Postpartum haemorrhage and emergencies: postpartum psychosis: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Postpartum haemorrhage and emergencies: postpartum psychosis

Sample item

On day 8 after delivery, a woman with no earlier psychiatric illness becomes insomniac and agitated, says the baby has been replaced by an impostor and hears voices telling her to harm it. What is the most appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Urgent admission, ideally to a mother-baby unit, with antipsychotic treatment

Postpartum psychosis is a psychiatric emergency with onset in the first 2 weeks, delusions, hallucinations and a risk of harm to the infant. Management is inpatient care with antipsychotics or mood stabilisers, and admission with the baby where possible. Postpartum blues is mild and self-limiting, and depression lacks psychosis.

Option by option

  • A. Outpatient SSRI and review in 2 weeks

    An SSRI alone does not treat a psychotic illness and outpatient care is unsafe.

  • B. Urgent admission, ideally to a mother-baby unit, with antipsychotic treatment (correct)

    Correct. Hospital admission and antipsychotic treatment are needed because of the risk to mother and baby.

  • C. Reassurance, as this is postpartum blues

    Postpartum blues does not cause delusions or hallucinations and settles by itself.

  • D. Discharge with family and advice to stop breastfeeding

    Discharge leaves the baby at risk, and stopping breastfeeding does not treat the psychosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Urgent admission, ideally to a mother-baby unit, with antipsychotic treatment. Postpartum psychosis is a psychiatric emergency with onset in the first 2 weeks, delusions, hallucinations and a risk of harm to the infant.

Why is "Outpatient SSRI and review in 2 weeks" not the answer?

An SSRI alone does not treat a psychotic illness and outpatient care is unsafe.

Why is "Reassurance, as this is postpartum blues" not the answer?

Postpartum blues does not cause delusions or hallucinations and settles by itself.

Why is "Discharge with family and advice to stop breastfeeding" not the answer?

Discharge leaves the baby at risk, and stopping breastfeeding does not treat the psychosis.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: postpartum psychosis in OBG. Management is inpatient care with antipsychotics or mood stabilisers, and admission with the baby where possible. Postpartum blues is mild and self-limiting, and depression lacks psychosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Postpartum haemorrhage and emergencies: postpartum psychosis?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.