NUTRITION FOR PREGNANT WOMEN

What are the basic principles of rational nutrition for a pregnant woman?

Rational nutrition promotes the normal development of pregnancy and the fetus, and also prevents the development of large fetuses, which significantly complicate the course of pregnancy, childbirth, the postpartum period, neonatal and postnatal development of newborns.

In the first half of pregnancy special diet not required. Food should be varied, containing sufficient amounts of proteins, carbohydrates, fats, salts and vitamins. In the first months of pregnancy, spicy and salty dishes are not excluded, if necessary; in the second half, predominantly dairy and vegetable foods are recommended. Meat and fish should be consumed 3-4 times a week. Hot and spicy foods are prohibited; carbohydrates, flour products, starch and liquid are limited within reasonable limits.

What amount of proteins, fats, carbohydrates and microelements should be in a pregnant woman’s daily diet?

The amount of proteins and fats is introduced into the daily diet at the rate of 1.5-2 g per 1 kg of a woman’s body weight. Carbohydrates, as the main energy material and source of fat formation, should be no more than 500 g per day (in case of obesity, the amount of carbohydrates is reduced to 300-400 g per day). To prevent late toxicosis in pregnant women, table salt in the second half of pregnancy should be limited to 5 g per day, liquid to 1-1.2 liters in recent weeks - to 0.8 liters per day. The amount of microelements, the sources of which are milk, cottage cheese, eggs, liver, meat, bread, nuts, buckwheat and barley, beets, peas, in the second half of pregnancy should be: calcium - 1.5-2 g, phosphorus - 2 g, magnesium - 0.5 g, iron - 15-20 mg per day.

What is the importance of vitamins for a pregnant woman?

Vitamins, which are part of a number of enzymes and perform the function of catalysts for metabolic processes in the body, are especially necessary in the diet of a pregnant woman. If there is a lack of vitamins entering the body of a pregnant woman with products of dairy and plant origin, ready-made dosage forms should be prescribed.

What is the importance and daily requirement of vitamins A, PP, C, E for a pregnant woman?

Vitamin A (carotene) has an effect on the uterine mucosa and promotes its regeneration, which is especially important in the postpartum period. Daily dose- 5000 ME, in recent months pregnancy - 10,000-20,000 IU.

Vitamin PP (nicotinic acid) is involved in the metabolism of sex hormones, and in small concentrations has an inhibitory effect on the contractile function of the pregnant uterus. The daily dose is 18-25 mg.

Vitamin C ( ascorbic acid) - a powerful catalyst for redox processes in the body, potentiates the effect of estrogens, enhances the effect of pituitrin and mammophysin on uterine contractions. Daily dose - 100-200 mg.

Vitamin C is involved in the regulation of calcium and phosphorus metabolism and is used in obstetric practice to prevent rickets in the fetus. The daily dose is 1000 ME.

Vitamin E (tocopherol) plays an important role in the normal course of pregnancy (fertility vitamin), its deficiency leads to dysfunction of the genital organs, sometimes to fetal death and miscarriage. Daily dose - 20-25 mg.

What is the importance and daily requirement of B vitamins for a pregnant woman?

Vitamin Bj (thiamine) is involved in the regulation of estrogen hormone metabolism, acetylcholine synthesis, and promotes proper metabolism in nervous system, liver, regulates water-salt metabolism. The daily dose is 10-20 mg.

Vitamin B2 (riboflavin) promotes the normal course of pregnancy and childbirth, is used to prevent threatened miscarriage, and enhances redox processes in the body. Daily dose - 2-3 mg.

Vitamin B6 (pyridoxine) is necessary for the metabolism of essential amino acids (histamine and tryptophan). Daily dose - 5 mg.

Vitamin B12 (cyanocobalamin) is effective for anemia caused by diseases gastrointestinal tract and liver, enhances the release of growth hormone. Used for fetal malnutrition. Daily dose - 0.003 mg.

Folic acid (vitamin B9) is considered one of the main vitamins for a pregnant woman. Shortage folic acid may cause early labor or mental retardation of the fetus. On the other hand, B9 prevents anemia in expectant mother and her child, is responsible for the normal condition of the skin and mucous membranes.

Therefore, the diet of pregnant women, especially in the first half of pregnancy, must include fish, meat, raw vegetables and fruits, and dairy products.

NB! Folic acid is destroyed by heat treatment, however, it is preserved better in meat products and milk.

It is very difficult to maintain a healthy diet when the body refuses to accept even the most ordinary foods - it is not up to it now, it is struggling with nausea and dizziness.

In these first weeks of pregnancy, the need for salty, spicy, etc. can be satisfied (of course, within reasonable limits) without harm to health.

In the fight against toxicosis, only natural, natural remedies are good. No drugs! Only properly selected products and diet. It is recommended to consume the most easily digestible foods. In the morning, while still lying in bed, you can eat light yogurt or an apple.

Man is in full swing. He really expects his mother to help him with building material! Among the most important substances now are calcium and phosphorus. They are found in the most optimal ratio in milk and dairy products.

7-8 weeks.

Pregnant women cannot live without milk, because milk in its pure form contains calcium, phosphorus, folic acid and other B vitamins, vitamin E, fluoride, complete protein, and animal fats.

Moreover, it is in milk that calcium and phosphorus are contained in that ideal proportion of 2:1, in which both elements are best absorbed. Unfortunately, not all people can drink milk due to the fact that their body lacks the enzyme responsible for the absorption of milk and dairy products. Kefir and live yogurt combine everything best properties milk, multiplied by the ease of absorption by the body.

Week 10

Iron is part of hemoglobin and ensures the normal process of hematopoiesis. What both mother and child need now! Iron is best absorbed from animal products. There is especially a lot of iron in cottage cheese. Calcium and fluoride will help your baby's teeth develop. Fluorine is found in meat, fish, milk, greens, and fruits.

Week 11

Zinc is responsible for the development of the organs of smell and taste, the reproductive system and hematopoiesis. The most zinc is found in cheese, seafood, meat, legumes and nuts. Vitamin E strengthens the immune system, helps the process of hematopoiesis in the mother’s body and the work of her heart muscle. Vegetable oils, wheat germ, soybeans, broccoli, Brussels sprouts, leafy greens, spinach, whole grains, eggs.

Week 12.

The risk of premature rupture of the placenta is significantly reduced with increased dietary intake of vitamins C and E. Iodine is necessary for the normal functioning of the thyroid gland. With hypofunction of the thyroid gland, growth retardation is observed due to metabolic inhibition. The main source of iodine is seafood.

Week 13.

During the first trimester, the expectant mother is unlikely to gain more than 1-3 kg in weight. But from this week you will have to closely monitor your weight and, of course, your diet. “To over-recruit” or “to under-recruit” are equally harmful. And this is the main problem of the next three trimesters.

If in the first trimester, when compiling her daily diet, the expectant mother constantly had to take into account the hormonal vagaries of her body and fight toxicosis with all her might, then starting from the second trimester the situation will change somewhat.

The two main reasons for poor digestion during pregnancy are dysbacteriosis and compression of organs. abdominal cavity due to an increase in the volume of the uterus. If constipation occurs, laxatives should never be used. This problem should only be solved with diet.

Fresh, stewed, baked vegetables and fruits, herbs will become especially relevant. Eating 30 grams (2 teaspoons) of bran daily will help the intestines get rid of all the excess.

You should start switching to a new diet now. If in the first trimester it was possible to maintain four meals a day, then from the second trimester until the end of pregnancy you need to eat more often, but in smaller portions.

A balanced diet contributes to the normal course of pregnancy and fetal development. A woman must adapt her diet to the needs of her growing body. What kind of diet is needed for pregnant women depends on the period, constitutional characteristics and health status of the expectant mother.

