neural tube defect


Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. It is a type of neural tube defect (NTD). These are birth defects that happen during the first month of pregnancy, usually before a woman knows she is pregnant. As the neural tube forms and closes, it helps form the baby’s brain and skull (upper part of the neural tube), spinal cord, and back bones (lower part of the neural tube).

Anencephaly happens if the upper part of the neural tube does not close all the way. This often results in a baby being born without the front part of the brain (forebrain) and the thinking and coordinating part of the brain (cerebrum). The remaining parts of the brain are often not covered by bone or skin.

Almost all babies born with anencephaly will die shortly after birth. CDC estimates that each year, about 1 in every 4,859 babies in the United States will be born with anencephaly

My Uworld notes- 6
  • serum sickness is a type 3 HSR characterized by deposition of circulation complement fixing immune complexes and resulting vasculitis. Associated findings include fever, urticaria, arthralgias, glomerulonephritis, lymphadenopathy and a low serum c3 level 5-10 days after intravascular exposure to antigen. type 3 HSR typically activate complement at local site where immune complexes containing IgG and or IgM complement fixing antibodies have been deposited. This often results in hypocomplementemia including decreased C3 level

  • liver dz-a/w AFP

  • carcinoembryonic antigen (CEA) a/w colorectal cancer

  • CA125 -ovarian cancer. Both CEA and ca125 are fr monitoring purposes

  • PSA prostate specific antigen is most useful in establishing extent of prostate cancer and evaluating response to prostate cancer tx.

  • Iced water think cold – cold think cold agglutinins – cold agglutinin associated with infection with mycoplasma pneumonia

  • another cold agglutinin is EBV

  • free air in peritoneal cavity= bowel perforation

  • pancreatic calcification= chronic pancreatitis

  • heavily calcified vessels = atherosclerosis and vascular dz

  • distended bladder= urinary retention

  • air in billiary tract a/w gallstone ileus

  • fluoxetine a/w anorgasmia and decreased libido and increase latency to orgasm. They can however be used to tx premature ejaculation

  • phenelzine= MAO-I used in tx of depression monoamine oxidase is a mitochondrial enzyme that deaminates primary and secondary aromatic amines

  • tricyclic antidepressants can cause orthostatic hypotension example imipramine

  • trazadone- priapism

  • paroxysmal breathlessness and wheezing in young patient unrelated to ingestion of aspirin, pulmonary infection inhaled irritant stress and or exercise should raise a strong suspicion for extrinsic allergic asthma. The granule containing cells in sputum are most likely eosinophils and the crystalloid bodies are most likely Charcot Leyden crystals (contain eosinophil membrane protein)

  • chronic eosinophilic bronchitis in asthmatics involves bronchial wall infiltration by numerous activated eosinophils largely in response to IL5 released by TH2 cells

  • digestion and absorption of nutrients primarily occurs in small intestine. SI cells produce enzymes responsible for nutrient absorption. Proteins in ingested food exist primarily as polypeptides and require hydrolysis to dipeptides tripeptides and amino acid for absorption. Hydrolysis of these polypeptides is accomplished by proteolytic enzymes such as pepsin and trypsin

  • these enzymes are secreted inactive proenzymes trypsinogen and pepsinogen from stomach and pancreas

  • trypsin activates other proteolytics enzymes including chymotrypsin carboxypeptidase and elastase. Activation of trypsinogen to trypsin is achieved by enteropeptidase (or enterokinase)an enzyme produced in duodenum

  • enteropeptidase deficiency results in defective conversion of trypsinogen to active trypsin

  • lipase secreted from exocrine pancreas is the most important enzyme of digestion of triglycerides. Chronc pancreatitis is a painful condition that causes lipase deficiency. This leads to poor fat absorption and steatorrhea

  • secretin is a peptide hormone secreted by S cells of duodenum un response to low duodenal pH. Secretins timulates secretion of bicarbonate from the pancreas and gall bladder and reduces acid secretion in the stomach by reducing production of gastrin. Neutralizing the acidic pH of food entering the duodenum from the stomachis necessary for proper function of pancreatic enzymes (amylase, lipase)

  • trisomy 18 (47XX: Edwards syndrome

    • face: micrognathia, microstomia, eye defects (microphthalmis, cataracts) low set ears and malformed ears prominent occiput

    • CNS: microcephaly, neural tube defects (meningocele, anencephaly), holoprosencephaly, arnold chiri malformation, severe MR delayed psychomotor development

