common period for Leg cramps. cause and treatment
--Common in 2nd and 3rd trimesters
--Cause unclear
--Suggested supplements of magnesium or calcium,
stretching, activity and hydration (supplements not consistently
effective.)
cause +treatment of fluid retention
-cause by pressure from the uterus on lower limbs
-Treatment: hydration + elevate legs.
warning of fluid retention
if with headache, fever/BP ↑ → possible pre-eclampsia.
in early to mid pregnancy, blood pressure is typically:
lower than non-pregnancy
what are the hypertensive disorders of pregnancy?
1. gestational hypertension
2. pre-eclampsia
3. eclampsia
what is Hypertension in pregnancy
High BP (>140/90 mmHg) after 20 weeks.
,What are the symptoms for Pre-eclampsia
Hypertension + edema + protein in urine, visual
disturbances and headache (usually arise ~32+ weeks)
What is the most common serious complication of pregnancy
Pre-eclampsia
what deficiency may cause eclampsia and what would it lead to?
may cause by calcium deficiency, leads to life-threatening
seizures. cure is delivery
WHO advice for calcium supplements intake:
for women with low Ca intake (<900 mg/day), supplement with
≥500 mg/day to prevent pre-eclampsia as it can help Ca regulate
blood pressure
Definition for Gestational Diabetes Mellitus (GDM)
glucose intolerance first recognized in pregnancy.
Diagnosis of GDM
if 50g GCT is positive(>7.8mmol/L), then followed by 75g
OGTT with FPG, 1hr PG, 2hrs PG.
Treatment for GDM
counselling on diet and exercise
If stil not controlled-->Insulin or other meds (rare)
Effects of GDM in infants:
LGA, hypoglycemia after birth, ↑ stillbirth
long terms effects of GDM in both infants and mother:
,Long-term risks: both mother and child → type 2 diabetes,
obesity.
General advice for pre and pregnancy-Key Recommendations
for a Healthy Pregnancy
Before pregnancy: Appropriate pre-pregnancy weight &
adequate nutrient intake and stores (iron & folate)
During pregnancy:
1. Appropriate weight gain and rate of gain
2. Healthy diet
3. Avoid known risks
4. Moderation in all things
5. Adequate social supports and care
Breastfeeding Recommendations
--Exclusive breastfeeding: first 6 months (WHO, Health Canada,
Dietitians of Canada).
--May Continue to 2 years & beyond with complementary foods.
Benefits of Breastfeeding for infant
1. contains antibodies, immune factors which protect from
infections, acute and chronic diseases (support gut microbes
grow)
2. bonding
3. Possible cognitive benefit ( confounded by SES)
, 4. proper quantity and quality of nutrients, with bioavailable
mineral
easily digestible fat and protein.
5. May increase acceptance for later meals
6. Nighttime milk may contain melatonin to help baby sleep
Benefits of Breastfeeding for mother
1. Bonding →emotional benefit.
2. Oxytocin release → promotes contraction of uterine.
3. Support ovulation
4. May ↓ breast & ovarian cancer risk.
5. Convenience.
6. Affordability.
7. Potentially ↓ postpartum bleeding.(maybe)
what is Postpartum Depression
Mood disorder that occurs within 1 year after childbirth
Risk for postpartum depression increased with:
• History of depression
• Higher stress during pregnancy
• Lack of support after birth
• Lifestyle - poor diet, lack of sleep, lack of exercise
etiology is unknown
Diagnosis of postpartum depression