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Physiology > Postnatal issues > Flashcards

Postnatal issues Flashcards

1
Q

what is the Puerperium

A

from the delivery of the placenta to six weeks following the birth

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2
Q

what is the postnatal period

A

the period after the end of labour during which the attendance of a midwife upon a woman and baby is required, not being less than 10 days and for such a longer period as the midwife considers necessary

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3
Q

name one report into postntal issues

A

saving lives improving care report

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4
Q

Do postnatal periods vary from person to person

A

yes, this is due to different experiences from the mothers view to the fathers view, some people may have a stress free P while others may be very stress full, this can impact on this period

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5
Q

what is one of the key findings from the saving lives improving care report

A

556 women died during the 1 year of the B life between the years of 2013-15

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6
Q

what changes in the maternal population may impact on maternal death

A

obesity,
age of mother
lifestyle- more sedentary

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7
Q

what is direct maternal death

A

Death- result of something that occurred in pregnancy eg heamroging in birth- specific disorder caused by P

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8
Q

what is indirect death

A

usually to do with pre-exsiting conditions eg heart conditions, sepsis ect, this is aggravated by P

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9
Q

what is coincidental death

A

not due to P, example road traffic accidents, murder ect

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10
Q

what is late death

A

death occurring more than 42 days but less than 1 year

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11
Q

what is the leading cause of direct maternal death

A

thrombosis and thromboembolism are the leading direct causes of death,

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12
Q

what is the leading indirect causes of maternal death

A

cardiovascular disease

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13
Q

how are most at risk from maternal death

A

Black women and those from a deprived background are at greater risk compared to the rest of the UK population

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14
Q

what are the 4 classifications of mental health issues after birth

A

Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth

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15
Q

what is postnatal depression

A

serious mental disorder, associated with afterbirth

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16
Q

can both gender get PND

A

yes both men and women can get PND, including fathers and mothers

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17
Q

what is Perinatal psychiatric disorder

A

V common in P, 15% will get it in 1st trimester

5% in 2 and 3- increase risk for depression and axity

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18
Q

how many women will suffer puerperal psychosis

A

2/1000

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19
Q

name three common maternal mental disorders

A

OCD, Panic disorder, generalised anxiety disorder

20
Q

what is generalised anxiety disorder

A

experienced of anxiety most days

signs include nausea, tremors, sweating, palpitations

21
Q

what is OCD

A

2% of pop affected

can causes anxiety due to rituals

22
Q

what is panic disorder

A

Anxiety disorder characterised by unexplained and repeated episodes of intense fear accompanied by physical symptoms

23
Q

name the 4 main areas of postnatal mental illness

A

Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth

24
Q

what is the baby blues

A

postnatal MI, occurs 2-4 days after birth- Linked to hormonal changes / surges
Affects 50-80% women, esp first time mothers
signs- tearfulness, irritability, headache, tiredness, emotional unstability during the transition to motherhood

25
Q

Will the majority of MI go by the 2 trimester

A

The majority of minor illnesses will resolve spontaneously by the second trimester of pregnancy

26
Q

what should be offered to women who have MI in P

A

support- counselling,
Women with a single episode of major mental illness in the past should be seen as part of joint care between primary and specialist care

27
Q

P women with a single episode of major mental illness in the past are at greater risk of what?

A

These women are at marked risk of puerperal psychosis during first 3 months following delivery

28
Q

what % of women experience PND

A

Prevalence rates range between 10-28% and affects all cultures, ethnic backgrounds and socio-economic groups.
However this could be as high as 31

29
Q

What is PND

A

Considered to be any non-psychotic depressive illness of mild –moderate severity within the first year following childbirth

30
Q

name some signs and symptoms of PND

A 
Low mood/miserable most of the time
• Constantly exhausted
• Feeling unable to cope
• Feeling guilty about not being able to cope about
       not loving the baby enough
• Overwhelming anxiety about the baby
• Tearful for no reason
• Difficulty in sleeping        
low energy
Low sex drive
withdraw from friends and family
31
Q

name 5 risk factors for PND

A 
hormonal changes
lack of support
loss of control
history with depression
stress in P
32
Q

what effect can PND have on the baby

A

lack of relationship with mother due to less positive experiences,
can lead to cognitive and language development issues

33
Q

can PND effect relationship with partners

A

Yes can have a negative impact

34
Q

Can mild PND resolve

A

this can happed around 3-6 months after birth in mild cases, however 1 in 10 with PND seek help after a year

35
Q

can men get PND

A

Yes 1 in 25 men will get PND

36
Q

what is Puerperal psychosis

A

Regarded as a severe mental disorder.
Affects 2/1000 women.
Psychotic illness requiring immediate psychiatric intervention – often sedation is required.
Untreated depression can turn into psychosis

37
Q

name 5 signs of Puerperal psychosis

A

rapid onset (usually within first week), hallucinations, mood swings, loss of contact with reality, intrusive though processes and loss of inhibitions

38
Q

what are some of the risk factors for Puerperal psychosis

A

Primigravidae (first pregnancies) with major obstetric complications
Older married mums with a long gap between marriage and the birth of their first B
Family history of bi-polar
previous history
Major event before or after birth

39
Q

name 6 risk factors for maternal suicide

A 
white older mum
history of MI
B under 3 months 
in contact or receiving treatment form psychiatric services
Generally well educated
Working in caring / health industry
40
Q

what are some of the management strats for maternal mI

A

Identification of any underlying stressors – lack of social support.
Referral to postnatal support groups / peer support
Active engagement of significant others in care of baby
Counselling /CBT / debriefing services
Medication
Prompt referral to psychiatric services- mother and baby units

41
Q

what are mother and baby units

A

Usually for women suffering with severe postnatal
depression or puerperal psychosis
allow mother to receive support from professional and keep her baby with her, this differs from normal units

42
Q

what is maternal suicide

A

third largest cause of direct maternal deaths occurring during or within 42 days
largest cause id direct deaths within the 1st year

43
Q

what happens if an MI starts in the 3rd trimester

A

increased risk of developing postnatal

depression

44
Q

what are some of the red flags (signs) of maternal suicide

A

significant change in mental state
self-harming acts
expression of incompetence
estrangment from B

45
Q

what can affect on maternal suicide risk

A 
Fear of treatment
Fear of children being removed
Stigma of mental illness
Cultural lack of recognition
Belief that health workers not interested
Denial by woman / partner / family

Physiology (10 decks)

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