    • musculoskeletal: clenched hands with overlapping fingers (index finger overrides the middle fingerand fifth finger overrides the fourth finger) rocker bottom feet short sternum and hypertonia

    • cardiac: VSD, PDA

    • distinguishing features: clenched hands and or overlapping finger

    • GI: Meckel diverticulum, malrotation

    • ultrasound: intrauterine growth restriction and polyhydramnios especially ina fetus with abnormal hand arrangement

  • unlike patients with Edward’s syndrome neonates with Patau syndrome (trisomy 13) have cleft lip and palate, polydactyly and omphalocele. Patau syndrome is not a/w low set ears and overlapping fingers but do present with rocker bottom feet also

  • 47XXX karyotype is clinically silent however, some affected women have slightly decreased IQ scores. Female newborns with this karyotype are phenotypically normal with no obvious dysmorphism

  • 47XXY Kleinfelter’s syndrome: may be a/w mild mental retardation or normal intelligence. The typical patient is tall mall adult with gynecomastia small testes and infertility. Male newborns with this karyotype are phenotypically normal with no obvious dysmorphism. The clinical findings do not become apparent until adulthood.

  • Sudden onset of abdominal or flank pain hematuria and left sided varicocele together suggests renal vein thrombosis a well known complication of nephrotic syndrome. Nephrotic syndrome is a hypercoagulable state d/t increased loss of anticoagulant factors especially anti thrombinIII (responsible for the thrombotic and thromboembolic complications of nephrotic syndrome)

  • venous drainage from left testes travels throught the left testicular vein into the left renal vein and from there the IVC. In contrast to the right testicular vein which empties directly into the IVC. This difference in venous drinage gives diagnostic significance to left sided varicocele in that it often indicates an occlusion of the left renal vein by a malignant tumour or thrombus

  • malaise low grade fever followed by a facial rash. Feels better now but still has the rash- red flushed cheeks with – clinical presentation of erythema infectiosum aka fifth dz. As the facial rash fades an erythematous rash in reticular lace like pattern often appears on trunk and extremities. The rash of erythema infectiosum is thought to result at lest partly from local immune complex deposition once serum levels of virus specific IgM and IgG have attained high enough levels.

  • Erythema infectiosum= non enveloped DNA virus called parvo B19. The blood group P antigen globoside is a parvovirus B19 is highly tropic for erythrocyte precursors particularly erythrocytes and erythroid progenitor cells

  • Parvo B19 replicates predominantly in the bone marrow

  • anthracyclines daunorubicin doxorubicin epirubicin and idarubicin are chemotherapeutic agents a/w severe cardiotoxicity because of their unique ability to generate free radicals.. Dilated cardiomyopathy is dose dependent and may present months after discontinuation of the drug . Swelling of sarcoplasmic reticulum is the morphologic sign of early stage doxorubicin associated cardiomyopathy. Followed by loss of cardiomyocytes and its symptoms are those of biventricular CHF including dyspnea on exertion orthopnea and peripheral edema

  • dexrazoxane prevents Doxorubicin associated cardiomyopathy because dex is a iron chelating agent that decreases formation of free radicals by anthracyclines.

  • Restrictive cardiomyopathy a/w hemochromatosis amyloidosis sarcoidosis and radiation theraapy : remember -osis

  • hypertrophic cardiomyopathy caused by mutation of beta myosin heavy chain

  • focal cardiomyopathyscarring commonly results in MI

  • pericardial fibrosis usually follows cardiac surgery radiation therapy or viral infections of the pericardium

  • PCP aka angel dust aka phencyclidine commonly associated with violent behaviour

  • LSD can also cause aggressive behaviour but it is more typically characterized by affective liability thought disruption )delusion) and visual hallucination whereas PCP produces more psychomotor agitation including clonic jerking of extremities

  • angel dust can be put on marijuana and smoked LD is ingested orally

  • secobarbital is a street barbiturate a CNS depressant which leads to drowsy drunken state of consciousness without the violent behaviour

  • heroin (opioid) produces CNS psychomotor depression and respiratory depression miosis and bradycardia are common

  • dry tap with no splenomegaly or lymphadenopathy – think aplastic anemia which causes pancytopenia

  • aplastic anemia= hypo cellular bone marrow with fat cells and fibrotic stroma

  • hyper cellular marrow with increased blasts found in myeloproliferative d/o and certain leukemias

  • most common side effect of streptokinase= hemorrhage . Streptokinase is a thrombolytic agent that acts by converting plasminogen to plasmin which subsequently degrades fibrin. It is a foreign protein derived from streptococci and induce HSR.

