Pre-Pregnancy Care ✅ Flashcards
What areas is advice given regarding to prospective mothers?
- Smoking in pregnancy
- Folic acid supplementation
- Vitamin D supplementation
- Medications
- Alcohol ingestion and drug abuse
- Congenital rubella
- Toxoplasmosis
- Listeria infection
- Eating liver
- Fish
- Pre-existing conditions
- Risk of fatal abnormality
What advice is given regarding smoking in pregnancy?
Avoid
Why should smoking be avoided in pregnancy?
- Reduces birth weight
- Increases risk of pregnancy related complications
- Increases risk of certain diseases in child
When is a reduction in birth weight caused by smoking particularly important?
If there is IUGR
What pregnancy related complications does smoking increase the risk of?
- Miscarriage
- Stillbirth
- Preterm delivery
What conditions in the child does smoking increase the risk of?
- SIDS
- Wheezing
- Asthma
- Bronchitis
- Pneumonia
- Otitis media
- Psychological problems, e.g. attention and hyperactivity problems
When should folic acid supplementation be taken in pregnancy?
Before conception and throughout first 12 weeks of pregnancy
What is the purpose of folic acid supplementation in pregnancy?
Reduces risk of neural tube defects (NTD)
Give 2 examples of NTDs?
- Anencephaly
- Spina bifida
Is eating folate rich foods sufficient in pregnancy?
May help but is often insufficient
What is recommended in mothers who are at higher risk of NTDs?
Higher dose supplements
What might indicate someone is at higher risk of having a child with a NTD?
- Previous NTD pregnancy
- Family history (including partner)
- Maternal diabetes
What programme exists to help women access folate acid supplements?
Healthy Start Programme
What does the Healthy Start Programme provide?
Free vitamin supplements (folic acid and vitamins C and D)
Who receives free supplements under the Healthy Start Programme?
Low-income pregnant women and those who have an infant less than 1 year
What is advised regarding vitamin D in pregnancy?
Advised for all women planning to breastfed their infants
What is the role of vitamin D in pregnancy?
It is required for fetal bone mineralisation and accumulation of infant vitamin D stores
What is a newborns vitamin D status determined by?
Largely the mother’s level of vitamin D during pregnancy
Is breastmilk a significant source of vitamin D?
No
What is the main source of vitamin D?
Sunlight
Why are many people deplete of vitamin D in the UK?
For a significant number of months in the UK, there is little ambient UV sunlight of an appropriate wavelength
What advice is given regarding medication use during pregnancy?
- Avoid medications with teratogenic effects
- All medications should be avoided unless essential
What advice should be given regarding alcohol and drug abuse during pregnancy?
Avoid
What advice should be given regarding congenital rubella in hopeful mothers?
Can prevent by maternal immunisation before pregnancy
What advice should be given regarding toxoplasmosis in pregnancy?
Minimise exposure by avoiding eating undercooked meat and wearing gloves when handling cat litter
What advice should be given regarding listeria infection during pregnancy?
Avoid eating unpasteurised dairy products, soft ripened cheeses, e.g. brie, camembert, and blue-veined varieties, pates, and ready-to-eat poultry
What advice should be given regarding eating liver in pregnancy?
Best avoided
Why is it best to avoid eating liver during pregnancy?
As it contains high concentrations of vitamin A
What should be advised regarding eating fish during pregnancy?
Avoid eating;
- Swordfish
- Shark
- Marlin
- Tuna
- Oily fish
Why should you avoid eating shark, swordfish, marlin, and tuna during pregnancy?
They may contain high levels of mercury
Why should you limit eating oily fish during pregnancy?
They may contain pollutants such as dioxins
What advice should be given regarding pre-existing conditions in pregnancy?
Optimise control of conditions such as diabetes and epilepsy
What should be done if there is an increased risk of fetal abnormality
Genetic counselling
What might indicate an increased risk of fetal abnormality?
- Previous congenital abnormality
- Positive family history
- Parents being known carriers of genetic disorder
- Ethnic group with increased risk
Give an example of an ethnic group that are at an increased risk of a genetic disorder
Ashkenazi jews are at increased risk of Tay-Sachs
