Optimizing Preconception, Prenatal & Postpartum Health Flashcards
1
Q
What is Lochia?
A
Extended bleedig that happens during recuperation after a woman has gone through post-birth
2
Q
What is the preconception phase?
A
The few months before conception occurs.
3
Q
What are the 3 Ps of Pregnancy?
A
- Preceonception
- Prenatal
- Postpartum
4
Q
What is the preconception phase?
A
The rough time frame of 6-12 months before conception.
5
Q
Why is the preconception time frame so important?
A
It has a huge impact on the genes that will pass down to our children.
6
Q
Can genes be altered through our nutrition and environment?
A
Yes
7
Q
What are eipgenetics?
A
The study of how your behaviors and environment can cause changes that affect the way your genes work.
8
Q
Can you physically add or delete genes within hyour body?
A
No, but you can control the way that they are expressed, that is if they are turned “on” or “off”.
9
Q
Each person has roughly BLANK genes, and each of these genes codes for certain proteins, delegating what aspects of a person’s genetic health are functional or dysfunctional, according to the health and status of the gene itself.
A
20,000 - 30,000
10
Q
BLANK in genes are often what are passed down family lines, leading people to be predisposed to certain pathological conditions.
A
Mutations
11
Q
True or False: Although a person may have a genetic mutation, it does not guarantee that the mutation will indeed express itself, and result in whatever dysfunction it codes for, such as breast cancer.
A
True
12
Q
How these genes are expressed — whether they are mutated or not — largely boils down to a person’s BLANK
A
Internal and external environment.
13
Q
What does the epigenome do?
A
It not only control how our genes function in the present day but also what genetic coding gets will pass down to our children, that is, how their genes will be expressed and affect their lives.
14
Q
What is Epigenetic Inheritance?
A
The epigenome is said to not only control how our genes function in the present day but also what genetic coding gets will pass down to our children, that is, how their genes will be expressed and affect their lives. There are even some theories that the epigenome may have 2 an impact on our grandchildren’s lives as well
15
Q
Can the epigenome be rewired?
A
Yes it can, allowing you to pass down the best genetic inheritance to your children as possible, giving them a quality start at life.
16
Q
What is a common theory of why certain predispositions are so prevalent within families?
A
Because families often share the same lifestyles — that means, they have similar nutrition & lifestyle habits that continually program those predisposed genes to be expressed, resulting in disease.
17
Q
What does dialing in one’s nutrition and lifestyle habits 6-12 months before planning to conceive do?
A
It allows them the chance to reprogram their Epigenetics, but it is also important for dialing in hormone balance, priming egg and follicle health for a healthy conception and implantation, and for promoting a healthy pregnancy, birth, and postpartum experience.
18
Q
Is it accurate that it takes 90 days for an egg to mature?
A
No
19
Q
What is Oogenesis?
A
The technical term for the development of egg cells (oocytes). There are certain stages an oocyte must go through to mature for ovulation, which interestingly enough, mostly occurs before a girl is even born.
20
Q
True or False? There are certain stages an oocyte must go through to mature for ovulation, which interestingly enough, mostly occurs before a girl is even born.
A
True
21
Q
When does the process of Oogenesis occur?
A
The process begins 2 weeks post-conception and by birth all of a female’s oocytes are partially matured, resting in a dormant state until puberty.
22
Q
Each oocyte has a follicle in which it will ovulate, which are considered BLANK (primordial) until they are recruited for development.
A
Immature
23
Q
What is Fulliculogenesis?
A
At puberty, and each cycle moving forward, a certain amount of primordial follicles become recruited to undergo their final stages of development.
24
Q
How long does Fulliculogensis take?
A
This development process takes roughly an entire year to perform.
25
When does the primary follicle initation of dormant primordial follciles begin?
Roughly 150 days before ovulation (about 5 months).
26
Where does the 90-day theory come from?
The 90-days it takes for the pre-antral follicles to develop through to ovulation, not the eggs.
27
At what point does the oocyte complete meiosis to become fully mature enough to ovulate?
Once the pre-ovulatory follicle is selected.
28
Why is it important to haVe a healthy corpus luteum formation?
For producing progesterone, a necessary hormone for facilitating a healthy pregnancy.
29
Even though a woman’s eggs are mostly mature before birth, there is still a BLANK stage of development that happens each cycle.
Second
Although brief, this stage is very important for ensuring chromosomal health and embryo development.
30
What is meiosis?
The second stage of development that the oocyte endures, which is a process requiring plenty of quality ATP (adenosine triphosphate) production from healthy mitochondria.
It is the process of chromosomal division within the egg
31
When does the second stage of meiosis occur?
