Depression in Pregnancy Flashcards
What are baby blues?
Seen in majority of women, in first week after birth
What is postnatal depression?
1/10 women, with peak around 3 months after birth
What is puerperal psychosis?
1/1000 women, a few weeks after birth
What are the clinical features of baby blues?
Mood swings
Low mood
Anxiety
Irritability
Tearfulness
- mild sx which last a few days and resolve within 2 weeks
What are the clinical features of post natal depression?
- triad of
low mood + anhedonia + low energy. - Symptoms should last at least two weeks before diagnosis.
What is puerperal psychosis?
delusions
hallucinations
depression
mania
confusion
thought disorder.
How to investigate for depression in post natal women?
Edinburgh post natal depression scale
Total score /30
Score above 10 = depression
What score out of 30 indicates Post natal depression on the edinburgh screening?
10/30
How to manage mild post natal depression?
Self help and GP follow up
How to manage moderate post natal depression?
SSRI and CBT
How to manage post partum psychosis?
Urgent assessment and specialist service
Admission of mother and baby unit
CBT + antidepressants, antipsychotics, mood stabilisers
What SSRI increases risk of congenital heart defect if given in the 1st trimester?
Paroxetine
What is the risk of giving SSRIs in the 3rd trimester?
risk of persistent pulmonary HTN of newborn
Which SSRIs are preferred which are avoided?
Sertraline and paroxetine are favoured
Avoid fluoxetine due to long half life
