MoonDragon's Pregnancy Information
For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.
Placenta Previa Description Frequent Signs & Symptoms of Placenta Previa Causes of Placenta Previa Placenta Previa Risk Factors Preventive Measures Expected Outcome Potential Placenta Previa Complications Conventional Medical Treatmennt Medication Activity Recommendations & Restrictions Diet & Nutrition Notify Your Midwife or Health Care Provider Recommended Dietary Supplement Products
PLACENTA PREVIA DESCRIPTION
Placenta previa is a placental attachment that is too low in the uterus and covers the cervix. Normally the placenta is attached to the uterus above the cervix. The placenta completely covers the internal os in slightly more than 10 percent of placenta previa cases. Under these circumstances the placenta precedes the fetus in vaginal delivery. This can be life-threatening to the unborn child and mother if untreated. It occurs to some degree in 1 of 200 pregnancies.
Persistent excessive prenatal bleeding may seriously threaten the mother. The maternal (not fetal) circulation is the source of bleeding. Vaginal or rectal examination or attempts to deliver from below may lacerate or separate the placenta, and as a consequence, the draining of blood (exsanguinating) maternal or fetal hemorrhage may occur. Placenta previa is a major cause of maternal and perinatal morbidity and mortality.
FREQUENT SIGNS & SYMPTOMS OF PLACENTA PREVIA
Sudden, painless bleeding during the second or third trimester of pregnancy is the primary symptom. Bleeding may begin slight or moderately and become severe and is bright red in color. Bleeding can occur as early as the 20th week of pregnancy but is most common during the third trimester.
Cramping in some women. Signs of preterm labor. One in 5 women with signs of placenta previa also has uterine contractions.
Bleeding from placenta previa may taper off and even stop for a while. However, it nearly always starts again days or weeks later.
Abnormal fetal position in the uterus.
Some women with placenta previa do not have any symptoms. In this case, placenta previa may only be diagnosed by an ultrasound done for other reasons.
CAUSES OF PLACENTA PREVIA
Normally, the placenta attaches high on the uterus wall, away from the cervix. In placenta previa, the placenta covers the cervix partially or completely. Any change in the cervix, such as the softening and dilating that occurs prior to delivery, can cause the placenta to bleed as it separates from the uterus.
PLACENTA PREVIA RISK FACTORS
Previous uterine procedures or surgery that affect the uterine lining, such as cesarean section or dilation and curettage (D & C) done with sharp curettage (rare) after a miscarriage (spontaneous abortion) or a medical abortion. Of women who have had a previous cesarean delivery, as many as 4 in 100 develop placenta previa. Of Women who have had four or more C-sections, 10 in 100 develop placenta previa.
Fibroid tumors of the uterus.
Smoking. Cigarette smoking is strongly linked to 1 of every 4 previas. Smoking decreases the amount of oxygen transferred to the fetus, thereby stimulating the growth of a larger placenta, which is more likely to grow low into the uterus.
Multiple previous pregnancies and deliveries. Placenta previa occurs in 1 in 1,500 first time pregnancies. In women who have had five or more pregnancies, this increases to about 5 in 100.
Advancing maternal age. Among women 19 or younger, only 1 in 1,500 develops placenta previa. Of women age 35 and over, 1 in 100 develops placenta previa.
Cocaine or crack cocaine use during pregnancy.
History of previous placenta previa.
If your midwife or health care provider has identified a placenta previa or low-lying placenta before your 20th week of pregnancy, chances are good that it will resolve on its own. About 90 percent of placenta previa cases diagnosed before the 20th week resolve on their own by the end of the pregnancy. As the lower uterus grows, the position of the placenta can change in relation to the cervix so that by the end of the pregnancy, the placenta no longer blocks the cervix.
Get good prenatal care during a pregnancy. It will not prevent previa, but can help identify complications early.
Do not smoke (or use cocaine) during pregnancy. Smoking also causes a secondary problem that can lead to poor growth of the fetus.
With prompt care, mothers and most infants survive without complications. Delivery is by cesarean section in most cases.
POTENTIAL PLACENTA PREVIA COMPLICATIONS
Premature delivery or fetal death, if extensive placenta previa develops before the expected delivery date.
Placental abruptio, also called placenta abruption, is the separation of the placenta from the uterine wall, either partially or totally resulting in potentially hazardous blood loss before or during delivery. Hemorrhaging requiring blood transfusions for the mother prior to delivery or following delivery may be needed. This can be life threatening for both mother and her baby. when the placenta has abnormally attached or grown into the uterine wall (placenta accreta, placenta increta, or placenta percreta), bleeding can be severe enough to require a hysterectomy.
MoonDragon's Pregnancy Information: Placental Abruption
Poor fetal growth due to an abnormal placenta providing a decreased blood flow and oxygen delivery. The site of implantation and size of the placenta are related. The circulation of the lower uterine segment is less favorable than that of the fundus (top of the uterus), placenta previa may have to cover a larger area for adequate efficiency. In placenta previa the surface area may be at least 30 percent greater than the average placenta implanted in the fundus. Twice as many placenta previas involve the anterior uterine wall as in normal implantation, and the probability is even greater after a cesarean birth because of scarring.
Placenta previa or low-lying placenta may encourage breech or transverse presentation and my prevent engagement of either fetal part.
Premature, or preterm, delivery (before the 37th week of pregnancy), which typically poses the greatest risk to the fetus.
Birth defects occur 2.5 times more frequently in pregnancies affected by placenta previa than in unaffected pregnancies. the cause is currently unknown. It may be that placenta previa is slightly more common among older women, as are babies with birth defects.
Puerperal infection (child bed fever or infection of the uterus).
Anemia from blood loss.
CONVENTIONAL MEDICAL TREATMENT
Have regular checkups during pregnancy with your midwife or health care provider. If signs of placenta previa appear (such as picking up placental sounds in the lower part of the uterus while checking for fetal heart tones) be prepared to go to the hospital for diagnosis confirmation, early observation and possible delivery. Arrange for fast transportation to the hospital in case of emergency, especially massive bleeding.
Diagnostic tests may include laboratory blood studies to determine the amount of blood loss. ultrasonography of the uterus is used most frequently to diagnose placenta previa and to determine exact location of the placenta. Most placenta previas are identified during the second trimester during a routine ultrasound or amniocentesis for a genetic testing, or when assessing the cause of vaginal bleeding or when bleeding begins at the onset of labor. However, ultrasound does not always provide a clear picture of the placenta's location.
When an early delivery is needed, an amniocentesis may be done. It is used to find out whether the fetus's lungs are ready to breathe well after birth. For an amniocentesis, a needle is inserted into the mother's belly to take a small sample of amniotic fluid from inside the uterus. This fluid is made by the fetus's lungs. A lab test of the fluid can test for signs that the lungs are well-developed.
With bleeding placenta previa, it is important that you avoid sexual intercourse, office vaginal exams, or putting anything else in your vagina since there is a high risk of further injuring the placenta, causing heavier bleeding. You may, however, have a carefully done vaginal exam at the hospital with an emergency surgery team standing by for an immediate cesarean delivery, just in case of hemorrhage.
Clinical classification is often described as complete, total, or central if the internal os is entirely covered by the placenta when the cervix is fully dilated (See fig. A.). Partial placenta previa implies incomplete coverage (See fig. B.). Nonetheless, complete placenta previa may be partial after dilation of the internal os, and marginal previa may become partial. Hence, with this terminology, accurate comparisons are impossible.
Marginal placenta previa indicates that only an edge of the placenta approaches the internal os (See fig. C.). The term low-lying implantation is used when the placenta is situated in the lower uterine segment but away from the os.
A better classification of placenta previa is the estimation of percentage coverage of the internal os at full dilation, the diameter required for delivery of a mature fetus through the cervix (See lower A., B., C.).
To better assess the percentage coverage, the healthcare provider should note whether on gentle vaginal examination the placental edge can be felt at or near the center of the internal os. (Vaginal examination of a woman with a known placenta previa is not recommended outside of a medical facility having full emergency surgical services immediately available!) Upon examination, the health care provider must consider how much of the os would be covered if the cervix were fully dilated. If about half of the area would be covered by the placenta with the cervix at full dilation, this would be a 50 percent placenta previa.
Although this is admitted to be an estimate, and one should not pursue the examination too vigorously or hemorrhage may occur, a woman with placenta previa less than 30 percent probably can be delivered safely vaginally. A woman with a placenta previa greater than 30 percent is better to have a cesarean birth.
If you are pregnant, be alert for any vaginal bleeding. Sudden, painless vaginal bleeding may be the only symptom of placenta previa, a placenta that partially or fully covers the cervix.
Call your midwife or health care provider or go to the closest emergency room immediately if you have:
- Moderate to severe vaginal bleeding during the first trimester.
