Perinatal Mental Health

Question 1

What is the rate of perinatal depression?

Answer 1

10%

50% are women with depression antenatally

Question 2

What are the impacted of depression on pregnancy?

Answer 2

Reduced care, attendance antenatal care
Poor health maintenance - smoking, alcohol
Suicide
Higher rates of spontaneous abortion
Increased rates of gestational hypertension pre-eclampsia

Question 3

What are cluster B borderline traits?

Answer 3

Instability of interpersonal relationships, self-image and affect, and marked impulsivity

Question 4

When are psychotropics indicated?

Answer 4

• Pregnancy is not protect for mental illness
• Relapse of schizophrenia or bipolar poses risks of mothers and babies
• Antenatal depression and anxiety have adverse effects on mother and baby
• Postnatal depression is common and associated with significant morbidity

Question 5

When babies most vulnerable to adverse effects of psychotrophics?

Answer 5

First 3-12 weeks

Question 6

What is Ebstein’s anomaly and which drug increases the risk?

Answer 6

Displacement of the tricuspid valve in the RV

Lithium

Question 7

Which SSRI should be avoided in pregnancy? Why?

Answer 7

Paroxetine

Increased rate of VSD

Question 8

What percentage of the dose of a medication will be present in breast milk?

Answer 8

10%

Question 9

Which psychotrophics are not considered safe during breast feeding?

Answer 9

Clozapine

Lithium