  • Dissection of ascending aorta manifests as tearing chest pain that radiates to the inter-scapular area commonly occurs in hypertension marfans and ehlers danlos

  • hyperactive jaw jerk reflex when lightly tapped= chvostek’s sign- Hypocalcemic – facial m contraction elicited by tapping facial nerve just anterior to ear. The most common cause of outpatient hypocalcemia is primary hypoparathyroidism which is often d/t prior loss of parathyroid tissue during thyroidectomy

  • scotoma is visual defect that occurs d/t pathologic processes that involve parts of retina or optic nerve resulting in discrete area of altered vision surrounded by zones of normal vision. Lesions of macula cause central scotomas.. examples would include MS, diabetic retinopathy and retinitis pigmentosa

  • verapamil is a calcium channel blocker that slows SA and AV node phase 0 depolarization (in nodal cells, the phase of depolarization is mediated by calcium influx)

  • phase 0 depolarization of cardiac conduction system occurs during diastole thus verapamil slows diastolic depolarization

Molecule of the Day: Folic acid

Folic acid (C19H19N7O6), also known as Vitamin B9, is a yellow powder that is insoluble in water under standard conditions. It is essential to metabolism and cell division, and is found in many fruits and vegetables.

Folic acid (in the form of tetrahydrofolate [THF], a metabolite) plays an integral role in methylation and other metabolic reactions by carrying one-carbon groups that react with other substrates. Additionally, it also is a key intermediate in the synthesis of purines and hence DNA via N10-formyl-THF (see diagram below).

It is also essential in the process of cell division, since the methylation and demethylation of DNA, which controls gene expression, and the synthesis of nitrogenous bases, which is required for DNA replication, are absolutely key to this process. 

Folic acid is commonly found as a food additive, as it lowers the probability of neural tube defects occurring in pregnant women. These are characterised by openings in the spinal cord or brain which fail to close during pregnancy, and can result in the death of the foetus. Hence, the fortification of cereal grains and other foods with folic acid is mandated by many governments.

The inhibition of dihydropteroate synthase, an enzyme that synthesises tetrahydrofolate, is one of the key mechanisms that antibacterial agents can target. Sulfonamides, which are similar in structure to 4-aminobenzoic acid, the natural substrate, are reversible inhibitors of the enzyme. As a result, insufficient folic acid is produced in bacteria, and they either stop dividing or die. 

This makes sulfonamides seem dangerous - wouldn’t this affect human cells as well? However, bacterial cells produce their own folic acid, whereas human cells do not; instead, we absorb it from our diet, while bacterial cells lack the ability to do so. As a result, sulfonamides selectively kill bacterial cells, leaving our cells intact and healthy.


Anencephaly is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic development. It is a cephalic disorder that results from a neural tube defect that occurs when the rostral (head) end of the neural tube fails to close, usually between the 23rd and 26th day following conception. it is accepted that children born with this disorder usually only lack a telencephalon, the largest part of the brain consisting mainly of the cerebral hemispheres, including the neocortex, which is responsible for cognition. The remaining structure is usually covered only by a thin layer of membrane— skin, bone, meninges, etc. are all lacking. With very few exceptions,infants with this disorder do not survive longer than a few hours or possibly days after their birth.

#anencephaly #brain #video #instavideo #genetics #child #pediatrics #congenital #pediatrics #neurology #neuroscience #usmle #usmlestep1 #usmlestep2 #doctor #doctordconline #nhs #nurse #nursing #hospital #patient #mbbs #md @doctordconline

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Routine Antenatal Care

According to Antenatal Care Guidelines developed by the National Institute for Health and care Excellence, here are the minimum set of tests for routine antenatal care:

First contact with health professional

  • Give specific information on folic acid supplements, food hygiene, healthy lifestyle, and all antenatal screening
  • offer information about screening for sickle cell diseases and thalassaemias.
  • Give information about the anomaly scan and let them know that this gives them a chance to terminate pregnancy, prepare for treatment or care of disability, manage the birth in a specialist center, and have intrauterine therapy. Inform them of the limitations of ultrasound screening and that the detection rates vary by the type of anomaly, pregnant person’s BMI, and the position of the fetus at the time of the scan.

