Puerperium: Mental Health and Thyroiditis Flashcards
What % of postpartum mental health is baby blues
70
What time frame does baby blues occur
4-7d
When is baby blues more common
Young mothers
First pregnancy
What are common symptoms of baby blues
Anxious, Tearful, Irritable
How is baby blues managed
Reassurance and support from health visitor
What % partum mental health conditions is post-natal depression
10%
What is the time frame for post-natal depression
1 month and peaks at 3 months
How will post-natal depression present
Similar to depression:
- Low mood
- Anhedonia
- Fatigue
How should post-natal depression be managed
Reassurance
CBT
SSRI if severe
When are SSRIs for post-natal depression considered
If severe
What SSRIs are offered
Sertraline, Paroxetine
What % of post-natal mental health conditions are puerperal psychosis
0.5%
What time frame does puerperal psychosis occur
2-3 Weeks
How does puerperal psychosis present
Extreme mood swings (bipolar-like)
Auditory hallucinations
What is the management for puerperal psychosis
Urgent admission to hospital
What is the risk of puerperal psychosis occurring in future pregnancies
20%
What is used to asses for depression postnatally
Edinburgh Post-Natal Depression Scale
What score on edingburgh post-natal depression score indicates depression
> 13
What are the 3 diagnostic criteria for post-partum thyroiditis
- Within 12 months pregnancy
- Clinical features coincide with hypothyroidism
- Abnormal TFTs
What are found in 90% of patients with postpartum thyroiditis
Thyroid peroxidase antibodies
What are the 3-stages of presentation of post-partum thyroiditis
- Thyrotoxicosis
- Hypothyroidism
- Normal TFTs
Why is the thyrotoxic phase not treated with anti-thyroid medications
As often patients are not actually hyper-thyroid
What is used to treat post-partum thyroiditis
B-blocker for symptoms
Thyroxine for hypothyroid phase
What is problem with post-partum thyroiditis
High chance recurrence in future pregnancies