A woman’s diet should include a variety of foods containing proteins, carbohydrates, fats, and vitamins. The need for these essential substances depends on individual characteristics body. The developing fetus needs proteins, and the pregnant woman’s body has insignificant reserves. They are the basis of cells, tissues, and metabolism is associated with them.

Squirrels

High-molecular compounds consist of amino acids, but only 20 are contained in nutrients. Proteins perform the following functions:

• construction;
• regulatory;
• catalytic;
• contractile;
• transport;
• protective.

During the period of bearing a child, a protein diet for pregnant women is optimal. It ensures normal development of the fetus and placenta. Thanks to protein nutrition:

• woman getting ready for breastfeeding and childbirth;
• transport of nutrients occurs;
• immune protection of the pregnant woman from viruses and bacteria is provided;
• blood supply improves;
• swelling does not occur and blood thickening does not occur;
• bleeding and blood clots are prevented.

Food contains a huge variety of proteins, but their importance is unequal. It is preferable for pregnant women to eat animal products. The amino acid composition of egg whites is considered ideal. The expectant mother's diet should include meat, fish, eggs, and dairy products. They are the main sources of protein.

Protein diet

Such nutrition during pregnancy does not harm the unborn child and maintains the woman’s normal weight. Protein diet for pregnant women differs from weight loss systems. It contains carbohydrates (porridge, vegetables). The diet of a pregnant woman includes the following products:

• meat (beef, lamb, turkey, rabbit, chicken);
• seafood;
• porridge;
• vegetable salads;
• dairy products(especially cottage cheese).

A pregnant woman should receive per day:

• 100-120 gamma proteins;
• 300-400 gamma carbohydrates;
• 80-100 grams of fat.

A protein diet for pregnant women requires 5 meals a day. Portions are divided as follows. At the first dose, the pregnant woman receives 30% of the calories of the daily diet. In the third - 40%, and in the second, fourth and fifth - 10% each. Nutrition according to this scheme is the best option.

The following products should be excluded from the menu:

• fast food;
• pastries and white bread;
• sweets;
• herring;
• mayonnaise;
• coffee and strong tea;
• mushrooms.

Menu

Sample diet during pregnancy.

1. The first breakfast consists of eggs and cheese.
2. For second breakfast, fruits, juices or dairy products are served.
3. Lunch consists of soups and hot dishes. The menu must include meat or fish, vegetables.
4. In the afternoon you can do without protein. We recommend juice, tea or a glass of kefir.
5. For dinner, meat or fish with vegetables is preferable.

Which cooking method is better? Steamer and grill. Frying is strictly prohibited, and boiling and stewing are not recommended. What fruits and vegetables are best to eat? Nutritionists say that preference should be given to products that are grown in our geographic area.

Diet for a week

A diet during pregnancy by day of the week may look like this:

• Monday.
  • For the first breakfast - muesli with milk or porridge with water and fruit.
  • The second breakfast consists of an apple and kefir. You can eat cottage cheese with apple, banana, dried apricots, prunes.
  • For lunch they offer a vegetable salad. They fill it up vegetable oil. The first is soup or borscht. For the second course, we recommend vegetable stew, stewed or baked meat.
  • Afternoon snack: bun, yogurt.
  • For dinner, it is recommended to serve a steamed meat cutlet, mashed potatoes, an apple and green tea.
• Tuesday
  • The first breakfast consists of milk porridge and yogurt.
  • On the second, they offer a boiled egg and tea.
  • Lunch – porridge with meat, cheese, banana, white bread, juice.
  • The afternoon snack consists of cottage cheese casserole, yogurt and cocoa.
  • Dinner – steamed fish, vinaigrette, rose hip decoction.
• Wednesday
  • For the first breakfast, meat, apple or banana, and tea are recommended.
  • Second breakfast – cottage cheese and kefir.
  • Lunch consists of vegetable salad, soup, beans or lentils.
  • Afternoon snack – bun, kefir.
  • Dinner - meat, rice, rye bread, dried fruit compote.
• Thursday
  • Breakfast consists of cheese, bread and butter, grapes.
  • Second breakfast – cottage cheese, green tea.
  • For lunch they offer vegetable salad, borscht, meat, and dried fruit compote.
  • Afternoon snack – cottage cheese and apple.
  • Dinner consists of fish, vegetable salad and fruit juice.
• Friday
  • For the first breakfast, the following products are offered: boiled egg, fresh cucumber, white bread and kefir.
  • The second breakfast consists of cottage cheese and tea.
  • Lunch – vegetable salad, soup, fish, fruit drink.
  • Afternoon snack – cake, yogurt, tea.
  • For dinner, boiled meat, cheese, vegetables, and tea are recommended.
• Saturday
  • The first breakfast consists of cottage cheese and green tea.
  • Second breakfast – diet cookies and milk.
  • For lunch they offer vegetable salad with meat and soup.
  • Afternoon snack – bun, honey, yogurt.
  • Dinner consists of fish, banana and fruit juice.
• Sunday
  • Breakfast – muesli, apple and banana.
  • Second breakfast – yogurt, diet cookies.
  • For lunch they offer vegetable salad, fish with stewed vegetables, and soup.
  • Afternoon snack – cottage cheese, nuts, kefir.
  • Dinner – meat, vegetable salad, apple, honey, tea.

If a woman gains more than normal during this period, it is necessary to reduce caloric intake. There is a special diet during pregnancy with overweight.

In the first trimester

In the first trimester, fetal organs are formed in the woman's body. During this period, good nutrition is important. The protein requirement in the first trimester is 1.5 g per 1 kg per day. Nutrition during this period of pregnancy is no different, but it must be balanced. In the first months you can eat pickles and sauerkraut.

In the 1st trimester, do not increase the caloric content of food. The daily diet of a short woman weighing 50 kg during this period is 2100-2300 kcal. A pregnant woman often gains excess weight in this trimester, so you should not overeat.

Nutrition in the second trimester

At this stage of pregnancy, the fetus is actively growing. In the second trimester, caloric intake is increased to 2600 kcal. Avoid sweets (sweets, jam, condensed milk).

In the second trimester, you should not consume fats such as cream and sour cream. Limit salt intake to avoid swelling. It retains water in tissues and fat layers, and the woman gains weight. You should not add enough salt to your food if you have swelling. It is recommended to limit the consumption of foods that contain allergens (exotic fruits, citrus fruits, strawberries).

In the second trimester, fresh vegetables and fruits are included in the daily menu. A woman should be responsible for the food she eats. You need to carefully ensure that your daily diet includes foods containing vitamins A, B, and E.

Increase the consumption of vegetable fats. In the second trimester, a pregnant woman’s menu includes 2 tablespoons of vegetable oil daily.

Diet in the third trimester

Dietary nutrition is especially important in the third trimester. During this period, do not eat fried, salty, sweet foods. Fried and smoked foods are not food for a pregnant woman. Meat and fish are included in the diet in the first half of the day, and in the second half preference is given to dairy and plant foods.

In the third trimester, products containing vitamins, calcium, and iron are recommended. How the formation of the fetus and the course of labor will be completed depends on this. In the third trimester, pay attention to the calorie content of foods so as not to gain weight. There are special diets for weight loss.

Losing weight during pregnancy

During this period, some women indulge their weaknesses by consuming sweets that affect their weight. In order to lose weight during pregnancy, it is enough to eat right. The following products should not be included:

• chips, crackers, any fast food;
• roast;
• sweet;
• baking;
• carbonated drinks, coffee, tea, alcohol.

Food should be eaten in small portions 5 times a day. In order to lose weight, cook it by steaming or grilling. Plant foods must be included in the diet. Must be consumed sea ​​fish. Those who want to lose weight should not forget about fruits. It is useful to include wholemeal bread in your daily diet. To lose weight, eat foods such as yogurt and kefir. It is enough to eat a few pieces of cheese a day.