It happens at fertilization, dividing the chromosomal copy in half yet again, leaving the egg with only one copy of each (23 total), with the second chromosome copy to be delivered by the sperm (resulting in 46 total — necessary for human development).
32
When does the first stage of meiosis occur?
While developing during gestation (meiosis 1), which is then stalled in what’s called a “primary oocyte” state until puberty, and is then completed right before ovulation, leaving the egg with two copies of each chromosome (46 total) — now called a “secondary oocyte”.
33
Female chromosomal errors can be developed either in BLANK or leading up to BLANK, suggesting that through preconception awareness, one may be able to improve the egg’s environment and provide sufficient energy to the egg so that it can undergo meiosis properly and avoid the potential for chromosomal errors.
Gestation or ovulation
34
What is spermatogenesis?
Sperm also go through a similar meiosis process while they are developing in the testes
Therefore it is just as important for men to optimize their mitochondrial health as well so that they can deliver the healthiest sperm with prime chromosomal quality.
35
What is one of the most important factors in proper meiosis and chromosomal delivery? Why is that?
Mitochondrial health
Mitochondria are very sensitive to inflammation and oxidation. When they are damaged due to these factors, they may not perform as well, resulting in the potential for chromosomal errors and unviable embryos.
36
By X weeks of pregnancy, it is said that many of the baby’s most vital organs have already started to develop
6
37
Optimizing preconception nutrition at least X months before conception can help to support a healthy and more comfortable pregnancy.
6
38
Adequate protein consumption, dialing in blood sugar balance, and supporting liver health pre-pregnancy may help prevent symptoms such as BLANK & BLANK as well as food aversions & cravings during the first trimester and beyond.
nausea & fatigue
39
Vitamin X deficiency can lead to poor embryonic organ development which may result in miscarriage or birth defects
A
40
What are some of the problems with standard lower grade multivitamins and prenatals?
* Vitamin concentration is often quite low, or the opposite, unnecessarily high.
* Many nutrients are often added in their cheapest, non-bioavailable, synthetic forms (such as folic acid, instead of methyl-folate, or synthetic vitamin E
* Minerals are added (often in high quantities) without taking into consideration a person’s bioindividual mineral needs
* Many additional (and often unnecessary) nutrients are added other than just vitamins & minerals.
* Humans are adapted to getting nutrients from whole foods because most nutrients require enzymes and synergistic cofactors to be properly absorbed. While these are naturally present in foods, they're often not included in synthetic vitamins and isolated nutrients.
* Many lower-quality multivitamins and prenatals contain excipients (inactive added ingredients) such as additives, fillers, solvents, preservatives, and even high amounts of sugar.
41
Why were prenatal vitamins created?
Prenatals were created as a way to add in folic acid and other nutrients that are necessary to prevent neural tube defects — an occurrence that started rising around the time of the development of processed, unhealthy foods.
42
Should women take a prenatal vitamin?
Yes, to at least cover their bases and provide extra support for their gorwing baby, as nutrient needs excel greatly during pregnancy.
43
When seeking a prenatal what should one look for?
* -Bioavailable nutrients such as methyl folate over folic acid, preformed vitamin A (either solo or with beta-carotene), natural forms of vitamin E over synthetic (natural: tocopherol or tocotrienol. Synthetic: tocopheryl or tocotrienyl)
* Additional necessary nutrients: Choline, Vitamin K (1 & 2), and higher amounts of B6 (deficiency is often a cause of morning sickness)
* Ensure they don't contain additives, such as soy or gluten, and look for 3rd party testing and verification.
44
If trying to conceive, it is recommended to start a prenatal at least BLANK - BLANK months before trying.
3-6 months
45
What are are two forms of omega 3 fatty acids that are necessary for proper brain function and development?
EPA (eicosapentaenoic acid) & DHA (docosahexaenoic acid)
These fatty acids are essential, so if the mother’s not intaking them daily through her diet, she isn’t able to synthesize them for herself or her baby.
## Footnote
Instead, they will likely get pulled directly from her brain to support fetal development. Some theories suggest this may be a factor behind the development of postpartum depression
46
Adequate BLANK consumption during pregnancy helps to curve pesky symptoms such as cravings and nausea, and may also help prevent stretch marks from occurring. Additionally, low, as well as high BLANK intake during pregnancy is associated with preeclampsia and low birth weight.
protein; protein
47
The need for BLANK hormone increases significantly during pregnancy.
Thyroid
48
BLANK hormone is critical for proper fetal development, especially for the growth of a baby’s brain and nervous system.
