Psychiatric Disorders in Pregnancy Flashcards

1
Q

List some risk factors for mental illness in pregnant women

A

Young female
Single mother
Domestic issues
Lack of support
Substance misuse
Unplanned pregnancy
Pre-existing mental illness

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2
Q

When should a pregnant patient be referred to psychiatry?

A

Psychosis
Severe anxiety/depression/suicidal/self-harm
History of bipolar/schizophrenia
History of postnatal psychosis
If on psychiatric medication

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3
Q

What is the principle of psychiatric medication treatment in pregnancy?

A

Low dose monotherapy, taken at increased frequency if need be

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4
Q

When should a foetal anomaly scan be carried out in someone pregnant and on psychiatric medication?

A

16 weeks

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5
Q

Breastfeeding should be encouraged whenever possible in psychiatric pregnant patients. True/False?

A

True
Unless drug toxicity/contraindication

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6
Q

Why should benzodiazepines be avoided in pregnancy?

A

Cause cleft and neonatal withdrawal

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7
Q

What is the risk of a baby developing bipolar disorder if a mother has it and is not on treatment?

A

50%

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8
Q

What foetal defects can sodium valproate cause?

A

Neural tube defects
Craniofacial defects
IUGR
Reduced IQ
Cleft

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9
Q

Which mood stabiliser/anticonvulsant is considered safest to use in pregnancy?

A

Lamotrigine

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10
Q

What effects does carbamazepine have on a foetus?

A

Vitamin K deficiency
Haemorrhagic disease of newborn

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11
Q

It is normally ok to breastfeed if you are on an anticonvulsant. True/False?

A

True

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12
Q

What foetal defect can lithium cause?

A

Ebstein’s anomaly

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13
Q

Is lithium contraindicated in breastfeeding?

A

Yes

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14
Q

Which antipsychotics - typical or atypical - are generally safe to use in pregnancy?

A

Typicals

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15
Q

Which antipsychotic is contraindicated in pregnancy because of its liability to induce life-threatening events in an infant?

A

Clozapine

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16
Q

Can anticholinergic drugs be used in pregnancy?

A

No

17
Q

Which antidepressant can cause cardiac abnormalities in an infant?

A

Paroxetine

18
Q

All antidepressants can cause withdrawal and toxicity in neonates. True/False?

A

True
Usually self-limiting though

19
Q

When does postnatal depression typically onset?

A

2-6 weeks postnatally

20
Q

List clinical features of postnatal depression

A

Anxiety, tearfulness
Lack of enjoyment
Poor sleep
Concerns re baby

21
Q

How does postnatal depression differ from “baby blues”?

A

Baby blues is more brief and self-limiting

22
Q

List clinical features of puerperal psychosis

A

Sleep disturbance
Confusion
Delusions, hallucinations
Irrational ideas
Mania

23
Q

Puerperal psychosis is an emergency. True/False?

A

True
Needs urgent admission to mother-baby unit

24
Q

List features of foetal alcoholic syndrome

A

Facial deformity
Lower IQ
Neurodevelopmental delay
Epilepsy
Hearing defect
Cardiac + renal defects

25
Q

What should be considered management-wise if substance abuse is occurring in pregnancy?

A

Methadone programmes
Social work/child protection
Labour planning
Postnatal plan