Pregnancy Flashcards
(23 cards)
Pregnancy Stages
- Blastogenesis stage (2 weeks): Fertilised ovum divides and implants itself in the uterus.
- Embryonic stage: Principal organs / membranes develop.
- Foetal stage (3 rd month til term): The most rapid period of growth. Pregnancy is often divided into trimesters (13 week periods).
Pregnancy: Supplements
Protein
Calcium
Magnesium
Iron
Vitamin A
Vitamin D
EPA/DHA
Pregnancy Supplements: Protein
Needed to support foetal, placental and maternal tissue growth.
Extra 6-10g per day
Pregnancy Supplements: Calcium
Dose: 1000mg/day
- Important for: Ossification of the foetal skeleton, teeth and neural development, and protection of maternal bones.
- Low maternal levels are associated with ↑ risk of pre eclampsia.
Pregnancy Supplements: Magnesium
Dose: 360-400mg
- Increased need in pregnancy and lactation.
- Deficiency increases risk of pre-eclampsia, foetal growth retardation, pre-term labour, metabolic dysregulation and SIDS.
Pregnancy Supplements: Iron
- Increased requirements to meet the growth demands of the foetus and placenta, and to support increased material production of erythrocytes.
- Essential for oxygen transport.
Pregnancy Supplements: Vitamin A
- Required for foetal growth, development of vision, hearing, immune and respiratory functions.
- It is neurogenesis in the embryo and control of neural plasticity.
- Pre formed vitamin A in excess of 10,000 IU has teratogenic effects so source from beta carotene in pregnancy.
Pregnancy Supplements: Vitamin D
- Vitamin D is especially important for calcium homeostasis, cell differentiation and immune function.
- Deficiency can affect a child’s bone health, brain development and Type 1 diabetes
- Low vitamin D can ↑ pre eclampsia risk.
Pregnancy Supplements: EPA/DHA
Adequate levels of EPA and DHA are especially important for neurodevelopment and are associated with:
* Healthy birth weight.
* Increased gestational length.
* Healthier BMI.
* Improved infant visual performance
* Lowered allergic response.
* Better mental processing.
Reduce 4 weeks before due date due to anti-coagulant effect.
Gut flora in pregnancy and birth
- Colonised by birth canal breastfeeding
- Excessive pre-pregnancy weight or excessive weight gain during pregnancy can lead to gut flora changes (↑ bacteriodes , ↑ E.coli, ↓ bifido ..) -> these alterations can predispose the child to obesity.
- Supplementation of 10 billion Lactobacillus rhamnosus GG 4 weeks before labour to 6 months postpartum can moderate weight gain and reduce eczema development in the infant in later life.
Pregnancy: Probiotics and optimising gut flora
- Probiotic supplementation of Lactobacillus rhamnosus GG and Bifidobacterium lactis has a protective effect against allergy development
Other ways to encourage optimal gut flora:
* Natural childbirth and breastfeeding.
* Avoidance of antibiotic use.
* Pets in the home.
* Avoidance of hyperclean environment (‘hygiene hypothesis)
* Outdoor activities let children play outside and eat dirt!
Morning sickness: Contributing Factors
- Rising hCG levels in first trimester (higher in women with twins or with hyperemesis gravidarum (severe / prolonged vomiting).
- High oestrogen
- Enhanced sense of smell.
- Poor nutritional status and poor blood sugar control.
Morning sickness: Prevention
- Take supplements with food.
- Stay hydrated.
- Make time to relax and sleep during the day.
- Try acupressure at the P6 point on the wrist.
- Try sepia 30C or Nux . vomica 30C
- 25mg of vitamin B6, three times a day for four days.
- Ginger (e.g., ginger tea).
- Eat smaller, frequent meals including
Pre-eclampsia
Pregnancy induced hypertension associated with protein in urine and oedema.
* Affects women around 20 weeks of pregnancy.
Pre-eclampsia: Risk factors
- Advanced maternal age (40+)
- First pregnancy
- Twin pregnancy
- Family history,
- Hypertension
- Chronic autoimmune disease
- BMI >35.
- Low serum levels of calcium, magnesium, zinc, vitamin D and omega 3s have been associated with ↑ risk of pre eclampsia.
Pre-eclampsia: Symptoms
- Water retention
- Severe headaches
- Vision problems
- Pain below ribs.
Pre-eclampsia: Complications
- Orthodox treatment is to give birth between 37-38 weeks.
Complications:
* Poor foetal growth
* Eclampsia (fits)
* Stroke
* Organ problems, liver and blood clotting disorder HELLP.
Pre-eclampsia: Supplementation
- 2 g calcium in second and third trimester.
- 200 mg CoQ10 from week 20 onwards.
- 500-750 magnesium (although reduce in third trimester as it can interfere with contractions).
Gestational diabetes mellitus (GDM)
- Affects 2-5% of pregnant women and occurs when pregnancy hormones make the body insulin resistant.
- It has been associated with ↑ chance of mother and infant developing diabetes mellitus.
- Increases risk of larger birth weight, caesarean
birth and neonatal hypoglycaemia.
GDM: Risk factors
Risk factors include family history of diabetes and obesity, history of large birth weight.
GDM: Treatment
- Low GI diet, daily exercise (e.g., a walk after meals) and possible supplementation of 4-8 mcg x kg of chromium picolinate.
Pregnancy: Heartburn
Relaxin allow the muscles in the oesophagus and restricted space for the digestive organs.
- Avoid trigger foods: Spicy foods, chocolate, caffeine, tomatoes.
- Avoid eating before bed. Raise the head of the bed with a wedge shaped pillow and sleep on the left side (right side will position the stomach higher than the oesophagus).
- Consider taking alkalising salts between meals or pasteurised apple cider vinegar.
- Manual therapy (e.g., osteopathy) to release the diaphragm.
Pregnancy: Constipation
Constipation occurs from enlarging uterus reduced digestive organ space). Also the increase in progesterone relaxes the intestinal muscles.
- Increase fluids and fibre rich foods.
- Consider ground flaxseeds mixed in water (caution: Large amounts of flaxseeds can affect hormone levels as they are oestrogenic).
- Probiotic rich foods or probiotic supplementation
- Supplement with magnesium citrate.