At booking

  • Explain the development of pregnancy, nutrition and diet (including vitamin D supplements), exercising (including pelvic floor exercises)
  • start planning the place of birth
  • information about breastfeeding and workshops in the area
  • information on participant-led classes
  • information on maternity benefits.
  • Identify people who may need additional care and plan pattern of care for the pregnancy.
  • Measure blood pressure and test urine for proteinuria (pre-eclampsia)
  • Inform those under 25 of the high prevalence of chlamydia in their age group and give details about STI screening.
  • Offer early ultrasound scan for gestational age assessment and structural anomalies.
  • Ask about mental health, ask about mood to identify possible depression.
  • Ask about occupation to identify potential risks.
  • Haemoglobinopathies screen
  • Blood group and rhesus D status
  • Hepatitis B virus screen
  • HIV screen
  • Rubella susceptibility
  • Syphilis screen
  • MSU for asymptomatic bacteriuria
  • risk of venous thromboembolism evaluated (previous VTE, thrombophilia, medical comorbidities, surgical procedures such as appendicectomy, age about 35, BMI above 30kg/m, 3 or more children, smoker, varicose veins, systemic infection, immobility, pre-eclampsia, dehydration, etc.)
  • test for gestational diabetes if there is an identified risk (height, weight, family history, ethnic group, previous pregnancies, etc)
  • measure Height, weight, and body mass index and give health advice.

After 10 weeks 0 days

  • Before 13 weeks 6 days: ultrasound scan to determine gestational age
  • Before 14 weeks 1 day: Combined test for Down Syndrome

16 weeks

  • Review, discuss, and record the results of any screenings.
  • Measure blood pressure and test urine for proteinuria (pre-eclampsia)
  • investigate if haemoglobin level is below 11g/100ml and consider iron supplements.
  • Give information on the routine anomaly scan to take place at 18 weeks.
  • offer those with significantly atypical red-cell alloantibodies a referral to a specialist.

After 14 weeks 2 days

  • Before 20 weeks 0 days: Serum quadruple test for Down Syndrome

All appointments

  • blood pressure
  • urine test for proteinuria

At booking and 28 weeks

  • Haemoglobin
  • Red-cell alloantibodies

18 weeks

Before 20 weeks 6 days: ultrasound screen for structural anomalies including

  • fetal echocardiography of fetal heart
  • detection of neural tube defects

25 weeks

only needed if you’ve never been pregnant before to measure blood pressure/test urine and measure and plot symphysis-fundal height

28 weeks

  • measure blood pressure/test urine
  • offer a second screening for anaemia and atypical red-cell alloantibodies.
  • investigate a haemoglobin level below 10.5g/100ml and consider iron supplements
  • offer anti-D prophylaxis to people who are rhesus D-negative
  • measure and plot symphysis-fundal height.

31 weeks

Only needed if you’ve never been pregnant; review, discuss, and record the results of screening taken at 28 weeks, measure blood pressure/test urine, measure and plot symphysis-fundal height

34 weeks

  • Review, discuss, and record results of screening taken at 28 weeks
  • measure blood pressure/test urine
  • offer second dose of anti-D prophylaxis to those who are D-negative
  • measure and plot symphysis-fundal height
  • give specific information on preparation for labor and birth including the birth plan, recognizing labor, and coping with pain.
  • Give information about cesarean section including indications of a need for c-section, what the procedure involves, risks and benefits, and implications for future pregnancies after c-section.

36 weeks

Fetus is approximately full term.

38 weeks

  • measure blood pressure/test urine
  • measure and plot symphysis-fundal height
  • give options for management of prolonged pregnancy.

40 weeks

only necessary if this is your first pregnancy; measure blood pressure/test urine, measure and plot symphysis-fundal height, and further discussion of management of prolonged pregnancy.

41 weeks

  • offer membrane sweep
  • offer induction of labor
  • measure blood pressure/test urine
  • measure and plot symphysis-fundal height

42 weeks

  • from this point on offer those who decline induction of labor increased monitoring (at least twice-weekly)

People should be able to make an informed choice about whether to accept or decline each tests, and notes should include a record of any tests offered and declined as well as the results of tests accepted

The Neural Tube

  •  the neural tube forms the brain and spinal cord
  • fusion of neural groove extends rostrally and caudally
  • begins at the level of 4th somite
  • closes neural groove “zips up” in some species.
    • humans appear to close at multiple points along the tube.
  • leaves 2 openings at either end - Neuropores
    • cranial neuropore closes before caudal

Failure for the neural tube to close correctly or completely results in a neural tube defect

anonymous asked:

I say this because I don't want bad advice out in the world, but being strictly vegan while pregnant is a bad idea, especially for your baby. You need to take supplements for vitamin B12, calcium, iron, folic acid, and protein. You can get calcium from kale and protein from nuts and/or soy, but it's likely to not be enough. Also, you just shouldn't consume soy while pregnant. It messes with hormones, especially for males.

