Perinatal Psychiatry Flashcards
Red flags that required urgent referral to perinatal mental health team
- Significant change in mental state
- New thoughts or acts of violent self harm
- New and persistent expressions of incompetency as a mother or estrangement from their baby
What is the ‘baby blues’
Brief period of emotional instability- tearful, irritable, anxiety, poor sleep
how common is the baby blues
50% of women
What is puerperal psychosis
early symptoms: sleep disturbance/confusion, irrational ideas
Mania, delusion, hallucinations
EMERGENCY ADMISSION
Risk factors for puerperal psychosis
Bipolar disorder (50%)
Previous episode
1st degree relative with history
How common is post natal depression? when does it present?
10% of women
2-6 weeks post natal, lasts weeks-months
what is the major risk to a fetus with paroxetine? (an SSRI)
fetal heart defects
Which TCA and SSRI are safe in breast feeding
Amytriptilline
Sertraline
what antidepressant should be avoided in breast feeding
citalopram (SSRI)
what drug used in treatment of anxiety should be avoided in pregnancy + breast feeding
Benzodiazepines
risk of benzodiazepine use in pregnancy
cleft palate
Neonatal withdrawal
fetal side effects of sodium valproate (used as a mood stabiliser)
Neural tube defects
IUGR
Reduced IQ
Cardiovascular abnormalities
fetal side effects of carbamazepine (used as a mood stabiliser)
Facial dysmorphism
Cardiac abnormalities
Neural tube defects
Vitamin K deficiency – haemorrhage disease of the newborn
fetal side effect of lamotrigine (mood stabiliser) in breast feeding
Steven Johnson syndrome
fetal side effects of lithium
Ebstein’s anomaly- congenital heart defect
Neonatal hypotonia, hypothyroidism, hypoglycaemia
is lithium safe in breast feeding?
NO
why should the anti-psychotic clozapine be avoided
risk of agranulocytosis
side effects of olanzapine
increased risk of gestational diabetes and weight gain
features of fetal alcohol syndrome
facial deformities low IQ Neurodevelopmental delay Epilepsy Hearing, Heart, kidney defects
what is wernicke’s encephalopathy
Neurological disorder caused by vitamin B1 deficiency
Usually due to chronic alcoholism
Effects of opiate use
maternal deaths neonatal withdrawal IUGR SIDS (sudden infant death syndrome) still birth
effects of nicotine consumption
Miscarriage placental abruption IUGR stillbirths SIDS