Monitor your salt intake

Proper nutrition and an active lifestyle (walking, group exercise) is what a woman needs during pregnancy. All this will keep her physically fit, and she will not need to go on special diets to lose weight. If you are overweight, you can do it several times a week. fasting days(curd, apple, kefir), but only with the permission of a doctor.

During pregnancy, a woman should monitor her salt intake. IN Everyday life people oversalt their food. The sodium intake rate is 1–15 grams per day. For edema, a salt-free diet during pregnancy is recommended. If there is fluid retention in the tissues, avoid foods with added salt. The following products should be excluded:

• mayonnaise;
• ketchup;
• salted fish;
• sauerkraut;
• semi-finished products;
• kvass;
• salt mineral water.

For edema, it is recommended to prepare food yourself. It is healthy to eat apple and pumpkin salad. For edema, the diet should include foods that thin the blood - birch sap, onions. A pregnant woman's diet must include meat, fish, dairy products, fruits and vegetables. For edema, it is recommended to include foods with diuretic properties.

Fluid consumption in the 3rd trimester is justified. A pregnant woman's tissues almost always swell, but this should be controlled. Nutrition for edema should be correct. A salt-free diet helps in this case. If you have edema, you should not completely give up salt, but only limit its use.

The doctor will help the pregnant woman adjust her diet. She can create a menu for edema on her own. In this case, the menu should include:

• egg whites;
• cottage cheese;
• fish (seafood);
• meat;
• milk or kefir.

For swelling, eat 5 times a day.

A special diet may be prescribed for pyelonephritis in pregnant women. The following foods are prohibited on this diet:

• onion garlic;
• mustard;
• cocoa, tea;
• confectionery;
• mushrooms;
• spinach, sorrel, radish;
• legumes

Diabetes mellitus in a pregnant woman

Gestational diabetes mellitus during pregnancy is a signal that you should definitely monitor your diet. Here are some dietary guidelines for gestational diabetes:

1. Eat food in small portions.
2. Eat at the same time.
3. For gestational diabetes mellitus, the diet includes porridge;
4. Vegetables and fruits are eaten.
5. If you have gestational diabetes, your diet must include whole grain products.
6. A patient with gestational diabetes mellitus needs to consume 1.5 liters of fluid daily.

With this disease, a pregnant woman must monitor her blood glucose levels. The amount of calories consumed for gestational diabetes is 25–30 per kilogram of weight. A diet for this disease is prescribed by a doctor. For gestational diabetes mellitus, the following foods are prohibited:

• easily digestible carbohydrates;
• fried foods;
• fatty foods;
• fast food.

The diet for diabetes includes the following foods:

• vegetarian borscht, or with weak broth;
• vegetable soups;
• meat (beef, lamb, chicken);
• fish (pike perch, pike, pollock);
• kefir, cottage cheese, yogurt, sour cream;
• rosehip, mineral water;
• fruits (sweet and sour).

The diet is agreed upon with an endocrinologist. Your daily diet should contain the same amount of carbohydrates. Meals for diabetes must be divided (up to 8 times). The diet includes plant fiber. For diabetes, up to 30 grams of sweetener per day is allowed. Limit salt intake (up to 4 grams). The doctor individually draws up a menu for a pregnant woman with diabetes.

Department of Public Health of the Kemerovo Region

State budgetary professional educational institution

"KEMEROVSK REGIONAL MEDICAL COLLEGE"

Prokopyevsky branch

(PF GBPOU "KOMK")

Methodological development practical lesson

PM. 04. Participation in diagnostic, treatment and rehabilitation processes

MDK. 02.01. Nursing care for various diseases and conditions/Nursing care in obstetrics and gynecology

for specialty 34.02.01 nursing

Lesson No. 1

Topic: “Planning nursing care for pregnant women, childbirth and the postpartum period”

Compiled by teacher: Prokhorenko M.V.

Learning Objective: To form a system of knowledge about the normal course of pregnancy, physiological changes in organs and systems, and hygiene of pregnant women.

Developmental goal: To develop interest in the educational subject, to promote the activation of students’ thinking. To develop the cognitive activity of students in mastering software educational material.

Educational goal: Form a conscious attitude towards the learning process, striving for independent work and comprehensive mastery of the specialty

The student must know:

pregnancy diagnostic methods

signs of pregnancy

the role of the nurse in women's health and her responsibilities when working in antenatal clinic;

anatomy of the pelvis and its main dimensions, structure of the fetal head.

instruments for examination and examination of pregnant women.

examination scheme for a pregnant woman in the antenatal clinic

preparation of documentation for a pregnant woman

pregnancy hygiene.

pregnant woman's diet.

psychoprophylactic preparation of a pregnant woman for childbirth .

The student must be able to:

Carry out an external examination of the genitals,

Measure the external dimensions of the pelvis.

Use the simplest test to determine pregnancy.

Determine the gestational age and due date by the date of the last menstruation and the first movement of the fetus.

Be able to examine the cervix and vagina using speculums (on a phantom).

Take material for bacterioscopic examination (on a phantom)

Conduct an external obstetric examination (Leopold maneuver)

Measure the circumference of the abdomen and the height of the fundus of the uterus.

Listen to the fetal heartbeat.

Conduct a conversation on hygiene and nutrition for pregnant women.

Have practical experience:

Planning and implementation of nursing examination

communication with patients

anamnesis collection and examination of patients

documentation of nursing documentation

Formed elements of competencies:

PC 1. Present information in a form understandable to the patient, explain to him the essence of the interventions.

PC 2. Carry out therapeutic and diagnostic interventions, interacting with participants in the treatment process.

PC 5. Observe the rules for the use of equipment, equipment and medical products during the diagnostic and treatment process.

PC 6. Maintain approved medical documentation.

PC 8. Provide palliative care.

OK 1.Understand the essence and social significance of your future profession, show sustained interest in it.

OK 2. Organize your own activities, choose standard methods and methods for performing professional tasks, evaluate their implementation and quality.

OK 5.Use information and communication technologies in professional activities.

OK 7. Take responsibility for the work of team members (subordinates) and for the results of completing tasks

Type of activity: development and consolidation of knowledge and skills

Type of activity: practical lesson

Interdisciplinary connections: clinical pharmacology, pediatric nursing, surgical nursing, fundamentals of resuscitation, human anatomy and physiology, fundamentals of pathology, psychology, a healthy person and his environment.

Lesson equipment:

obstetric phantoms

obstetric and gynecological instruments

gloves,

antiseptic solution

manipulation algorithms

projector

multimedia presentation

test forms, recipes, individual pregnancy cards

methodological development practical lesson

Literature:

main: Slavyanova, I.T. Nursing in obstetrics and gynecology [Text]: secondary vocational education textbook / I.T. Slavyanova – Rostov-on-Don, “Phoenix”, 2014. – 395 p.: ill.

additional:

1 Androsova, E. N., Ovrutskaya, Z. L., Novitsky, S. N., Marchenko, A. M. Obstetrics and gynecology. Methodological recommendations for performing manipulations. – M.: “ANMI”, 1995 – 64 p.; 39 ill.

2. Slavyanova, I. T. Nursing in obstetrics and gynecology

[Text]: Workshop. SPO / I.T. Slavyanova - Rostov n/Don: Phoenix, 2002. – 352 p.

3 Krylova, E. P. Nursing in obstetrics and gynecology [Text]: secondary vocational education textbook / E. P. Krylova - Rostov-on-Don: “Phoenix”, 2000. – 384 p.

Electronic sources:

Internet sites.

Electronic supplement to the “National Guidelines. Obstetrics" - M.: GEOTAR-Media. – 2007.