- Severe vaginal bleeding means soaking more than one pad in 1 hour (you should not be using tampons).
- Moderate vaginal bleeding means soaking more than eight pads in 24 hours.
- Any vaginal bleeding in the second or third trimesters.
- Call your health professional today if you have mild vaginal bleeding (soaking fewer than eight pads in 24 hours) during the first trimester of pregnancy.
If you have had placenta previa - You may have questions about a future pregnancy once you have experienced placenta previa. Based on the nature of your condition, your midwife or health care provider will be able to answer your questions and address your concerns.
In very rare cases, placenta previa causes a stillbirth or newborn death. Should you experience such a loss, allow yourself time to grieve. Expect that your partner, children, and other family members may also be deeply affected. Consider meeting with a support group, reading about the experiences of other women, and talking to friends, a counselor, or a member of the clergy to help you and your family cope with your loss.
Although placenta previa is contraindicated for a homebirth setting or birthing center delivery, often times your midwife will be able to continue prenatal care and support before a cesarean delivery is performed, and provide delivery support to the mother and her partner during the cesarean surgery, and afterwards continue with postpartum and breast-feeding support and care for mother and newborn infant.
As stated before, a midwife or other health care provider should NEVER do a vaginal or rectal examination on a woman with vaginal bleeding and suspected placenta previa outside of a fully staffed emergency surgery unit available.
If you have placenta previa, your treatment will depend upon:
- How much you are bleeding (which influences whether you are monitored as an outpatient or in the hospital), whether you need a blood transfusion, and when delivery is necessary.
- Your overall physical condition, such as whether you have lost blood and are anemic.
- Your fetus's overall maturity and physical condition. Whenever possible, delivery is delayed until fetal lungs are mature.
- How much of your cervix is covered by the placenta. Because a vaginal delivery is likely to cause heavy placental bleeding, a cesarean is used for placenta previa deliveries.
If you have placenta previa and are not bleeding, it is important to follow certain precautions:
- Avoid all strenuous activities, such as running or lifting more than approximately 20 lbs. (9.1 kg).
- See your midwife or health care provider immediately if you have any bleeding. Be sure that he or she knows you have placenta previa.
- Have a phone nearby at all times.
- Advise all health professionals who examine you that you must not have pelvic examinations.
- Refrain from sexual intercourse after 28 weeks of pregnancy; before 28 weeks, ask your midwife or health care provider about any possible risks.
- Avoid inserting anything, such as tampons or vaginal douches, into the vagina.
- Be close to a hospital that can provide emergency care for both you and a sick or premature infant.
If you have placenta previa and begin to bleed, you may be hospitalized. If your fetus is mature, you will have a cesarean delivery. If your bleeding lessens or stops, delivery can most likely be delayed. This watching and waiting approach is called expectant management. The course of expectant management is based on your and your fetus's condition. Electronic fetal monitoring is used in the hospital to check the fetus's condition.
- If your fetus is between 24 to 34 weeks gestation, you may be given corticosteroids to improve fetal lung development and prepare for an early birth. You may have an amniocentesis to see how developed your fetus's lungs are. You may also be given Iron supplements to treat or prevent anemia and a high-Fiber diet with stool softeners to ease any straining during a bowel movement. If you have Rh-negative blood, you will be given Rh immune globulin in case your fetus has Rh-positive blood. Should you be exposed to your fetus's Rh-positive blood without Rh immune globulin, your immune system will develop antibodies that are dangerous to an Rh-positive fetus (Rh sensitization).
- If your bleeding does not stop, expect to remain hospitalized and closely monitored until your fetus is mature enough to deliver. Moderate blood loss can be replaced with a blood transfusion to prolong your pregnancy until your fetus is mature enough to deliver.
- If you have labor contractions, you may be given tocolytic medication to slow or stop the contractions. However, the benefit of tocolytic medications in stopping labor is uncertain.
- Should bleeding become severe and uncontrollable, an immediate cesarean delivery, possibly with a blood transfusion, is the only treatment available for stopping it. About 1 in 10 of women with placenta previa requires a hysterectomy to stop uncontrollable bleeding.
A marginal placenta previa requires bed rest, usually in the hospital, sometimes at home, until bleeding stops. If bleeding stops, you may get up, but you should stay in the hospital if your midwife and other health care providers recommend it until delivery. If you leave the hospital, your life and that of your child will be at risk. Massive bleeding can occur before you can get back to the hospital.
In determining the best time for delivery, tests of fetal lung maturity, amniotic fluid studies and ultrasonic growth measurements (not reliable) are usually recommended.
If you are near the expected delivery date and studies reveal more than a marginal or low-lying placenta, cesarean section is often recommended to reduce the complications for both mother and child that could result from an emergency delivery.
Delivery involving placenta previa is done by cesarean section. Cesarean delivery is the method of choice with placenta previa. When your fetus is mature enough, or if too much bleeding is endangering you or your fetus, your baby will be delivered. Because disturbing the placenta with a vaginal delivery can cause severe bleeding, a cesarean section is always used when placenta previa is present. Emergency surgery may need to be performed if severe bleeding (hemorrhage) occurs.
Nearly half of placenta previa deliveries are preterm (before the 37th week of pregnancy). Infant problems following placenta previa are usually related to prematurity. If your infant is premature, he or she may need care in a neonatal intensive care unit, or NICU. Care in the NICU can last days or weeks, depending on the extent of a baby's problems and the amount of care needed.
Treatment for placenta previa can be done by an obstetrician or perinatologist. Treatment for a premature infant can be provided by a neonatologist.
Only minimal analgesic medications, if any, will be used in delivery so as to increase the child's survival chances.
Blood transfusions may be necessary.
Do not use aspirin during pregnancy unless advised to do so by your midwife or health care provider (it may increase risk of bleeding).
If the mother is Rh negative and the baby is Rh positive, the mother may be given a Rhogam injection to help prevent Rh antibodies from developing in the mother (Rh sensitivity) either during her pregnancy or within 72 hours of delivery. The mother should be informed about pros and cons of Rhogam and the potential hazards and side effects associated with it. Rhogam is a blood-product and it is not 100 percent effective.
MoonDragon's Pregnancy Information: Rh Isoimmunization (Erythroblastosis Fetalis)
MoonDragon's Pregnancy Information: Rhogam Question
ACTIVITY RECOMMENDATIONS & RESTRICTIONS
If you are able to remain at home, rest in bed until bleeding and other symptoms cease. Do not resume normal activities until specific instructions to do so are given to you. Avoid sexual relations until otherwise instructed.
MoonDragon's Pregnancy Information: Bedrest Checklist
MoonDragon's Pregnancy Information: Bedrest, Coping With
MoonDragon's Pregnancy Information: Bedrest Exercise
MoonDragon's Pregnancy Information: Bedrest Family Tips
DIET & NUTRITION RECOMMENDATIONS
While you are bleeding and as long as surgery is being considered, drink liquids only. Eating solid food before surgery can cause anesthesia problems.
If you are resting at home, continue with your regular prenatal dietary program. See MoonDragon's Nutrition Index for helpful dietary information for proper nutrition during pregnancy. A good prenatal diet will not only ensure a healthy pregnancy and baby, but it will assist you in recovery from surgery.
MoonDragon's Nutrition Information Index
Nutritional guidelines, food guide, dietary menus and suggestions, recipes, and nutritional therapy.
NUTRITION & POSITIVE PREGNANCY OUTCOMES
Nearly all pregnant women can benefit from nutritional and multivitamin supplementation one year before and all during pregnancy, and throughout labor, delivery, and breast-feeding. The effects of poor nutrition during pregnancy can be seen in the increase of birth defects during times of famine. But a standard Western diet (high in fats, salt, sugar, and low in complex carbohydrates) also lacks necessary essential vitamins and minerals needed during pregnancy and breast-feeding, leading to a "compromise in an offspring's health." The appropriate diet is well-balanced and varied, and includes fresh fruits, vegetables, whole grains, legumes, beans and fish, with a limit on refined sugars, processed foods, and saturated fats. Organically grown produce, meats, and poultry are preferable, or at least carefully washed produce to remove agricultural chemicals.
In an observational study involving 76 healthy pregnant women, 78 percent had "one or more glaring nutritional deficiency." Another study showed an "overall apparent protective effect of multivitamin use for prevention of certain pregnancy-related illnesses and birth defects. Of special importance are Folate (Folic Acid) and Calcium intake, since the requirement for both of these substances (one a vitamin, the other a mineral) doubles during pregnancy.
