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TEALE FENNING
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1852
Location: Nottingham
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 Posted: Mon Feb 26, 2007 5:36 pm Post subject: Pyschiatric illness in pregnancy |
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A 24-year woman with a long-standing pyschiatric history presents for booking at 21 weeks gestation.
What are the implications of this situation? (5 marks)
What modifications would you make to her antenatal care? (10 marks)
How would you manage the puerperium? (5 marks)
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Last edited by Nick Raine-Fenning on Thu Mar 15, 2007 1:38 pm; edited 1 time in total |
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vani s
Century Club
Joined: 20 Jan 2007
Posts: 141
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| Posted: Mon Mar 05, 2007 9:05 am Post subject: Re: Pyschiatric illness in pregnancy |
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| Nick Raine-Fenning wrote: | A 24-year woman with a long-standing pyschiatric history presents for booking at 21 weeks gestation.
What are the implications of this situation? (5 marks)
high risk preg....
teratogenicity of drugs, majority not(TCA, SSRI), if teratogenic (lithium, antipsychotics) can change or cont..as risk of no treatment is not acceptable
issues of child care.
nutrition of mother affected, IUGR
disease may deteriorate,esp post partum( risk of infanticide n suicide.)
issue of competence for consent..
What modifications would you make to her antenatal care? (10 marks)
sym, support etc etc ? family n friends
language , ethnicity of pt to consider..
involve everybody... 
dose adjustment by psychiatrist
regular scans.. anomaly and IUGR
ensure ANC by home visit , GP, midwife..
involve consultant..
ensure drug compliance..
plan for delivery and postpartum care
How would you manage the puerperium? (5 marks)
Discharge only after careful assessmnet
ensure support from friends n family
Communicate to GP, community care...
6 wk, edinburgh postnatal dep score..
If needed, admit in 'mother n baby unit"
BF can be avoided if drugs harmful , but not to stop drugs
beware of risk of suicide n infanticide...
Can anyone add .... 
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Abik
Century Club
Joined: 15 Jan 2007
Posts: 243
Location: Poole
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| Posted: Mon Mar 05, 2007 9:21 am Post subject: |
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Brilliant! Thanks vani!
how bout specific mention of watching babe for withdrawal
breast feeding recommended as drug levels low and can aid withdrawal? |
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