Nutritional deficiencies in pregnancy

2012 ◽  
pp. 234-239
2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anna Walch ◽  
Madeline Duke ◽  
Travis Auty ◽  
Audris Wong

We present a case of a 39-year-old G8P6 Pacific Islander woman who at 15+5 weeks’ gestation had an out-of-hospital cardiac arrest secondary to profound hypokalaemia which was associated with severe hyperemesis gravidarum (HG). Her clinical course after arrest was complicated by a second 5-minute cardiac arrest in the Intensive Care Unit (ICU) (pre-arrest potassium 1.8), anuric renal failure requiring dialysis, ischaemic hepatitis, and encephalopathy and unfortunately fetal demise and a spontaneous miscarriage on day 2 of admission. Despite these complications, she was discharged home 4 weeks later with a full recovery. Following a plethora of inpatient and outpatient investigations, the cause of her cardiac arrest was determined to be profound hypokalaemia. The hypokalaemia was presumed second to a perfect storm of HG with subsequent nutritional deficiencies causing electrolyte wasting, extracellular fluid (ECF) volume reduction, and activation of the renin-angiotensin-aldosterone axis (RAAS). This combined with the physiological changes that promote potassium wasting in pregnancy including volume expansion, increased renal blood flow, increased glomerular filtration rate, and increase in cortisol contributed to the patient having a profoundly low total body potassium level. This diagnosis is further strengthened by the fact that her pre- and post-pregnancy potassium levels were within normal limits in the absence of supplementary potassium. This case highlights the potentially life-threatening electrolyte imbalances that can occur with HG and the importance of recognising the disease, comprehensive electrolyte monitoring, and aggressive management in pregnancy.


2014 ◽  
Vol 23 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Meghana D. Gadgil ◽  
Hsien-Yen Chang ◽  
Thomas M. Richards ◽  
Kimberly A. Gudzune ◽  
Mary M. Huizinga ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2394
Author(s):  
Deidre Meulenbroeks ◽  
Isabel Versmissen ◽  
Nanique Prins ◽  
Daisy Jonkers ◽  
Jessica Gubbels ◽  
...  

With an growing number of people on a strict plant-based diet, its potential effect on pregnancy and lactation becomes increasingly important. It is, however, unclear how obstetric caregivers currently handle and think about a strict plant-based diet in pregnancy. The aim of the study was therefore to evaluate the self-reported knowledge and advice given by Dutch obstetric caregivers and dietitians when treating pregnant women on a strict plant-based diet. A cross-sectional study was performed by sending an online survey to Dutch midwife practices, obstetricians, and dietitian practices. Descriptive statistics are reported. A total of 121 midwives, 179 obstetricians, and 111 dietitians participated in this study. The majority of midwives (80.2%) and obstetricians (93.9%) considered a strict plant-based diet to be a significant risk factor for nutrient deficiency during pregnancy. Maternal dietary preferences, including a potential strict plant-based diet, were discussed at the first prenatal appointment by 59.5% of midwives and 24.1% of obstetricians. A self-reported lack of knowledge concerning the strict plant-based diet was mentioned by 66.1% of midwives and 75.4% of obstetricians. Obstetric caregivers mostly considered the identification of this dietary habit and subsequent referral to a dietitian or a reliable website as optimal care for pregnant women on the strict plant-based diet. However, only 38.7% of dietitians indicated to have sufficient knowledge to counsel these women. Although obstetric caregivers thought that a strict plant-based diet in pregnancy may lead to increased risks of nutritional deficiencies, the majority report to have insufficient knowledge to provide adequate advice. Only a minority referred these women to dietitians, of whom a minority indicated to have adequate knowledge on this specific diet. These results suggest that current care is suboptimal for an increasing number of pregnant women. Women on a strict plant-based diet could benefit from increased knowledge about this topic among obstetric caregivers and dietitians, as well as from clear guidelines regarding this diet during pregnancy.


Author(s):  
Raksha Dubey

Nausea and vomiting commonly known as morning sickness in pregnancy is extremely common. During pregnancy normal nausea and vomiting may be evolutionary protective mechanism as it may protect the pregnant woman and her embryo from harmful substances in food such as pathogenic microorganisms in meat products and toxins in plants, these effects are maximal during embryogenesis the most vulnerable period of pregnancy. Studies suggest that women who had nausea and vomiting were less likely to have miscarriages and stillbirth. Hyperemesis gravidarum is rare but the most severe form of nausea and vomiting in pregnancy that may necessitate hospitalization. It is characterized by persistent nausea and vomiting associated with ketosis and weight loss (>5%) which may lead to volume depletion, electrolyte and acid base imbalances, nutritional deficiencies and even death.