The fetus, the neonate, and the pregnant woman have an increased requirement for Folic Acid and Vitamin B-12, and are more likely to suffer from a deficiency of these vitamins. Nutrients such as Folic Acid, Vitamin B-6 and Vitamin B-12 all have been correlated with prevention of the more common negative pregnancy outcomes, such as spontaneous abortion, placental abruption, pre-term delivery, low infant birth weight, and neural tube defects (e.g. spina bifida and anencephaly). Supplementation with Calcium, the only mineral whose requirement doubles during pregnancy, has been positively correlated with prevention of pregnancy hypertension and preeclampsia, preterm delivery, and low birth weight, as well as puerperal psychosis (postpartum depression). Magnesium supplementation has also been shown in studies to reduce the complications of pregnancy and improve the health of the infant.
RECOMMENDED NUTRITIONAL SUPPLEMENTS
FOLIC ACID (VITAMIN B-9): Folate is the only vitamin, whose requirement doubles in pregnancy. Deficiencies of Folic Acid have been linked in studies to low birth weight infants and neural tube defects. According to one controlled study, women at high risk (having previously given birth to babies with neural tube defects) given folate supplementation, showed a 72 percent protective effect compared to the placebo group. In one study, a group of pregnant women given folate supplementation gave birth to infants with increased birth weight and Apgar scores, and had a decreased incidence of fetal growth retardation and maternal infections. Other studies also showed significant prevention with supplementation. Because of firmly-established connections between deficiencies of Folic Acid and low birth weight infants and neural tube defects, the US Public Health Service recommends that all women of childbearing age take daily Folic Acid supplementation to reduce their risk of congenital birth defects.
Dietary Folic Acid is a mixture of folates in the form of polyglutamates, which are readily destroyed by cooking. Higher levels of dietary folate intake has been shown in some cases to decrease the incidence of neural tube defects, but women hereditarily predisposed to such defects may need to take in more Folic Acid through supplements in order to reach optimal levels. Folic acid can be found in green leafy vegetables, nuts and whole grains, liver, Watercress, Parsley, and Dandelion. With artificial supplementation, care must be taken, because large doses of Folic Acid have been associated with a decrease in Zinc absorption, a mineral required for proper fetal growth and immunity, as well as maternal infection and abnormally slow fetal heart rate.
Folic Acid: 600 mcg per day, RDA
Nursing: 500 mcg per day
Food Sources: Green Leafy Vegetables, Nuts, Whole Grains, Liver, Watercress
Herb Sources: Parsley, Dandelion.
MoonDragon's Nutrition Basics: Vitamin B-9 (Folic Acid / Folate) Information
NIACIN (NICOTINIC ACID - VITAMIN B-3): Niacin supplementation in the first trimester has been positively correlated in studies with higher birth weight, longer length, and newborn head circumference (all signs of healthier infants). Good food sources of niacin are Wheat Germ, Fish, and Garlic. Herbal sources are Burdock root and seed, Dandelion, Alfalfa, and Parsley.
Vitamin B-3 (Niacin): 17 mg per day, RDA
Nursing: 20 mg per day
Food Sources: Wheat Germ, Fish, Garlic
Herbal Sources: Alfalfa, Burdock Root & Seed, Dandelion, Parsley
MoonDragon's Nutrition Basics: Vitamin B-3 (Niacin / Niacinamide) Information
THIAMINE (VITAMIN B-1): Direct correlation has been shown between supplementation of thiamine early in pregnancy and higher infant birth weight and size, and thiamine depletion is common during pregnancy; supplementation is recommended. Food sources are green peas, bell peppers, and sunflower seeds. Herbal sources include Dandelion, Alfalfa, Red Clover, Fenugreek, Red Raspberry leaf, and Kelp seaweeds.
Vitamin B-1 (Thiamine): 1.5 mg per day, RDA
Nursing: 1.6 mg per day
Food Sources: Bell Peppers, Green Peas, Sunflower Seeds
Herbal Sources: Alfalfa, Dandelion, Fenugreek, Red Raspberry Leaf, Red Clover, Kelp Seaweeds
MoonDragon's Nutrition Basics: Vitamin B-1 (Thiamine / Thiamin) Information
RIBOFLAVIN (VITAMIN B-2): Studies show that riboflavin depletion is common during pregnancy (up to 40 percent less at term than non-pregnant women and men), so riboflavin supplementation is recommended to prevent metabolic disturbances. Good sources of riboflavin are Watercress and Brown Rice. Herbal sources include Rose Hips, Parsley, Saffron, Dandelion, Dulse Seaweed, and Fenugreek.
Vitamin B-2 (Riboflavin): 1.6 mg per day, RDA
Nursing: 1.8 mg per day
Food Sources: Watercress, Brown Rice.
Herbal Sources: Rose Hips, Parsley, Saffron, Dandelion, Dulse Seaweed, Fenugreek.
MoonDragon's Nutrition Basics: Vitamin B-2 (Riboflavin) Information
VITAMIN B-6 (PYRIDOXINE): Vitamin B-6 is "marginally deficient" in about 50 percent of pregnant women. Supplementation has been linked to relief of nausea and morning sickness, especially in extreme cases that include vomiting. In one experimental study, 75 percent of women taking Vitamin B-6 experienced complete relief from symptoms of morning sickness. Higher doses were used for treatment of first trimester morning sickness (25 to 200 mg 3 times daily), but are not recommended before delivery, as higher doses may shut off breast milk in nursing mothers, or cause the baby withdrawal seizures if commercial formula is given that does not include enough pyridoxine (B-6). However, when given during labor, Vitamin B-6 may prevent many postnatal adaptation problems by increasing the oxygen-carrying capacity of the blood.
Local application of B-6 as a lozenge provided protection from dental cavities, which are more common during pregnancy. Supplementation may also prevent toxemia of pregnancy (preeclampsia). Food sources are Wheat Germ, Egg Yolks, Peas and Carrots. Pyridoxine is found in all whole grains.
Vitamin B-6 (Pyridoxine): 2.2 mg per day, RDA
Nursing: 2.1 mg per day
Food Sources: Whole Grains, Wheat Germ, Egg Yolks, Peas, Carrots
MoonDragon's Nutrition Basics: Vitamin B-6 (Pyridoxine) Information
VITAMIN B-12: The coenzyme form of Vitamin B-12 is a very complex molecule containing cobalt, designated in humans as cobalamin, which is required for proper homocysteine metabolism. At least 12 different inherited inborn errors of metabolism related to cobalamin are known; low plasma Vitamin B-12 levels have been shown to be an independent risk factor for neural tube defect in one study. Supplementation is recommended and may also help in prevention of anemia. Food sources are cauliflower and broccoli. Herbal sources are Alfalfa, Comfrey, miso, Kelp seaweeds, and Catnip.
Vitamin B-12 (Cobalamin): 2.2 mcg per day, RDA
Nursing: 2.6 mcg per day
Food Sources: Cauliflower, Broccoli, Miso
Herbal Sources: Alfalfa, Catnip, Comfrey, Kelp Seaweed
MoonDragon's Nutrition Basics: Vitamin B-12 (Cobalamin) Information
VITAMIN A: Daily doses of 40,000 units or more of vitamin A during pregnancy may be toxic, while doses lower than 10,000 units appear to be safe. A study of 22,000 pregnant women, those who consumed more than 15,000 units of vitamin A per day from food and supplements, or 10,000 units as a supplement, showed a significant increase in birth defects associated with cranialneural-crest tissue (several-fold higher incidents of birth defects). Most of these women consumed the vitamin A before the seventh week of pregnancy. Rat studies show a possible link to Folic Acid metabolism. Elevated levels of Vitamin A in the blood have also been correlated with low birth weights.
Preterm infants have been shown to be deficient in Vitamin A, which may predispose them to development of chronic lung disease. Healthy pregnant women who developed pre-eclampsia were shown to be deficient in Vitamin A (but not Beta-Carotene). Pre-eclampsia is a potentially dangerous condition characterized by high blood pressure, swelling, and /or protein spilling into the urine. Supplementation with no more than 6,000 units of Vitamin A is recommended. Do not exceed 10,000 IU daily during pregnancy. Beta-Carotene, which has the same positive effects as vitamin A, has not been associated with toxicity or teratogenicity in humans or animals.
Plant sources of the non-toxic "provitamin A" Beta Carotene are organic fruits and vegetables, especially yellow and orange ones; for example, one sweet potato or one cup of carrot juice contains 25,000 IU of beta carotene.
Vitamin A: more than 6,000 IU daily is not recommended. Do not exceed 10,000 IU daily from all supplement sources.
