5) Hygiene and nutrition in pregnancy. Gestational age and fetal weight estimation formulas. Flashcards
what are main stations in the hygiene pregnancy we touch upon
REST AND SLEEP - strenuous work should be avoided especially the first trimester and the last 4 weeks
HABITS
PHYSICAL ACTIVITY
OCCUPATION
CLOTHING
DEFACATION AND
MICTURINATION
SEXUAL LIFE
DENTAL MOUTH AND CARE
MAMMARY GLANDS
IMMUNISATION DURING PREGNANCY
vaginal discharge - local cleanliness important and if infection immediate local treatmnet
WHAT ARE THE CONTRADICTED BAD HABITS IN PREGNANCY ?
not to smoke , drink or take drugs
why is alcohol contraindicated in pregnancy ?
alcohol can diffuse through placenta - embryo fetal alcohol syndrome - reduced birth weight , body length , head circumference , development delay , malformation of face , brain and skull
why is smoking contraindicated in pregnancy ?
smoking reduces the blood flow to the uterus and placenta -
USUALLY babies born to smokers are always small
other risks from smoking:
PROM
miscarriage
placental abruption
eclampsia/ pre -eclampsia
linked to sudden infant death syndrome and perinatal mortality
What are the worrying matters in physical activity of a pregnant women
should be moderate , if its excessive it will be too much stress to your, if you do not exercise than the chance of have thrombus is high
how much physical activity is recommenced for a pregnancy women
it is recommended to go walking twice a day
occupational wise what are the stuff to avoid
areas with high radiation , chemicals , poisons , same goes for extreme temperatures
especially dangerous is vibration diseases
why is vibration really dangerous?
vibration can cause contraction of the uterus - leading to abortion and premature pregnancy
what should we take care of in clothing
clothing should no put pressure non the abdomen , neither should women wear tight clothing on their legs - because it can cause varicose veins and swellings
why is constipation common in pregnant women ?
hormones such as progesterone that relax the intestinal muscle and the pressure of the expanding uterus on the intestines
what is given for constipation
laxatives, fluid fruits and vegetables
why is the frequent urination in the beginning of pregnancy ?
in the beginning of pregnancy first trimester -hCG increases the blood flow to the pelvic area , and your kidneys
there is also an increased blood volume
and also pressure on the bladder to the expanding uterus
when does urine production peek then drop down and why does it drop down
increased urine production peaks to week 9-16 then settles down , because your kidneys adapt
in the third trimester the urine production increases again after going down why is that ?
because the uterus pushes down on the bladder ,and the end of third trimester when the baby’s head moves to the pelvis it presses into the bladder more.
why should sex in pregnant women be careful ?
sex increases uterine contractions - due to release of prostaglandins and oxytocin
dangerous for women predisposed for miscarriages or premature delivery
protect the front uterine wall - abdominal wall from pressure during intercourse
why is pregnant women predisposed to caries and gingivitis
the hormonal changes increase the blood flow to gum tissue causing the gums to be more sensitive, irritable and swollen ,
caries due to -vomitting , change in saliva and mouth flora
what are the hygiene standard that needs tone taken care of for mammary glands
good hygiene of mammary glands mandatory - wash with water and soap regularly , massaging it can help develop glandular parenchyma
if there is inverted nipples you should not stimulate it a lot to make it flatter why ?
nipples can cause increased uterine contractions - thus careful in women with predisposition to misscarriage or premature delivery
why are flu vaccination recommenced in pregnant women
flu can be dangerous in early embryogenesis
what is the normal average weight gain in pregnant women
a gain in 9-12 kg
eating well and this weight gain in pregnancy ensures what ?
ensures the normal development if the fetus which grows 400-500g per week especially during 2nd half of pregnancy
if the women tries to fight this weight gain what can it lead to ?
this will lead to malnutrition - giving low birth weight
during the whole pregnancy women are supposed to have additional how many calories
additional 80,000kcal whole gestation, approx 300kc per day
women’s diet should ensure which key elements ?
vitb12 and folic acid enough fruit and vegetables
folic aid - 4 weeks prior to conception to 12 weeks of gestation - decrease in rural tube defects
what types of food should be avoided in pregnancy?
spicy food , fat food , fried food and burnt food should be minimised
at the end of pregnancy protein intake increases to ?
70-80g daily
deficiency in protein intake can lead to?
damage of the CNS of fetus
what are the methods for estimating gestational age ?
LMP is the most reliable parameter for estimation of gestational age
calculate due date
Date of fruitful coitus 266 days are to be added to the date of the single fruitful coitus
Naegele’s formula: Provided the periods are regular
Add seven days to the first day of your LMP and then subtract three months
or adding 9 calender months and 7 days to the last day of LMP
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the US is the best
first trimester
US : crown rump length
CRL in cm + 6.5 = weeks of pregnancy
Gestation sac mean diameter — ( 5-7 weeks weeks formed)
2nd trimester
US : BPD, HC, AC and FL measurement. Most accurate when done between 12 and 20
weeks (variation ± 8 days)
3rd trimester
same as US in 2nd - however less reliable
variation ± 16 days
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Lightening- when the baby’s head literally “drops” lower into your pelvis = labor is likely to commence within 3 weeks
SFH
what is SFH ?
symphysis to fundal height
SFH used particularly in what period ?
after 24 weeks of gestation
discrepancy of SFH to gestational age needs to be how many cm ?
3cm
discrepancy of more 3cm in SFH is due to ?
fetus with growth problems , abnormal amniotic fluid , transverse lie , twin pregnancy ,uterine fibroid
when does SFH become unreliable ?
unreliable due to maternal obesity , twin pregnancy , polyhydromnios, or uterine leiyomyomas
when does does the CRL need to be replaced with head circumference value for age estimation ?
if CRL is above 8.4 cm - use head circumference value
compare these with standardised tables which correlate gestational week to CRL/ head circumference
what method is used estimating the weight of the baby ?
johnsons formula 155 x (fundal height in cm - K) k= 11 if at plus station k= 12 if to 0 station k = 13 if at minus station
applicable only in vertex presentation.
liquor amnii and thickness of the abdominal wall also plays a role
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US - better
Shepard and hadlock formula
what are the following parameters needed to use the shepard and haddock formula ?
with the help of ultrasound
biparietal diameter
head circumference
abdominal circumference
femur length
what are he immunisations recommended n pregnancy ?
routine tetanus toxoid and flu vaccine
LIVE VIRUS SUCH AS RUBELLA , MUMMPS , VARICELLA AND YELLOW FEVER, hep b, polio = are usually avoided even though there is no evidence having these vaccines causes birth defects so they can be used in pregency if there very high risk of getting infected
get MMR (mumps and rubella vaccine before pregnancy ) and hepatitis vaccine in a non immune woman offered
what are the minor ailments during pregnancy ?
backache due to
joint ligament laxity (relaxin, estrogen), weight gain, hyperlordosis and anterior tilt of the pelvis
Heartburn is common in pregnancy due to relaxation of the esophageal sphincter.
leg cramps - deficiency of diffusible serum calcium or elevation of serum phosphorus. Supplementary calcium therapy in tablet or syrup after the principal meals may be effective. Massaging the leg, application of local heat and intake of vitamin B1
varicose vein - no blood return due the enlarged uterus
elastic crepe bandage
elevation of limbs
carpel tunnel syndrome - compression the median nerve leading to pain and numbessof the thumb and index and middle finger
round ligament pain - stretching of round ligament during moving in pregnancy cause sharp pain to the groin
