanan 7" Me$%uru*n&a 'ua'ana !a#i, 'erin di'er#ai a#au di%a&ani

ole! *e3e$a'an &an %era#

Ber*urann&a $ina# a#au *e'enanan dala$ *eia#an

5anuan na8'u $a*an *e!ilanan na8'u $a*an %ia'an&a

di'er#ai denan (enurunan %era# %adan

5anuan #idur (alin 'erin in'o$nia dan #idur

#er8ra$en#a'i, %a!*an *e#i*a %a&i #idur

9i'i* ai#a'i :(alin 'erin; a#au (erla$%a#an ('i*o$o#or

Kelela!an, (enurunan eneri Pera'aan #ida* %er!ara a#au %er'ala! &an %erle%i!an a#au

#ida* #e(a#

Penurunan *on'en#ra'i a#au *e$a$(uan un#u* $e$%ua#

*e(u#u'an

Berulann&a (i*iran #en#an *e$a#ian a#au *eininan %unu!diri


5/15

Penyebab

Penurunan 3e(a# !or$on re(rodu*'i 'e#ela!$ela!ir*an

9a*#or (redi'(o'i'i lain "

Peri'#ia '#re' dala$ *e!idu(an

E(i'ode de(re'i (ada $a'a lalu :#ida* 'elalu%er!u%unan denan $ela!ir*an;

Ria&a# anuan $ood (ada *eluara

Tida* %er!u%unan

Tin*a# (endidi*an ani#aJeni' *ela$in %a&i

Men&u'ui a#au #ida* $en&u'ui

Jeni' (er'alinan

A(a*a! *e!a$ilan diren3ana*an a#au #ida*.


6/15

Screening

S*ala De(re'i Po'#na#al Edin%ur!


7/15

EvaluasiMe$erlu*an ru)u*an (eraa#an &an 3e(a#

Ren3ana $ela*u*an #inda*an %unu! diri

Pi*iran un#u* $elu*ai %a&i

Me$(un&ai anuan 8un'ional $a&or :'e(er#i$en!indari *eluara dan #e$an, *e#ida* $a$(u $en)aa

*e%er'i!an, a#au *e#ida*$a$(uan un#u* $eraa# %a&idenan %ai*;

Pen&ala!unaan


8/15

Dierensial Diagnosis

+. Ba%& Blue'

2. P'i*o'i' Po'#(ar#u$


9/15

Pengobaan Ani!e"resanTabel #$ %ar&a'oera"i unu' De"resi Pos"aru&

Oba Do'i'

Re*o$enda'

i :$1!ari;@

E8e* 'a$(in I$(li*a'i (enunaan o%a#

'ela$a $en&u'ui

Selecive seroonin(reu"a'e inhibiorSerraline =?2 Mual, $en3re#, #re$or,

in'o$nia, di'8un'i 'e*'ual ,

in#era*'i o%a# &an $un*in 7

O%a# dan $e#a%oli# a*#i8 le$a!

u$u$n&a #ida* #erde#e*'i (ada

%a&i #ida* ada la(oran e8e*

'a$(inParo)eine 2? Mual, $enan#u*, *elela!an,

(u'in,di'8un'i 'e*'ual ,in#era*'i o%a# &an $un*in 7

Me#a%oli# #ida* a*#i8 #in*a# #ida*

#erde#e*'i (ada %a&i, #ida* adala(oran *e)adian %uru*

%luo)a&in =?2 Mual, $enan#u*, anore*'ia,

*e3e$a'an, di'8un'i 'e*'ual,


Me#a%oli# #ida* a*#i8 #in*a# #ida*

#erde#e*'i (ada %a&i, #ida* ada

la(oran *e)adian %uru**ialo"ra& 2?0 Mual, in'o$nia, (u'in,

$enan#u*

%a&i lainn&a #ida* $e$ili*i

$a'ala! dan *adar 'eru$ &an

#ida* #erde#e*'i a#au !an&a dia#a' %a#a' de#e*'i

%luo)eine 2? Mual, $enan#u*, anore*'ia,

*e3e$a'an, di'8un'i 'e*'ual,


O%a# dan $e#a%oli# a*#i8 #ela!

rela#i8 (an)an a*#u (aru!n&a

'eru$ 'eru(a denan &an

dila(or*an (ada oran dea'a

#in*a# e)ala (ada %e%era(a %a&i

#in*a# (a(aran (rala!ir$ena$%a! *adar 'eru$ (ada


10/15

Tricyclic ani!e"ressansNorri"yline =?+= Seda'i, %era# %adan, $ulu#

*erin, *on'#i(a'i, !i(o#en'i

or#o'#a#i*, $un*in in#era*'i

o%a# 7 da'ar?line EK5

dire*o$enda'i*an

O%a# dan $e#a%oli# u$u$n&a di

%aa! a#au 'edi*i# di a#a' %a#a'

#erde#e*'i #ida* ada la(oran e8e*

'a$(in (ada %a&i

Desi"ra&ine +? Seda'i, %era# %adan, $ulu#

*erin, *on'#i(a'i, !i(o#en'i

or#o'#a#i*, $un*in in#era*'i

o%a# 7 da'ar?line EK5

dire*o$enda'i*an

O%a# dan $e#a%oli# di %aa!

#in*a# *uan#i#a#i8 #ida* ada e8e*

'a$(in

Sero#onin?nore(ine8rin reu(#a*e

in!i%i#orSeroonin(nore"ine"hrine reu"a'e inhibior+enlaa)ine =? Mual, %er*erina#, $ulu# *erin,

(u'in, in'o$nia, $enan#u*,

di'8un'i 'e*'ual

Tida* #erde#e*'i a#au renda! *adar

'eru$ o%a# $e#a%oli# %ia'an&a

diu*ur dan $iri( denan &an

dia$a#i (ada oran dea'a di

%e%era(a %a&i #in*a# o%a# &an

le%i! %e'ar dala$ ASI dari(ada di

#in*a# 'eru$ i%u,ainnya-u"ro"ion ?0= Pu'in, 'a*i# *e(ala, $ulu#

*erin, %er*erina#, #re$or,

ai#a'i, *e)an )aran #er)adi,

$un*in in#era*'i o%a# 7

Tida* di*e#a!ui

Nea.o!one ? $enan#u*, $ual, (u'in,

*e$un*inan in#era*'i o%a# 7

Tida* ada da#a &an di#er%i#*an

(ada #in*a# 'eru$ (ada %a&i'eda'i dan $a*an &an %uru*


11/15

ASI

'er#raline 9IRSTLINE dala$ (eno%a#an un#u*i%u $en&u'ui 'edi*i# ri'i*o.

9luoFe#ineKoli*, %era# %adan 'e#ela! la!ir*uran,

Ci#alo(ra$ #idur %a&i eli'a!

An#ide(re'an #ri'i*li*do*'e(inde(re'i(erna(a'an dan 'eda'i


12/15


13/15

Psi'oera"i

('i*o#era(i in#er(er'onal, +2?'e'i &an %er8o*u'(ada (eru%a!an dan !u%unan (en#in , 'ana#e8e*#i8 un#u* $en!ilan*an e)ala de(re'i dan(er%ai*an dala$ 8un'i ('i*o'o'ial


14/15

Tera"i /or&onal

E'#radiol (eno%a#an un#u* de(re'i (o'#(ar#u$:2 $1!ari ;


15/15

Kesi&"ulan !an Re'o&en!asi

depression postpartum

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