Beta Carotene: 10,000 IU
Food Sources: Yellow and Orange Fruits and Vegetables
Herbal Sources: Alfalfa, Cayenne, Comfrey, Dandelion, Elderberries, Lamb's Quarters, Kelp Seaweed
MoonDragon's Nutrition Basics: Vitamin A Information
VITAMIN C: Vitamin C plays a vital role in the formation of collagen - a major protein found in connective tissue, cartilage, and bone, and is "chronically underdosed." It is essential to the nerves, healthy gums and teeth, and prevents infection. Although one study showed that women who took 5000 mg of vitamin C daily during pregnancy delivered healthy infants who developed scurvy (preg-rel. 528), this "rebound scurvy" is very rare, and the infant recovers quickly without treatment. Supplementation with Vitamin C may be as effective as calcium for leg cramps during pregnancy. Food sources of vitamin C are fruits (particularly Citrus), Green Chilies, Tomatoes, Honey, Cabbage, Cucumbers, Prunes. Herbal sources include Elderberries, Rose Hips, Parsley, Dandelion Greens, Nettles, Alfalfa, and Cayenne.
Vitamin C: 70 mg per day, RDA
Nursing: 95 mg per day
Food Sources: Cabbage, Cucumbers, Fruits (especially Citrus), Green Chilies, Honey, Tomatoes
Herbal Sources: Alfalfa, Cayenne, Dandelion Greens, Elderberry, Nettles, Parsley, Rose Hips
MoonDragon's Nutrition Basics: Vitamin C Information
VITAMIN D: The absorption of vitamin D (as well as calcium, which vitamin D helps metabolize) is enhanced during pregnancy, and since vitamin D tends toward toxicity, supplementation should be "judicious," to prevent excessive amounts of it from spilling into the urine. Fish Oil and sunshine are good sources of natural vitamin D, which benefits the development of good teeth and bones. Herbal sources of vitamin D are Alfalfa and Nettles and, of course, sunshine!
Vitamin D: 10 mcg per day, RDA
Nursing: 10 mcg per day
Food Sources: Fish
Herbal Sources: Alfalfa, Nettles
MoonDragon's Nutrition Basics: Vitamin D Information
VITAMIN E: Vitamin E status declines during pregnancy creating deficiencies, and fetal vitamin E levels are usually low. Lower plasma levels in the mother may be associated with increased risk of pre-eclampsia, as well as premature and low birth weight infants. Supplementation has been shown to be effective in preventing habitual or chronic abortion. Good food sources are Parsley, Brown Rice, and Wheat Germ. Herbal sources include Alfalfa, Rosehips, Red Raspberry leaf, Dandelion, Kelp seaweeds, and Watercress (although watercress should be avoided in the first trimester).
Vitamin E: 10 mg per day, RDA
Nursing: 12 mg per day
Food Sources: Brown Rice, Parsley, Wheat Germ, Watercress
Herbal Sources: Alfalfa, Dandelion, Red Raspberry Leaf, Rosehips, Kelp Seaweed
MoonDragon's Nutrition Basics: Vitamin E Information
VITAMIN K: Necessary for bone metabolism and to maintain healthy bones. Vitamin K (required by law in most states) is given to newborns in the hospital by injection in the foot immediately after birth, or a shot is given during labor, to prevent hemolytic disease in the newborn, characterized by anemia, jaundice, enlargement of the liver and spleen, and generalized edema. Naturopathic doctors recommend checking the pregnant mother's diet for vitamin K deficiency (to see if she is getting enough of the vitamin through her intake of squash and dark leafy vegetables), and adding oral supplementation of vitamin K in the last month of pregnancy, if needed, rather than automatically giving the shots, which have been shown in some studies to link with childhood cancer. Vitamin K helps support proper coagulation and blood clotting. The liver uses Vitamin K to synthesize blood-clotting proteins. Without Vitamin K, the level of the blood-clotting proteins drop, and clotting time is prolonged. Vitamin K cream is used to treat brusing and spider veins (capillaries viewed on the skin surface) helping them to fade. People using anticoagulant or blood thinning medications should consult with their health care provider before taking Vitamin K supplements.
Vitamin K (along with Vitamin C) is effective in preventing the nausea and vomiting of early pregnancy, and may reduce the risk of intraventricular hemorrhage in premature infants. Some food sources are Parsley and Brown Rice. Nettle or Alfalfa leaf infusion or tea taken throughout the pregnancy will increase available vitamin K and hemoglobin in the blood; also helpful is Kelp.
Vitamin K: 65 mcg per day, RDA
Nursing: 65 mcg per day
Food Sources: Parsley, Brown Rice
Herbal Sources: Alfalfa, Nettle, Kelp
MoonDragon's Nutrition Basics: Vitamin K Information
CALCIUM: Calcium is the only mineral whose requirement doubles during pregnancy. Low dietary intake is associated with pre-eclampsia, a potentially dangerous (but preventable) condition characterized by high blood pressure (hypertension), swelling, and/or protein spilling into the urine. Supplementation with calcium may reduce the risk of preterm delivery, often associated with pre-eclampsia, and may also prevent the hypertensive disorders of pregnancy. Calcium supplementation can also help to ease leg cramps during pregnancy.
Excessive levels of calcium in the body, however, can result in spillage into the urine and the increased possibility of kidney stones. Supplementation with calcium must be done with efficient forms of the mineral, such as Calcium Citrate or Citrate/Malate, which are the more absorbable forms. And attention must be paid to the relationship between Calcium and other minerals, such as Magnesium and Zinc.
Red Raspberry leaf infusion contains calcium in its most absorbable form; also Nettle infusions, fresh Parsley, and Watercress. Other food sources of calcium include milk products, (although consumption of these can lead to an allergic condition in the baby) dark green leafy vegetables, asparagus, and Pumpkin seeds. Avoid bone meal or oyster shell calcium tablets, which have been found to be high in lead, mercury, cadmium, and other toxic metals.
Calcium: 1,000 mg per day if age 19 to 50, 1,300 mg per day if under age 18; may be able to use lower doses if using calcium citrate/malate.
Nursing: Same as for pregnancy.
Food Sources: Asparagus, Dairy Products, Dark Green Leafy Vegetables, Pumpkin Seeds
Herbal Sources: Raspberry Leaf, Nettles, Horsetail
MoonDragon's Nutrition Basics: Calcium Information
CHROMIUM, COBALT, & COPPER: These three trace minerals were positively associated in studies with higher infant birth weights, and supplementation is therefore recommended.
Chromium: 120 mcg per day, RDA
Cobalt: Presumably as part of Vitamin B-12, 2 mcg per day, RDA
Copper: 2 mg per day; RDA
MoonDragon's Nutrition Basics: Chromium Information
MoonDragon's Nutrition Basics: Copper Information
MoonDragon's Nutrition Basics: Vitamin B-12 Information
MoonDragon's Nutrition Basics: Multimineral Complex Information
IRON: Some researchers have concluded that iron supplementation is essential during pregnancy in order to maintain adequate maternal iron stores. But iron supplementation can exacerbate zinc depletion by blocking absorption of that mineral, so any supplementation should be warranted by tests that show a deficiency in the mother's hemoglobin, so routine iron supplementation during pregnancy is not clearly indicated.
If a woman gets sufficient iron in the first trimester of pregnancy, then studies show a definite positive association with infant birthweight and size (but not in the second and third trimesters. Good food sources are Almonds, Honey, Beets (including greens), Molasses, Brewers Yeast and high quality protein foods like egg yolks and organ meats (liver, kidney, heart). Herbs high in iron are Nettles, Dandelion, Yellow Dock and Alfalfa, as well as Kelp.
Iron: 30 mg per day, RDA
Nursing: 15 mg per day
Food Sources: Almonds, Honey, Beets (including greens), Molasses, Brewers Yeast Egg Yolks, Organ Meats (Liver, Kidney, Heart)
Herbal Sources: Nettles, Dandelion, Yellow Dock, Alfalfa, Kelp.
MoonDragon's Nutrition Basics: Iron Information
MAGNESIUM: Magnesium deficiencies are associated with preeclampsia, and preterm labor. Supplementation must be in the first trimester to positively affect birthweight and size. Researchers think that magnesium may act by opposing calcium-dependent arterial vasoconstriction, and also prevent cell damage and death, making magnesium sulfate the "drug of choice" in the treatment of pre-eclampsia. In general, supplementation may reduce the complications of pregnancy and improve the health of the infant. In studies, magnesium-treated women had a 29.5-percent reduction in the risk of hospitalization, as well as a 37 percent reduction in per capita hospital days. Food sources are Honey, Almonds, Barley, dried fruits, and Potatoes. Herbs are Dandelion, Alfalfa, and Watercress (avoid in first trimester), as well as Kelp & Dulse (Seaweed). Magnesium and Calcium should be taken with 1 part magnesium to 2 parts Calcium (e.g., 250 mg / 500 mg)
Magnesium: 300 mg per day, RDA
Nursing: 355 mg per day
Food Sources:Honey, Almonds, Barley, dried fruits, Potatoes
Herbal Sources: Dandelion, Alfalfa, Watercress, Kelp & Dulse (Seaweed)
MoonDragon's Nutrition Basics: Magnesium Information
POTASSIUM: Potassium levels may be deficient in pregnancy, with lowest concentrations in women with eclampsia. Supplementation is recommended. Food sources are Bananas, Potatoes (especially peels), Olives, Oat Bran and Wheatbran, and green leafy vegetables. Herbs are Nettles, Dandelion, Alfalfa, and Chamomile.
