Paediatrics, pregnancy , breastfeeding

what is corrected gestational age

weeks of pregnancy
+ weeks after birth

which trimester is the most vunreable?

first trimester

3rd-11th week of pregnancy

safest trimester

second trimester,

third trimester drugs can affect growth or functional development of the foetus, or they can have toxic effects on foeatal tissues

exposure to drugs in the first 17 days (pre-embryonic phase)

results in either survival of intact embryo or death

‘all or nothing’ principle

exposure to drugs during 18-55 days of pregnancy (embryonic phase)

embryo most vunreable to tetaogens during this time. drugs can produce congenital malformations

exposure to drugs during 56 days- birth (foetal period)

organs continue to develop. drugs can affect growth or functional development of foetus.

when is pregnancy considered full term

when gestation has lasted 39-41 weeks

before 37 weeks → pre term

before 39 weeks→ early term

after 41 weeks→ late term

after 42→ post term

effect of progesterone on gastric emptying

slows gastric empyting

affects hepatic enzyme changes

when to start folic acid for pregnancy

ideally 3 months before + vit D

folic acid until at least 12 weeks and vit D until birth

who needs folic acid 5mg

risk of pre-eclempsia

long term conditions e.g diabetes

long term meds?

drugs with a high risk of physical birth abnormality

carbamazepine

phenoarbital

phenytoin

topiramate

valproate

examples of drugs that can affect breastfeeding

phenobarbital can inhibit sucking reflext in infants

bromocriptine will reduce milk supply

domperidone can inc milk supply which can sometimes be a problem