Pregnancy Conditions and Interventions Flashcards
obesity can increase the risk of a child developing ______ later in life
overweight/obesity
type 2 diabetes
pregnancy after bariatric surgery should be avoided for _____ due to ______
several years
nutrient deficencies
interventions for pregnancy after bariatric surgery ?
assessment of dietary intake, supplement use, and measurements of nutrient stores at every trimester
hypertensive disorders of pregnancy
chronic hypertension
preeclampsia-eclampsia
gestational hypertension
hypertensive disorders affect ____% of pregnancies
5-10%
Hypertension in pregnancy is related to _______
inflammation
oxidative stress
damage to endothelium of blood vessels
consequences of damage to endothelium
restriction of placental blood flow
increased tendency to clot
atherosclerotic plaque formation
chronic hypertension is when it doesn’t go away after pregnancy or was there before and is defined as systolic BP of ____ and diastolic BP of _____
systolic ≥140 mm Hm
diastolic ≥90mm Hm
____% of women will develop preeclampsia
20%
nutrition interventions for chronic hypertension
if sodium reduction helps before you can stay with that as long as u don’t go under 1500 mg
do not go low sodium if u weren’t already, it is not proven to help during pregnancy
What is preeclampsia
after 20 weeks gestation
increased blood pressure (140/90 or above)
proteinuria (more than .3 g protein excreted in 24 hrs)
what is eclampsia
seizures late in pregnancy in a women with preeclampsia
preeclampsia affects __________ with blood vessel spasms and constriction of blood flow, insulin resistance, high TG and FFA
placenta
maternal kidney
baby liver
baby brain
signs and symptoms of preeclampsia
hypertension
proteinuria
low urine output
sever and persistant headache
sensitive to light
abdominal pain
nausea
cause of preeclampsia
unknown but think it originates from abnormal implantation of placenta
cure to preeclampsia
deliver the baby
nutrition interventions for preeclampsia
1000-2000 mg/day of dietary or supplemental calcium
adequate fiber, fruits, and veggies
avoid high dose iron supplements
moderate exercise
what is gestational hypertension
hypertension diagnosed after 20 weeks of pregnancy
NO proteinuria
what is gestational diabetes
diabetes diagnosed in pregnancy that is clearly not chronic diabetes
high maternal BG = increased fetal BG = more fetal insulin production = increases glucose uptake and TG formation in fetus
outcomes associated with gestational DM in mother
increased risk for type 2 diabetes, hypertension, and obesity later in life
increased risk for gestational DM in next pregnancies
outcomes in baby associated with gestational DM
macrosomia (weigh more than 10 lb)
neonatal hypoglycemia
increased risk of insulin resistance, type 2 DM, HTN, and obesity later In life
how do they test for gestational diabetes
between 24-28 weeks, all pregnant women are given a 75 gram, 2 hr oral glucose tolerance test (OGTT)
after first test for GDM if one of the plasma glucose values exceeds these, you have to come in for another test, and if it does it again they diagnose you. what are the values?
fasting ≥92 mg/dl
1 hr ≥180 mg/dl
2hr ≥153 mg/dl
how do they manage gestational diabetes
first with diet and exercise
if that doesn’t work in the 2 weeks after, they will add insulin injections
nutrition recommendations for GDM
- 3 regular meals and several snacks including bedtime snack
- whole grain breads, cereals, veggies, fruits, high fiber foods
- limit intake of simple sugars
- emphasis on unsaturated fats
- foods with low glycemic index
monitoring of gestational diabetes invloves _____
urinary ketone testing
postpartum follow up bc 10-15% develop type 2 within 2-5 yrs
women who have GDM should have screening every ____ years and may take lifestyle interventions and ______ to prevent DM
3 years
metaformin
mother with type 1 diabetes is at risk of
kidney disease
HTN
preeclampsia
newborn of other with diabetes type 1 have risk for ________
hypoglycemia at birth
LGA or SGA
preterm delivery
congenital malformations
mortality
interventions for type 2 diabetics getting pregnant
replace DM medications with insulin before conception
maintain BG levels
risks associated with type 2 diabetes in pregnancy
maternal hypoglycemia
- miscarriage
- congenital anomalies
hyperglycemia
- high blood ketone levels (blood glucose >200 mg/dl)
- diabetic ketoacidosis, which can decrease intelligence or increase fetal mortality
dizygotic twins
fraternal
2 eggs are fertilized
70% of twins
different DNA (genetic “fingerprints”)
hereditary
monozygotic twins
identical
1 egg fertilized and splits
30% of twins
always same sex
same DNA
not influenced by heredity
in twin pregnancy how much should normal, overweight, and obese women gain
normal: 37-54 lb
overweight: 31-50 lb
obese: 25-42 lb
rate of weight gain in twin pregnancy
5-7 lb in 1st trimester
1-2 lb per week in 2nd and 3rd trimesters
weight gain in triplet pregnancy
50 lb result in healthy sized triplets
1.5 lb per week from beginning of pregnancy
for twin pregnancy increase calories by _____
450
what is hyperemesis gravidarum
severe nausea and vomitting during much of pregnancy
____% of women have hyperemesis gravidarum
1-2%
risks in hyperemesis gravidarum
dehydration
ekectrolyte imbalances
inadequate weight gain
ketosis
- small infants
treatment goals of hyperemesis gravidarum
adequate weight gain and preventing hospitalization
management of hyperemesis gravidarum
6 small meals/snacks during the day
hydration with water or caffeine-free beverages
ginger or gingerale
limit high fat foods, which worsen naesua
easy to digest foods
treatment of HIV and AIDS in pregnancy
needed before, during, and after pregnancy to try not to pass on to baby
goals in pregnant women with HIV/AIDS
educate on food safety
maintain positive nitrogen balance and preservation of lean muscle and bone mass
______ is the most common ED seen in pregnant women in the US
bulimia
eating disorder symptoms in pregnancy
subside in 2nd and 3rd trimester but return postpartum
nutritional interventions for pregnancies with eating disorders
weight gain
improve nutritional status
educate on needed behavioral changes and rationale of “for the baby”
alcohol disorders include….
alcohol-related developmental disorder
alcohol-related birth defects
fetal alcohol syndrome
alcohol easilt passes across the placenta to the fetus and stays in feal circulation longer bc ______
they dont have the enzymes to metabolize it
most severe form of FASD is characterized by
- abnormal facial features
- growth problems
- intellectual disability
- flat midface
- upturned nose
- small eyes
- small chin
dietary recommendations for pregnant adolescents
calorie intake is increases more for asolescents that are pregnant
