Pregnancy Flashcards
What is post-partum blues? How long does it last? What can it lead to?
Emotional liability, crying, irritability, worrying about coping with baby
Usually lasts DAYS and is self limiting but can -> post parts depression
What are the extra features with post partum depression vs blues
Guilt / anxiety concerning baby
Feelings of inadequate mothering
Unreasonable fears about baby’s health
Reluctance to hold / feed (may have rare thoughts of harming)
Management of postpartum depression
Psychosocial (including a risk) assessment
Try to use psychological due to risk of ADR in breastfeeding infants
What risks are there for not prescribing in post partum depression
Depression-> lack of maternal/child bonding
/ lack of child development
What class of antidepressants are the best to use in pregnancy ?
Tricyclics have the lowest teratogenic effect
What is the most common complication of SSRIs in pregnancy
Persistent newborn pulmonary hypertension
What is the best SSRI in pregnancy?
Sertraline (still aim for other type)
Which antidepressants have the highest levels exerted in breast milk?
Relatively low levels?
Citalopram / fluoxetine
Imipramine, nortriptyline, sertraline
Mood stabilisers in pregnancy
Valproate
Carbamazepine
Lithium
V - neural tube defects / intellectual development
C - neural tube defects / major fetal malformations (GI/Cardio)
L - Cardiac malformations
Which antipsychotic has strong links to gestational diabetes?
Olanzapine
Are antipsychotics better or worse than mood stabilisers in pregnancy ?
Less severe effects
Can still lead to problems / ESPEs in babies
What risks do benzodiazepines have for babies?
Cleft palate, malformations, floppy baby syndrome
