psychiatry and childbirth Flashcards
benzos in pregnancy?
cleft palate, withdrawls
risk of baby being bipolar if mother is?
1/7
sodium valproate effects on child?
NTD, craniofacial defects, CV abnormality, IUGR, reduced IQ, cleft palate, genitourinary
carbamazepine cam
facial dysmorphism, cardiac anomalies, fingernail hypoplasia, NTD
lamotrigine?
cleft, steven johnson syndrome to baby if breastfed
carbamazepine - can cause vitamin K deficiency, what could this ca use?
haemorrhagic disease of the newborn
Lithium ?
cardiac abnormalities, risk maternal toxicity, abstains anomaly
lithium also causes?
neonatal hypogycaemia, hypotonia and hypothyroidism
lithium is contraindicated in ?
breeastfeeding
can you breastfeed on carbamazepine?
yes
in pregnancy, lithium should be stopped gradually
.
schizophrenia - which antipsychotics are totally safe in pregnancy?
typicals. haloperidol, chlorpromazine are safe
which antipsychotic contraindicated in breastfeeding due to its liability of inducing life threatening events on the infant
cozapine
which other drug should not be used in breast feeding
olanzipine
anti cholinergics?
not to be used in pregnancy
eatin disorders tend to improve in pregnancy
y
depression in pregnancy - mild/moderate?
psycholoigical treatment
moderate/severe?
pharmalogical
side effects of venlafaxine?
insomnia, hypertension, arrythmia
in pregnancy, venlafaxine causes?
hypertension
paroxetine causes - cardiac abnormalities
w
which two classes of ad are found in high concentrations in breast milk?
TCAs and SSRIs
ALL antidepressants carry risk of withdrawal or toxicity in neonates
.
TCAs, breast feeding, pregnancy?
ok in breastfeeding, ok in pregnancy
high levels of which two SSRIs in breast milk?
citalopram, fluoxetine
POst natal depression. onset usually?
2-6 weeks post natal
if mild/moderate?
counselling/self help
if moderate/severe
psychotherapy/antidepressants
day 3-10, tearful, irritable, anxiety, poor sleep, confusion
baby blues. reassure and support
puerperal psychosis, when does it usually present?
within 2 weeks of delivery
mania, delusions, ahllucinations, irrational ideas, sleep disturbance?
ps
risk factors?
bipolar, 1st degree relative with history
what is the management of this?
EMERGENCY - needs admission. antidepressants, antipsychotics, mood stabilisers and ECT
what is ECT?
shock therapy used to induce seizures to provide relief from mental distress
80% have a 10 year recurrence rate
alcohol in pregnancy, abstinence best but no harm in 2 units per week, no evidence that it is detrimental
risk of miscarriage in alcoholism - cervix dilation
y
facial derformities, lower IQ, neurodevelopment delay, epilepsy, hearing, heart and kidney defects
y
cocaine, amphetamines and ecstasy. what could these cause?
death by stroke and arrhythmia. they are teratogenic, PET, abruption, IUGR, PTL, miscarriage
OPIATES cause maternal deaths, neonatal withdrawal, IUGR, SIDS and still birth
nicotine causes miscarriages, still births, IUGR and SIDS