Thryoid
49
Up until the 20th week of gestation, the mother supplies the baby with her own BLANK hormones until the baby’s thyroid starts to producing thyroid hormone on its own. If the mother goes into pregnancy with BLANK, she may be at more risk for miscarriage, gestational diabetes, preeclampsia, premature birth, and low birth weight
Thyroid; hypothyroidism
50
The increased need for BLANK hormone throughout pregnancy may put the mother at risk for developing BLANK or other BLANK conditions during pregnancy and postpartum if she is not adequately supported throughout her pregnancy.
thyroid; hypothyroidism; thyroid
51
Women at risk should ideally have their BLANK levels monitored throughout their pregnancy, and with that, it’s important to note that markers such as TSH and Total T4 may be elevated as a result of the pregnancy itself.
Thyroid
## Footnote
The normal reference ranges for pregnant women may need to be altered to meet their higher thyroid hormone requirement
52
During the BLANK trimester, the fetus is the most susceptible to environmental toxins, teratogens in certain herbs/drugs, infections, and nutritional deficiencies
First
53
True or False: a fetus’s ability to metabolize and detoxify certain substances is just as effective than an adult’s.
False; it's less effective
## Footnote
If a mother is subjected to toxins or other substances, such as caffeine, not only does her liver have to process the material, but so does the baby’s, as the substance will bypass the placenta and enter into the baby’s bloodstream as well. Because of this, women should be extra mindful of what they are consuming, putting on their bodies, and surrounding themselves with while they are pregnant
54
Why is a pregnant woman more susceptible to insulin resistance?
Becuase the body naturally diverts glucose and insulin toward the fetus to support its maturation.
55
True or False: If a woman is already insulin resistant or experiences blood sugar imbalances before she becomes pregnant, the natural increase of risk for insulin resistance during pregnancy may increase her risk for developing gestational diabetes.
True
56
What is an ectopic pregnancy?
Ectopic pregnancies are where the fertilized embryo implants within the uterine tube instead of the endometrial lining.
When the embryo implants in this area, it is not able to grow and expand to be viable.
57
Where can ectopic pregnancies be found?
The uterine tubes, but also within the ovaries, abdomen, and cervix.
58
What is a cornual or interstitial ectopic pregnancy?
One of the most rare forms of ectopic pregnancies is where the embryo implants in the space where the uterine tube meets the uterine lining. Accounts for about 2% of all ectopic pregnancies.
59
What are symptoms of an ectopic pregnancy?
Spotting, sharp, or dull pain on the side where the ectopic pregnancy exists, and a low serum hCG level (an hCG drop of < 21% is likely due to an ectopic pregnancy).
60
What are risk factors for an ectopic pregnancy?
Obstruction of the uterine tube caused by scar tissue build-up either due to endometriosis, surgical error, or an infection such as with a sexually transmitted infection like Chlamydia or Gonnorhea.
Exposure to DES in utero, uterine malformation or malposition (such as with a retroverted uterus), pelvic inflammatory disease (PID), In Vitro Fertilization (IVF) & Intrauterine Insemination (IUI), and a history of a previous ectopic pregnancy
## Footnote
There is some research connecting the prevalence of ectopic pregnancies with cannabis usage, caffeine consumption, and parasitic infections
61
What are treatments for an ectopic pregnancy?
Either fetal and/or tubal surgical removal, or if caught early enough, a chemotherapy drug called methotrexate can be used to help initiate a miscarriage.
62
What can cause a Missed Miscarrige?
An early pregnancy loss that occurs within the 4-6 week mark.
This is often due to luteal phase deficiency and/or poor uterine receptivity due to inflammation or immune system up-regulation. It may also be due to poor fertilization or DNA/chromosomal error.
63
What is a Chemical Pregnancy? And what are potential causes?
A pregnancy loss that occurs shortly after implantation (usually within the 4-5 week mark).
Exact causes are not well known but may be due to poor embryo development due to DNA damage within the sperm or egg. There may also be a connection to luteal phase deficiency and/or poor uterine receptivity due to inflammation or immune system up-regulation.
64
What is a Molar pregnancy?
Where a tumor (typically benign) forms within the uterus due to a non-viable pregnancy.
In this case, there is usually a dysfunction that occurs during fertilization which causes a tumor to form instead of a placenta. If the tumor (and pregnancy) are not removed in a timely manner, a molar pregnancy may turn into a rare form of cancer called Gestational Trophoblastic Disease (GTD).
65
What causes morning sickness or in more severe cases hyperemesis gravidarum (HG)?
Sensitivity to increasing estriol and hCG levels during early pregnancy, as well as low blood sugar, biliary insufficiency, and deficiencies in B6, Magnesium, Zinc, Vitamin K, and protein.
There is also some research showing that H.Plyori infection may increase the risk for HG24.
66
What is one of the best ways to avoid morning sickness and HR?
## Footnote
hyperemesis gravidarum (HG) = more severe case of morning sickness
Ensure nutrient stores are up to par before pregnancy by dialing in one’s preconception nutrition
67
What is Gestational diabetes?
