REPRO 5.5 Flashcards
risks of alcoholism during pregnancy
miscarriage
FAS
wernickes
karsokoff
FAS
smooth philtrum, thin vermillion, small palpable fissures
decrease IQ, neurodevelop delay, epilepsy, hearing, heart and kidney defects
wernickes lack of what
B1
cocaine/amphetamines/ecstacy risks
death via what
death via arrhythmias/stroke
teratogenic
PET, abruption, withdrawal, IUGR, miscarriage, development delay
opiates risks
maternal death
maternal death 1-2%
NAS, IUGR, IUD
nicotine risks
miscarriage, abotrtion, IUGR, IUD
when can u not breast feed (3)
alcohol >8 units, cocaine, HIV
baby blues when
treatment
d3-10
self limiting
post natal depression when
2-6 PN
post natal depression how many last a year or more
recurrence rate
life tie risk of depression
1/3
25%
70%
post natal depression can have an affect on what
bonding with child and child development
treatment for post natal depression mild/mod
severe
councelling
pharma/psychotheray
venlefaxine
htn
SSRIs
caution after 20w - pulmonary htn
paroxetine
cardiac abn
TCAs and SSRIs
sedation
citalopram and fluoexetine
high levels in breast milk
all antidepressants
risk of withdrawal or toxicity in neonates - usually self limiting and mild
pharma treatment for post natal depression
sertalline and parox - safe for BF
amitrip and nora trip also safe in BF
puerperal psychosis when
DDX
2w post fatally
episode of bipolar, unipolar depression, schizophrenia, organic brain dysfunction
symptoms of puerperal psychosis
sleep, confusion, irrational ideas, mania, delusions, hallucinations
RF for puerperal psychosis
BPD, prev PP, 1st degree relative with history
suicide risk
infancide risk
10y recurrent
BPD
5%
4%
80%
25%
treatment for puerperal psychosis
admit, anti depressants, mood stabilisers, ECT
risk of postnatal episode of BPD with treatment
50%
chance of baby getting BPD
1/7
valproate
NTD, craniofacial, CDV, IUGR, decreased IQ, clef, CU dx
carbamazepine
facial dysmorphism, cardiac, fingernail hyperplasia, NTD, haemorrhagic dx
lithium
cardiac anomalies, maternal toxicity, ebsteins, hypotonic, hypoglycaemic, hypothyroid
safest drug for BPD
lamotrigene
lamotrigene BF
SJS syndrome
consider what postnatally for BPD
elective lithium
risk of schizophrenia to child
10%
clozapine
olanzapine
not safe in BF
extrapyridimal when BF
what type of psychotics are safe in schizophrenia whilst pregnancy
typical
risks of eating disorders
IUGr, pre, decrease k and na, mat alk, miscarriage
avoid benzo’s in anxiety why
cleft lip
NAS