Food Sources: Bananas, Potatoes (especially peels), Olives, Oat Bran and Wheatbran, Green Leafy Vegetables
Herbal Sources: Alfalfa, Chamomile, Dandelion, Nettles
MoonDragon's Nutrition Basics: Potassium Information
ZINC: Zinc is required for proper fetal growth and immunity. Plasma zinc levels decline about 30 percent during pregnancy, and low zinc intake is associated with spontaneous abortion and premature delivery, as well as complications and labor abnormalities. Low zinc was also associated with the specific complication of fetal distress, and may be associated with ONS abnormalities in infants, including neural tube defects, as well as low birthweight infants and toxemia of pregnancy. Supplementation, especially if zinc levels are low, is recommended to reduce the risk of fetal and maternal complications. In one study, complications during labor (vaginal bleeding, fetal acidosis, uterine inertia) were improved. Another study showed a lower incidence of pregnancy-induced hypertension (which is associated with pre-eclampsia and preterm labor). Some food sources of zinc are oysters, Beets, Broccoli, Wheat Germ, Wheat Bran, fish, and lentils; and Watercress (not in the first trimester).
Zinc: 15 mg per day, RDA
Food Sources: Beets, Broccoli, Fish, Lentils, Oysters, Wheat Germ and Wheat Bran
MoonDragon's Nutrition Basics: Zinc Information
BIOFLAVONOIDS: When women who chronically abort were placed on citrus bioflavonoids daily as soon as a period was missed, many stopped aborting. One study demonstrated that previously Rh immunized mothers treated with bioflavonoids during their pregnancy delivered babies who were less erythroblastotic than expected. (See Vitamin C Supplements for some additional recommended products.)
MoonDragon's Nutrition Basics: Bioflavonoids Information
MoonDragon's Nutrition Basics: Vitamin C Information
ESSENTIAL FATTY ACIDS (EFAs): Essential fatty acids have a unique role during pregnancy because of the rapid development of new cell growth, new tissues, and new organ systems in a developing fetus. Fetal development is associated with a high EFA requirement, and this supply is dependent on the amount and availability of EFAs from the mother.
Prostaglandins are also involved in the development and clinical expression of pre-eclampsia. These prostaglandins are modulators of vascular smooth muscle tone and platelet aggregation (blood platelets sticking together). Pre-eclampsia is characterized by increased vasoconstriction, frequently associated with increased platelet aggregation, reduced uteroplacental blood flow, and premature delivery. In a placebo-controlled clinical trial, a group of pregnant women receiving a combination of Evening Primrose Oil and Fish Oil had a significantly lower incidence of edema. Evening Primrose Oil has also been shown effective in preventing pregnancy-induced hypertension (associated with pre-eclampsia and preterm labor).
There is some evidence that EPO, taken both orally and vaginally can be used to promote cervical ripening. Clinically, EPO supplementation during pregnancy has been found by practitioners of natural childbirth to be an efficacious method to stimulate cervical ripening during labor, and PGE1 is known to stimulate cervical ripening and hasten the progression of labor. Although practitioners using this supplement report no adverse effects, a retrospective trial comparing the oil to no supplement did not note a difference between groups and there was a suggestion that there was an increased incidence of premature rupture of membranes, labor augmentation, and assisted vaginal delivery in the evening primrose group.
The main food sources of essential fatty acids are raw seeds and nuts or fish. Whole and ground Flaxseeds or the purified Flaxseed Oil are excellent sources of the two essential oils, linoleic acid and linolenic acid. Borage Oil and Black Current Oil can be taken in capsule form as nutritional supplements.
Maternal levels of omega-3 fatty acids, especially DHA, decrease during pregnancy. EFAs are components of breast milk and maternal levels may be reduced further in nursing women. For the fetus, a deficiency of EFAs, particularly EPA and DHA, may lead to a poorly developed central nervous system. EFA deficiency may also lead to intrauterine growth retardation leading to a lower whole body weight and slower growth of the brain. Supplementation with a daily complex of essential fatty acids and fish oils during pregnancy provides vital nutrients that supply the necessary EFAs for the increased nutritional and metabolic demand throughout the nine months of gestation.
Several trials have been conducted to study the effects of fish oil supplementation on the duration of pregnancy. In one such study, fish oil was investigated for its effects on pregnancy duration, birthweight, intrauterine growth restriction and pregnancy induced hypertension: 2.7 g/day of omega-3 fatty acid supplementation was compared to an olive oil and/or no supplement. The fish oil supplemented pregnancies lasted 4 days longer and birthweight was 107 gm greater. Fish oil also appeared to be related to a reduction in the risk of preterm delivery in those women who had a previous preterm delivery. There was no effect of fish oil on intrauterine growth restriction or pregnancy induced hypertension.
Although research clearly shows that moderate EFA supplementation is beneficial and safe for pregnant women, caution should be exercised when consuming large doses. Also, there may be some caution about increased fish intake due to the mercury content. Fish like shark, swordfish, king mackerel, tilefish and tuna have higher mercury content than other fish. Salmon Fish Oil is a good and safe source of necessary EFAs obtained from fish.
MoonDragon's Nutrition Basics: Essential Fatty Acids Information
COENZYME Q-10 (CoQ10): Coenzyme Q10 is a fat soluble quinone occurring in the mitochondria of every cell, whose primary biochemical action is as a cofactor in the electron transport chain on which most cellular functions rely, making it "essential for the health of virtually all human tissues and organs." Plasma levels of this enzyme rise during normal pregnancy, reaching highs of 50 percent above normal by the 36th week. Decreased levels have been linked in studies to spontaneous abortion and threatened abortion, particularly before 12 weeks.
MoonDragon's Nutrition Basics: CoEnzyme Q-10 / CoQ10 Information
METHIONINE & SAM-e: Methionine, an amino acid, is a component of many proteins, serving as a source of available sulfur for synthesizing both cysteine and taurine, crucial to cellular metabolism. Supplementation with methionine in mice reduced neural tube defects by 47 percent, and also positively affected birthweight and size. SAM-e (S-Adenosyl-Methionine) is a supplement formed in the body by an enzymatic reaction between adenosine-triphosphate (ATP) and methionine. SAM-e (S-Adenosyl-Methionine) was discovered in 1952 in Italy and has been researched and manufactured there. SAM-e works closely with Folic Acid (Vitamin B-9) and Vitamin B-12.
MoonDragon's Nutrition Basics: Methionine (L-Methionine) Amino Acid Information
MoonDragon's Nutrition Basics: SAM-e Supplement Information
PHOSPHATIDYL CHOLINE (PC): PC is a primary component of Lecithin, sometimes referred to as pure lecithin, from which dietary choline is derived. Dietary choline, after absorption by the intestinal mucosa, is metabolized in the liver to choline, a critical nutrient for brain and nerve development and function. In mammals, amniotic fluid has a ten-fold greater concentration of choline than that in maternal blood and at birth, all mammals studied have plasma choline concentrations much higher than those found in adults. When rats were supplemented with choline, the spatial memory of their offspring was permanently enhanced, they showed more accurate performance on both working and reference memory components of tasks. From these studies, researchers believe that choline is critical for optimal brain development, and therefore supplementation is suggested. Lecithin consists of Choline, Inositol, Linoleic Acid, and as a fat emulsifier in relieving arteriosclerosis, cardiovascular disease, brain function, proper nerve function, and maintains proper electrical energy and nutrients transfer across the cell membranes. Lecithin, a derivative of the Soy Bean, is needed by the brain to function properly, and helps to break down fatty cholesterol deposits in the body. Lecithin contains phosphorus and stimulates the metabolism. Lecithin is also found in fertile eggs, soy products and, in small amounts, in all vegetables which have been vine ripened.
MoonDragon's Nutrition Basics: Choline Supplement Information
TAURINE: Taurine is an amino acid found widely distributed in foods of animal origin (but not milk or milk products). Taurine is biosynthesized from methionine or from cysteine during the metabolic process, and disturbances in enzymatic reactions that take place in this process can lead to mental retardation. Vegetarian mothers who consume no meat products during their pregnancy, and therefore have a low-taurine diet, as well as others on a protein, methionine, or B-6 deficient diet might be at particular risk. Although dietary deficiency of Taurine has not been demonstrated to impact fetal development in humans, researchers recommend that vegetarian women who intend to have children optimize dietary levels of protein and B-6, since there is no Taurine present in plants and vegetables. Meat-eaters are advised to eat only organic or "free range" animals, in order to avoid the high concentrations of hormones and pesticides found in animal products raised in farm "factories."
