Pregnancy

Question 1

Pregnancy summary

Answer 1

40 weeks
0-12 weeks
13-27 weeks
28-40 weeks

Question 2

Week 0-2

Answer 2

Fertilisation of egg makes the embryonic disk

High rate of lethality

Question 3

Week 3-8 of Pregnancy

Answer 3

Most sensitive to teratogenesis

Question 4

Brain formation

Answer 4

3-28 weeks

Question 5

Heart formation

Answer 5

3-6 weeks

Question 6

Lungs

Answer 6

5-24/28 weeks

Question 7

When does GI tract develop

Answer 7

3-24 weeks

Question 8

Liver

Answer 8

3/4-12 weeks

Question 9

Kidneys

Answer 9

4/5-12 weeks

Question 10

Limbs

Answer 10

4/5 - 8 weeks

Question 11

Eyes

Answer 11

3 - 20/24 weeks

Question 12

Genitals

Answer 12

5 -7 weeks

Question 13

Spinal

Answer 13

3/4 weeks

Question 14

Physiological changes pregnancy

Answer 14

Weight gain
Blood volume and cardiovascular changes
Renal changes
Respiratory Changes
Gastrointestinal changes
Metabolic adaptions

Question 15

Blood volume expansion pregnancy

Answer 15

Needs to expand to make sure nutrients gets to baby
1-1.5litre increase of body water
Plasma volume increases by 40-50% resulting in less plasma proteins (albumin)
despite increase in red blood cells and haemoglobin does not increase as much as plasma.

Hard to notice anaemia as lower concn of iron

Question 16

Renal Changes Pregnancy

Answer 16

Kidneys - support cardiovascular changes
Better capacity for excreting metabolic rate
Urine production actually decreases to 80%

Question 17

Respiratory Changes Pregnancy

Answer 17

Gas exchange becomes more efficient
Maternal diaphragm greater movement and ribs increase outwards
As pregnancy goes on size of foetus limits this but respiration efficiency maintain as pregnant women breathe more rapidly

Question 18

Metabolic Adaptions

Answer 18

Insulin resistance

2nd and 3rd trimester insulin secreted at 2-2.5 times higher

Question 19

Gastrointestinal changes

Answer 19

Progesterone and oestrogen increases causing gut absorptive capacity to increase
Increased availability to mum and baby
Reduction in secretion of gastric juice
Gastric emptying slowed
Motility of small and large intestine reduced

Question 20

Weight Gain Pregnancy

Answer 20

Foetus, placenta and amniotic fluid (4.8kg)
Mammary glands, uterus (1.4kg)
Lean body mass, fat (3.3kg)
Plasma volume and extracellular body water (2.9kg)

Question 21

Underweight Weight gain during pregnancy

Answer 21

12.5kg-18kg

Question 22

Healthy weigh gain during pregnancy

Answer 22

11.5-16kg

Question 23

Overweight weight gain during pregnancy

Answer 23

7-11.5kg

Question 24

Obese weight gain during pregnancy

Answer 24

6.8kg

Question 25

Gastrointestinal Changes Pregnancy

Answer 25

Progesterone and oestrogen increase - causing gut absorptive capacity to increase Reduction in secretion of gastric juice Gastric emptying slowed Motility of small and large intestine

Question 26

Factorial Method for assessment of requirement during pregnancy

Answer 26

Pregnant require = Non-pregnant + Increased requirement - Reduced requirement

Question 27

Energy requirements during pregnancy

Answer 27

No need to increase energy intake till last few weeks Increase intake EAR is by 200kCal a day However, if underweight at start of pregnancy or active then may require more

Question 28

Protein Requirements during pregancy

Answer 28

Gain almost 1kg of protein during pregnancy (mostly 1st and 2nd) DRV states and additional 6g/day (RNI is 51g/day) After 20 weeks foetal liver can synthesis non-essential

Question 29

Lipid intake During pregnancy

Answer 29

Crucial for fpetal development - membrane and brain made up of them Depletion of DHA is associated with reduced visual function High intake of n-3 increased gestation, birth weight and reduce risk of premmie. Need to be cautious though as fish and fish oils may be contaminated with mercury

Question 30

Which Vitamin Requirements Increase during pregnancy

Answer 30

Vitamin A Vitamin C Vitamin D

Question 31

Vitamin A and Pregnancy

Answer 31

Increase requirement by 100ug However, most mothers consume enough If consume more than 8000ug can increase chance of birth defects No Vit A supplement

Question 32

Vitamin C and Pregnancy

Answer 32

Increase RNI by 10mg/day in third trimester

Question 33

Vitamin D and Pregnancy

Answer 33

10ug/day supplement

Question 34

Minerals and Pregnancy

Answer 34

Often with minerals need increases but ability to uptake increases due to GI changes so no additional requirement is needed

Question 35

Aversion during pregnancy

Answer 35

Strong disliking's during pregnancy Early - tea, coffee, alcohol, fried food, eggs Later - sweet

Question 36

Cravings during pregnancy

Answer 36

Compulsive urge for food not previously desired in excess

Question 37

Pica

Answer 37

Craving for a non-food substance May indicate nutrient deficiency Higher prevalence in rural areas Leads to toxicity or malnutrition

Question 38

Morning Sickness

Answer 38

Nausea and Vomiting in the first trimester Recommended to eat cracker, toast and dry cereals Small frequent meals Keep hydrates Avoid tea and coffee Avoid or limit fatty and spicy foods

Question 39

Ginger

Answer 39

Has been found to improve mild to moderate nausea

Question 40

Hypermis Gravidarum

Answer 40

Persistent Vomiting 3 episodes of vomiting a day Lose at least 3kg or 5% body weight Leads to Dehydration, acidosis and alkalosis Requires fluid and electrolyte replacement If not treatment can be life threatening Oesophageal rupture

Question 41

Pre-eclampsia

Answer 41

``` Hypertension proteinuria Oedema Lead to haemolysis Elevated liver enzymes Low platelets ``` Prevention - magnesium sulphate, calcium

Question 42

Heartburn and pregnancy

Answer 42

Increased abdominal pressure caused by enlarge uterus pushing against GI Progesterone decreases integrity of cardiac sphincter resulting in mor acid reflux Common in third trimester Small frequent snacks, eat slowly, milk and yogurt, avoid lying down after eating

Question 43

Constipation and Haemorrhoids

Answer 43

Progesterone slows peristaltic action of smooth muscles in bowel Enlarged uterus displaces internal organs Increase fluid intake High fibre diet Increased physical activity

Question 44

Gestational Diabetes

Answer 44

Pregnant women with no prior history of diabetes Mostly resolves after birth Associated with increased incidence of premmie and pre-natal motility Low sugar High Fibre Regular snacks

Question 45

Smoking and pregnancy

Answer 45

6% women currently smoke at the end of pregnancy

Question 46

Alcohol and pregnancy

Answer 46

Alcohol can pass through placenta ``` Can lead to spontaneous abortion Nervous system impairment Birth defects Foetal alcohol syndrome Attachment disorder Difficulty socialising ```

Question 47

Food safety and pregnancy

Answer 47

Toxoplasmosis - abnormalities, blindness, mental retardation | Listeriosis - brain damage

Question 48

Obesity during pregnancy

Answer 48

Higher risk of Gestation diabetes pre-eclampsia and childhood obesity for baby. Exposes foetus to bad uterus environement (changing reward pathway to prefer high fat and saturated foods)