On day 4 after a normal vaginal delivery, a primiparous woman describes tearfulness, irritability, and mood swings. She sleeps adequately when the baby sleeps, cares for the infant well, and has no thoughts of self-harm. Which statement best characterizes her condition?
- A It peaks between days 3 and 5 and resolves spontaneously within 2 weeks ✓
- B It typically begins in the second week and requires antidepressant therapy
- C It carries a high lifetime risk of progression to puerperal psychosis
- D It is characterized by delusions centred on the infant
Correct answer: A. It peaks between days 3 and 5 and resolves spontaneously within 2 weeks
Explanation
Postpartum blues affect up to 50 to 80 percent of mothers, peak around days 3 to 5, and remit spontaneously within 2 weeks without treatment and without functional impairment. Persistence of symptoms beyond 2 weeks raises concern for postpartum depression, which is the discriminating point against option B. Delusions define puerperal psychosis, a separate and far rarer entity.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.