postpartum psych + thyroiditis

Question 1

scale used for screening for depression in the postpartum period

Answer 1

Edinburgh Postnatal Depression Scale
- indicates how mum has felt over previous week

score >13 = depressive illness of varying severity

Question 2

baby blues

Answer 2

seen 3-7days following birth
- more common in primips

• anxious
• tearful
• irritable

Question 3

management of baby blues

Answer 3

reassurance + support

health visitor has a key role

Question 4

onset of postnatal depression

Answer 4

most start within a month, peaks at 3 months

Question 5

management of postnatal depression

Answer 5

CBT

SSRI - sertraline, paroxetine
(secreted in breast milk, not harmful to child)

Question 6

puerperal psychosis onset + features

Answer 6

onset = within 2-3weeks post birth

• severe mood swings (bipolar vibes)
• disordered perception - audiotry hallucinations

Question 7

management of puerperal psychosis

Answer 7

admission to hospital, ideally in a Mother&Baby unit

25-50% risk of recurrence in future pregnancies

Question 8

3 stages of post partum thyroiditis

Answer 8

1. thrytotoxicosis
2. hypothyroidism
3. normal thyroid function
   - high rate of recurrenc in future pregnancies

Question 9

antibodies found in 90% of mums with postpartum thyroiditis

Answer 9

thyroid peroxidase antibodies

Question 10

management of postpartum thyroiditis

Answer 10

thyrotoxic phase
- propranolol for symptoms
- no anti-thyroid drugs (thyroid not overactive)

hypothyroid phase
- thyroxine
- closely monitored