Electronic supplement to the textbook “Obstetrics. Textbook for obstetric departments of secondary specialized medical institutions." edited by V.E. Radzinsky - M.: GEOTAR-Media. - 2008.

Electronic supplement to the textbook “Women's consultation”, ed. V.E. Radzinsky M.: GEOTAR - Media - 2009.

Electronic supplement to practical guide"Infections in

Lesson structure

Organizing time

Setting goals and objectives for the lesson

Motivation

Update basic knowledge

Instructing students for independent work/demonstration of performing manipulations

Independent work of students

Summing up the lesson, checking diaries, marking (diagnostics)

Homework

№ p/p	Lesson elements, educational questions	(min)	Teaching methods and techniques
	Organizing time
	1.1. Greeting students, checking absentees		The teacher welcomes and notes absentees
	1.2. Lesson Plan Coverage		The teacher announces the topic (written on the board)
	Setting goals and objectives for the lesson		The teacher sets the goals and objectives of the lesson
	Motivation During pregnancy, from the moment of conception to childbirth, a pregnant woman should be under the supervision of a doctor at the antenatal clinic. Early registration allows you to accurately determine the duration of pregnancy, timely resolve the issue of continuing pregnancy in women suffering from any diseases, and most effectively prevent pregnancy complications. When examining women, problems arise: fear of manipulation, anticipation of pain, anxiety. The nurse must learn to conduct preventive examinations and conversations, observe ethical standards, reduce feelings of fear, be able to reassure the patient, explain the need for manipulation, prepare the pregnant woman for the examination		The teacher gives concepts and asks students about the role of a nurse in obstetrics, how they see it in their future profession
	Updating basic knowledge		Situational tasks (presentation). Work at the board. Work in pairs. Frontal survey
	Instruction for independent practical work includes labor safety issues and explanations to students of the course of the practical lesson.		Studying the instructions -
	Break (airing the audience, physical education)		Health saving
	Doing practical work.		Work in pairs. Work in groups. Individual work. Perform manipulations according to the teacher's instructions.
	Summing up the lesson, marking (diagnostics) Reflection		The teacher evaluates each type of student’s work (oral frontal and individual surveys, SRS, filling out a workbook and practice diary), based on the assessments of each type of activity, the overall rating for the practical lesson and communicates it to the student. Marks the best and weakest answers of students, makes recommendations for improving students’ knowledge and reports the topic and homework of the next practical lesson
	Homework :		Slavyanova I.T. Nursing in obstetrics and gynecology [Text]: textbook of secondary vocational education. / I.T. Slavyanova – Rostov-on-Don, “Phoenix”, 2014. – 395 p. : ill.

Oral frontal interview

What does the obstetric and gynecological history include?

Rules for conducting pelviometry?

Characteristics of the size of the pelvis.

4. Changes in a woman’s body during pregnancy

5. Determination of gestational age.

6. Methodology for studying pregnant women

SRS: Preparation of abstract reports on the topic:

"Modern research methods in obstetrics"

"Pain relief for childbirth"

“Prevention of postpartum infectious and toxic diseases in an obstetric hospital”

“Modern diagnostic methods in gynecology”

Students work in groups: “Diagnosis of pregnancy”

Exercise 1

On your tables there are three groups of signs and the signs themselves. Lay out the signs of pregnancy and list them.

probable: cessation of menstruation, enlargement of the mammary glands, cyanosis of the mucous membranes of the vagina and cervix, changes in the size, shape and consistency of the uterus.

reliable: palpating small parts of the fetus, listening to the fetal heartbeat, fetal movement

suspected: nausea, vomiting, change in appetite, pigmentation on the face, linea alba, changes in the central nervous system - irritability, drowsiness, fatigue.

Task 2. Solving situational problems

Situational tasks:

TASK 1. Patient Zh., 22 years old, first pregnancy. Last menstruation August 22; First fetal movement on January 14th.

on menstruation;

at the first movement of the fetus.

Questions. Estimated due date:

on menstruation;

at the first movement of the fetus.

Patient I., 24 years old, second pregnancy, first normal birth. Last menstruation February 16; first fetal movement on June 30.

Questions. Estimated due date:

on menstruation;

at the first movement of the fetus.

TASK 4 Patient N., 21 years old, pregnancy 1. Last menstruation April 3; first fetal movement on August 27

Questions. Estimated due date:

on menstruation;

at the first movement of the fetus.

or slide presentation

Work at the board. Drag the cards to the desired places in the picture.

anterior view, first position, cephalic presentation;

posterior view, first position, cephalic presentation;

anterior view, second position, cephalic presentation;

posterior view, second position, cephalic presentation;

anterior view, first position, breech presentation;

posterior view, first position, breech presentation,

anterior view, second position, breech presentation;

posterior view, second position, breech presentation.

Business game “Reception at the antenatal clinic”

goal: to teach correct sequence studies of a pregnant woman, manipulations carried out in the antenatal clinic

selected from students: Senior nurse, Nurse working with documentation, “Patient”.

Equipment: Individual card of the pregnant woman, test forms, prescriptions.

task No. 1 (students work one at a time).

conduct (survey, history taking, anthropometry, blood pressure measurement, pelviometry.)

Record the results obtained in the pregnant woman’s individual chart.

task No. 2 (second student)

Prepare the following instruments for external examination: obstetric stethoscope, measuring tape, tazomer, tonometer with phonendoscope, disinfectant solution, cotton balls.

obstetric and gynecological examination: vaginal examination, bimanual examination, speculum examination.

task number 3

cover the table for examining the patient in the gynecological chair and for taking smears.

gloves, forceps, tweezers, glasses, Cusco mirrors, spoon-shaped mirrors, disinfectant solution, container with disinfectant solution, sterile balls, skin aseptic, Volkmann spoons, Eyre spatula.

task No. 4

check in the mirrors

take a smear to determine the degree of cleanliness of the vagina, pronouncing the algorithm of action

Choose from the directions and forms for tests that I have suggested that are necessary when a pregnant woman is discharged.

Task No. 6 (entire subgroup)

Write a prescription for folic acid tablets No. 50 for oral administration

Reflection.

test control:

7 minutes to answer. One correct answer.

Menstrual cycle- This

1. attachment of the egg to the wall of the uterus

2. cyclical changes in a woman’s body

4. capture of the egg from the abdominal cavity

2. Menstruation is

1. release of the egg from the follicle

3. rejection of the functional layer of the endometrium

3. Internal genitalia

1. pubis

4. labia

4. In regulation menstrual cycle participate

1. parathyroid glands

2. hypothalamic-pituitary system

3. adrenal glands

4. pancreas

5.. The ovaries form

1. estrogens

2. prolactin

3. blood cells

4. enzymes

6. B corpus luteum hormone is formed

1. estradiol

2. insulin

3. progesterone

4. oxytocin

7. Rupture of the follicle and release of the egg into the abdominal cavity

1. menstruation

2. ovulation

3. fertilization

4. implantation

8. Implantation ovum

1. accumulation of secretion in the uterine glands

2. attachment of the fertilized egg to the wall of the uterus

3. release of the egg from the follicle

4. Fusion of germ cell nuclei

9. The main component of the placenta

1. muscle tissue

2. epithelium

3. villi

4. uterine glands

10. Membrane secreting amniotic fluid

1. chorion

3. decidua

4. myometrium

11. For vomiting in pregnant women, it is prescribed

1. papaverine

3. heparin

4. tserukal

12. Complication of reproductive function due to induced abortion

1. infertility

2. prolapse of the genital organs

3. polyhydramnios

4. multiple births

Scheme of examination of a pregnant woman in the antenatal clinic:

STANDARD ANSWERS

Finding out basic passport data:

The passport number and insurance certificate are recorded. The woman's last name, first name, and patronymic are found out (it is necessary to find out what the woman wants to be called, the midwife herself must introduce herself to the woman, and also introduce the doctor who will guide her, or the doctor will do this). Age (risk factors include young age under 18 years, after 30 for primiparous women and over 35 for multiparous women). Home address and telephone number (registration and residence; it is preferable for the woman to be observed at her place of residence; this is convenient for patronage; however, in modern conditions, given the availability of convenient means of communication, the option of registration is also possible).

the living conditions are clarified, with whom the woman lives together, and what are the amenities. Place of work and profession (working conditions and the presence of occupational hazards are immediately clarified; in this case, exemption from performing hazardous work is provided).

