Anorexia nervosa in pregnancy 2012 TOG Flashcards
Which psychiatric condition in young women has highest mortailirty rate?
Anorexia nervosa
5% per decade
In pregnant women with anorexia, how much increased risk of perinatal mortality?
6 fold
Female to male ratio for anorexia and bulimia nervosa?
9:1
Can women with amenorrhoea become pregnant
Yes, can lead to delated diagnosis of pregnancy
Effect of pregnancy on anorexia
Majority symptoms improve
relapse of around 20%
Effect of anorexia on pregnancy
Late booking
Higher rates hyperemesis
FGR/LBW - mostly in 3rd trimester
Anaemia
Anxiety
Miscarriage
Higher rates CS
Changes to symptoms postpartum
2/3rds symptoms return to pre-pregnancy levels within 6-9months
90% mother and baby bonding has been an issue
Difficulties breast-feeding
Flow diagram for detecting and managing eating disorder in pregnancy
Who should be involved in the care of a women with active or previous Hx of anorexia?
High risk obs consultant
Experience MW
Dietician
Eating disorder specilist
Perinatal mental health
GP
Imaging specilist
Obs anaesthetist
Who should be screened for eating disorders
Low body mass index
Concern about bodyweight and image, although not overweight
Gastrointestinal symptoms (more than morning sickness)
Physical signs of starvation or repeated vomiting
Psychological problems
Suggested screening questions:
° Do you think you have eating problems?
° Do you worry excessively about your weight?
