Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUT2005 > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

… and … are considered to be among the most important environmental factors influencing the course and outcome of pregnancy?

A

Maternal diet and nutritional status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long is gestation and trimesters?

A 
Gestation 40 weeks
Divided into trimesters
First trimester: 0-12 weeks
Second trimester: 13-27 weeks
Third trimester: 28-40 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens at 0-2 weeks of fetal development?

A

fertilisation to embryonic disc, less sensitive to teratogenesis ( process by which congenital (disease from birth) malformations are produced) and high rate of lethality (death of embryo).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens to a foetus at 3-8 weeks?

A

Turns from embryo into fetus, most sensitive to teratogenesis, major organs form each of which have a peak sensitivity period.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to a fetus from week 9 to 38?

A

Turns from fetus to baby, decreasing sensitivity to teratogenesis, period of growth and functional maturation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physiological changes during pregnancy?

A

Maternal weight gain and body composition changes
Blood volume expansion and cardiovascular changes
Renal changes
Respiratory changes
Gastrointestinal changes
Metabolic adaptations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Components of maternal weight gain during pregnancy?

A

Foetus (only a third of the weight gain, placenta and amniotic fluid
Mammary glands, uterus
Lean body mass, fat
Plasma volume, extracellular body water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Optimal maternal weight gain?

A 
Underweight (< 18.5kg/m2) = 12.5 – 18kg
Healthy (18.5 – 24.9kg/m2) = 11.5 – 16kg
Overweight (25 – 29.9kg/m2) = 7 – 11.5kg
Obese (>30kg/m2) = 6.8kg minimum
No one should loose weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Gastrointestinal Changes?

A

Adaptations to increase gut absorptive capacity influenced by progesterone and oestrogen
Increased availability to maternal and foetal structures and stores
Reduction in secretion of gastric juices
Gastric emptying slowed (food churned in stomach longer)
Motility of small and large intestine reduced (so food exposed to more enzymes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The nutrient requirements during pregnancy must provide adequate nutrients to meet…?

A

The needs of the mother
The needs of the foetus
To some extent, then needs of mother and foetus in the future (lactation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Maintenance of a normal pregnancy requires energy due to…?

A 
increased mass of the uterus
formation of the foetus
formation of the placenta
the expanded blood volume
extra adipose tissue to provide energy reserve for lactation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Energy requirements may increase but what factors might slightly mitigate this effect/ cause issues?

A

BMR may decrease due to endocrine changes in pregnant women
Physical activity may decrease in the pregnant woman
Food intake may decrease in the pregnant woman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When does energy intake increase in pregnancy?

A

Last few weeks, average increase under 100 extra calories a day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the recommendations for energy intake in the third trimester? Exceptions

A

Increase EAR by 200kcals/day above pre-pregnant EAR (only during last trimester)
Large increase in food intake NOT required
Maternal obesity associated with increased risk of congenital malformations
Exceptions:
women underweight at beginning of pregnancy, and women who do not reduce activity may need more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a better indicator than the recommendations of energy sufficiency?

A

Appropriate weight gain and appetite are better indicators of energy sufficiency that the amount of kcal consumed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Protein Requirements

A

Protein required for growth of the foetus and maternal tissue
Overall gain of almost 1kg protein during pregnancy
most during 1st to 2nd trimester
Increased protein turnover during pregnancy
Excess protein associated with health risks
DRV additional 6g /day (RNI 51g/day)
Current UK intakes in excess of RNI
After 20 weeks foetal liver can synthesise non-essential amino acids from precursors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Importance of lipids in pregnancy?

A

Crucial for foetal development
membranes and brain
Uptake depends on dietary supply
Effects
Depletion of DHA associated with reduced visual function and learning defects in children, supplementation from 2nd trimester may improved visual aspects and tests on intelligence and achievement in infants.
High intakes of n-3 fatty acids proposed to extend gestation, increase birth weight and reduce risk of premature delivery. Caution with increased intake from potential contamination of fish oils with mercury and other potentially teratogenic agents. Fish oil supplementation may increase maternal bleeding and risk of postpartum haemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Importance of vitamin A and food recomendations?

A

Vitamin A
Required for growth and maintenance of foetus
Maternal requirements increased by 100µg throughout pregnancy but most UK women already consume sufficient
> 8000 µg/d increased risk birth defect
Advise
no liver/ liver products
No Vitamin A supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vitamin C recommendation in third trimester?

A

Increase mothers RNI by 10mg/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Vitamin D recommendations?