Husband details:
(Full name, age, place of work and profession, presence of occupational hazards). It is necessary to ask: which relative can be contacted and whom the woman trusts most, if necessary. All this information should be on the first page. Also, the most important information about risk factors is placed on the first page in natural or encoded form.

Collection of complaints:
A healthy pregnant woman may have no complaints. However, it is necessary to find out whether she has any discomfort, pain. When studying subsequent topics, those complaints that need to be identified will be studied

History taking:
Information about working and living conditions. It is necessary to find out the nature of the work, what the hazards are at work, and also to clarify what kind of work the woman does at home, to warn about the exclusion of excessive workload, household hazards, and also to find out whether there are animals at home (the likelihood of infection). Find out about the woman’s education and interests, which will help improve contact with her.

Heredity:
Identify the pregnant woman’s hereditary predisposition: did her parents have diabetes, hypertension, or other endocrine or genetic diseases. It is important to know your husband’s heredity. It is necessary to obtain information about the bad habits of the pregnant woman and her husband and give recommendations.

AND Information about previous diseases:
Childhood infections colds, diseases of cardio-vascular system, diseases of the urinary system, liver, baseline blood pressure, etc. First of all, ask about tuberculosis, rubella and infectious hepatitis.

Determine whether the woman entered into Lately contacts with tuberculosis and infectious patients, whether she has such patients at home, find out about her trips to epidemiologically disadvantaged areas recently.

Separately ask about surgical interventions, whether there was a blood transfusion. Ask about the characteristics of menstrual function (at what age does menstruation begin, duration, regularity, periodicity, pain of menstruation, abundance of discharge). From what age sex life outside of marriage, within marriage, what means were used to prevent pregnancy. List past gynecological diseases, sexually transmitted diseases (the health of her sexual partner - the child’s father).

List all pregnancies, their outcome and complications in order of priority. Separately tell about the course of this pregnancy before registration.

Next, a general inspection is carried out, in which they pay attention to height, weight, posture, physique, nutrition, condition of the skin, subcutaneous tissue, blood vessels, lymph nodes, and the presence of edema. Pulse and blood pressure, heart sounds are examined. The temperature is measured and the nasopharynx is examined, and the lungs are listened to. They palpate the abdomen and liver, check the symptom of tapping on the lower back, and inquire about physiological functions.

Measuring blood pressure in a pregnant woman

Goal: to train the student to measure blood pressure in a pregnant woman and record the obtained data in the pregnant woman’s individual card.

Equipment:

Tonometer;

Stethoscope;

Execution method:

Explain to the woman the need for the procedure;

Familiarize the woman with the progress of the procedure and the need for it;

Sit the pregnant woman down at the table, placing her forearm in a horizontal position on the table (clothing should not squeeze the arm above the forearm); you can measure blood pressure in the lying position;

Fasten the cuff tightly so that only a finger passes between it and the shoulder;

Place your hand palm up in an extended position, asking the pregnant woman to relax;

Connect the pressure gauge to the cuff;

In the area of ​​the ulnar fossa, feel the pulse and place a phonendoscope in this place;

Close the valve on the bulb and use it to inflate air until the pressure in the cuff exceeds 20 mm Hg. Art. (or units) is the level on the scale at which the pulse ceases to be detected;

Open the valve and slowly release the air from the cuff, using a phonendoscope to listen to the sounds on the brachial artery, while simultaneously monitoring the scale readings;

When a sound appears on the brachial artery, note the level of systolic pressure;

The moment of disappearance of sounds on the brachial artery corresponds to the level of diastolic pressure;

Release the air from the cuff completely and repeat the procedure on the second arm;

Record the data obtained when measuring blood pressure in both arms in the pregnant woman’s individual chart;

Wash and dry your hands.

Pulse study

Equipment:

Stopwatch;

Execution method:

Explain to the woman the purpose, necessity and course of the procedure;

Can be carried out in the “sitting” and “lying” positions;

Place the second, third and fourth fingers of the right crayfish on the area of ​​the radial artery: the first finger - from the back of the hand, the second and third - on the radial artery;

Press the artery against the bone, feeling its pulsation;

Note and characterize the rhythm of the beats and their clarity (pulse tension);

Record the received data in the pregnant woman’s individual card;

Wash and dry your hands.

MEASUREMENT OF THE EXTERNAL DIMENSIONS OF THE PELVIS

Goal: to teach the student to measure the main dimensions of the pelvis using a pelvis meter and record it in the individual chart of the pregnant woman.

Equipment:

Couch;

Tazomer;

Cotton balls or gauze;

70% ethyl alcohol;

Individual card of a pregnant woman;

Oilcloth.

Execution method:

Explain to the woman the purpose, necessity and course of the procedure;

Place the pregnant woman on the couch, placing an oilcloth under her (under the buttocks and under the legs), in the “on her back” position with her legs straightened;

Sit or stand to the right of the couch facing the woman;

Take the pelvis meter in your hands so that the scale is facing upward, and the first and second fingers lie on the buttons of the pelvis meter;

Wipe the tazomer buttons with a ball of alcohol;

Palpate the anterior superior iliac spines with your index fingers, attach the buttons of the pelvis to them - spinarum distance (normal size corresponds to 25-26 cm);

Move the buttons of the pelvis gauge to the most distant points of the iliac crests (the cristarum distance normally corresponds to 28-29 cm);

Find the greater trochanter of the femur with your index fingers;

Press the buttons of the pelvis gauge onto the greater trochanters of the femurs;

Determine the distance between the greater trochanters of the femurs using the pelvic meter scale (the trachanteric distance normally corresponds to 30-31 cm);

Invite the woman to lie on her side with her back to the midwife, lower leg bent, upper leg straight;

Place one button of the pelvis meter on the upper edge of the symphysis pubis, and the second - in the upper corner of the Michaelis rhombus, determine the distance on the scale of the pelvis meter (the normal external conjugate distance is 20-21 cm);

To obtain the value of the true conjugate, you need to subtract 8-9 cm from this figure, which will correspond to 12-13 cm;

Enter the data obtained into the pregnant woman’s individual card in the following columns:

a) dist. spinarum:

b) dist. cristarum

c) dist. trachanterika

d) con. externa

Treat the tazomer with a ball of alcohol;

Wash and dry your hands.

All subsequent studies are carried out in the second half of pregnancy.

Abdominal circumference measurement

Goal: to teach the student to measure the abdominal circumference of a pregnant woman using a centimeter tape and record the result in the pregnant woman’s individual chart.

Equipment:

Couch;

Tape measure;

Oilcloth;

70% ethyl alcohol;

Individual card for a pregnant woman.

Execution method:

If it is difficult for a woman to stand, place her on the couch with her legs straightened, placing an oilcloth under her buttocks;

Stand or sit to the right of the pregnant woman, facing her;

Wipe the measuring tape with a ball moistened with alcohol;

Place a measuring tape under your back so that in front it is at the level of the navel, and in the back at the level of the lumbar region;

Mark the volume of the abdomen at the level being examined on a measuring tape scale;

Help the pregnant woman get up from the couch, first turning on her side and then sitting on the couch;

Dump the oilcloth into a basin;

Wash and dry your hands;

Enter the result obtained during the measurement into the pregnant woman’s individual card.