When embarking on such a journey as parenthood, mothers and fathers need to ensure they are informed and aware of both baby and mother’s nutritional needs. Research must be done, books read and eating plans formulated. 

A most recommended vegan pregnancy book, written by mothers with successful pregnancies, births and healthy children is ‘Pregnancy, Children, and the Vegan Diet’ by Dr. Klaper. Another recommended by the Vegan Society is ‘Raising Your Vegan Infant - With Confidence’ by dietician Sandra Hood.

Dr. McDougall also published an informative newsletter about vegan pregnancy, including a part on morning sickness. What I found most fascinating in the newsletter was the research on how most morning sickness is related to meat, fish, poultry, and eggs and that morning sickness is effectively the body’s tool to remove food that is harmful to the mother and child. Dr. McDougall notes that societies with less of a focus on eating animal products have less instances of morning sickness. He also talks about prenatal vitamins, omega-3s, and more.

In their 5th Edition (2004) of the Pediatric Nutrition Handbook, the American Academy of Pediatrics says:

Children exhibit good growth and thrive on most lacto-ovo vegetarian and vegan diets when they are well planned and supplemented appropriately. (Chapter 12: Nutrition Aspects of Vegetarian Diets, p. 194)

In their 2009 Position Paper, Vegetarian Diets, the American Dietetic Association and Dietitians of Canada state:

Well-planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets are appropriate for all stages of the life cycle, including pregnancy and lactation. Appropriately planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets satisfy nutrient needs of infants, children, and adolescents and promote normal growth.

As of 2003 the American Dietetic Association and Dietitians of Canada considered well-planned vegan diets “appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood and adolescence.”[133] 


To make certain that you are getting adequate nutrition, pay particular attention to the following nutrients.

Calcium: The Dietary Reference Intake (DRI) for calcium during pregnancy is the same as before pregnancy, 1000 mg/day for women ages 19-50,2 due in part to increased maternal calcium absorption.

Just as it was before pregnancy, getting enough calcium on a vegetarian diet is easy. In fact, calcium absorption from plant foods is often superior to that of dairy products.3 Good sources of calcium include tofu and soy beans, dark green leafy vegetables, bok choy, broccoli, beans, figs, sunflower seeds, tahini, almond butter, calcium-fortified nondairy milk, and calcium-fortified cereals and juices. If these foods are included in the diet every day, calcium needs are easily met.

Essential fatty acids: Alpha-linolenic acid (ALA) is an essential fatty acid and an important component of the diet. ALA converts in the body into omega-3 fatty acids (DHA and EPA).

The Institute of Medicine has set the adequate intake (AI) for ALA at 1.1 g/day for women ages 19-50 and 1.4 g/day during pregnancy.1 ALA can be found in a number of vegetarian foods. Flaxseeds and flaxseed oil are the most concentrated sources; however, ALA is also found in canola and walnut oils, walnuts, and soybeans.

An important factor in essential fatty acid status for vegetarians is the ratio of omega-6 to omega-3 fatty acids. The World Health Organization recommends a ratio of 5:1 to 10:1 for proper conversion of ALA into DHA and EPA.4 The lower the ratio of omega-6 to omega-3 fatty acids, the better the conversion. Omega-6 fatty acids are found in seeds, nuts, grains, legumes, and green leafy vegetables, as well as in high concentrations in certain vegetable oils (corn, soybean, safflower, cottonseed, sesame, and sunflower).

The fatty acid that is often discussed regarding vegetarian pregnancy is DHA. DHA has been shown to be lower in the plasma and umbilical cord of babies born to vegetarian mothers.5 Since vegetarians don’t consume any preformed DHA in the diet, they must convert it from ALA. It certainly is possible to meet omega-3 fatty acid needs on the vegetarian diet by consuming enough sources of ALA, balanced by not having too many omega-6 fatty acids. However, if a vegetarian woman is concerned about DHA, microalgae-based supplements are available, marketed under the name Neuromins.

