On postpartum day 3, a primiparous woman cries easily, feels irritable and describes rapid mood swings. She sleeps adequately when the baby sleeps, eats normally, denies suicidal thoughts and bonds well with the infant. The most appropriate management is:

• A Reassurance and supportive follow-up ✓
• B Admit for observation of puerperal psychosis
• C Start fluoxetine and refer to psychiatry
• D Check thyroid profile and start levothyroxine

Explanation

Postpartum blues affect up to 50 to 80 percent of mothers, peak around days 3 to 5, resolve spontaneously within 10 to 14 days, and need only reassurance because function and bonding are preserved. Psychosis requires admission because it presents with delusions, hallucinations and risk to mother or baby. Depression is distinguished by persistence beyond two weeks and functional impairment, not brief labile symptoms on day 3.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.