Leopold's first move: Determination of the height of the uterine fundus

Goal: To teach the student to measure the height of the uterine fundus using a centimeter tape and record the data in the individual chart of the pregnant woman.

Equipment:

Couch;

Cotton balls;

70% ethyl alcohol;

Oilcloth;

Tape measure;

Individual card for a pregnant woman.

Execution method:

Explain to the woman the purpose, necessity and progress of the procedure;

Warn about the need to empty the bladder;

Place the pregnant woman on the couch with her legs straight, placing an oilcloth under her buttocks;

Sit to the right of the woman, facing her;

Wipe the measuring tape with a ball of alcohol;

Place a measuring tape vertically along the midline of the abdomen; from below, the measuring tape should touch the upper edge of the symphysis, from above - the highest point of the fundus of the uterus;

Mark the result obtained on the measuring tape scale;

Help the pregnant woman get up from the couch by turning on her side and then sitting on the couch;

Dump the oilcloth into a basin;

Evaluation of the data obtained

Leopold's second move: Determination of position, presentation, position, type of fetus using four methods of external obstetric examination of a pregnant woman.

Goal: to teach the student to conduct an external obstetric examination of a pregnant woman using four obstetric techniques and record the result in the pregnant woman’s individual chart.

Equipment:

Couch;

Oilcloth;

Individual card for a pregnant woman.

Execution method:

Explain to the woman the need, purpose and progress of the procedure;

Place the pregnant woman on the couch in the “supine” position with her legs straightened, placing an oilcloth under her buttocks;

Sit to the right of the pregnant woman, facing her;

I Reception - determination of VSDM by palpation. The palms of both hands are located on the fundus of the uterus and determine the level of the fundus of the uterus in relation to the upper edge of the symphysis pubis, the navel and the xiphoid process.

II Reception – determination of the position, position and type of the fetus.

Hands are moved to the side walls of the uterus, parts of the fetus are palpated alternately with the right and left hands. In the longitudinal position of the fetus, the back is determined on one side, and small parts on the other.

Fetal position is the relationship of the longitudinal axis of the fetus to the longitudinal axis of the uterus.

The position of the fetus can be longitudinal, transverse and oblique.

Longitudinal position - the longitudinal axis of the fetus coincides with the longitudinal axis of the uterus.

Transverse position of the fetus - the longitudinal axis of the fetus is at right angles to the longitudinal axis of the uterus.

Oblique position - the longitudinal axis of the fetus is at an acute angle to the longitudinal axis of the uterus.

Fetal position is the relationship of the fetal back to the lateral wall of the uterus.

I position – the back is turned to the left,

II position – the back is facing to the right.

View - the relationship of the fetal back to the anterior or posterior wall of the uterus. The back is facing more anteriorly - anterior view, more posteriorly - posterior view.

III Leopold's Reception

Determines the presenting part of the fetus, which is closest to the entrance to the pelvis (head, pelvic end)

The nurse stands on the right, facing the patient's face, moves the thumb of the right hand as far as possible and carefully plunges the fingers into the depths above the symphysis pubis and covers the presenting part. If it is the head, then it is dense, round and shoots, and if it is the pelvic end, then it is soft, not round and does not shoot.

IV Leopold's Reception

determination of the relationship of the presenting part of the fetus to the entrance to the small pelvis (movable, pressed, in the small pelvis).

Listening to and assessing the fetal heartbeat

Goal: to teach the student to use an obstetric stethoscope to find the best place to listen to the fetal heartbeat, listen, count and evaluate the fetal heartbeat.

The fetal heartbeat can be heard using an obstetric stethoscope after 20 weeks (preferably 24 weeks) of pregnancy.

Equipment:

Couch;

Oilcloth;

Obstetric stethoscope;

Stopwatch;

70% ethyl alcohol;

Individual card for a pregnant woman.

Execution method:

Explain to the woman the purpose, necessity and progress of the procedure;

Place the pregnant woman on the couch in the “supine” position with her legs straightened, placing an oilcloth under her buttocks;

Sit to the right of the pregnant woman;

Wipe the obstetric stethoscope with a ball of alcohol and take it in your right hand;

Take a stopwatch in your left hand;

using an obstetric stethoscope, moving it along the abdomen, find a place to clearly listen to the fetal heartbeat (with a cephalic presentation below the navel, and with a breech presentation - above the navel);

Using a stopwatch, record the time and count the number of beats in one minute (to eliminate errors with the pregnant woman’s pulse, which should not coincide in rhythm with the fetal heartbeat);

Note the rhythm and clarity of the beats;

Help the pregnant woman get up from the couch, first turning on her side and then sitting on the couch;

Wipe the stethoscope again with a ball of alcohol;

Throw the oilcloth into a basin;

Wash and dry your hands;

Enter the received data into the pregnant woman’s individual card.

With twins, the fetal heartbeat is heard clearly at two points, independently of each other, while a “silent zone” is noted between these points.

Normally, the fetal heartbeat is 120-140 beats per minute, rhythmic and clear.

Deviations in the frequency, rhythm and clarity of beats may indicate threatening intrauterine asphyxia of the fetus.

Work at the board. Match

Method of taking a smear to determine the degree of vaginal cleanliness and preparation for examination by a doctor

Goal: to teach the student to correctly place a woman on a gynecological chair and take a smear from the vagina to determine the degree of purity.

Equipment:

Gynecological chair;

A sterile table with instruments (mirrors, tweezers) and soft equipment (balls, napkins);

Crane lamp;

Slides;

Volkmann spoon;

Latex gloves;

Referral to the laboratory;

Disinfectant solution.

Execution method:

Explain to the woman the need and progress of the procedure;

Inform about the need to empty the bladder;

Place oilcloth and lining on the chair;

Help the woman lie on the gynecological chair in the “supine” position, legs bent in hip joints, separated, popliteal fossae resting on the supports;

Explain that breathing should be free during the examination;

Prepare the external genitalia for examination by lubricating the outside and inner surface of the thighs with a disinfectant solution using a forceps and a ball;

Wash your hands and put on gloves;

With the first and second fingers of the left hand, separate the labia majora and minora;

Right hand carefully insert the Cusco speculum into the vagina: first in a longitudinal position, then move it to a transverse position and open it into the vagina, not reaching the cervix;

Secure the mirror in the open state with a screw;

Insert a Volkmann spoon into the vagina (you can use tweezers) and carefully take a smear, lightly touching the upper-lateral wall of the vagina;

Apply a thin layer of smear onto a glass slide without crushing the cells;

If there is heavy discharge in the vagina, then before taking a smear, it is recommended to carefully blot the vagina using a cotton swab on tweezers (for better visibility);

Unscrew the screw on the mirror;

Carefully remove the speculum from the vagina, gradually closing it;

Place the mirror in a 3% chloramine solution for one hour;

Remove gloves and wash hands;

Submit a referral to the laboratory:

answers to problems :

1. Patient Zh., 22 years old, first pregnancy. Last menstruation August 22; First fetal movement on January 14th.

Patient A., 28 years old, pregnancy 3, births 2. Last menstruation December 25; first fetal movement on May 19th.

Patient I., 24 years old, second pregnancy, first normal birth. Last menstruation February 16; first fetal movement June 30

Patient N., 21 years old, pregnancy 1. Last menstruation April 3; first fetal movement on August 27th.

Work at the board.

1 - anterior view, first position, cephalic presentation;

2 - posterior view, first position, cephalic presentation;

3 - anterior view, second position, cephalic presentation;

4 - posterior view, second position, cephalic presentation;

5 - anterior view, first position, breech presentation;

6 - posterior view, first position, breech presentation,

7 - anterior view, second position, breech presentation;

8 - posterior view, second position, breech presentation.

test survey: (answers)

1.2 ; 2.3; 3.2; 4.2; 5.1; 6.3; 7.2; 8.2; 9.3; 10.2; 11.4; 12.1.