High blood sugar during pregnancy
68
What complications can gestational diabetes cause?
Complications in pregnancy by increasing risk for preeclampsia (discussed below), premature birth, cesarean birth, and even stillbirth.
69
What is a Glucose Tolerance Test?
Where you take a fasting blood measurement of glucose to gather a baseline level, and then glucose is tested again 1 and 2 hours after administration of an incredibly glucose-rich beverage, one that may not be supportive of pregnant women’s blood sugar health.
70
True or False: blood sugar is meant to be naturally lower during pregnancy
True, so a mild form of insulin resistance may be normal as well.
71
What is preeclampsia?
Where high blood pressure is found in tandem with high protein levels in urine, and fluid retention/swelling in the extremities.
72
WWhat symptoms can preeclampsia lead to?
Nausea, dizziness, fatigue, and shortness of breath.
73
What usually causes preeclampsia?
A result of organ dysfunction in later-term pregnancies and tends to show up after the 20th week in those who are at a higher risk.
74
How can you help a client maintain healthy blood pressure during pregnancy?
Make sure your client is staying hydrated as hydration needs increase during pregnancy to make up for the additional blood flow needed to support the baby’s development.
Dialing in blood sugar regulation
Being mindful of one’s fructose intake can be an important piece in blood pressure regulation as high fructose can lead to salt reabsorption by the kidneys, resulting in higher blood pressure.
Ensure adequate choline intake through a healthy source of dietary egg yolks, liver, and potentially supplementation.
Vitamin D
75
What are some of the risk factors for developing preeclampsia?
High blood sugar levels, insulin resistance, and gestational diabetes.
76
The BLANK phase is sometimes referred to as the 4th trimester
Postpartum
77
Once the baby and the placenta have been delivered, BLANK and BLANK drop rapidly to their pre-pregnancy levels
Estrogen and progesterone
## Footnote
For many, this sudden drop in hormones, specifically progesterone, can put the body into a state of temporary shock, leaving mothers at risk for developing postpartum depression, anxiety, sleeping problems, and other hormonal imbalances
78
What is Postpartum Thyroiditis?
An autoimmune condition that may develop temporarily after pregnancy.
It typically starts with symptoms similar to hyperthyroidism, and then slowly progresses toward hypothyroidism over a period of 12 or so months.
79
What is Postpartum Thyroiditis characterized by?
Inflammation of the thyroid and is likely triggered by a combination of stress from the pregnancy and birth, low progesterone levels & fluctuating estrogen during the postpartum period, and in some cases, TH1-Dominance immune system rebound.
80
What causes the TH1-Dominance immune system rebound in postpartum?
The let up of suppression on TH-1. Dominant thyroid autoimmunity during pregnancy. When progesterone levels decrease rapidly post-birth, this can re-trigger TH-1 autoimmune conditions, inflaming the thyroid and increasing risk for postpartum thyroiditis.
81
What are symptoms of Postpartum Thyroiditis?
Extreme fatigue, depression, irrational thoughts, joint pain, excessive hair loss, sensitivity to temperatures, and a rapid heart rate.
82
What can be taken to help increase prolactin and oxytocin hormones, which can support milk production?
Hops, nettle leaf, oat straw, alfalfa, red raspberry leaf, blessed thistle, and fenugreek.
83
True or False: as the baby’s immune system is developing, mother’s milk provides a steady supply of probiotics that populate and nourish her baby’s gastrointestinal system, setting them up for prime immune system function later in life.
True
84
Why might a woman have abdominal or uterine prolapse?
It can occur due to poor pelvic floor health or abdominal muscle dysfunction as a result of pregnancy or birth-related injury or trauma.
85
What is pregnancy spacing?
For nutritional reasons, it is recommended to wait at least three years in between pregnancies.
86
True or False: some research showing that conceiving children within 1-2 years of each other leads to worse pregnancy outcomes, such as a higher risk of placental abruption, low birth weight, and preterm births.
True
## Footnote
Close conceptions are also associated with psychological effects in the child such as autism and depression, and physical degeneration such as with bone structure and facial symmetry
87
How does breastfeeding help promote the mother's healing post-birth?
Breastfeeding increases the hormone oxytocin which can help promote post-birth uterine contractions, allowing the lochia to flow naturally out of the body.
Oxytocin also supports the uterus in returning to its natural pre-pregnancy size.
## Footnote
Lochia is the vaginal discharge you have after giving birth.
88
What is important for boosting milk production?
* Eating enoug food and nutirious food at that
* Hydration (b-milk is made up of more than 80% water)
* Breastfedeing on demand
* Working with specific herbs such as oat straw, fennel, fenugreek, alfalfa, milk thistle, and brewer’s yeast.
