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increase of cals in the 1st trimester? 2nd? 3rd?
1st- none
2nd- 340 a day
3rd- 450 a day
Why is calcium important in maternal diet?
Protects maternal bones and helps with fetal skeletal development
Why should mom consume protein with every meal?
Prevents glucose swings
What is supine hypotensive syndrome and how do we cure?
Uterus compresses vena cava. We turn mom onto her left side
What leads to ligament softening resulting in back pain and pelvic discomfort?
Relaxin
weight gain for normal bmi pregnancy?
25-35 lbs
What is first line therapy to gestational diabetes?
Diet
When does uterus expand up into abdomen?
By 12 weeks
Is mild dyspnea normal?
Yes! There is an increase in oxygen needs
What are these 3 normal skin changes ?
chloasma
linea nigra
striae gravidarum
Chloasma is darkening around eyes
linea negra is vertical line that runs down belly
striae gravidarum is stretch marks
400-600mcg of folic acid is started when to prevent what?
Begin before pregnancy to prevent neural tube defects
Diet education with meals for mom?
-small, frequent meals (helps with heartburn)
-complex carbs
-protein with each meal
-bedtime snack with protein
-avoid fruit juice alone
-avoid simple sugars
-avoid skipping meals
What is goodells sign and chadwicks sign?
goodell- cervix softens
chadwicks- bluish purple color change
What happens with kidneys in mom?
Increase in renal blood flow and increase in GFR; mild glucose in urine is normal!
When is a drop in BP slightly expected?
2nd trimester
27mcg of iron a day is needed for what?
Needed for increase in maternal blood volume.
*preggo women often present with anemia due to lack of iron
Which foods would you suggest for mom to eat that are safe choices?
-lean cooked proteins
-pasteurized dairy
-whole grains
-fruits and vegetables
-low mercury fish like salmon
When pregnant, progesterone is produced by corpus luteum. When and what eventually takes over?
Placenta takes over ~10-12wks
How does progesterone impact GI tract?
Decreases motility; leads to constipation and bloating
T or F?
pregnancy has no effect on immune system
False! pregnant people are considered immunocompromised
What dietary education should be given when taking iron?
Take with vit c for better uptake and avoid taking with dairy
Which foods would you suggest to avoid mom avoids?
-unpasteurized milk
-soft cheese
-deli meats
-any fish with mercury
-anything over 200mg/day of caffeine
Is an increase in BP normal in pregnancy!
No! could be a sign of preeclampsia
Explain the role of each hormone:
progesterone
hCG
estrogen
hPL
Progesterone maintains pregnancy
hCG maintains corpus luteum
estrogen for uterine growth
hPL for insulin resistance
Is it a normal finding for polyuria and burning to happen?
No! This is a UTI. Treat immediately