Perinatal Psychiatry Flashcards
Maternal suicide is the leading cause of direct maternal deaths for how long after delivery of a pregnancy?
Leading cause of maternal death for 1 year after birth
What symptoms reported by pregnant women would indicate urgent referral is needed to the perinatal mental health team?
- significant change in mental state OR new symptoms
- New thoughts / acts of violent self harm
- New / persistent expressions of incompetency as a mother or estrangement from their baby
What recommendations does the “Saving Mother’s Lives” campaign make with regards to communication in perinatal psychiatry?
- At booking enquire about current/ PMHx of mental health problems
- If women visit their GP during pregnancy, GPs should communicate about past psych. history in antenatal referral
- Antenatal services, GPs and psychiatry should communicate with well with each other
When should admission to a mother and baby unit be considered?
- rapidly changing mental state
- suicidal ideation
- significant estrangement from infant
- pervasive guilt/ hopelessness
- beliefs of inadequacy as a mother
- evidence of psychosis
How should mental health disorders be screened for at booking appointments?
- Check for Hx of mental health problems
- Previous treatment
- Family Hx
- Risk factors:
- Young/ single
- domestic issues
- lack support
- substance abuse
- unplanned/unwanted pregnancy
- pre existing mental health problem
What questions about mental health problems should be screened for at every antenatal appointment?
- During the last month have you been bothered by feeling down, depressed or hopeless?
- During the last month have you been bothered by having little interest or pleasure in doing things?
- Is this something you feel you need or want help with?
What mental health symptoms or conditions during or after pregnancy should be referred to a psychiatrist?
- Psychosis
- Severe anxiety, depression, suicidal, self-neglect, self harm
- Symptoms impairing daily functioning
- History of bipolar/ schizophrenia/ puerperal psychosis
- Psychotropic medications
- Developed moderate mental illness in late pregnancy or early postpartum
Pregnancy can cause previous mental health problems to get better? TRUE/FALSE?
FALSE
- Pregnancy is not protective
- Some may improve slightly (e.g. eating disorder) but risk of relapse is high
What are the risks of a mother suffering from an eating disorder during pregnancy?
- IUGR
- prematurity
- hypokalaemia
- hyponatraemia
- metabolic alkalosis
- miscarriage
If a patient experiences mild to moderate depression and wishes to come off her medication during pregnancy, what options can be offered?
- Stop medication and refer for psychological treatment during this time
- Promote self help strategies – CBT (computerised)
How long does Baby Blues normally last?
- Day 3-10 postnatal
- self-limiting
What symptoms are commonly experienced in Baby Blues?
Tearful irritable anxiety poor sleep confusion
HOw is Baby Blues treated?
Support and reassurance
When does Puerperal psychosis normally present?
Usually presents within 2 weeks of delivery
What symptoms are often seen in puerperal psychosis?
- Early symptoms = sleep disturbance, confusion, irrational ideas
- Late symptoms = Mania, delusions, hallucinations, confusion
