Healthy Eating Guidelines for Life & Pregnancy

The Australian Dietary Guidelines updated their recommendations a year or so ago. Many of you who might have been familiar with the “Healthy Food Pyramid or Healthy Food Circle” may not have seen the change to these diagrams and their associated information.

Visually it hasn’t changed but the content inside has been updated to reflect current recommendations. There are now 5 layers in the pyramid or divisions of the pie (circle). This diagrammatic representation is by no means new and has been in existence for 30 years. In 2012 a survey revealed that the average Australian was getting over a third of their daily energy requirements from junk food.

The evidence is mounting that many are confused about food types and the nutritional levels of food and this has lead to the change in the food “pyramid” guidelines for the first time in 15 years. Food fads & diets are very topical and there are not many days that these aren’t being discussed in the media. Add to this the large number of reality programs on TV & cooking programs and it is no wonder people are feeling overwhelmed.

Over the next few weeks I plan to break down the Pyramid and explain it at each level including food amount  and provide additional dietary requirements for pregnancy where it is recommended.

Reference -http://www.nutritionaustralia.org/national/news/2015/05/new-look-healthy-eating-pyramid-help-tackle-nutrition-confusion

 

MC&M Antenatal Record Card

Have you forgotten your MC& M Antenatal card lately???

Why do we ask that you keep your MC&M antenatal card in your hand bag, even in early pregnancy? It is because you never know when you might need it!

The MC&M Antenatal Card, is a record of your pregnancy and contains all the important details required by the hospital when you present for assessment in the labour ward or go to your GPs for a check up. It also has the hospital numbers printed on it. We will generally give you the card at a routine visit at around 12-16 weeks.

If you are unwell between appointments, have a fall or are involved in a car accident. It may be recommended, that you present to the Emergency Department,  the labour ward or your GP for a  check up. If you are not carrying your antenatal card it can be difficult to get all the necessary information required for a thorough assessment.

The following information is about the details on the MC&M Antenatal Card & what the abbreviations mean.

On the “Front” of the card : demographic details/medical history/recent pathology (blood results)ultrasound details/immunisations. As the pregnancy progresses further results are gathered & they are added to this part of the card.

The “Back” section is divided into two sections. It is the place to record your antenatal visits, GP visits and hospital admissions during the pregnancy.

Weight is mostly recorded.

Urine testing is sometimes attended but not routine.

Blood Pressure (BP) is always recorded.

Oedema (swelling) comment made if present

Calculated Gestation– How many weeks pregnant you are at the visit

Fundal Height a measurement of your uterus size by tape measure after 20 weeks.  An ultrasound may also be done to check the growth of the baby. The tape measurement should be equal to your gestation plus or minus 2 centimetres e.g. if you are 28 weeks a measurement could be 26-30cm and this would be considered to be in normal range.

EFW/Centile Estimated weight by Ultrasound & centile the baby is tracking along.

Presentation & position: this describes what part of the baby is presenting into the pelvis & how the baby is lying. Head (cephalic or vertex)/ Bottom (breech)/ Baby lying sideways(Transverse-nothing in  the pelvis) or oblique.

PP above Brim 5/5 ths: this describes “engagement” it is the depth the baby’s head or bottom presenting  inside  the pelvic brim e.g. 5/5, 4/5,3/5,2/5,1/5.  Written as ENG (presenting part is deep in the pelvis) N/E (not engaged presenting part above the pelvic brim).This is not usually recorded on the card  until later in the third trimester.

F.M/F.H.S.these abbreviations are for Fetal movement and fetal heart sounds. FHS is documented as present every visit and FM each visit after the mother starts to feel the baby move. This is usually 20-24 weeks with your first baby but as early as 14 weeks with your second or subsequent pregnancy.

Remarks: is self explanatory

At the base of the card are 4 large columns to record various aspects in you care including information to be discussed as the pregnancy progresses. It is also where notes are made to “alert” labour ward and or postnatal staff when you are admitted to hospital.

 

Doctors Travels

 

Dr Neil Campbell recently returned to MC&M from a 4 week UK/European holiday but it wasn’t all relaxation. Neil managed to squeeze in 3 conferences whilst he was away!! The first was in London on the 4 & 5th June where The British Society for Gynaecological Endoscopy (BSGE) held its Silver Jubilee Scientific Meeting. The highlight, was a presentation titled “Possibilities and Limitations” by Professor Fabio Ghezzi an Italian Gynaecologist who is a recognized leader in mini Laparoscopy. The presentation discussed and demonstrated how the use of smaller instruments and ports is resulting in less pain and better outcomes for the patient.  The President of BSGE has since stated that 2015 was the “best meeting ever” with over 600 delegates in attendance and the presentations exceeding expectation.

Neil then spent some time with family and friends in the United Kingdom before jumping on another flight, this time to Nice. Along with 1800 other international delegates Neil attended the 40th Annual Meeting of the International Urogynaecological Association(IUGA) from the 9th to the 13th of  June. The highlight was the “Day of Live Surgery”. Videoconference link ups enabled questions to be asked of various European gynaecologists whilst they were operating. The surgeons were able to demonstrate a variety of new techniques that have been developed for prolapse and incontinence.

Lisbon, Portugal was Neils’ final port of call, here the European Society of Human Reproduction and Embryology (ESHRE) held its annual conference. Again delegates were able to interact with Surgeons as they performed their surgery. This time the specialty was dealing with techniques to manage severe endometriosis. The 2016 ESHRE meeting will be in Helsinki Finland,  time will tell if Neil is missing in action next July!