A woman consults you on the fifth day after an uncomplicated vaginal delivery. She reports tearfulness, mild mood swings, irritability, and poor sleep, but she is bonding well with the baby and functioning normally. Symptoms began around day 3. What is the most likely diagnosis and expected course?

• A Postpartum hypothyroidism, requiring levothyroxine replacement
• B Postpartum depression, requiring immediate sertraline therapy
• C Postpartum psychosis, requiring urgent psychiatric admission
• D Postpartum blues, peaking around days 3 to 5 and resolving spontaneously within two weeks ✓

Explanation

Postpartum blues affect up to 80 percent of mothers, begin within the first few days, peak around days 3 to 5, and resolve without treatment within two weeks. The hallmarks are lability and tearfulness with preserved function and normal bonding. Postpartum depression persists beyond two weeks and impairs function or bonding. Postpartum psychosis involves delusions, hallucinations, or thought disorder and is a psychiatric emergency. Thyroid dysfunction can mimic low mood but would not produce the characteristic brief self-limited course described here.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.