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Flashcards in Perinatal Psychiatry Deck (27)
1

What risks factors are there for mental health problems in pregnancy

Young/single
Domestic abuse
Lacking support
Substance abuse
Unplanned/unwanted pregnancy
Pre existing mental illness

2

What should always be exluded when a women presents with changes to mood/mental health

anaemia
thyroid
diabetes
infection
SOL

3

When would the woman be seen by the psychiatry team during pregnancy

Psychosis
Severe anxiety, depression, suicidal, self-neglect, self harm
Symptoms with significant interference with daily functioning
History of bipolar or schizophrenia
History of puerperal psychosis
Psycotropic meds
If developed moderate mental illness in late preg or early postpartum
Mild- mod illness but 1st degree relative with bipolar or puerperal psychosis
Previous in-patient admissions to mental health unit

4

What anxiety medications should be avoided in pregnancy and why

Benzodiazepines
cleft palate and neonatal withdrawal

5

Risks of valproate

craniofacial defects
CV abnormality
IUGR
reduced IQ
cleft
GU anomalies

6

Risks of Carbamazepine

facial dysmophism
cardiac anomalies
fingernail hypoplasia
vit k deficiency - Haemorrhagic disease of newborn

7

Risks of lamotrigine

Steven Johnson syndrome if breast fed

8

are anticonvulsants safe in breastfeeding

yes

9

What is the risks of lithium to the fetus

cardiac abnormalities
Ebsteins anomaly

10

what are the risks of lithium to the neonate

hypotonia
nypothyroidsim
hypoglycaemia

11

is litium safe in breastfeeding

no

12

What can be used instad of lithium to manage bipolar

SSRIs

13

Why are TCAs not used in bipolar

high risk of switching to mania

14

Are antipsychtotics safe in pregnancy

yes

15

What antipsychotics are preferable in pregnancy

typical

16

Why are typical antipsychotics preferred in pregnancy

atypicals are associated with higher risk of gestational diabetes and IUGR

17

What should babies born to mothers on antipsychotics be observed for

Lethargy, sedation and reaching developmental milestones

this is because antipsychotics are all sedating

18

What antipsychotisc are not used in breastfeeding

Clozapine -CONTRAINICATED
Olanzapine - increased risk of extrapyramidal reaction in baby

19

Are anticholinergics safe in pregnancy

no

20

Which SSRI is associated with cardiac abnormalities

paroxetine

21

Which SNRI is associated with hypertension

venlafaxine

22

Are SSRIs safe in pregnancy

Yes - with caution after 20 weeks

23

Are TCAs and SSRIs safe in breastfeeding

Yes however high levels of SSRIs in breastmilk so baby should be monitored for withdrawal which is usually mild

24

Which SSRI is best for breastfeeding

Sertraline

25

when does postnatal depression usually present

2-6 weeks post natal

26

What are the 'baby blues'

50% women
Brief period of emotional instability
Tearful, irritable, anxiety and poor sleep confusion
Day 3-10 self-limiting
Support and reassurance

27

What are the risk factors for puerperal psychosis

Bipolar, previous PP, 1st degree relative with Hx