Pregnancy Nutrition Flashcards
what nutrition advice is given pre-conception
consumption of varies and balanced diet
supplements of:
- iron
- folic acid
- calcium
- iodine
- Vit D (10 micrograms through pregnancy and breast feeding)
- folic acid (400 micrograms pre-conception and T1)
polyunsaturated fatty acids
what groups are most at risk of lack of nutrition in pregnancy
Vegetarians Vegans Gluten free underweight overweight adolesence multiple pregnancies low income families smokers previous poor outcome pregnancies
why is folic acid given in pregnancy
plays crucial role in metabolic reactions and biosynthesis of DNA and RNA as well as amino acid metabolism
where in the diet is folic acid found
green leafy vegetables
fruits
cereals
offal
where in the diet is iron found
meat
fish
legumes
leafy green veg
why is extra iron needed in pregnancy
helps transfer oxygen to fetus
prevents anaemia
how much protein should be consumed in pregnancy
daily recommendations increased by 1g/day T1
8g/day T2
26g/day third trimester
why is vitamin D given in pregnancy
for calcium metabolism
regulation of cytokine metabolism
modulation of immune system
should you eat fish when pregnant
yes
2-3 servings per week recommended for optimal fetal development
maternal risks of vitamin D deficiency
osteomalacia pre-eclampsia gestational diabetes C-section bacterial vaginosis
fetal risk of vitamin D deficiency
Small for gestational age
Neonatal hypocalcaemia
Asthma/resp infection
Rickets
what foods should you avoid in pregnancy
Soft cheese Undercooked meat, cured meat, game Tuna Raw/partially cooked eggs Pate Liver Vitamin and fish oil supplements
by how much does exclusive breast feeding increase calorie need
640kcal/day
maternal risks of being underweight (<18.5 BMI)
nutritional depletion
Intrauterine growth restriction
Preterm labour
Low birth weight
how do you manage underweight pregnant mother s
exclude eating disorders
USS for growth 28, 32 and 36 weeks
labour management
- usually normal
- beware ‘normal blood loss’
- drug adjustments
what are the increased maternal risks of obesity
Infertility Risk of miscarriage Gestational diabetes Pre-eclampsia Thromboembolic disease Risk of infection Risk of labour dystocia Risk of shoulder dystocia Risk of C-section Risk of post partum haemorrhage depression/mental health issues reduced breast feeding
what are the increased risks to the fetus in obesity in pregnancy
fetal anomalies miscarriage macrosomnia still birth neonatal death less likely to be breast fed increased later life risk of T2DM and CVD
how to you manage obesity during birth
Consultant led unit Fetal monitoring difficulty (need USS to determine presentation) Iv access FBC, Group and save Early epidural bariatric bed ranitidine regularly 3rd stage - IM syntometrine (oxytocin) into deltoid
how do you deliver a baby if BMI >40
consultant obstetrician and anaesthetist operate (CS)
extra prophylactic antibiotics given
Anticipate post partum haemorrhage
management of obese women post-partum
extra monitoring if sleep apnoea
thromboprophylacis - fragmin given (dose weight dependent)
support breast feeding
weight management
wound problems
what is the risk involve in pregnancy if the mother has had bariatric surgery
nutritional deficiencies
hyperemesis
high risk of GDM
how do you manage bariatric surgery patients in pregnancy
supplements and monitoring is essential
- A-Z supplements
- adcal D3
- Vit D
- Iron
- Thiamine
- Folic acid
- Vit B12
avoid oral contraception
what are some sources of iron for a vegetarian
pulses dark green veg wholemeal bread eggs fortified breakfast cereals dried fruit eg. apricots
how do you manage gestational diabetes
usually with diet and lifestyle alone
exercise v helpful
