So I can't eat WHAT???!!?!
BIG FISH....
Shark, Swordfish, Bigeye Tuna, Tilefish (from gulf of mexico), Marlin, King Mackerel
Recommended weight gain of 11-20 lbs
What is a BMI > 30
BMI <18.5 - 28-40 lbs
BMI 18.5-25 - 25-35 lbs
BMI 25-30 - 15-25 lbs
"Doctor, do you see all of my gray hairs?? Can I go get my hair dyed even though I am pregnant?"
What do you respond?
ACOG states that this is fine after the first trimester.
High doses in chemical exposure resulted in birth defects in rodents...but its hard to get to this level of exposure
"Doctor, I know I'm 32 wks pregnant but I really want to fly home for the holidays, is this safe??"
Things that have been considered: cosmic radiation, x-ray machine at airport, airline regulations
Tuna is commonly know to contain harmful levels of ___________
MERCURY!
Two reasons:
- Big fish eat many small fish that have mercury
- Big fish live longer, so more time to accumulate
Eating an extra 300 calories/day during pregnancy (added to your baseline average diet), equates to about how much weight gain during your pregnancy?
An additional 300 calories/day amounts to about an average of 25-35 pounds over the course of the pregnancy
Pt presents with severe cystic or nodular acne. What are your options for treatment?
Can treat with benzoyl peroxide. Erythromycin and clindamycin can also be used.
Topical retinoids are still absorbed through skin, although at small levels than PO....but very weak evidence. Probably better to avoid.
True or False:
All alcohol must be completely avoided during pregnancy
FALSE
Probably 1 beer or 1 glass of wine is safe. However, hard liquor is not recommended.
Turns out that turkey meat is the biggest culprit. Other deli meats are dangerous if eaten cold (listeria THRIVES at cold temperatures). Can eat other meats (hot dogs, ham, salami, bologna) if meat is re-heated to steam.
Studies show that drinking 2 cups of this (8 oz/ea) is safe in pregnancy
What is coffee
Yes! Women do not have to completely avoid caffeine during pregnancy. Per ACOG and multiple studies, 2-8 oz cups of coffee are safe. Other studies show that up to 3-4 cups is PROBABLY safe.
Over 4 cups can have a link to miscarriage or LBW
Spina bifida and anencephaly have been linked to exposures to temperatures above _____F and provide 2 examples of these types of exposures.
Temperatures above 101F
1. Hot tub (usually 105F)
2. Hot yoga
Increased risk of:
Pre-term labor, problems with the placenta, LBW, and SIDS (postpartum)
What is tobacco smoke
A study from Missouri showed women that smokes 1-9 cigarettes/day had just as many complications as those smoking more than pack
What is Sushi!
Don’t worry too much about sushi and raw eggs, might carry bacteria but no worse than when you are not pregnant vs pregnant (salmonella, campylobacter)
"Sorry honey, I can't help you clean out the kitty litter because I am afraid of __________"
Toxoplasmosis
Usually only a big deal during the cat's first exposure (that is when they will excrete the parasite eggs in their feces).
If your cat is old or lives inside, risk is less.
True or False:
Getting a tattoo during pregnancy is safe
True....probably
Still risk of infection (esp if not legit place), avoid potential IV sites, lower back, and try to wait until the 2nd trimester!
One of the only interventions that has been shown to encourage labor ("naturally") successfully
What is nipple stimulation
How do you counsel your patient to do this?
3 types of cheeses that should be avoided due to higher risk of Listeria:
1. Feta
2. Brie
3. Queso Fresco
(others include: camembert, roquefort, blue veined, goat)
True or False:
A pregnant person should wear gloves while gardening
This has been found to be another way to contract toxoplasmosis!
"Doctor, I am going to travel to (insert place with large amount of mosquitos here), is DEET safe to use in pregnancy?"
Yes!
CDC recommends that repellents containing DEET or picaridin can be used to prevent mosquito bites and decrease transmission of mosquito born illnesses.
*Oil of lemon eucalyptus is more organic--but must be applied more frequently*
Your patient is now GA 38w2d and states that she doesn't want to be pregnant any longer! Today, you can offer her _______
Stripping of Membranes!
25% more likely to go into labor within the next 2 days.