A

Vitamin D deficiency can be passed on to the baby during pregnancy
Requirement 10µg/d supplementary Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If mother supplements with vitamins what should she take?

A

Avoid use of single vitamin supplementations

If supplementation necessary, use pregnancy suitable multi-vitamins (exclude vit. A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Zinc requirements?

A

During pregnancy there is a requirement for extra zinc, but studies have found no benefit to providing zinc supplements. It is likely that there is some metabolic adaptation to provide sufficient zinc so no additional requirements.

23
Q

Magnesium requirements?

A

adaptive response and release from maternal stores overcome additional requirements

24
Q

Iron recommendations and issue?

A

cessation of menstruation, mobilisation of maternal stores and increased intestinal absorption overcome additional requirements
if supplements required, can contribute to constipation

25
Q

Common aversions in pregnancy?

A

Early pregnancy - commonly tea, coffee, alcohol, fried food, eggs
Later pregnancy - sweet foods

26
Q

What are pregnancy cravings and should they be a reason for concern?

A

compulsive urge for food not previously desired in excess
Random foods, varying within individuals
Rarely adversely affects overall nutritional intake

27
Q

What is Pica and what are the potential causes?

A

Desire for substances not fit for food
Higher prevalence in rural areas or those with childhood or family history of Pica
Not limited to geography, race, sex, culture, social status or pregnancy
Causes:
? Relieves nausea and vomiting
? Craving produced by nutrient or mineral deficiency

28
Q

What are some common things to desire eating due to pica?

A 
Dirt or clay (geophagia) - most common
Starch e.g. laundry starch (amylophagia)
Ice 
Paper
Burnt matches, cigarette ashes,
Stones or gravel 
Charcoal
Antacid tablets, milk of magnesia
Baking soda, coffee grounds
29
Q

What are some potential consequences of pica?

A 
Toxicity
Malnutrition
Obesity
Interference with absorption of mineral
Intestinal obstruction
30
Q

Nausea and vomiting in pregnancy (NVP) effects most women in the first trimester, what are the recommendations for this?

A

Eat crackers, melba toast (dry thinly sliced crispy bread) or dry cereal before getting out of bed
Small frequent meals
Keep hydrated, but separate liquids from solids
Avoid tea or coffee
Avoid or limit fatty and spicy foods
Experiment with food temperatures, flavours and textures

31
Q

What can be taken to reduce nausea and vomiting in pregnancy, but don’t neceserally recomend?

A

Ginger has been found to improve mild to moderate nausea and vomiting across several studies and meta-analyses.
Additionally, ginger helps stimulate GI tract motility and increase bile and gastric acid secretion.
vitamin B6 (pyridoxine) taken at doses of 10–25 mg every 8 hours reduces symptoms among women with NVP (would be prescribed)

32
Q

What is Hyperemesis gravidarum? Complications? Management?

A

Persistent vomiting occurring before the 20th week of gestation
the occurrence of >3 episodes of vomiting per day with associated ketonuria (using fats and proteins as energy) and weight loss of >3 kg or 5% of body weight.
Complications
Benign
Dehydration, acidosis, alkalosis, ketonuria, poor micro and macro-nutrient provision for mother and child
Life Threatening
Management – fluid and electrolyte replacement, anti-emetics, nutrition support

33
Q

What is pre-eclampsia? Risk factors? Potential prevention?

A

Characterised by:
hypertension, proteinuria and oedema
Risk factors
< 20 or > 40 years of age, primiparity,  BMI, family Hx
Eclampsia includes grand-mal seizures or coma
May be fatal
Prevention
? Magnesium sulphate, ? Calcium, ? Oxidative stress therefore use of antioxidants
Could antioxidant supplementation prevent pre-eclampsia?

34
Q

Heartburn?

A

Increased abdominal pressure caused by enlarged uterus pushing up against the stomach and intestines
Progesterone decreases integrity of cardiac sphincter allowing reflux of food and acid
Exacerbated by spicy, fatty, fizzy or acidic foods, and often by lying down
Commonly occurs in third trimester

35
Q

Recommendations for heartburn?

A

Small, frequent meals or snacks
Eat slowly
Milk and yoghurt, or antacids
Avoid lying down for 1 - 2 hours after meals

36
Q

Gestational Diabetes Mellitus? Associations? Treatment?

A 
Pregnant women with no prior history of diabetes
Mostly resolves after birth
Associated with:
Increased incidence of prematurity
Peri-natal mortality
Treatment:
Low sugar, high fibre diet, regular meals
Occasionally require insulin injections
37
Q

Alcohols potential effect on pregnancy?

