Antenatal Advice

Question 1

Guidance for taking nutritional supplements in pregnancy?

Answer 1

folic acid 400mcg should be given from before conception until 12 weeks to reduce risk of neural tube defects

iron supplementation should not be offered routinely

vitamin A supplementation (intake above 700 micrograms) might be teratogenic. Liver is high in vitamin A so should be avoided

vitamin D: ‘women should be advised to take a vitamin D supplement (10 micrograms per day)

Question 2

Advice for smoking cessation in pregnancy?

Answer 2

NRT may be used but women must have stopped smoking and risks/benefits need to be discussed
neither varenicline nor bupropion should be offered to pregnant or breastfeeding women

Question 3

General diet advice for pregnancy?

Answer 3

listeriosis: avoid unpasteurised milk, ripened soft cheeses (Camembert, Brie, blue-veined cheeses), pate or undercooked meat

salmonella: avoid raw or partially cooked eggs and meat, especially poultry

Question 4

Advice for air travel during pregnancy?

Answer 4

women > 37 weeks with singleton pregnancy and no additional risk factors should avoid air travel

women with uncomplicated, multiple pregnancies should avoid travel by air once >32 weeks

associated with increased risk of venous thromboembolism, wearing correctly fitted compression stockings is effective at reducing the risk

Question 5

Advice for exercise in pregnancy?

Answer 5

women should be informed that beginning or continuing moderate exercise is not associated with adverse outcomes
certain activities should be avoided e,g, high-impact sports where there is a risk of abdominal trauma and scuba diving

Question 6

Advice for women concerned about foetal movements?

Answer 6

There should be no change to the pattern of movements or number of movements after 28 weeks gestation.

If a patient is unsure about the baby’s movements after 28 weeks, they should be advised to lie on their left side and focus on foetal movements for 2 hours. If they do not feel 10 or more movements during this time they should contact their maternity unit immediately.

Question 7

Advice about normal length of morning sickness?

Answer 7

Normally starts between the 4th and 7th week and should settle by week 20

however can continue throughout pregnancy

Question 8

Advice for women experiencing heartburn in pregnancy?

Answer 8

Alleviate by sitting up after meals, reducing fat and spice and eating smaller portions. Can suggest Gaviscon or omeprazole in severe cases.