Nutrition in Pregnancy

Question 1

What supplements should be taken pre-conception?

Answer 1

400mcg folic acid

Question 2

What supplement should be taken through pregnancy and continued if breast feeding and why?

Answer 2

Vit D 10mcg/day, List

helps with fatigue, weight problems, mood problems, digestive problems and immune impairment

Question 3

smoking during pregnancy is associated with lower levels of DHA. What is this?

Answer 3

omega-3 fatty acid that is an important structural component of human Brian, skin and retina

Question 4

What patients should take 5mg of folic acid?

Answer 4

obese women,
diabetic patients,
history of abby with NTD or FH,
on anti-epileptics

Question 5

Where are folates found naturally in diet?

Answer 5

green leafy veg,
oranges,
cereals

Question 6

Why is iron intake very important in pregnant women?

Answer 6

anaemia v common and iron is involved in numerous enzymatic processes, increased risk of still-birth in severe deficiency

Question 7

Who is at most risk of low iron in pregnancy? (3)

Answer 7

young age at first pregnancy,
repeated pregnancies,
multiple pregnancies

Question 8

How much should calorie intake be increased in first trimester, second trimester and first 6 months of breastfeeding?

Answer 8

first trimester: 70kcal.day,
second trimester: 260-500kcal.day,
third: 250-500kcal/day,
breastfeeding: 500kcal/day

Question 9

How much should protein intake be increased in first trimester, second trimester and third trimester?

Answer 9

first trimester: 1g/day,
second trimester: 8g/day,
third trimester: 26g/day

Question 10

How much fish is recommended during pregnancy per week?

Answer 10

2-3 servings

Question 11

maternal risks of low vitamin D? (5)

Answer 11

osteomalacia, 
pre-eclampsia, 
gestational diabetes, 
c-section, 
bacteria vaginosis

Question 12

Fetal risks of low vit D? (4)

Answer 12

SGA,
neonatal hypocalcaemia,
asthma/resp infection,
rickets

Question 13

List 7 foods that should be avoided in pregnancy?

Answer 13

soft cheese, 
undercooked meats, 
tuna, 
raw eggs, 
pate, 
liver, 
vitamin & fish oil supplements

Question 14

50% of women of child-bearing age in UK are overweight or obese. T/F?

Answer 14

The

Question 15

Why are women with low BMI <18.5kg/m 2 times more likely to take more than 1 year to get pregnant?

Answer 15

Due to hormonal imbalances

Question 16

Low BMI risks in pregnancy? (4)

Answer 16

maternal nutritional depletion,
fetal intrauterine growth restriction,
preterm labour,
LBW

Question 17

Antenatal management for woman with low BMI? (2)

Answer 17

exclude and manage ED,

USS for growth at 28, 32 and 36 weeks

Question 18

Labour management for woman with low BMI? (3)

Answer 18

Usually normal,
beware of blood loss as “normal” may be more for them,
may need to adjust drugs

Question 19

List 6 maternal risks of obesity

Answer 19

Basically everything increased!! 
miscarriage, 
gestational diabetes, 
pre-eclampsia, 
infection, 
labour dystocia, 
PPH

Question 20

List 5 fetal risks of obesity

Answer 20

increased risk of: 
fetal anomalies, 
macrosomia, 
miscarriage, 
still birth, 
less likely to be breastfed

Question 21

Management of obesity in pregnancy? (7)

Answer 21

folic acid 5mg till 12 weeks,
vit D10mg,
low dose aspirin (150mg daily from 12wks to delivery),
VTE score (fragmin from booking/12wks if needed),
OGTT 24-28wks,
USS growth from 28wks,
anaesthetic review 3rd semester if BMI >40

Question 22

Postpartum management in terms of thromboprophylaxis for obese women

Answer 22

Fragmine dose weight dependent and give for 6 weeks postnatal

Question 23

What are 4 common deficiencies in bariatric surgery?

Answer 23

vitamin D,
B12,
folate,
Fe

Question 24

What test may not be possible when checking for gestational diabetes mellitus in pregnant women who have had bariatric surgery? What should you do instead?

Answer 24

OGTT may be impossible,

do HBA1c, BG monitoring, fasting blood sugar

Question 25

Muslim women who are pregnant should avoid fasting and islamic law permits this. T/F?

Answer 25

T

Question 26

Food sources of Vit B12 (4)

Answer 26

milk,
cheese,
eggs,
fortified unsweetened soya drinks

Question 27

Sources of vita (4)

Answer 27

direct sunlight,
egg yolk,
some cereals,
most plant based spreads

Question 28

Majority of GDM needs to be managed by medication. T/F?

Answer 28

False! 80% can be managed by diet alone

Question 29

Why is exercise so important in GDM?

Answer 29

More glucose used by muscles for energy so BGs lower and insulin used more efficiently so BGs are maintained/lower