MoonDragon's Nutrition Basics: Taurine (L-Taurine) Amino Acid Information
(1.) Balaskas, J. Preparing for Birth with Yoga. MA, Element, Inc., 1994, 37.
(2.) Barnes, B. and Bradley, S. G. Planning for a Healthy Baby. London: Ebury Press, 1990.
(3.) Price, W.A. Nutrition and physical Degeneration. 50th Anniv. Ed. New Canaan, CT: Keats Publishing, Inc., 1989.
(4.) Strohecker, J. (Exec. Ed.) Alternative Medicine: The Definitive Guide. WA: Future Medicine Publishing, Inc., 1994, 795.
(5.) Dostalova, L. Correlation of the vitamin status between mother and newborn during delivery. Dev Pharmacol Ther 4 Suppl: 45-57, 1982.
(6.) Mulinare, J. et al. Periconceptional use of multivitamins and the occurrence of neural tubs defects. JAMA 260 (21):3141-45, 1988.
(7.) Shojania, AM. Folic acid and vitamin B-12 deficiency in pregnancy and in the neonatal period. Clin Perinatol 1984:11:433-459.
(8.) Miller, AL and Kelly, G.S. Methionine and homocysteine metabolism and the nutritional prevention of certain birth defects and complications of pregnancy. Alt Med Rev 1996:1(4):220.235).
(9.) Truswell, A.S. Nutrition for pregnancy. Br Med J July, 1985.
(10.) Ferris TF. Pregnancy, preeclampsia, and the endothelial cell. Editorial. N Engl J Med 325(20):1439-40, 1991.
(11.) Villar J et al. Epidemiologic observations on the relationship between calcium intake and eclampsia. Int J Gynaecol Obstet 21(4):271-78, 1983.
(12.) Taufield PA et al. Hypocalciuria in preeclampsia. N Engl J Med 316(12):715-18, 1987.
(13.) Villar J, Repke JT. Calcium supplementation during pregnancy may reduce preterm delivery in high-risk populations. Am J Obstet Gynecol 163:1124-31, 1990.
(14.) Ward NI et al. Elemental factors in human fetal development. J Nutr Med 1:19-26, 1990.
(15.) Riley DM, Walt DC. Hypercalcemia in the etiology of puerperal psychosis. Biol Psychiatry 20:479, 1985.
(16.) Spatling L. Spatling G. Magnesium supplementation in pregnancy. A double blind study. Br J Obstet Gynaecol 95:120-25, 1988.
(17.) Truswell AS. ABC of nutrition. Nutrition for pregnancy. Br Med J 29l:263-6, 1985.
(18.) MRC Vitamin Study Research Group. Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet 338:131-7, 1991.
(19.) Tamura T, Goldenberg R, Freeberg L. et al. Maternal serum folate and zinc concentrations and their relationships to pregnancy outcome. Am J Clin Nutr 1992:56:365-370.
(20.) Steegers-Theunissen RPM et al. Neural-tube defects and derangement of homocysteine metabolism. Letter. N Engl J Med 324(3):199-200, 1991.
(21.) Bower D, Stanley FJ. Dietary folate as a risk factor for neural-tube defects: Evidence from a case-control study in Western Australia. Med J Aust 150:613-19, 1989.
(22.) Mulinsky A et al. Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 262(20:2847-52, 1989).
(23.) Laurence KM et al. Double-blind randomized controlled trial of folate treatment before conception to prevent recurrence of neural-tube defects. Br Med. J 282:1509, 1981.
(24.) Lucock MD, Wild J, Schorah CJ, et al. The methylfolate axis in neural tube defects: in vitro characterisation and clinical investigation. Biochem Med Metabol Biol 1994;52:101-114.
(25.) Editorial staff. Excessive folic acid. Amer Fam Phys 32(4):290-91, Oct 1985.
(26.) Simmer K, James C, and Thompson RP. Are iron-folate supplements harmful? Amer J Clin Nutr 45(1)122-5, Jan 1987.
(27.) Doyle W et al. The association between maternal diet and birth dimensions. J Nut Med 1:9-17, 1990.
(28.) Heller S et al. Riboflavin status during pregnancy. Am J Clin Nutr 27:1225-30, 1974.
(29.) Doyle W et al. The association between maternal diet and birth dimensions. J Nut Med 1:9-17, 1990.
(30.) Heller S et al. Vitamin B-1 status in pregnancy. Am J Clin Nutr 27:1221-24, 1974.
(31.) Heller S et al. Vitamin B-6 status in pregnancy. Am J Clin Nutr 26(12):1339-48, 1973.
(32.) Sahakian V et al. Vitamin B-6 is effective therapy for nausea and vomiting of pregnancy. A randomized double-blind placebo-controlled study. Obstet Gynecol 78:33-36, 1991.
(33.) Anonymous. Vitamin B-6 curbs severe nausea, emesis in gravida. Fam Pract News 21(11):10, 1991.
(34.) Baum G et al. Meclozine and pyridoxine in pregnancy. Practitioner 190:251, 1963.
(35.) Marcus RG. Suppression of lactation with high doses of pyridoxine. S Afr Med J December 6, 1976, pp. 2155-56.
(36.) Foukas MD. An antilactogenic effect of pyridoxine. J Obstet Gynaecol Br Common w August 1973, pp. 718-20.
(37.) Temesvari P et al. Effects of an antenatal load of pyridoxine (vitamin B6) on the blood oxygen affinity and prolactin levels in newborn infants and their mothers. Acta Paediatrica Scand 72(4):525-9, 1983.
(38.) Hillman RW et al. Am J Clin Nutr 10:512, 1962.
(39.) Klieger JA et al. Abnormal pyridoxine metabolism in toxemia of pregnancy. Ann N Y Acad Sci 166:288-96, 1969.
(40.) Kirby PN, Molloy AM, Daly LE et al. Maternal plasma folate, and vitamin B-12 are independent risk factors for neural tube defects. Q J Med 1993;86:703-708.
(41.) Martinez-Frias ML, Salvador J. Megadose vitamin A and teratogenicity. Letter. Lancet 1:236, 1988.
(42.) Smithell RW. Spina bifida and vitamins. Br Med J 286:388-89, 1983.
(43.) Rothman KJ, Moore LL, Singer MR, et al. Teratogenicity of high vitamin A intake. N Engl J Med 1995; 333:1369-1373.
(44.) Fell D, Steele RD. Modification of hepatic folate metabolism in rats fed excess retinal. Life Sci 1986; 38:1959-1965.
(45.) Kubler W. Nutritional deficiencies in pregnancy. Bibl Nutr Dieta 1981:30:17-29.
(46.) Hustead VA et al. Relationship of vitamin A (retinol) status to lung disease in the preterm infant J Pediatrics 105(4):6101-15, 1984.
(47.) Jendryczko A, Drozdz M. Plasma retinol, beta-carotene and vitamin E levels in relation to the future risk of pre-eclampsia. Zent bl Gynakol 111:1121-23, 1989.
(48.) Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by pericanceptional vitamin supplementation. N Engl J Med 1992;327:1832-1835.
(49.) Kizer KW, Fan AM, Bankowska J, et al. Vitamin A - a pregnancy hazard alert. West J Med 1990; 152:78-81.
(50.) Lark SM. Women's Health Companion. CA: Celestial Arts, 1995.
(51.) Rhead WJ, Schrauzer GN. Risks of long-term ascorbic acid overdosage. Nutr Rev 29:(11)262-63, 1971.
(52.) Hammar M et al. Calcium and magnesium status in pregnant women: A comparison between treatment with calcium and vitamin C in pregnant women with leg cramps. Int J Vitam Nutr Res 57(2):179-83, 1987.
(53.) Mino M, Nagamatu M. An evaluation of nutritional status of vitamin E in pregnant women with respect to red blood cell tocopherol level. Int J Vitam Nutr Res 56:149-53, 1986.
(54.) Shah RS et al. Vitamin E status of the newborn in relation to gestational age, birth weight, and maternal vitamin E status. Br J Nutr 58:191-8, 1987.
(55.) Marks J. Critical appraisal of the therapeutic value of alpha-tocopherel. Vitam Hormones 20:573-98, 1962.
(56.) Golding J et al. Childhood cancer, intramuscular vitamin K, and pethidine given during labour. Br Med J 305(6849):Aug 1992:341-346.
(57.) Morales WJ et al. The use of antenatal vitamin K in the prevention of early neonatal intraventricular hemorrhage. Ama J Obstet Gynecol 159:774-79, 1988.
(58.) Villar J et al. Epidemiologic observations on the relationship between calcium intake and eclampsia. Int J Gynaecol Obstet 21(41):271-78, 1983.
