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Maternal Mental Health During Pregnancy and Postpartum / Intensive Care Unit Cognitive Disorders · Journal article
Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya · July 31, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 22-year-old woman with acute fatty liver of pregnancy complicated by intrauterine fetal death, hepatic encephalopathy, and delirium, who subsequently developed postpartum depression. The report documents clinical features, psychiatric assessment scores, and multidisciplinary management including psychopharmacology and psychotherapy, with modest improvement in depression severity at one-month follow-up; it illustrates integrated care principles but does not constitute evidence of efficacy.
Single case report. 22-year-old primigravida admitted with acute fatty liver of pregnancy presenting in third trimester; complicated by intrauterine fetal death, hepatic encephalopathy, and delirium. Intervention: Multidisciplinary psychiatric management: low-dose haloperidol (0.5 mg) during acute delirium phase, followed by sertraline (25 mg), structured cognitive behavioral therapy, and grief counseling.
Patient met diagnostic criteria for mixed-type organic delirium on CAM-ICU during acute phase PANSS-EC score of 19 during acute delirium phase EPDS score of 13 documented postpartum depression after delirium resolved
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This case illustrates the importance of integrated psychiatric care in managing complex postpartum psychiatric sequelae following severe obstetric illness and fetal loss. The specific clinical approach (hepatic-safe pharmacotherapy, psychotherapy, grief counseling) may inform management principles for similar cases, but the single-case format precludes drawing generalizable conclusions about efficacy or outcomes.
Single case report describing clinical management and outcomes in a rare obstetric condition; documents feasibility of multidisciplinary psychiatric intervention but provides no comparative data or control group.
As stated by the source record.
Quoted from the source exactly as published.
This case illustrates the importance of integrated psychiatric care in managing complex postpartum psychiatric sequelae following severe obstetric illness and fetal loss. The specific clinical approach (hepatic-safe pharmacotherapy, psychotherapy, grief counseling) may inform management principles for similar cases, but the single-case format precludes drawing generalizable conclusions about efficacy or outcomes.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Acute Fatty Liver of Pregnancy (AFLP) is a rare but life-threatening metabolic disorder that typically occurs in the third trimester and may lead to hepatic dysfunction, hepatic encephalopathy, and multisystem organ failure. While prompt delivery and intensive care can stabilize the patient physically, significant psychological complications may arise in the postpartum period. We report the case of a 22-year-old primigravida diagnosed with AFLP complicated by intrauterine fetal death (IUFD), hepatic encephalopathy, and delirium. The patient required 10 days of Intensive Care Unit (ICU) management before transitioning to the High Care Unit (HCU). Psychometric evaluation via the Confusion Assessment Method for the ICU (CAM-ICU) confirmed a mixed-type organic delirium, alongside a Positive and Negative Syndrome Scale–Excited Component (PANSS-EC) score of 19. After resolution of the acute organic delirium, the patient developed persistent grief, emotional lability, and severe postpartum depression, evidenced by an Edinburgh Postnatal Depression Scale (EPDS) score of 13. Her psychological distress was exacerbated by unique psychosocial stressors, particularly the concurrent healthy pregnancy of her identical twin sister, which triggered profound feelings of envy, inadequacy, and identity disruption. Management involved a tight multidisciplinary approach including Obstetrics & Gynecology, Internal Medicine, and Psychiatry. Psychiatric treatment focused on hepatic-safe pharmacotherapy using low-dose haloperidol (0.5 mg) during the acute delirium phase, followed by sertraline (25 mg) and structured Cognitive Behavioral Therapy (CBT) combined with grief counseling. At the one-month follow-up, her EPDS score improved to 10, demonstrating the crucial role of integrated medical and psychosocial care in mitigating complex bereavement and promoting neuro-psychiatric recovery following severe obstetric crises.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.