A

Placenta protective, but fat-soluble toxins and teratogens, e.g. alcohol, able to cross
Alcohol during pregnancy may result in
spontaneous abortion, central nervous system impairment, birth defects, foetal alcohol syndrome
attachment disorders (children), difficulties in social situations (adolescents), increased trouble with the law, inappropriate sexual behaviour, depression, failure to care for children and suicide (adulthood)

38
Q

What are pregnant women with a BMI over 30 more at risk of?

A

Higher gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) rate
Higher chronic hypertension rate
Higher cesarean section rate
Higher preterm birth and PROM rate
Higher meconium-stained amniotic fluid rate
Higher LGA infant rate
More frequent low APGAR scores at 1 and 5 min
Higher perinatal death rate, hypoglycemia and the newborn ICU requirement
Higher infection rate

39
Q

What are pregnant women who are under BMI of 18.5 at risk of?

A 
Higher placental abruption rate
Higher vaginal delivery rate
Higher SGA (small gestational age) infant rate
40
Q

Between what weeks in pregnancy do all major organs start to develop?

A

Between week 3 to 5.

41
Q

What changes about a pregnant women’s blood?

A

During pregnancy cardiovascular system needs to adapt to supply large organs and maintain blood suplly to placenta ensuring foetal nutrient supply so overall blood volume increases. When this hsappens compostition of blood changes, mainly plasma increases reducing proportion of proteins notably albumin (involved in plasma pressure and transport in blood). To meet increased demands of oxygen support haemoglobin increases but is still lower than before, so harder to diagnos anemia.

42
Q

Renal changes in a pregnant women?

A

Need to pee more often but volume has not increased this is in response to blood and cardiovascular changes (increased plasma)

43
Q

Respiratory changes in pregnant women?

A

Diaphragm has a greater range of motion, ribs flair outwards at the bottom so greater amount of air inhaled and expelled. Later on foetus growth starts to get in the way but efficiency is maintained.

44
Q

Insulin issues in pregnancy and how are the overcome?

A

Hormones in pregnancy cause some insulin resistance but in 2nd 3rd trimester insulin is 2.-2.5 times higher, some do still develop gestational diabetes though.

45
Q

What is the factorial method of generating requirements for pregnant women?

A

Non-pregnant Requirement + increased requirements (increased body mass) - decreased requirements (decreased physical activity, nutrient losses, increased absorbtion)

46
Q

Requirements for calcium?

A

mobilisation of calcium stores and increased calcium absorption suggest no additional Ca required
Adolescent pregnancy - supplements required as both mother and foetus require extra calcium

47
Q

Requirements for zinc?

A

adaptive response - no additional requirements

48
Q

Nutrition support for NVP in order of which they would be tried?

A

Oral nutrition, nasogastric tube, nasojejunal tube (goes past stomach), parentenal nutrition (needle in arm nutrition).
More permanent options: Percutaneous Endoscopic Gastrostomy (tube straight frm stomach wall) and Percutaneous Endoscopic Gastro Jejunostomy (tube from stomach t jejunum)

49
Q

Constipation and hemorrhoids causes in pregnancy and recommendations?

A

Progesterone slows peristaltic action of smooth muscles in bowel
Enlarging uterus displaces internal organs (disrupts movement through the GI tract)
Recommendations:
Increased fluid intake
High fibre diet
Increased physical activity

50
Q

Risks for gestational diabetes?

A

Ethnicity, over 40, previous elevated blood glucose, previous gestational diabetes, Family history of diabetes (1st degree relative (parents) with diabetes or sister with GDM), polycystic ovary syndrome, previous perinatal loss (miscarriage), multiple pregnancies, BMI over 30, previous large birth weight baby, Medications (corticosteroids (steriods), antipsychotics)

51
Q

What is toxoplasmosis, what can it lead to, food items that can cause it?

A 
Toxoplasmosis - parasite infection
foetal abnormalities, blindness, mental retardation
avoid- raw/ undercooked meat
unpasteurised goats milk/ milk products
unwashed fruit and vegetables
cat faeces
52
Q

What is listeriosis? major sources? results in?

A 
Listeriosis
Food poisoning monocytogen
Major sources:
 raw/ undercooked meat
unpasteurised milk/cheese
Results in: 
Brain damage
53
Q

What puts pregnant women at risk of toxoplasmosis?

A

Unwashed fruit and veg

NUT2005 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions