A Case with Amentia which Developed during Gestation

Abstract

Case : A 27-year old woman, para O, gravida O, who is married to her cousin, was anxious about delivery before gestation bacause of her intermarriage.In the seventh to eighth week of gestation, she developed hyperemesis gravidarum.In the tenth week of gestation, she drank much water after her gynecologist had told her to drink water for her fetus.In the sixteenth week of gestation, there were urinary retention, distension of abdomen and abnormalities of serum electrolyte values (hypokalemia, hyponatremia, hypochloremia). Moreover the anxiety about gestation increased and she developed amentia at last.After that, physical symptoms improved but she was still anxious about gestation together with her family. Therefore in consultation with gynecologist we tried to approach her family to give supportive psychotherapy. And she safely delivered a dauthter.Through the course of this case, we considered her psychological background and character features which produced amentia.With regard to her psychological background, we stated the following : The situation of gestation produced excessive anxiety under the psychologically prepared situation by intermarriage, and hyperemesis gravidarum, compulsive drinking water, urinary retention and distension of abdomen appeared. Moreover these symptoms increased anxiety and finally amentia developed by abnormalities of serum electrolyte.With regard to character features, we stated that immaturity and dependency are important factors which produced these symptoms.Through the treatment of this case, we made some discussion from the viewpoint of clinical psychiatry and emphasized an approach to patient and family as well as consultation with gynecologist. Lastly we briefly refered to side effects of psychotropic drugs on fetus.