2021 ◽  
pp. 67-74
Author(s):  
O. I. Mikhailova ◽  
D. D. Mirzabekova ◽  
N. E. Kan ◽  
V. L. Tyutyunnik

This review focuses on the causes and consequences of nutritional deficiencies in the pregnant woman’s diet, as well as on the possibilities of its supplementation. It has been shown that inadequate intake of vitamins and minerals during pregnancy is accompanied by a lack of nutrient supply to the fetus, which can cause growth retardation, low birth weight and other obstetric and perinatal complications.According to the analysed guidelines and recommendations, the body’s need for vitamins and minerals increases at least twice as much during pregnancy. Adverse effects of the environment, a number of gastrointestinal and liver diseases, chronic diseases, antibiotic therapy, etc. increase this need.However, adequate nutritional support of the fetus is the result of several steps. These include the frequency of maternal food intake, the availability of nutrients in the food and the ability of the placenta to transport substrates effectively to the fetus.The most recommended vitamin for consumption in pregnancy is folic acid, alone or in combination with other B vitamins, as its deficiency leads to birth defects in the child.The authors of this review have reviewed a number of large studies conducted over the past decade that recommend iron and folic acid for pregnant women, regardless of dietary intake, as they have proven beneficial effects on the course and outcome of pregnancy. Folic acid, according to current recommendations, must be prescribed to every pregnant woman in the form of 400 mcg tablets daily regardless of her diet. Other most important and necessary vitamins for pregnant women are: vitamins A, C, D, E, K, B1, B2, B6, B12, PP, pantothenic acid, biotin.


2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Jürgen Harreiter ◽  
Karin Schindler ◽  
Dagmar Bancher-Todesca ◽  
Christian Göbl ◽  
Felix Langer ◽  
...  

The prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can resolve hormonal imbalance. So far, guidelines suggest conceiving after losing maximum weight and thus recommend conception at least 12–24 months after surgery. As limited data of these suggestions exist, further evidence is urgently needed as well for weight gain in pregnancy. Oral glucose tolerance tests for the diagnosis of gestational diabetes mellitus (GDM) should not be performed after bariatric procedures due to potential hypoglycaemic adverse events and high variability of glucose levels after glucose load. This challenges the utility of the usual diagnostic criteria for GDM in accurate prediction of complications. Furthermore, recommendations on essential nutrient supplementation in pregnancy and lactation in women after bariatric surgery are scarce. In addition, nutritional deficiencies or daily intake recommendations in pregnant women after bariatric surgery are not well investigated. This review summarizes current evidence, proposes clinical recommendations in pregnant women after bariatric surgery, and highlights areas of lack of evidence and the resulting urgent need for more clinical investigations.


Author(s):  
Praveen Kumar Gautam ◽  
Beenu Prajapati ◽  
Manju Lata Arya

Background: Anaemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. In India anaemia in pregnancy is a major health issue with adverse maternal and foetal outcome. Nutritional anaemia in pregnant women continues to be a cause of concern despite the fact that this problem is largely preventable and easily treatable. Objectives was to determine the prevalence and severity of anaemia in the pregnant women.Methods: Around 350 pregnant women in different trimesters of pregnancy were enrolled coming for the 1st time in outpatient department of Obstetrics and Gynaecology, in Rama Medical College Hospital and Research Centre, Kanpur from Janurary 2016 to December 2016. Information regarding age, age at marriage, age at 1st pregnancy, parity, Interval between previous and index pregnancy, no of abortions, educational status, dietary habits, Type of family, Socioeconomic status was collected in pre-designed structured schedule after taking written consent from pregnant women attending out-patient department. Haemoglobin estimation was done by auto analyser and anaemia was graded according to WHO criterion. Statistical analysis was done by percentages and proportions.Results: A high prevalence of anaemia, (87.71%) was observed in pregnant women. The current study shows (24.7%) cases of mild anaemia, (54.5%) cases of moderate anaemia, and (7.9%) of severe anaemia.Conclusions: A very high prevalence of anaemia in pregnancy needs awareness about late marriage, birth spacing, one or two child norm, antenatal care, green leafy vegetable in diet, mandatory regular supply of iron folic acid (IFA) tablets to adolescent and pregnant women along with correction of other nutritional deficiencies.


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