Folate: Folate, or folic acid, is necessary to help prevent neural tube defects and serves other functions as well. Folate is especially important in the first weeks of pregnancy, and it is therefore important that all women of childbearing age get adequate amounts daily. As its name (derived from the word “foliage”) implies, its natural source is leafy greens. Legumes are also rich in folate. Because diets can be erratic, it is prudent to take a multiple vitamin or other supplement that provides at least 400 μg/day. Many breakfast cereals and other grain products are now fortified with folate. During pregnancy, 600 μg/day of folate is needed.6

Iron: Iron needs increase during pregnancy to aid in the development of the fetus and placenta and to maintain increased maternal blood volume. The DRI for women ages 19-50 is 18 mg/day, increasing to 27 mg/day during pregnancy.7 Iron needs may be greater for those on a vegetarian diet because of less efficient absorption of iron from nonanimal sources.8 Iron supplements (or prenatal vitamins containing iron) are often prescribed for women on any kind of diet, as it is difficult for any woman to meet increased needs through diet alone.

Vegetarian women should include iron-rich plant foods daily, in addition to taking their prescribed vitamins or supplements. Iron supplements should not be taken at the same time as tea, coffee, or calcium supplements. Dairy products decrease iron absorption and should be avoided. Iron sources include whole and enriched grains, legumes, nuts, seeds, dark green vegetables, dried fruit, and blackstrap molasses. Including vitamin C-rich foods at meals can increase absorption of iron from these sources.

Protein: The DRI for women ages 19-50 is 46 g/day, increasing to 71 g/day during the second and third trimesters of pregnancy (25 grams more than pre-pregnancy needs).1 This is a greater increase than previously recommended; however, it is still easy to meet these protein needs on a vegetarian diet. DRIs are intended to cover the needs for 97.5 percent of the population, so actual needs for most individuals may be slightly lower than this.

Protein sources on a vegetarian diet include whole grains, beans and legumes, soy products, vegetables, and nuts and seeds. A balanced vegetarian diet, providing adequate calories and including these foods, will likely meet protein needs.9 The meal-planning chart above provides plenty of protein for pregnancy.

Vitamin B12: Vitamin B12 needs increase only slightly during pregnancy, increasing from 2.4 μg/day for women ages 19-50 to 2.6 μg/day during pregnancy.6 Vitamin B12 is found in fortified foods, such as fortified cereals, meat substitutes, nondairy milk, and nutritional yeast. Be certain to check the labels to find out which foods are fortified. Seaweed and foods like tempeh are generally not good sources of vitamin B12. To be sure of getting adequate B12, it is prudent to take a prenatal vitamin containing vitamin B12 or to take a vitamin B12 supplement.

Vitamin D: Although vitamin D needs during pregnancy are the same as before pregnancy (5 μg per day),2 it is important to both mother and baby to ensure adequate intake. Vitamin D is made in the body as the result of exposure to sunlight. For many people, 5 to 15 minutes per day of sun between the hours of 10 a.m. and 3 p.m. on the arms and legs or hands, face, and arms during the spring, the summer, and the fall is sufficient to meet vitamin D needs.10

This nutrient is poorly supplied in all diets unless people use foods that are fortified with it. Many brands of ready-to-eat cereals and nondairy milks are fortified with vitamin D. Pregnant women who don’t regularly spend time in the sun, live in northern latitudes, or have darker skin will want to be sure to include fortified foods in their diet. Many prenatal vitamins contain adequate amounts of vitamin D as well.

Zinc: Zinc needs increase during pregnancy. The DRI for women ages 19-50 is 8 mg/day and increases to 11 mg/day during pregnancy.7 Needs for women following a vegetarian diet may be higher, however, because of lower absorption of zinc on a plant-based diet.8

Zinc is often included in prenatal vitamins. In addition, zinc is found in legumes, nuts, whole grains, and cereals. Zinc absorption from plant-based sources can be increased by including sprouted grains, beans, or seeds and yeast-raised breads in the diet, soaking and cooking legumes, and combining zinc sources with acidic ingredients such as lemon juice or tomato sauce.

A note about dietary supplements: Your doctor may recommend a supplement to ensure you are meeting your vitamin/mineral needs. Most prenatal vitamins will be adequate to cover your needs. If you are interested in taking any additional dietary supplements, including herbal or botanical supplements, talk to your doctor. Many herbal supplements may not be safety for pregnancy.

I understand many women are different and I understand that supplements may be taken as well, but there are enough proof that if you eat right and you know what you’re doing you can have a healthy pregnancy. (Birth Stories).

And everybody knows I’m not a doctor, I provide information and advice and people should look for their current doctors and health professionals to double check always how they’re are and if they’re good to go. 


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