Question

Part I – “We are expecting!”                                                                  

Excited and overwhelmed, John and Shirley Reid have just found out that they are expecting a child once again.

After Shirley’s previous two miscarriages, it seemed that the chances of this occurring were very slim. Due to her history, Shirley wanted to make sure she took all the prenatal precautions necessary to have a normal and healthy baby: prenatal vitamins, a healthy diet plan, and prenatal testing (not before the 9th week of pregnancy). Dr. Sheppard, their OB/GYN, had advised the Reids that although there could be some complications and harmful risks involved (fetal only) based on their history of miscarriages, it was in their best interest to have prenatal testing. John completely agreed with Dr. Sheppard, but Shirley was hesitant. She feared the risks involved in the procedures, and could not bear the thought of losing another baby prematurely. Shirley also had doubts because her mother, a devout Catholic, had instilled in her very strong feelings against prenatal procedures— that by having the procedures done they would be interfering in “God’s Plan.”

Questions

1. (5p) What are the recommended nutrition supplements for pregnancy (FIVE!)? Explain, in each case, why are they required. (Mayo Clinic Pregnancy Diet)

2. (5p) List five first trimester causes and/or risk factors for miscarriage (see the NHS list)

3. (5p) Taking into account her history of miscarriages and the risks involved in these procedures – mention the risks of the procedures -, should Shirley decide to have prenatal testing? Explain your opinion.

Answer 1

1.The recommended nutritional supplements during pregnancy are

• The foods should be rich in folate and folic acid supplements in order to prevent neural tube defects. The development of brain occurs in the first trimester which needs this nutrients. Generally this is provided as folic acid tablets every day for first three months.
• The blood carrying oxygen can bind with hemoglobin only with the presence of iron.The pregnant women needs about 27 mg per day and can be received from meats and poultry in a higher content
• Vitamin D supplements to strengthen the skeletal system of the baby with tooth growth
• Calcium rich foods for good musculoskeletal, cardiac and central nervous system function.
• Nearly 71 grams of protein is required for the development of the fetus and fir the mother to gain weight.

2.The major risk factors or the causes for miscarriage are

• It increases with age
• Increased body weight
• History of smoking and alcohol intake or any substance abuse
• Chromosomal or genetic abnormalities
• Problems associated with the placenta

3. Prenatal testing posing some of the risks are

• Chance of miscarriage is high
• Injury to fetus
• Can lead to developmental changes if the fetus is injured
• Risk for infection
• Risk for bleeding

Shirley could undergo this testing with certain and she has already had two miscarriages without any actual cause.