#410 ‒ The biology of pregnancy: physiologic adaptation, gestational diabetes, preeclampsia, childbirth, and long-term maternal health | Kathryn Gray, M.D., Ph.D.

“but they will continue to, to make the fluid and leak the fluid. Got it. Do you ever give antibiotics in that situation or is that a no-no? We do. So it's not continuous. So the, the recommendation is to give antibiotics at the time they present.”

“we do give some antibiotics at the, at the start and then like no more after that. Going back to the C-section versus vaginal discussion. Again, my vague recollection is one of the advantages of a vaginal delivery is related to the bacterial transfer between mother and fetus.”

“is the greatest. There's also increased nutrient demands, which is why, you know, we have folks taking prenatal vitamins and also that contain iron because that will also support like the developing blood expansion as well.”

“have been deficient. So that's one of the most essential things early on. Now, you said 50% of pregnancies are unplanned, which suggests that prenatal vitamins should be recommended to all women of childbearing age, correct?”

“There are other hypertensives that we use sometimes, but those are two mainstays. Which is so interesting because, I mean, we just don't use those outside of pregnancy at all because they're not that good. So does that mean we do not know or we do know that ACE inhibitors or ARBs, which would be first line in someone who's not pregnant, do we know for sure that those are not safe in pregnancy?”

“There are other hypertensives that we use sometimes, but those are two mainstays. Which is so interesting because, I mean, we just don't use those outside of pregnancy at all because they're not that good. So does that mean we do not know or we do know that ACE inhibitors or ARBs, which would be first line in someone who's not pregnant, do we know for sure that those are not safe in pregnancy?”

“correct? Well, or a healthy diet. So, I mean, I think if you have a well-balanced diet and a lot of the food is now supplemented with, you know, B vitamins and folic acid and things that you want to be replete in with pregnancy.”

“we will send them home with a blood pressure cuff and have them monitor more. Sometimes people present more robustly with like very severe blood pressures from the get-go and other symptoms.”

“know, B vitamins and folic acid and things that you want to be replete in with pregnancy. So I think a lot of folks will have adequate levels if they're eating a well-balanced diet with fruits and vegetables and whole grains.”

“So metformin, we think of as fairly safe in pregnancy and potentially helpful. But really, insulin is most effective and we have good safety data, and it has the best influence on improving the neonatal outcomes.”

“If the water's broken and we don't help induce the labor, then there's the risk of infection. So we recommend coming in, getting started on some Pitocin and helping the labor progress. We want to see like labor and progression and ideally delivery within like 24 hours, but there's no absolute clock.”

“And by the way, are your standard anti-emetics safe during pregnancy? I can't remember, Zofran and things like that. Can they be used during pregnancy? Yeah, they can be used during pregnancy. You know, there's various, we could get into the data on that, but in general, we do have some tools and anti-emedics”