5: Perinatal psychiatry Flashcards Preview

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Flashcards in 5: Perinatal psychiatry Deck (38)
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1

What is the leading cause of maternal death in the year following birth?

Suicide re: mental illness

2

Women who develop post-partum mental health problems often have a history of what?

Mental health problems

so it doesn't come out of nowhere

3

What are three red flags for mental illness in a pregnant women?

Recent significant change in mental state

New thoughts of violence / self-harm

New thoughts of estrangement from baby

4

If a pregnant woman has red flag symptoms for mental illness, where should she be admitted?

Perinatal mental health unit

which is referred to as the 'Mother and baby unit'

5

What mental health screening questions should be asked at antenatal clinic?

Do you have any new feelings which are making your disturbed or anxious?

Do you have any thoughts of self-harm or suicide?

Do you feel a sense of distance or estrangement from your baby?

Do you feel you are getting worse in general?

6

When do pregnant women have their first appointment with their midwife?

12 weeks

At which point you should be screening for mental health

7

Pregnant women with a history of which disorders should be referred to psychiatry?

Anxiety

Depression

Bipolar

Psychosis

8

What is the recurrence rate of peurperal psychosis?

50%

9

Under what circumstances should you refer a pregnant / post-natal woman to psychiatry?

Severe anxiety, depression, bipolar or psychotic symptoms

10

Pregnancy is (protective / not protective) for pre-existing mental health problems.

not protective

Pregnant women being so elated that their mental disorders disappear is a myth

11

What are baby blues?

Mild periods of emotional instability during pregnancy

12

What is the course of baby blues?

Up to 10 days

Self-limiting

13

What percentage of pregnant women develop peurperal psychosis?

0.1%

14

What are the symptoms of puerperal psychosis?

Delusions

Hallucinations

Mania

Confusion (separating from standard psychosis)

15

What is the prevalence of puerperal psychosis?

1 in 1000 pregnant women

or 0.1%

16

How is puerperal psychosis managed?

Admission to antenatal mental health unit

Antidepressants, antipsychotics, mood stabilisers, ECT

17

Puerperal psychosis has a (high / low) relapse rate.

high relapse rate

18

What do many women with undiagnosed postnatal depression worry about?

Effect of diagnosis on possession of child

19

How do you differentiate baby blues from postnatal depression?

Baby blues lasts up to 2 weeks and is self-limiting

Postnatal depression has a later (2 weeks+) onset and negatively affects relationship with child

20

Does maternal depression have physical effects on the child?

What are some examples?

Yes

Low birth weight, premature delivery, poor relationship

21

What are the principles for drug treatment of psychiatric problems in pregnancy?

Avoid high risk drugs (which change with trimester)

Use lowest dose monotherapy

Consider interactions

Encourage breastfeeding (exception: lithium)

22

Adverse effects re: teratogenic drugs may have occurred before the ___ is discovered.

before pregnancy is discovered

23

Which psychiatric drugs are notably teratogenic?

Lithium

Sodium valproate

24

Which sedative drugs should be avoided in pregnancy?

Benzodiazepines

25

In general, antipsychotics are safe to use during pregnancy.

Which specific drugs should be avoided?

Clozapine - agranulocytosis

Olanzapine - obesity, diabetes

26

Why should depot injections be avoided in pregnant women?

High concentration of drug can accumulate in foetus

27

Which drug, used in bipolar disorder and epilepsy, is contraindicated in pregnancy?

Why?

Sodium valproate

Neural tube defects (which often occur before the pregnancy is discovered)

28

If a woman of childbearing age is on sodium valproate, she should be using ___.

contraception

29

What lifestyle disorder increases a pregnant woman's chances of mental health problems?

Substance abuse

30

Which bloodborne viruses should be tested for in pregnant women?

HIV

Hep B & C