6 - Obs - Other Medical Disorders in Pregnancy - Mental Illness + Recreational Drug use in pregnancy Flashcards
Mental illness.
Major RF for maternal ?, esp ?
4 main illnesses?
death, suicide
BAD
depression
anxiety disorders
schizophrenia
BAD - ?% women. ? common. Episodes of ? and ?, can have ? Sx, may present ?. ? freq used, ass w incr risk ? defects, but discontinuation risks ?. Usually stopped in well/? risk women. If continued monitor levels due to incr ?. High risk of maternal ? and postnatal ?
important.
1% FHx dep + mania psychotic postnatally lithium cardiac relapse low clearance suicide meds
Depression -
Common ?, but up to 3% women ? taking ?. SSRIs eg ?
preferable to ? (v toxic in ?). Paroxetine > ? defects, avoid.
postnatally conceive antidepressants fluoxetine TCAs OD cardiac
Anxiety Disorders - common and variable - ? > drugs eg ???s
CBT > drugs eg BDZs
Schizophrenia -
Up to 1% women req ? for this. Therapy usually ? due to dangers of ? . Avoid ? and ?.
meds continued relapse clozapine olanzapine
Recreational drugs - illegal drugs - These women vulnerable ? and ?. Incr risk of: ?, ?/Hep C, maternal ?. MDT preg care inc ? support. Newborn may be subject of ? ?
Consider preg ? risk, esp cause of ???? and ? delivery.
personally and socially STIs HIV death social care order high IUGR preterm
Opiates: Not ? , but ass w ?deliv, IUGR, ?, dev ? and SIDS. ? maintenance advised, don’t ? as fetus can have severe withdrawal -> ?.
Cocaine: Prob terat, can -> ?
impairment, esp ass w ????and abruption, can cause ?
deliv, stillbirth and ????. Counsel ?, social support and preg ?
teratogenic preterm stillbirth delay methadone withdraw convulsions intellectual IUGR preterm SIDS (sudden infant death syndrome) risks monitoring
Ecstasy: is ? , incr risk of ?
defects and ?. Preg compx sim to ?, counsel and social support.
BDZs: Ass w facial ?, neonatal ? and ? Sx.
Cannabis: May cause ???? and affects later childhood ?
teratogenic
cardiac
gastroschisis
cocaine
clefts hypotonia withdrawal IUGR dev
Legal drugs - avoid alcohol esp in first ? weeks as can cause ?
higher levels -> incr risk of ???? and birth ?
Alcohol abuse in preg : incr these risks and ass w ???. ?abnormalities, IUGR, ? or abnormal brain, ? delay (w confirmed alcohol exposure >18units/day).
Alcohol Spectrum disorder: Advice and social support, ? to monitor fetal growth.
12 miscarriage IUGR defects foetal alcohol syndrome facial small dev USS
Legal drugs - Tobacco
: Related to ? class, ? (a fraction) women smoke in preg, 1/10th of pregs exposed to env smoke. Prob not ?, but ass w incr risk of ?, ????, ?birth, ? abruption, stillbirth and ?. Also ass w ? illnesses. Pre-eclampsia less common but more ? if it occurs. Encourage to stop or cut down, ? > smoking. ? risk preg
1/3 teratogenic miscarriage, IUGR, preterm, placental, SIDS childhood severe NRT high
