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Reproduction > Perinatal Psychiatry > Flashcards

Perinatal Psychiatry Flashcards

1
Q

What is the leading cause of direct maternal death in the year after childbirth?

A

Suicide

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2
Q

What are the red flag mental health presentations for recent mothers?

A

Significant change in mental state
Thoughts/acts of violent self harm
Feelings of estrangement from their baby

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3
Q

When may a woman be admitted to the mother and baby unit?

A 
Rapidly changing mental state
Suicidal ideation 
Estrangement from infant
Guilt or hopelessness
Beliefs of inadequacy 
Evidence of psychosis
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4
Q

Pregnancy is thought to be protective of mental health problems. True/false?

A

False - not protective

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5
Q

When do baby blues occur?

A

Days 3-10 postpartum

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6
Q

What occurs in baby blues?

A

Brief period of emotional instability where woman is tearful/irritable/anxious

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7
Q

How is baby blues treated?

A

Support and reassurance

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8
Q

Puerperal psychosis is a psychiatric emergency. True/false?

A

True

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9
Q

Give some features of puerperal psychosis

A 
Sleep disturbance
Confusion
Mania
Delusions
Hallucinations
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10
Q

What are the main risk factors for puerperal psychosis?

A

Bipolar disorder
Previous puerperal psychosis
1st degree relative with history

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11
Q

What are the main risks of puerperal psychosis?

A

Suicide

Infanticide

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12
Q

How is puerperal psychosis managed?

A

Admission to mother-baby unit

Antidepressants; antipsychotics; mood stabilisers; ECT

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13
Q

When is the onset of postnatal depression?

A

2-6 weeks postnatally

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14
Q

Give some common clinical features of postnatal depression

A 
Tearful
Irritable
Anxiety
Poor sleep
Weight loss
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15
Q

Most antidepressants should be avoided during pregnancy and breastfeeding. True/false?

A

False - most are pretty safe

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16
Q

Which antidepressant increases risk of fetal heart defects?

A

Paroxetine

17
Q

Which SSRIs are women advised to take during pregnancy?

A

Sertraline

Fluoxetine

18
Q

Benzodiazepines should be generally avoided during pregnancy and breastfeeding. True/false?

A

True

19
Q

Give some risks of BZDs in the 1st and 3rd trimester

A

1st trimester - increased risk of fetal malformation

3rd trimester - increased risk of floppy baby syndrome

20
Q

Most antipsychotics should be avoided in pregnancy due to risk of fetal malformation. True/false?

A

False - most are pretty safe

21
Q

Which antipsychotics should be avoided in pregnancy? Why?

A

Clozapine - risk of agranulocytosis

Olanzapine - risk of gestational diabetes

22
Q

Can lithium be continued during pregnancy?

A

Yes - but caution is advised

23
Q

Lithium must be avoided during breastfeeding. True/false?

A

True

24
Q

Why should sodium valproate be avoided in all women of childbearing age?

A

Increased risk of neural tube defects and craniofacial defects

25
Q

Why should all women of childbearing age on valproate be using contraception?

A

As the neural tube defect will commonly occur before the woman realises she is pregnant

26
Q

What are the main risks of carbamazepine and lamotrigine in pregnancy?

A

Carbamazepine - neural tube defects

Lamotrigine - oral cleft

27
Q

Can women who abuse opiates be prescribed diamorphine in labour?

A

Yes - probably will need a higher dose

28
Q

Give some risks of alcoholism in pregnancy

A

Miscarriage
Fetal alcohol syndrome
Wernicke-Korsakoff syndrome

29
Q

Give some risks of cocaine/amphetamine use in pregnancy

A

Death (stroke/arrhythmia)
Teratogenicity
Pre-eclampsia
IUGR

30
Q

Give some risks of opiates in pregnancy

A

IUGR
SIDS
Stillbirth

31
Q

Give some risks of nicotine in pregnancy

A

Miscarriage
Abruption
IUGR
SIDS

Reproduction (33 decks)

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