Antenatal Care And Pregnancy (1.1) Flashcards
How long does a baby spend in the womb and what is the the average length of pregnancy (gestation)?
- Unborn baby spends 38 weeeks in the womb
- Average length of pregnanacy (gestation) is counted as 40 weeks
How long does the unborn baby spend in each of the trisemesters?
- First trisemester: conception to 12 weeks
- Second trisemester: 12 to 24 weeks
- Third trisemester: 24 to 40 weeks
What are some of the common ailments/issues that a pregnant patient will come into the pharmacy for?
- Morning sickness, heartburn
- Constipation, haemorrhoids
- Pain, fever, colds
- Immunisations (flu, pertussis-rubella)
- Pelvic pain, sciatica, pelvic floor issues
- Varicose veins, stretch marks
- Nutrition and Supplement advice
What is the range of weight gain in a woman provided their BMI is normal? How is the weight lost/gained in each of the trisemesters?
- 11.5 - 16 kg gained in a pregnancy (normal BMI)
- <2kg gained in trisemester 1
- 0.75kg/week gain in trisemester 2 and 3
What are some of the vitamins/minerals that have to be increased for the recommended dietary intake (RDI)?
- Iron (27mg/day)
- Folate (Folate 600mcg/day)
- Iodine (220mcg/day)
- Zinc (10-11 mg/day)
- Vit C (55-60 mg/day)
- Vit D (5mcg/day)
What are some of the instances to refer pregnant women who are seeking dietary and nutrition advice?
- Adolescent
- Overweight or underweight pre-pregnancy
- 3 pregnancies in 2 years (iron, calcium, protein stores)
- Restricted diet: macrobiotic,vegan
- Unhealthy eating habits
- Medicines, medical conditions eg diabetes
Does folic acid reduce the risk of neural tube defects (NTD)? How much must be administered a day in order for the risk of NTD to decrease?
- Pre-conceptual administration of Folic Acid = Decreased NTD risk
- Folic Acid = 400 mcg (0.4mg) /day
A)How much folic acid should a healthy person take a day?
B) Why do some woman need increased folic acid amounts a day and what is this amount?
A)
- 0.5mg daily: -1 month to +3 months
B)
Increased Folic acid required for women;
- Family or personal history of pregnancy with NTD
- Medication that may afect folic acid ( anti-convulsant, dihyrofolate reductase inhibitors, methotrexate, trimethoprim)
- With pre-conception Type 1 or Type 2 Diabetes Mellitus
- Who are obese
- 5mg daily: -1 month to +3 months
Do calcium and vitamin D levels need to be increased during pregnancy
Calcium: RDI: 1000mg -1300mg
- No evidence that needs to increase during pregnancy
Vitamin D: RDI: 0.005mg (5mcg)
- Levels have to be normal during pregnancy
A) What is the RDI of iron in an adult woman, pregnant woman and during lactation?
B) When to check iron(Hb) levels?
C) Who are the women at risk of iron deficiency
Take 60-120mg iron daily for prevention
A)
- Adult Women: 8mg daily
- Pregnancy: 27mg daily
- Lactation: 9mg daily
B)
- RDI from diet alone can be difficult
- Check Hb level at first antenatal visit and at 28 weeks
C)
- Vegeterains, vegan or a multiple pregnancy
What is the role of iodine?What are some of the sources of Iodine?
Role: synthesis of thyroid hormones
- Growth and development of brain
- Regulation of somatic growth
- Regulation of metabolism
Sources
- Seafood
- Dairy
- Iodised salt
- Fortified bread
A) What is the RDI of iodine in pregnant women and women who are lactating?
B) Why is iodine so critical in pregnancy and lactation
A)
- Pregnant: 220mcg/day
- Lactation: 270mcg/day
B)
- Pregnancy: There is a 50% increase in thyroid hormone production (iodine is required to produce TH) to maintain the pregnancy and supply the foetus
> Foetal thyroid becomes functional (T4) in last weeks of gestation
- Lactation: Production rate normalises, breast milk is an iodine source to build the infants reserves
A) What is iodine deficiency disorder (IDD)?
B) Why has iodine deficiency re-emerged in Australia?
A)
- Constitutes the greatest cause of preventative brain damage in the foetus and infant
- Also the greatest cause of retarded psychomotor development in young children
- Significant problem in >100 countries
B)
- Decreased use of iodophors in the dairy industry
- Decreased use iodised salt
- Increased processed foods containing non-iodised salts
How much iodine should be taken daily during pre-conception, pregnancy and breast-feeding
150mcg daily
Is iodine the only vitamin/mineral that is required for fortification? If so, why?
Yes
- For all the other vitamins and minerals in pregnancy, there is little evidence to support routine supplementation unless nutrient intake is inadequate
