Pregnancy

Question 1

Advice for trying to get pregnant

Answer 1

Have sex every 2-3 days
Have sex during ovulation (12-16 days before period due)
Maintain healthy weight
Stop drinking alcohol
Stop smoking
Take folic acid

Question 2

Referral for trying to get pregnant

Answer 2

Trying for >1 year (80% chance of conception in 1 year).
You are taking teratogenic medicines
>36

Question 3

When to take pregnancy test

Answer 3

From first day of a missed period
If unsure of when this is, 21 days after UPSI.

Question 4

How do pregnancy tests work?

Answer 4

Detect hCG, a hormone which is produced 6 days after fertilisation

Question 5

If pregnancy test positive?

Answer 5

Consider your options
Visit a GP or sexual health clinic

Question 6

If pregnancy test negative?

Answer 6

Take another in a few days. False negatives more common than false positives.

Question 7

Which vitamins should you take in pregnancy?

Answer 7

400mcg/5mg folic acid - upto 12 weeks.
100 mcg Vitamin D
Iron (if anaemic)

Question 8

Which vitamins should you avoid in pregnancy?

Answer 8

Vitamin A

Question 9

What foods should you avoid in pregnancy?

Answer 9

Soft or blue cheeses
Cured meats
Pates
Liver
Rare/undercooked meats
Raw/partially cooked eggs which aren’t under British Lion or Laid in Britain scheme
No more than 2 oily fish or tuna
Smoked/cured fish

Question 10

How much caffeine can you have in pregnancy?

Answer 10

200mg a day

Question 11

Common pregnancy issues

Answer 11

Constipation
Indigestion
Incontinence
Back pain
Thrush
Stretch marks
Swollen feet/fingers/hands

Question 12

Key point for thrush in pregnancy?

Answer 12

Can still use pessary but advise to use finger to insert, not applicator, especially in later trimesters as can scratch cervix.
Do not supply oral fluconazole capsules OTC.

Question 13

Constipation in pregnancy OTC treatment?

Answer 13

Ispaghula husk (Fybogel) bulk-forming laxative (1st line) - 1 sachet in the morning and 1 in the evening after meals. Add to >150ml water and stir.
Can cause wind or bloating.

Question 14

Analgesics in pregnancy?

Answer 14

Paracetamol
Codeine not recommended but can be prescribed.
NSAIDs - not recommended, especially not in 3rd trimester

Question 15

Weight gain and stretch marks in pregnancy advice.

Answer 15

It is normal to gain 10-12.5kg.
Gaining more weight increases risk of stretch marks.
Don’t try lose weight while pregnant.
Have a healthy balanced diet
Stretch marks fade over time but may be permanent.
Use moisturisers, creams, and oils which can help prevent stretch marks.

Question 16

Urinary incontinence in pregnancy advice.

Answer 16

Pelvic floor exercises - tensing the muscles. See NHS website for tutorial.

Question 17

Heartburn in pregnancy advice.

Answer 17

DON’T advise to lose weight
Stop smoking
Don’t drink
Avoid spicy fatty foods
Have smaller more regular portions.

If lifestyle insufficient:
Advise using Rennie peppermint chewable tablets prn, max 10 a day. Don’t take within 2 hours of any medications or supplements as can impact absorption.

Question 18

Swollen hands/feet in pregnancy advice.

Answer 18

Avoid standing for long periods
Wear comfy shoes and socks
Raise feet when resting
Take regular walks or do foot exercises (rotate, stretching)

Question 19

Swollen hands/feet in pregnancy cause?

Answer 19

Body retains more water when pregnant and it gathers usually in the ankles/feet. Also pressure of womb can affect blood supply to legs which can increase swelling/

Question 20

Swelling in pregnancy red flags.

Answer 20

Pre-eclampsia symptoms:
Sudden increase in swelling of face, hands, or feet
Vision issues
Nausea and vomiting
Severe headache.