MIDTERMS NDT LEC (PREGNANCY AND LACTATION)

Question 1

• 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

Answer 1

Gestation

Question 2

• fertilized ovum implants itself in the uterus and begins to develop
• occurs during the 1st 2 weeks of conception

Answer 2

1. Implantation period

Question 3

• 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

Answer 3

Source of nourishment :

Question 4

• smoking, drug abuse and malnutrition
• these will result to failure to implant
• Neural Tube Defect (NTD )

Answer 4

Adverse Influences are :

Question 5

• 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

Answer 5

2. Organogenesis

Question 6

• 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

Answer 6

3. Rapid Fetal Growth

Question 7

1. Achieve and maintain a healthy body weight.
2. Choose an adequate and balance diet.
3. Be physically active.
4. Avoid harmful influences.

Answer 7

HABITS TO ESTABLISH IN PREPARATION FOR A
HEALTHY PREGNANCY

Question 8

if the pregnant mother is underweight she is a high
risk of giving birth to a low birth weight (LBW) infant

Answer 8

Underweight Pregnant

Question 9

– infants have impaired growth and development
- prone to infection and disease
- will have lower adult IQ

Answer 9

LBW

Question 10

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.

Answer 10

Overweight or Obese Pregnant

Question 11

Underweight (BMI <18.5)

Answer 11

Recommended Weight Gain
28 to 40 lb (12.5 to 18.0 kg)

Question 12

Healthy weight (BMI 18.5 to 24.9)

Answer 12

Recommended Weight Gain
25 to 35 lb (11.5 to 16.0 kg)

Question 13

Overweight (BMI 25.0 to 29.9)

Answer 13

Recommended Weight Gain
15 to 25 lb (7.0 to 11.5 kg)

Question 14

Obese (BMI ≥30)

Answer 14

Recommended Weight Gain
15 lb minimum (6.8 kg minimum)

Question 15

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.

Answer 15

PREGANANCY WEGIHT GAIN BREAKDOWN

Question 16

• 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

Answer 16

Choose an adequate and balance diet

Question 17

1. ENERGY
2. CARBOHYDRATES
3. PROTEINS

Answer 17

NUTRITIONAL REQUIREMENT

Question 18

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.

Answer 18

ENERGY

Question 19

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.

Answer 19

CARBOHYDRATES

Question 20

+ 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

Answer 20

PROTEINS

Question 21

1. AI or RDA
   < 18 -80mg/day
   19-50 - 85mg/day

RATIONALE:
1. To prevent preeclampsia

Answer 21

VITAMIN C

Question 22

1. 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

Answer 22

THIAMIN

Question 23

Enriched or fortified whole grains and products

Answer 23

PYRIDOXINE

Question 24

1. 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

Answer 24

PYRIDOXINE

Question 25

1. AI or RDA
   600 mcg/ day

RATIONALE:
1. For blood volume increase
2. Development of new cells
3. To prevent Neural Tube Defect (NTD)

Answer 25

FOLIC ACID

Question 26

1. Inadequate folate
2. NTD on previous pregnancy
3. GDM
4. Use of anti-seizure medications
5. Maternal obesity
6. Exposure to high temperature (fever, hot tube use)
7. Race/Ethnicity- common among Hispanic people
8. Low economic socio status

Answer 26

FACTORS AFFECTING NTD

Question 27

2 KINDS OF NTD

Answer 27

1. ANENCEPHALY
2. SPINA BIFIDA

Question 28

• An uncommon and always fatal type of NTD
• Characterized by the absence of a brain

Answer 28

ANENCEPHALY

Question 29

• One of the most common types of NTD, characterized by the incomplete closure of the spinal cord and its bony encasement

Answer 29

SPINA BIFIDA