Flashcards in Maternal Adaption of the Digestive System Deck (26):
What effect can oestrogen have on a pregnant woman's gums?
Can cause them to become oedematous (excess fluid retention) and so prone to bleeding
What is PTYALISM?
An increase in salivation. Saliva may not actually increase however women may swallow less often due to nausea
What is PICA?
Abnormal cravings for non-food items
What are the causes of nausea?
Reduction in gastric secretions and slower gastric emptying
How does progesterone cause REGURGITATION and ACID REFLUX
It causes relaxation of the lower oesophageal sphincter
Why is there an increase int he absorption of nutrients in the small intestine?
Progesterone makes the peristaltic motion less efficient and so the food spends more time in the small intestine
What causes constipation?
Reduced motility within the large intestine caused by progesterone which allows more water to be reabsorbed
What causes a sensation of thirst?
Adaptions in the cardiovascular system require an increase in fluid intake
Why are pregnant women less able to tolerate large meals in the third trimester?
The pressure of the enlarged uterus reduces the stomach capacity
What are HAEMORRHOIDS?
A swollen vein or group of veins in the region of the anus
What causes haemorrhoids?
The effects of the pressure exerted by the enlarged uterus gradually reducing the efficiency of venous return. This is further compounded by the effect of progesterone reducing smooth muscle tone.
What treatments and advice would you offer for constipation?
Increase daily intake of fibre - at least 18-30g of fibre a day. High-fibre foods include fruit, vegetables and cereals.
Avoid dehydration by drinking plenty of water.
Get more exercise by going for a daily walk or run.
Identify a routine of a place and a time of day when you are comfortably able to spend time in the toilet. Respond to your bowel's natural pattern: when you feel the urge, do not delay.
Laxatives may also be offered if the above doesn't work
What treatments and advice would you offer for haemorrhoids?
Eat plenty of food that is high in fibre, like wholemeal bread, fruit and vegetables, and drink plenty of water – this will prevent constipation, which can make piles worse
Avoid standing for long periods
Take regular exercise to improve circulation
Might be helpful to use a cloth wrung out in iced water to ease the pain – hold it gently against the piles
Avoid straining to pass a stool as this may make piles worse
When hyperemesis is diagnosed what would you expect to discover when carrying out a urinalysis and why are these abnormalities present?
Excessive ketones in the urine (ketonuria) indicate that the body is not using carbohydrates from food as fuel and is inadequately trying to break down fat as fuel. Ketonuria is a sign that the body is beginning to operate in starvation mode.
What is the average weight gain in pregnancy?
What are the increased risks of obesity in pregnancy?
Fetal congenital malformations
Stillbirth and neonatal death
There is a higher caesarean section rate and lower breastfeeding rate for women with an elevated BMI
How many servings of bread, rice, pasta and cereal should be consumed during pregnancy?
6-11 per day
How many servings of vegetables and fruit should be consumed during pregnancy?
3-5 per day for vegetables
3-4 per day for fruit
How many servings of dairy and protein should be consumed during pregnancy?
4 servings of dairy
3-4 servings of protein
How often should oils, fats and sugars be consumed during pregnancy?
As occasionally as possible
What is the standard daily dose of folic acid?
400 μg (micrograms)
Why is folic acid prescribed during pregnancy?
To lower the risk of Neural Tube Defects
Which foods should be avoided in pregnancy?
Soft mould-ripened cheeses like brie, all blue veined cheese, camembert and unpasteurised milk; this is to reduce the exposure to listeria which can cause miscarriage, stillbirth and neonatal complications.
Meat or vegetable pate.
Undercooked or poorly heated ready meals.
Organ meat particularly liver as Vitamin A in large quantities in the first trimester may be detrimental.
Shark, marlin and swordfish. Sardines, herring, mackerel and salmon must be eaten in moderation due to mercury levels.
Caffeine must be limited to 300mg per day as high levels have been associated with low birth weight and miscarriage.
Alcohol should be avoided.
All eggs must be cooked thoroughly to avoid salmonella.
What are the parameters of normal glucose level?
3.5 & 5.5 mmols
Which hormones cause systemic insulin resistance?
Human placental lactogen (HPL) and progesterone