Perinatal Psychiatry

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Venous Thromboembolism is the leading cause of maternal death the year after birth of the child

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2/3 of mothers who commit suicide within 7 weeks of delivery have a history of mental health problems

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Which 3 of the following are key red flags of mental illness in pregnancy?

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At which point in the pregnancy does the mother have her first appointment with a midwife?

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Shortly after delivery of their child, 50% of women enter a brief period (3-10 days) of emotional instability whereby they are tearful, irritable and anxious. They may also be confused and sleeping poorly. What is this brief period known as?

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7 days following delivery a woman is brought to her GP by her partner who is complaining that she has barely slept in the past week and has also seemed confused, frequently thinking that the news anchor on her television was telling people to steal her baby.
What is this woman suffering from?

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The recurrence rate of Puerperal Psychosis is %

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Puerperal Psychosis is a common disorder and should be routinely treated in the community with antipsychotics.

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25% of women who experience puerperal psychosis go on to develop which condition?

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( 10%, 5%, 25%, 40% ) of women experience a period of postnatal depression, with around 1/3 lasting over a year

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Baby blues typically lasts up to around ( 10 days, 3 days, 4 weeks, 6 weeks ) and is typically self limiting

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( Postnatal depression, Baby blues ) typically has a later onset than ( baby blues, Postnatal depression ), usually presenting around 2 weeks after delivery

( Postnatal depression, Baby blues ) is known to cause problems with the mother-baby relationship, whereas ( baby blues, Postnatal depression ) does not typically have this effect.

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A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression.
Should this medication be changed?

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A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression.
Why should this medication be changed?

1

Order the following drugs based on their safety in pregnancy, with the most safe at the top.
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❌
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Amitriptyline

Sertraline

Fluoxetine

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In terms of Benzodiazepines
1st trimester: ( Unsafe to use, Safe to use )
2nd trimester: ( Unsafe to use, Safe to use )
3rd trimester: ( Unsafe to use, Safe to use )

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Benzodiazepines are safe to use in breastfeeding.

1

In terms of Antipsychotics:
( Clozapine, Olanzapine, Risperidone ): Should be avoided due to risk of agranulocytosis
( Olanzapine, Clozapine, Risperidone ): Should be avoided due to risk of gestational diabetes

1

In terms of Lithium for Epilepsy:
During pregnancy: ( Can continue if necessary, Avoid )
Breastfeeding: ( Avoid, Can continue if necessary )

1

Which anticonvulsant medication should be avoided in all women of childbearing age due to the potential for neural tube defects very early in pregnancy?

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Women with history of opiate abuse should not be given opiates such as diamorphine during pregnancy due to their likelihood of becoming dependent again.

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If a mother frequently intakes alcohol during pregnancy, she risks her baby developing syndrome

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Hyperemesis should resolve by which approximate stage of pregnancy?

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Intravenous drug users are at an increased risk of and are thus typically prescribed Dalteparin for 6 weeks after delivery.

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Having a C-section significantly reduces the likelihood of a woman having a postpartum haemorrhage

Perinatal Psychiatry lecture given on the Wednesday of Week 4

Perinatal Psychiatry

Venous Thromboembolism is the leading cause of maternal death the year after birth of the child

2/3 of mothers who commit suicide within 7 weeks of delivery have a history of mental health problems

Which 3 of the following are key red flags of mental illness in pregnancy?

At which point in the pregnancy does the mother have her first appointment with a midwife?

Shortly after delivery of their child, 50% of women enter a brief period (3-10 days) of emotional instability whereby they are tearful, irritable and anxious. They may also be confused and sleeping poorly. What is this brief period known as?

7 days following delivery a woman is brought to her GP by her partner who is complaining that she has barely slept in the past week and has also seemed confused, frequently thinking that the news anchor on her television was telling people to steal her baby. What is this woman suffering from?

The recurrence rate of Puerperal Psychosis is %

Puerperal Psychosis is a common disorder and should be routinely treated in the community with antipsychotics.

25% of women who experience puerperal psychosis go on to develop which condition?

10% 5% 25% 40%( 10%, 5%, 25%, 40% ) of women experience a period of postnatal depression, with around 1/3 lasting over a year

Baby blues typically lasts up to around 10 days 3 days 4 weeks 6 weeks( 10 days, 3 days, 4 weeks, 6 weeks ) and is typically self limiting

A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression. Should this medication be changed?

A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression. Why should this medication be changed?

Order the following drugs based on their safety in pregnancy, with the most safe at the top. ❌ ❌ ❌

In terms of Benzodiazepines 1st trimester: Unsafe to use Safe to use( Unsafe to use, Safe to use ) 2nd trimester: Unsafe to use Safe to use( Unsafe to use, Safe to use ) 3rd trimester: Unsafe to use Safe to use( Unsafe to use, Safe to use )

Benzodiazepines are safe to use in breastfeeding.

In terms of Antipsychotics: Clozapine Olanzapine Risperidone( Clozapine, Olanzapine, Risperidone ): Should be avoided due to risk of agranulocytosis Olanzapine Clozapine Risperidone( Olanzapine, Clozapine, Risperidone ): Should be avoided due to risk of gestational diabetes

In terms of Lithium for Epilepsy: During pregnancy: Can continue if necessary Avoid( Can continue if necessary, Avoid ) Breastfeeding: Avoid Can continue if necessary( Avoid, Can continue if necessary )

Which anticonvulsant medication should be avoided in all women of childbearing age due to the potential for neural tube defects very early in pregnancy?

7 days following delivery a woman is brought to her GP by her partner who is complaining that she has barely slept in the past week and has also seemed confused, frequently thinking that the news anchor on her television was telling people to steal her baby.
What is this woman suffering from?

( 10%, 5%, 25%, 40% ) of women experience a period of postnatal depression, with around 1/3 lasting over a year

Baby blues typically lasts up to around ( 10 days, 3 days, 4 weeks, 6 weeks ) and is typically self limiting

A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression.
Should this medication be changed?

A 24 primigravida presents to her first appointment with the midwife at 12 weeks. During this consultation, the midwife finds that the woman is taking Paroxetine for her depression.
Why should this medication be changed?

Order the following drugs based on their safety in pregnancy, with the most safe at the top.
❌
❌
❌

In terms of Benzodiazepines
1st trimester: ( Unsafe to use, Safe to use )
2nd trimester: ( Unsafe to use, Safe to use )
3rd trimester: ( Unsafe to use, Safe to use )

In terms of Antipsychotics:
( Clozapine, Olanzapine, Risperidone ): Should be avoided due to risk of agranulocytosis
( Olanzapine, Clozapine, Risperidone ): Should be avoided due to risk of gestational diabetes

In terms of Lithium for Epilepsy:
During pregnancy: ( Can continue if necessary, Avoid )
Breastfeeding: ( Avoid, Can continue if necessary )