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Year Three - Reproductive System > Postnatal Depression > Flashcards

Postnatal Depression Flashcards

1
Q

What is postnatal depression?

A

It is characterised by low mood in the postnatal period

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2
Q

What are the three types of postnatal depression?

A

Baby blues

Postnatal depression

Puerperal psychosis

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3
Q

What are the two causes of postnatal depression?

A

Physical Issues - After childbirth, there is a dramatic drop in oestrogen and progesterone hormones, alongside other hormones produced by the thyroid gland. This can result in individuals feeling tired, sluggish and depressed

Emotional Issues - Due to the neonatal care, patients are often sleep deprived, overwhelmed and feel a loss of control over their life. These issues can also contribute to postpartum depression.

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4
Q

What increases the risk of postnatal depression?

A

When patients have a personal or family history of depression, or other mental health conditions

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5
Q

What % of women are affected by baby blues?

A

> 50%

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6
Q

When does baby blues take place?

A

It occurs in the first week after birth

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7
Q

How long does baby blues tend to last?

A

A few days

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8
Q

Does baby blues require treatment?

A

No

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9
Q

What are the five clinical features of baby blues?

A

Mood Swings

Low Mood

Anxiety

Irritability

Tearfulness

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10
Q

How common is postnatal depression?

A

It affects one in ten women

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11
Q

When does postnatal depression tend to affect patients?

A

Three months after birth

However, it can continue on from baby blues

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12
Q

How can we distinguish the difference between baby blues and postnatal depression?

A

Postnatal depression clinical features are more intense and last longer

They typically interfere with the patient’s ability to care for their baby and handle other daily tasks

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13
Q

What are the triad clinical features of postnatal depression?

A

Low mood

Anhedonia

Low energy

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14
Q

What is anhendonia?

A

A lack of pleasure in activities

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15
Q

How long do clinical features ned to persist before a diagnosis of postnatal depression can be obtained?

A

More than 2 weeks

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16
Q

What scale can be used to help diagnose postnatal depression?

A

‘Edinburgh Postnatal Depression Scale’

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17
Q

What is the ‘Edinburgh Postnatal Depression Scale’?

A

It involves patients answering ten questions, with a total score out of 30 point

18
Q

What ‘Edinburgh Postnatal Depression Scale’ score suggests a diagnosis of postnatal depression?

A

> 10

19
Q

In what three ways do we manage mild postnatal depression?

A

Additional support

Self-help

A follow up with their GP

20
Q

What is the first line management option for moderate to severe postnatal depression, without previous history of severe depression?

A

Cognitive behavioural therapy (CBT)

21
Q

What is the management option for severe postnatal depression, with a history of severe depression?

A

SSRIs

22
Q

Name two SSRIs used to manage severe postnatal depression

A

Sertraline

Paroxetine

23
Q

Which SSRIs should be avoided when managing severe postnatal depression

A

Fluoxetine

24
Q

When does puerperal psychosis tend to develop?

A

Two to three weeks after birth

25
Q

What is puerperal psychosis?

A

It is an extremely severe and rare form of mental illness, which can cause harm to either the mother or baby

26
Q

What are the three risk factors for puerperal psychosis?

A

A previous diagnosis of bipolar disorder or a psychotic illness

A history of puerperal psychosis in the patient’s mother or sister also increases the risk

A previous episode of puerperal psychosis

27
Q

What is the chance of puerperal psychosis recurring in another pregnancy, after a previous episode?

A

50%

28
Q

What are the five clinical features of puerperal psychosis?

A

Delusions

Hallucinations

Depression

Mania

Confusion

29
Q

How do we treat puerperal psychosis?

A

We direct patients to specialist mental health services

In most cases, women suffering from puerperal psychosis need to be treated as an inpatient in mother and baby units

30
Q

What are mother and baby units?

A

This is a specialist unit for pregnant women and women that have given birth in the past 12 months

31
Q

What is the purpose of mother and baby units?

A

They are designed so that the mother and baby can remain together and continue to bond

32
Q

What are the three treatment options available for puerperal psychosis?

A

Cognitive behavioural therapy

Electroconvulsive therapy (ECT)

Antipsychotics and/or mood stabilisers

33
Q

How long do severe symptoms of puerperal psychosis last?

A

Two to twelve weeks

34
Q

How long does it take patients to fully recover from puerperal psychosis?

A

Six to twelve months

35
Q

Why is an early diagnosis of puerperal psychosis important?

A

It reduces the likelihood of long term difficulties

36
Q

How do we prophylactically treat postnatal depression?

A

We refer women with existing mental health concerns to perinatal mental health services for advice and specialist input

This includes initiation and ongoing management of psychiatric medications

In addition to this, a plan is put in place for after delivery to ensure that these patients are followed up closely, so that treatment and additional support can be put in place early if required

37
Q

What three medications can be used to treat postnatal depression prophylactically?

A

SSRIs

Antipsychotics

Lithium

38
Q

What is the teratogenic effect of prescribing SSRIs during pregnancy?

A

Neonatal abstinence syndrome

39
Q

When does neonatal abstinence syndrome present?

A

In the first few days of birth

40
Q

How do we manage neonatal abstinence syndrome?

A

Supportive management

Year Three - Reproductive System (52 decks)

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