Fizminutka

DIRECTION ANALYSIS OF A smear for the degree of cleanliness of the vagina FULL NAME……………………………………………………………….. G.R……………………………………………………………..

It is difficult to overestimate the influence of nutrition on the well-being and health of children and adults - especially in modern conditions of massive use in industrially prepared food of quite toxic, and often simply harmful, prohibited dietary supplements, flavoring and coloring substances, including many.

It should be understood that normal conception, gestation (the period of intrauterine gestation), the process of childbirth and natural feeding of a child are normal physiological processes that do not require any medical or other external assistance.
During normal childbirth (now in Russia in 40% of cases, it is desirable, but not completely obligatory, only the help of a modern nurse-midwife, previously, according to popular definitions, a “grandmother-midwife,” i.e., highly trained and experienced in assisting childbirth women). In reality, with modern childbirth in Russia, in 60% of cases a serious medical assistance both the newborn and his mother.

Rational nutrition is one of the main conditions for a favorable course and outcome of pregnancy and normal fetal development. A pregnant woman's body requires a greater than usual amount of nutrients needed not only by the mother herself, but also by the growing child.

In the diet of a pregnant woman (and nursing mother, and child), the freshest possible products and freshly prepared food should be used. It is highly advisable to exclude sucrose from the diet (including in confectionery products), replacing it with glucose, fructose, honey and confectionery products made on their basis.

Energy intake must correspond to the body's expenditure. Often, the expectant mother deliberately overeats, moreover, against the background of reduced physical activity.

Excess nutrients lead to changes in the metabolism and functions of the endocrine glands of the fetus, which disrupts the harmonious development of all organs and systems of the fetus. As a result, a large baby is born with overweight body, “loose” muscles and insufficient development of individual organs. On the other hand, insufficient and inadequate nutrition of women during pregnancy, especially a deficiency in the diet of any essential substances - amino acids, vitamins, polyunsaturated fatty acids, minerals - also negatively affects the body of the woman and the fetus, leading to disruption of metabolic processes. This can contribute to miscarriages, disruption of intrauterine development of the fetus, the birth of a child with very low body weight, the development of children's tendency to diseases, developmental delays, anomalies and deformities, etc.

One of the most important indicators rational nutrition of pregnant women is an increase in their body weight, which is normally 8-10 kg during pregnancy (300-350 g per week in the second half of pregnancy).

A woman’s diet should not differ significantly from usual. But since the first 3 months are the period of formation of organs in the fetus, it is especially important that the pregnant woman receives complete proteins, fats, carbohydrates, vitamins, minerals and trace elements in optimal physiological quantities. The daily diet should contain an average of 110 g of protein, 75 g of fat and 350 g of carbohydrates with a total energy value of 2400-2700 kcal; this ratio fully covers the needs of the pregnant woman’s body and ensures the normal functioning of the digestive system. If your taste changes and you feel the need for something sour or salty, you are allowed to eat herring, caviar, sauerkraut, and pickles in small quantities. In general, you can satisfy your food cravings, but not overindulge in anything. The only thing that should be completely excluded from the very beginning of pregnancy is alcoholic drinks. Smoking is unacceptable - every cigarette smoked inevitably makes its own “contribution” to the development of fetal malnutrition (and the more cigarettes, the stronger the malnutrition). Should not be taken without a doctor's prescription and medication, especially in the first months of pregnancy. You should also exclude mustard, pepper, horseradish, and vinegar from consumption. The food taken must, of course, be of good quality - the consequences of food poisoning are too severe for both the fetus and the pregnant woman herself. Also, during pregnancy and lactation, any canned food should be excluded (due to the content of toxic preservatives), except those with the inscription on the label: either “For baby food” or “No preservatives are guaranteed.”

the amount of protein in the diet should already be 120 g, fat 85 g, carbohydrates 400 g with a total energy value of the daily diet of 2800-3000 kcal. During prenatal leave, when the volume and conditions of work change and the body's energy consumption decreases, the calorie content of food must be reduced. At this time, you should not consume extractive substances (fish, meat, mushroom broths and gravies), various smoked meats and canned food. Vegetable, milk and fruit soups, cottage cheese, sour cream, mild cheese are recommended, although the diet of pregnant women during this period should not be limited to dairy and plant foods. IN balanced diet pregnant women are provided with optimal quantitative and qualitative ratios in the daily diet of basic nutrients - proteins, fats, carbohydrates, vitamins, mineral salts and microelements. For the growth of the uterus, placenta, mammary glands, and to increase the amount of blood, the mother’s body needs additional proteins. The need for them is satisfied mainly by complete animal proteins, which should account for 50% of the daily diet of a pregnant woman, of which about 25% - from meat (120-200 g) or fish (150-250 g), 20% - from due to milk (500 g) and up to 5% - due to eggs (1 pc.). Milk, curdled milk, kefir, low-fat cottage cheese, mild cheese, boiled lean meat, fish contain complete, easily digestible proteins, essential amino acids, which are in optimal proportions.

The diet of pregnant women should include 75-85 g of fats per day, of which 15-30 g of vegetable (sunflower, corn, olive) oils containing unsaturated fatty acid and vitamin E; of animal fats, premium-grade butter and ghee are recommended. Refractory lamb and beef lard, as well as some other types of animal fats and margarine are excluded from the diet. A direct relationship has been established between the content of carbohydrates in a pregnant woman’s diet and the weight of the fetus. A pregnant woman should receive 350-400 g of carbohydrates per day, mainly from foods rich in plant fiber - wholemeal bread (black bread enhances intestinal motility and is thus one of the means of combating constipation, which often occurs during pregnancy ), vegetables, fruits, berries. In winter and spring, juices (apple, plum, tomato), compotes from dried fruits and jelly from fresh frozen berries are recommended. Starting from the second half of pregnancy, a woman should limit the consumption of confectionery, jam, and sweets, as they contribute to an increase in body weight of the pregnant woman and the fetus. The amount of sugar should not exceed 40-50 g per day. It can be replaced with bee honey (at the rate of 1.25 g of honey instead of 1 g of sugar). For a favorable course of pregnancy, preparing the woman’s body for childbirth, normal development of the fetus and newborn great importance have vitamins, the need for which in pregnant women almost doubles.

Vitamin A promotes the development of the placenta, its daily requirement is 2.5 mg. Vitamins B1 and B2 strengthen muscle fibers, the daily requirement for vitamin B1 is 3-5 mg, B2-3 mg. Vitamin C (ascorbic acid) helps contract the muscles of the uterus and strengthens immune system body, the daily need for it is 100-200 mg. With a lack of vitamin D, the fetus’ bones develop incorrectly, defects in the formation of teeth are formed, and the pregnant woman herself may develop anemia. The daily requirement for it is 500 IU. A lack of vitamin PP (nicotinic acid) is fraught with fetal development abnormalities, miscarriage and premature birth, the daily requirement is 15-20 mg. Vitamin E promotes the growth of the pregnant uterus and intrauterine development fetus, daily requirement 15-20 mg. The use of a wide range of products of plant (wholemeal flour products, buckwheat and barley groats, legumes, potatoes, tomatoes, fruits, berries) and animal (liver, meat, eggs, cottage cheese, milk, butter) origin provides the basic need for vitamins for a pregnant woman. In the winter and early spring months, food should be fortified, including syrups containing vitamins A, B, C, D, E in the diet, or take multivitamin tablets. To prevent rickets in a child in the last months of pregnancy, take fish oil or vitamin D (the latter only as prescribed by a doctor).

