MIDTERMS NDT LEC (PREGNANCY AND LACTATION) Flashcards
- is the period from conception to birth
- that is 38 to 42 weeks or 9 months pregnancy
- divided into 3 trimesters
- has 3 events or periods
Gestation
- fertilized ovum implants itself in the uterus and begins to develop
- occurs during the 1st 2 weeks of conception
- Implantation period
- uterine substances (UTMP)
- glands in the endometrium ( the lining of the uterus) will secrete UTMP ( Uterine Milk Protein )
- progesterone will stimulate the glands to secrete UTMP
- estrogen causes endometrium to thicken to produce UTMP
Source of nourishment :
- smoking, drug abuse and malnutrition
- these will result to failure to implant
- Neural Tube Defect (NTD )
Adverse Influences are :
- period of organ formation
- occurs from 2 to 8 weeks after conception or next 6 weeks
- critical period when organs are formed and most vulnerable to adverse influences
- Organogenesis
- the last 7 months
- characterized primarily by growth in the number of cells and size of the organs until it can support extra uterine environment.
Source of nourishment : Placenta
Simple diffusion – passive process in w/c nutrients move from high concentration in the maternal blood to lower concentration in the fetal capillaries until equilibrium is reached.
- O2 ,CO2 , FA, Steroids , Nucleotides ,electrolytes
and Fat soluble vitamins
- Rapid Fetal Growth
- Achieve and maintain a healthy body weight.
- Choose an adequate and balance diet.
- Be physically active.
- Avoid harmful influences.
HABITS TO ESTABLISH IN PREPARATION FOR A
HEALTHY PREGNANCY
if the pregnant mother is underweight she is a high
risk of giving birth to a low birth weight (LBW) infant
Underweight Pregnant
– infants have impaired growth and development
- prone to infection and disease
- will have lower adult IQ
LBW
Birth defects - heart defects and neural tube defects (NTDs)
Problems with diagnostic tests — too much body fat leads to
inaccurate ultrasound results.
Macrosomia — In this condition, the fetus is larger than normal. Baby have a greater chance of being obese later in life.
Preterm birth — obese pregnant may developed preeclampsia, may lead to a medically indicated preterm birth.
Stillbirth - The higher the woman’s BMI, the greater the risk of stillbirth.
Overweight or Obese Pregnant
Underweight (BMI <18.5)
Recommended Weight Gain
28 to 40 lb (12.5 to 18.0 kg)
Healthy weight (BMI 18.5 to 24.9)
Recommended Weight Gain
25 to 35 lb (11.5 to 16.0 kg)
Overweight (BMI 25.0 to 29.9)
Recommended Weight Gain
15 to 25 lb (7.0 to 11.5 kg)
Obese (BMI ≥30)
Recommended Weight Gain
15 lb minimum (6.8 kg minimum)
BABY 7.5 LBS
ENLARGING UTERUS 2 LBS.
PLACENTA 1.5 LBS.
AMNIOTIC FLUID 2 LBS.
BREAST ENLARGEMENT 2 LBS.
EXTRA BLOOD AND FLUID VOLUME 8 LBS.
EXTRA FAT RESERVS 7 LBS.
TOTAL 30 LBS.
PREGANANCY WEGIHT GAIN BREAKDOWN
- malnutrition reduces fertility and impairs the early development of an infant.
- placental development, implantation, and early critical periods of embryonic and fetal development depend on maternal nutrition before and during pregnancy.
Dietary Management:
- Pinggang pinoy
- the basic food groups
Choose an adequate and balance diet
- ENERGY
- CARBOHYDRATES
- PROTEINS
NUTRITIONAL REQUIREMENT
Normal TER + 340 kcal on the start
of 2nd semester
Normal TER + 450 KCAL on the 3rd
trimester
Choose nutrient – dense foods
RATIONALE: To supply the
increased fuel, demanded by the
enlarged metabolic workload.
ENERGY
60 % of TER/ day
RATIONALE:
1. Necessary to fuel the fetal brain.
2. Fiber in CHO rich foods such as WG,V, F will help alleviate constipation.
3. To spare CHON for the added tissue-building requirement.
CARBOHYDRATES
+ 25g to normal CHON requirement/day
RATIONALE:
1. For baby’s rapid growth
2. For the development of the placenta
3. Due to the increase in maternal blood volume
4. Needed in the synthesis of Hgb and plasma CHON.
5. For the formation of amniotic fluid
6. For tissue storage reserve
PROTEINS
- AI or RDA
< 18 -80mg/day
19-50 - 85mg/day
RATIONALE:
1. To prevent preeclampsia
VITAMIN C
- AI or RDA (according to age)
<18 -1.4mg/day
19-50 - 1.4mg/day
RATIONALE:
1. For loss of appetite
2. For increase in metabolic workload
3. Prevention of beri-beri
4. To prevent leg cramps
RICHEST FOOD SOURCE
- Enriched or fortified whole grains and products
THIAMIN
Enriched or fortified whole grains and products
PYRIDOXINE
- AI or RDA
1.9 mg/day
RATIONALE:
1. To prevent nausea and vomiting
2. To prevent convulsion
RICHEST FOOD SOURCE
- Meats, fish, poultry, liver
- Potatoes,legumes, non-citrus fruits, soy products
PYRIDOXINE