(59.) Taufield PA et al. Hypocalciuria preeclampsia. N Engl J Med 316(12):715-18, 1987.
(60.) Villar J, Repke JT. Calcium supplementation during pregnancy may reduce proteins delivery in high-risk populations. Am J Obstet Gynecol 163:1124-31, 1990.
(61.) Page EW and Page EP. Leg cramps in pregnancy: etiology and treatment. Obstet and Gyn 1(1953):94.
(62.) Ward NI et al. Elemental factors in human fetal development. J Nutr Med 1:19-26, 1990.
(63.) Hemminkl E, Rimpelu U.A randomized comparison of routine versus selective iron supplementation during pregnancy. J Am Call Nutr 10(1):3-10, 1991.
(64.) Doyle W et al. The association between maternal diet and birth dimensions. J Nutr Med 1:9-17, 1990.
(65.) Franz KB. Correlation of urinary magnesium excretion with blood pressure of pregnancy Magnesium Bull 4:73-78,1982.
(66.) Weaver K. Magnesium in Health and Disease. Jamaica, NY, Spectrum Publications. 1980:833.
(67.) Kurzel RB. Serum magnesium levels in pregnancy and preterm labor. Am J Perinatol 8:119-27. 1991.
(68.) Conradt A. Pathophysiology and clinical aspects of pre-eclampsia. Z Geburtshilfe Perinatal 189(4):149-61, 1985.
(69.) Spatling L and Spatling G. Magnesium supplementation in pregnancy. A double-blind study. Br J Obstet Gynaccol 95:120-25, 1988.
(70.) Sjogren A eet al. Reduced concentrations of magnesium, potassium and zinc in skeletal muscle from women during normal pregnancy or eclampsia. Abstract J Am Coll Nutr 7(5):408, 1988.
(71.) Argemi J et al. Serum zinc binding capacity in pregnant women. Ann Nutr Metab 32:121-26, 1988.
(72.) Apgar J, Evertt G. Low zinc intake affects maintenance of pregnancy in guinea pigs. J Nutr 121:192-200, 1991.
(73.) Lazebnik N et at. Zinc status, pregnancy complications and labor abnormalities. Am J Obstet Gynecol 158(1):161-66, 1988.
(74.) Mukherjee MD et al. Maternal zinc, iron, folic acid, and protein nutriture and outcome of human pregnancy. Am J Clin Nutr 40(3):496-507, 1984.
(75.) Buamah PK et al. Maternal zinc status: A determinant of central nervous system malformation. Br J Obstet Gynaecol 91:788-90, 1984.
(76.) Bergmann KE et al. Abnormalities of hair zinc concentration in mothers of newborn infants with spine bifida. Am J Clin Nutr 33:2145, 1980.
(77.) Malhotra A et at. Placental zinc in normal and intro-uterine growth-retarded pregnancies. Br J Nutr 63:613-21, 1990.
(78.) Higashi A et al. A prospective survey of serial serum zinc levels and pregnancy outcome. J Ped Gastroenterol 7:430-33, 1988.
(79.) Singh P et al. Maternal hypozincemia and low-birth-weight infants. Clin Chem 33:1950, 1987.
(80.) Cherry FF et al. Am J Clin Nutr 34:2367-75, 1981.
(81.) Cherry FF et al. Adolescent pregnancy: Associations among body weight, zinc nutriture, and pregnancy outcome. Am J Clin Nutr 50:945-54, 1989.
(82.) Kynast G, Saling S. Effect of oral zinc application during pregnancy. Gynecol Obstet Invest 21(3):117-22, 1986.
(83.) Hunt IF et al. Zinc supplementation during pregnancy: effects on selected bleed constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. Am J Clin Nutr 40(3):508-21, 1984.
(84.) Redman JC. Letter. Med Trib April 16, 1980.
(85.) Jacobs WM. The use of the bioflavonoid compounds in the prevention or reduction in severity of erythroblastosis fetalis. Surg Gynecol Obstet 103:233-36, 1956.
(86.) D'Almeida A, Carter J, Anatol A, Prost C. Women and Health, 1992;19(2/3):117-131.
(87.) O'Brien PMS et al. The effect of dietary supplementation with linoleic acid and linolenic acid on the presser response to angiotension II: a possible role in pregnancy-induced hypertension? Br J Olin Pharmacol 19(3):335-42, 1986.
(88.) McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J nurse-Midwifery 44(3):2095. 1999.
(89.) Dove D, Johnson P. Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk Nulliparous women. J Nurse Midwifery. 1994;44:320-324.
(90.) Hornstra G, Al MD, Van Houselingen AC, et al. Essential fatty acids in pregnancy and early human development. Eur J Obstet Gynecol Reprod Biol. 1995;61:57-62.
(91.) Olsen S, Sorensen J, Secher N, et al. Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. Lancet. 1992;339:1003-1007.
(92.) Olsen S, Secher N, Taber A, et al. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish oil trials in pregnancy team. Br J Obstet Gynaecol. 2000;107:382-395.
(93.) Noia G, Lippa S, Di Maio A, et al. Blood levels of coenzyme Q-10 in early phase of normal or complicated pregnancies. In Folkers K, Yamamura Y. Biomedical and Clinical Aspects of Coenzyme Q. Amsterdam: Elsevier, 1991;209-13.
(94.) Essien FB, Wannberg SL. Methionine but not folinic acid or vitamin B-12 alters the frequency of neural tube defects in Axd mutant mice. J Nutr 1993; 123:973-974.
(95.) Potier do Courey G. Bujoli J. Effects of diets with or without folic acid, with or without methionine, on fetus development, folate stores, and four acid-dependent enzyme activities in the rat. Biol Neonate 1981;39:132-140.
(96.) Zeisel SH. Choline and human nutrition. Annu Rev Nutr 1994; 14:269-296.
(97.) Zeisel SH, Epstein MF, Wurtman RJ. Elevated choline concentration in neonatal plasma. Life Sci 1980;26:1827-1831.
(98.) Garner SC, Mar MH, Zeisel SE. Choline distribution and metabolism in pregnant rats and fetuses are influenced by the choline content of the maternal diet J Nutr 1995;125:2851-2858.
(99.) Sturman JA. Nutritional taurine and central nervous system development. Ann NY Acad Sci 477:1986:196-213.
Source: Pregnancy and the Use of Nutritional Supplements - Women's Health Update
Townsend Letter for Doctors and Patients, Jan, 2002 by Tori Hudson
Bibliography for "Pregnancy and the Use of Nutritional Supplements - Women's Health Update"
Tori Hudson "Pregnancy and the Use of Nutritional Supplements - Women's Health Update". Townsend Letter for Doctors and Patients. Jan 2002. FindArticles.com. 14 Jul. 2007.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER
If You or your family member has symptoms of placenta previa. Report any bleeding immediately to your midwife or health care provider. Call 9-1-1 and immediately transport to the emergency facility at your local hospital if you start bleeding. This is an emergency! The mother and the baby's life may be in danger and death may occur if it is not treated.
HELPFUL ORGANIZATIONS FOR MORE INFORMATION ABOUT PLACENTA PREVIA AND TREATMENTS
American College of Obstetricians and Gynecologists (ACOG)
409 12th Street, S.W., P.O. Box 96920
Washington, DC 20090-6920
Web Address: http://www.acog.org
American College of Obstetricians and Gynecologists (ACOG) is a nonprofit organization of professionals who provide health care for women. The ACOG Resource Center publishes manuals and patient education materials. The Web site has information on many women's health topics, including quitting smoking.
SHARE: Pregnancy and Infant Loss Support
C/o St. Joseph's Health Center
300 First Capitol Drive
St. Charles, MO 63301-2893
Fax: (636) 947-7486
Web Address: http://www.nationalshareoffice.com
This organization provides mutual support for bereaved parents and families who have suffered a loss due to miscarriage, stillbirth, or neonatal death. SHARE provides newsletters, pen pals, and information regarding professionals, caregivers, and pastoral care.
MoonDragon's Pregnancy Information: Miscarriage (Spontaneous Abortion)
MoonDragon's Guidelines: Retained Placenta
MoonDragon's Parenting: Placenta Disposal Rituals & Recipes
MoonDragon's Pregnancy Information: Placenta Abruption
MoonDragon's Pregnancy Information: Placenta Anatomy & Physiology
MoonDragon's Pregnancy Information: Pregnancy Information & Survival Tips
MoonDragon's Pregnancy Index
MoonDragon's Womens Pregnancy Health Information Index
MoonDragon's Pediatric Information Index
MoonDragon's Parenting Information Index
MoonDragon's Nutrition Information Index
QUALITY SUPPLIES & PRODUCTS
PREGNANCY NUTRITIONAL SUPPLEMENTS & PRODUCTS
Nutrients, herbs, supplement products for pregnant women to maintain a healthy pregnancy and lower risks of complications associated with nutritional deficiencies. Consult with your midwife or health care provider before taking nutritionals supplements if you are pregnant or breastfeeding.