For detailed information about the pregnant woman’s body’s need for vitamins, the conditions for using vitamin preparations, as well as tables of the content of various vitamins in food, see the “Vitamins” page.

The pregnant woman's need for mineral salts increases in the second half of pregnancy. A varied diet ensures that most of them enter the body in sufficient quantities. A special problem in the nutrition of a pregnant woman is the provision of iron, necessary for normal hematopoiesis and tissue respiration. The daily requirement for it is 15-20 mg and is covered by eating liver, egg yolk, greens, fruits, buckwheat and oatmeal. Here you can see a table showing the iron content of basic foods.

Sometimes women at the beginning of pregnancy feel the urge to eat lime, chalk, salt, etc. This condition indicates an insufficient supply of calcium salts to the body and requires a review of the food consumed, in extreme cases (if it is impossible to provide adequate nutrition) the prescription of vitamins (mainly vitamin D), calcium, iron and phosphorus. The daily calcium intake for a pregnant woman is 1500-2000 mg (while the usual intake for an adult is 800 mg per day). The most significant and complete sources of calcium are milk and dairy products. Just 100 ml of pasteurized milk adds 128 mg of calcium to the diet. Full-fat cottage cheese contains 150 mg%, while low-fat cottage cheese contains 120 mg%. Cheeses exceed all other food products in calcium content (up to 1000 mg per 100 g).

In the first half of pregnancy, a woman can consume 10-12 g of table salt, in the second - up to 8 g, and in the last 2 months - up to 5 g per day.

You should consume approximately the following amount of minerals per day (for pregnant women):
Calcium - 1500-2000 mg
Magnesium - 300-500 mg
Phosphorus - 1-1.5 g
Potassium - 3-5 g
Sodium - 4-6 g
Chlorine - 4-6 g
Iron - 18 mg

A pregnant woman's daily fluid requirement is about 2-2.5 liters. A significant portion of this amount is contained in consumed foods. Free liquid usually needs to be consumed 1-1.2 liters (water, tea, milk, jelly, compotes, first courses). In the last weeks of pregnancy, especially if there is a tendency to edema, the amount of free liquid in the daily diet is limited to 4 glasses (including tea, milk, compotes, fruit juices, soups).

Proper nutrition of a woman in itself is the prevention of pregnancy complications. For healthy women, no diet is required in the first half of pregnancy; adherence to the regimen is important healthy eating.

In the first half of pregnancy the most physiological is 4 meals a day. The first breakfast should contain about 30% of the energy value of the daily diet, the second breakfast - 15%, lunch - 40%, dinner - 10%, at 21:00 a glass of kefir - 5%.

In the second half of pregnancy 5-6 meals a day are recommended. A woman should receive (approximately): wheat bread - 100-150 g, rye bread - 150-200 g, meat or fish - 200 g, butter - 40 g, vegetable oil - 30 g, 1 egg, milk - 500 g, cottage cheese - 150 g, kefir - 200 g, sour cream - 30 g, flour products (cookies, buns, etc.) - 100 g, pasta - 60 g, cereals - 50 g, potatoes - 400 g, cabbage - 100 g, onions - 35 g, carrots - 100 g, tomatoes - 200 g, as well as tea, cocoa (coffee and hot spices should be avoided).

From the same products we can offer pregnant woman's menu, which includes 4 meals a day:
first breakfast at 7-8 am,
second breakfast at 11-12 o’clock,
lunch at 14-15 hours,
dinner at 18-19 hours.
you can arrange an afternoon snack: a glass of milk with cookies or a glass of juice,
or a glass of rose hip decoction, or fruits, berries,
A glass of kefir is recommended before bed.

This meal schedule may change depending on the pregnant woman's routine, activities, etc. Food should be distributed so that meat, fish, and cereals are included in breakfast and lunch. For dinner, it is recommended to eat mainly dairy and plant foods. The last dose should be taken 2-3 hours before bedtime.

Sample menu per week for women in the second half of pregnancy

Monday:
First breakfast: goulash with mashed potatoes, apple juice.
Lunch: milk.
Dinner: pea soup with minced meat, boiled fish with vegetable stew, compote.
Afternoon snack: fruits or berries.
Dinner: curd soufflé, cranberry mousse.
21h: kefir.

Tuesday:
First breakfast: curd soufflé, boiled egg, vinaigrette, rosehip infusion.
Lunch: milk, bun.
Dinner: Ukrainian borscht with minced meat and sour cream, boiled chicken with vermicelli, cranberry mousse.
Afternoon snack: a glass of rosehip infusion, a bun.
Dinner: low-fat cottage cheese.
21:00 kefir.

Wednesday:
First breakfast: boiled fish with mashed potatoes, low-fat cottage cheese, milk.
Lunch: protein omelet with sour cream, fruit juice.
Dinner: pureed vegetable soup with sour cream, boiled tongue with oatmeal, fruits, berries.
Afternoon snack: rosehip infusion, bun.
Dinner: low-fat cottage cheese.
21:00 kefir.

Thursday:
First breakfast: boiled fish with vegetable stew, low-fat cottage cheese, coffee with milk.
Lunch: milk, bun.
Dinner: rice soup with minced meat, boiled chicken with mashed potatoes, fruit.
Afternoon snack: low-fat cottage cheese, cranberry mousse.
Dinner:
21:00 kefir.

Friday:
First breakfast: protein omelet with sour cream, fresh cabbage salad, coffee with milk.
Lunch: milk, bun, low-fat cottage cheese.
Dinner: potato fish soup, sausages with buckwheat porridge and salad, fruit jelly.
Afternoon snack: fruits or berries, cookies.
Dinner: low-fat cottage cheese, rosehip infusion.
21:00 kefir.

Saturday:
First breakfast: boiled fish with mashed potatoes, milk.
Lunch: herring with onions, vinaigrette, cranberry mousse.
Dinner: pea soup with minced meat, boiled beef with carrot puree, compote
Afternoon snack: cookies, rosehip infusion.
Dinner: protein omelet with sour cream, tea.
21:00 kefir.

Sunday:
First breakfast: stewed liver with carrots, low-fat cottage cheese, fruit juice.
Lunch: wheat milk porridge.
Dinner: fish soup, goulash with buckwheat porridge and salad, compote.
Afternoon snack: cookies, cranberry mousse.
Dinner: low-fat cottage cheese, tea.
21:00 kefir.

During pregnancy with any complications, if the pregnant woman has diseases, obesity or other deviations from the norm, the diet and diet are agreed upon with the antenatal clinic doctor. It is not uncommon for pregnant women to become intolerant to certain foods that cause allergic reactions. If it is impossible to exclude such foods from your diet, you can, after consulting with your doctor, try to consume them in gradually increasing quantities. Milk, egg yolk or white, flour, fish and other products are diluted in boiled water in a ratio of 1:1000, 1:100, 1:10, 1:2. First, start taking the maximum dilution, 1 teaspoon 1 time a day, then 2-3 times a day, then repeat daily up to 10 spoons 3 times a day, then move on to a dilution of 1:100, etc. The course of such intake of products is 3-6 months. In case of mild food allergies, for training, you can take a small amount of intolerant food (a quarter of a teaspoon of egg, 20-30 ml of milk) 45-60 minutes before the main meal for 3-4 weeks.

In case of pregnancy complications, most often for late toxicosis, fasting diets may be recommended: apple diet (5 times a day, 300 g of ripe raw or baked apples, 1.5 kg in total); watermelon (5 times a day, 300-400 g of watermelon pulp, total 1.5-2 kg); cottage cheese (5 times a day, 100 g of cottage cheese with 9% fat content, 2 glasses of tea, 1 glass of rosehip decoction, 2 glasses of low-fat kefir, only 1 liter of liquid. Such diets are incomplete in energy and chemical composition, so they are prescribed no more than once a week.

Future mothers! Be sure to read p.