Beruflich Dokumente
Kultur Dokumente
2013
weight (current and amount of change)
normal wt gain = 1lb/week
OVERVIEW
I.
II.
III.
Symptoms
headache, altered vision, abdominal pain, N&V, bleeding,
vaginal fluid leakage and dysuria
Height of uterine fundus from top of symphysis (in cm)
Vaginal exam (late pregnancy)
a) confirmation of the presenting part and its station
b) clinical estimation of pelvic capacity and its general
configuration
clinical measurement of passage way
c) consistency, effacement and dilatation of cervix
3) Incompetent cervix
4) Prior fetal structural or chromosomal abnormality
May have chance of recurrence
5)
6)
7)
8)
HR: 110-160bpm
NOTE: sounds like tickling WATCH under a pillow. Hindi CLOCK!
DROPPER US often used at 10th week
3. SONOGRAPHY
1st trimester part of aneuploidy screening
2nd trimester fetal anatomy
NOTE: note required pero kung mapilit kelangan mo irespeto yung
pasyente, magkakapera ka pa haha
PRENATAL SURVEILLANCE
FETAL evaluation:
heart rate
size
current and rate of change
assess fundic height
some women undergo diet because they dont want their
baby to be big (to avoid CS)
C. GONOCOCCAL INFECTION
same with Chlamydia
early prenatal visitor 3rd trimester
D. GENETIC DISEASES SCREENING
depends on ethnic or racial background
NUTRITION
MATERNAL
blood pressure
Anak
ng Dilim
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2013
D. PROTEINS
metabolized rather than spared
required for demands in fetal growth, remodelling, placenta, uterus,
breast as well as increased maternal blood volume
1000g are deposited during second half of pregnancy
Thus, 5-6g/day
Ornithine, glycine, taurine, proline
Glutamate and alanine
Milk and other dairy products are ideal sources for pregnant and
lactating women
E. MINERALS
All diets that supply sufficient calories will contain enough minerals to
prevent deficiency when iodized food are ingested
1) IRON
Needed during the 2nd trimester
Hematopoiesis occurs
27 mg per day Singleton
60 - 100 mg per day for:
a. Large women
b. Twin pregnancies
c. Anemia
2) CALCIUM
RDA 1000 to 1300 mg/day
For replenishment of bone calcium
Lesser chance of developing osteoporosis (esp. during
menopause)
OVERNUTRITION
3) ZINC
RDA 12 mg
Deficiency may lead to:
a. Poor appetite
b. Suboptimal growth
c. Impaired wound healing
SEVERE UNDERNUTRITION
birthweight can be inuenced signicantly by starvation during later
pregnancy
The perinatal mortality
incidence of malformations signicantly increased
frequency of pregnancy toxemia
severe dietary deprivation during pregnancy caused no detectable effects
on subsequent mental performance
Progeny exposed in mid to late pregnancy dietary deprivation:
lighter, shorter, and thinner at birth
higher incidence of subsequent diminished glucose tolerance,
hypertension, reactive airway disease, dyslipidemia, and coronary
artery disease.
Early pregnancy exposure was associated with:
obesity in adult women but not men
central nervous system anomalies, schizophrenia, and
schizophrenia-spectrum personality disorders.
4) IODINE
RDA 200 ug
Deficiency may lead to:
a. Maternal subclinical hypothyroidism
b. Cretinism & neuro-development defects
Common among high-landers
5) MAGNESIUM
no known effect when deficient
THIAMINE (B1)
RDA 1.4 mg
EFFECTS OF NUTRITION
RIBOFLAVIN (B2)
RDA 1.4 mg
NIACIN
RDA 18 mg
PYRIDOXINE (B6)
RDA 1.9 mg
Combined with doxylamine (anti-histamine)
reduce vomiting, hyperemesis gravidarum
Avoid triggering factors like odor
Small frequent meals if gets nauseous easy
C. CALORIES
Requires additional 80,000kcal
accumulated at last 20 weeks
Increase of 100-300kcal/day
Anak
ng Dilim
VITAMIN A
RDA 750 to 770 ug
Potentially teratogenic
Can be found in acne or dematologic meds
Isotretinoin, retinoic acid
topical preparations only reach the blood stream at minute
amounts, some tend to get stored in adipose tissue for as
long as 5 years
Deficiency may lead to:
a. Anemia
b. Spontaneous preterm birth
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2013
CYANOCOBALAMIN (B12)
RDA 2.6 ug
Only present from animal sources
Deficiency neural tube defects
If vegetarian, give B12 supplements instead
CAFFEINE:
Caffeine intake < 300 mg daily or 1cup/day
VITAMIN C
RDA 80 85 mg
VARICOSITIES
COMMON CONCERNS
HAEMORRHOIDS
EMPLOYMENT
EXERCISE:
FISH CONSUMPTION:
Due to posture
Reduced w/ squatting than bending
Provide back support
Avoid high-heeled shoes
Avoid fish wi/ potentially methylmercury lvls (skin & belly fat of fish)
Not more than 12oz of canned tuna per week
Not more than-6oz of albacore/white tuna
Avoid bottom dweller fish because mercury gravitates towards the sea
floor
Attacks nerves
Tremors
Mercury in fluorescent lamps
LEDs now used & CFCs
TRAVEL:
A. Automobile:
Lap belt portion: under the abdomen and across the upper thighs
Shoulder belt between the breasts
HEARTBURN
Most common complaints of pregnant women
Low peristalsis due to pregnancy hormones
caused by reflux of gastric contents into the lower esophagus
relieved by a regimen of more frequent but smaller meals and avoidance
of bending over or lying flat
Antacids may provide considerable relief.
Aluminum hydroxide, magnesium trisilicate, or magnesium hydroxide
alone or in combination are given
Rx topical anesthetics, warms soaks, stool softeners, high fiber diet
Dont sit in the toilet kung hindi ka naman talaga natatae (feelingera)
PICA
Cravings of pregnant women for strange foods
craving for non-food:
Ice pagophagia
Starch amylophagia
Clay geophagia
* triggered by severe iron deficiency
NOTE: if strange foods dominate the diet, iron deficiency will be
aggravated or will develop eventually
PTYALISM
B. Air travel:
Safe to travel up to 36 weeks
Airline policy: no travelling if 7 months AOG
Excessive salivation
Stimulation of the salivary glands by the ingestion of starch
COITUS
Generally safe (if no preterm labor)
Oral-vaginal intercourse causes air embolism from partner blowing air
inside vagina, thus harmful
Missionary nalang kasi hahaANO BAY YAN! haha
LEUKORRHEA
DENTAL CARE
IMMUNIZATION:
CORD BLOOD BANKING
Vaccine
TT1
TT2
TT3
TT4
TT5
Anak
Minimum age/interval
As early as possible during pregnancy
At least 4 wks later
At least 6 mos. Later
At least 1 yr. later
At least 1 yr. later
ng Dilim
% protected
80
95
99
99
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