Puerperium Cotard´ syndrome after preterm birth

The hormonal changes that occur during pregnancy, childbirth and puerperium; and the psychological and social changes that take place in women, make she more vulnerable and contribute to the development  of mood pathology. The symptomatology ranges from the mild form of postpartum sadness to severe forms  of puerperal psychosis as postpartum delusional depression. However, it is rare for postpartum  depression with psychotic symptoms to present with nihilistic delusions as it does in Cotard´s Syndrome. On  the other hand, it is well known that maternal stress can have harmful effects on fetal development and in  the course of pregnancy, sometimes associated with obstetric complications such as delayed intrauterine  growth and preterm delivery, among others.
We present the case of a 26-year-old patient with a history of postpartum sadness and previous abortion,  who during the pregnancy presents hypochondriacal cognitive ruminations and reactive sadness. The pregnancy ends with an urgent cesarean section due to loss of fetal well-being, after which she develops an episode of postpartum depression with psychotic symptoms characterized by delusional ideas of emptiness and rot that requires hospital admission and treatment with antidepressants and antipsychotics.