PREGNANCY SUPPLEMENT PRODUCTS
Alfalfa Herbal Products Almonds Herbal Products Barley Herbal Products Barleygrass Herbal Products Beets Herbal Products Beta Carotene Supplement Products Bioflavonoids Supplement Products Black Currant Oil Products Borage Oil Products Brewers Yeast Herbal Products Burdock Herbal Products Calcium Supplement Products Carotene Complex Products Catnip Herbal Products Cayenne Herbal Products Chamomile Herbal Products Choline Supplement Products Chromium Supplement Products Comfrey Herbal Products Copper Supplement Products Coenzyme Q-10 Supplement Products Dandelion Herbal Products EFA Complex Supplement Products Elderberry Herbal Products Fenugreek Herbal Products Fiber Supplement Products Flaxseed Herbal Products Flaxseed Herbal Oil Products Folic Acid Supplement Products Garlic Herbal Products Greens Herbal Products Honey Products Horsetail Herbal Products Iron Supplement Products Kelp Seaweed Herbal Products Kyogreen Herbal Products
Lecithin Supplement Products Magnesium Supplement Products Methionine Supplement Products Molasses Products Multimineral Supplement Products Multivitamin Supplement Products Nettles Herbal Products Parsley Herbal Products Potassium Supplement Products Prenatal Supplement Products Pumpkin Herbal Products Red Clover Herbal Products Red Rasbperry Herbal Products Rosehips Herbal Products Saffron Herbal Products Salmon Fish Oil EFA Products SAM-e Supplement Products Taurine Amino Acid Products Vitamin A Supplement Products Vitamin B-1 Supplement Products Vitamin B-2 Supplement Products Vitamin B-3 Supplement Products Vitamin B-5 Supplement Products Vitamin B-6 Supplement Products Vitamin B-12 Supplement Products Vitamin B-Complex Products Vitamin C Supplement Products Vitamin D Supplement Products Vitamin E Supplement Products Vitamin K Supplement Products Watercress Herbal Products Wheat Bran Herbal Products Wheat Germ Herbal Products Wheatgrass Herbal Products Yellow Dock Herbal Products Zinc Supplement Products
AROMATHERAPY: ESSENTIAL OILS DESCRIPTIONS & USES
Allspice Leaf Oil Angelica Oil Anise Oil Baobab Oil Basil Oil Bay Laurel Oil Bay Oil Benzoin Oil Bergamot Oil Black Pepper Oil Chamomile (German) Oil Cajuput Oil Calamus Oil Camphor (White) Oil Caraway Oil Cardamom Oil Carrot Seed Oil Catnip Oil Cedarwood Oil Chamomile Oil Cinnamon Oil Citronella Oil Clary-Sage Oil Clove Oil Coriander Oil Cypress Oil Dill Oil Eucalyptus Oil Fennel Oil Fir Needle Oil Frankincense Oil Geranium Oil German Chamomile Oil Ginger Oil Grapefruit Oil Helichrysum Oil Hyssop Oil Iris-Root Oil Jasmine Oil Juniper Oil Labdanum Oil Lavender Oil Lemon-Balm Oil Lemongrass Oil Lemon Oil Lime Oil Longleaf-Pine Oil Mandarin Oil Marjoram Oil Mimosa Oil Myrrh Oil Myrtle Oil Neroli Oil Niaouli Oil Nutmeg Oil Orange Oil Oregano Oil Palmarosa Oil Patchouli Oil Peppermint Oil Peru-Balsam Oil Petitgrain Oil Pine-Long Leaf Oil Pine-Needle Oil Pine-Swiss Oil Rosemary Oil Rose Oil Rosewood Oil Sage Oil Sandalwood Oil Savory Oil Spearmint Oil Spikenard Oil Swiss-Pine Oil Tangerine Oil Tea-Tree Oil Thyme Oil Vanilla Oil Verbena Oil Vetiver Oil Violet Oil White-Camphor Oil Yarrow Oil Ylang-Ylang Oil Aromatherapy
Healing Baths For Colds
Using Essential Oils
AROMATHERAPY: HERBAL & CARRIER OILS DESCRIPTIONS & USES
Almond, Sweet Oil Apricot Kernel Oil Argan Oil Arnica Oil Avocado Oil Baobab Oil Black Cumin Oil Black Currant Oil Black Seed Oil Borage Seed Oil Calendula Oil Camelina Oil Castor Oil Coconut Oil Comfrey Oil Evening Primrose Oil Flaxseed Oil Grapeseed Oil Hazelnut Oil Hemp Seed Oil Jojoba Oil Kukui Nut Oil Macadamia Nut Oil Meadowfoam Seed Oil Mullein Oil Neem Oil Olive Oil Palm Oil Plantain Oil Plum Kernel Oil Poke Root Oil Pomegranate Seed Oil Pumpkin Seed Oil Rosehip Seed Oil Safflower Oil Sea Buckthorn Oil Sesame Seed Oil Shea Nut Oil Soybean Oil St. Johns Wort Oil Sunflower Oil Tamanu Oil Vitamin E Oil Wheat Germ Oil
HELPFUL RELATED MOONDRAGON NUTRITION BASICS LINKS
MoonDragon's Nutrition Basics Index MoonDragon's Nutrition Basics: Amino Acids Index MoonDragon's Nutrition Basics: Antioxidants Index MoonDragon's Nutrition Basics: Enzymes Information MoonDragon's Nutrition Basics: Herbs Index MoonDragon's Nutrition Basics: Homeopathics Index MoonDragon's Nutrition Basics: Hydrosols Index MoonDragon's Nutrition Basics: Minerals Index MoonDragon's Nutrition Basics: Mineral Introduction MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index MoonDragon's Nutrition Basics: Dietary Supplements Introduction MoonDragon's Nutrition Basics: Specialty Supplements MoonDragon's Nutrition Basics: Vitamins Index MoonDragon's Nutrition Basics: Vitamins Introduction
NUTRITION BASICS ARTICLES
MoonDragon's Nutrition Basics: 4 Basic Nutrients MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute? MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods MoonDragon's Nutrition Basics: Foods That Destroy MoonDragon's Nutrition Basics: Foods That Heal MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods MoonDragon's Nutrition Basics: Phytochemicals MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce MoonDragon's Nutrition Basics: Limit Your Use of Salt MoonDragon's Nutrition Basics: Use Proper Cooking Utensils MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water
RELATED MOONDRAGON HEALTH LINKS & INFORMATION
MoonDragon's Nutrition Information Index MoonDragon's Nutritional Therapy Index MoonDragon's Nutritional Analysis Index MoonDragon's Nutritional Diet Index MoonDragon's Nutritional Recipe Index MoonDragon's Nutrition Therapy: Preparing Produce for Juicing MoonDragon's Nutrition Information: Food Additives Index MoonDragon's Nutrition Information: Food Safety Links MoonDragon's Aromatherapy Index MoonDragon's Aromatherapy Articles MoonDragon's Aromatherapy For Back Pain MoonDragon's Aromatherapy For Labor & Birth MoonDragon's Aromatherapy Blending Chart MoonDragon's Aromatherapy Essential Oil Details MoonDragon's Aromatherapy Links MoonDragon's Aromatherapy For Miscarriage MoonDragon's Aromatherapy For Post Partum MoonDragon's Aromatherapy For Childbearing MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing MoonDragon's Aromatherapy Chart of Essential Oils #1 MoonDragon's Aromatherapy Chart of Essential Oils #2 MoonDragon's Aromatherapy Tips MoonDragon's Aromatherapy Uses MoonDragon's Alternative Health Index MoonDragon's Alternative Health Information Overview MoonDragon's Alternative Health Therapy Index MoonDragon's Alternative Health: Touch & Movement Therapies Index MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy MoonDragon's Alternative Health: Therapeutic Massage MoonDragon's Holistic Health Links Page 1 MoonDragon's Holistic Health Links Page 2 MoonDragon's Health & Wellness: Nutrition Basics Index MoonDragon's Health & Wellness: Therapy Index MoonDragon's Health & Wellness: Massage Therapy MoonDragon's Health & Wellness: Hydrotherapy MoonDragon's Health & Wellness: Pain Control Therapy MoonDragon's Health & Wellness: Relaxation Therapy MoonDragon's Health & Wellness: Steam Inhalation Therapy MoonDragon's Health & Wellness: Therapy - Herbal Oils Index
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MOONDRAGON'S REALM - WEBSITE DIRECTORY
A website map to help you find what you are looking for on MoonDragon.org's Website. Available pages have been listed under appropriate directory headings.