PGIMER Sangrur NO - 2023
Obstetrics & Gynaecology
Easy
A pregnant woman should start the IFA tablets from?
Appeared in: PGIMER Sangrur NO - 2023
Explanation
- Combined Iron and Folic Acid (IFA) supplementation is initiated in the second trimester, typically from the 14th to 16th week of pregnancy.
- This timing is recommended to avoid aggravating nausea and vomiting (morning sickness) which is common in the first trimester.
- The physiological demand for iron increases significantly in the second half of pregnancy to support fetal growth and expanded maternal blood volume, making this the ideal time to start.
- National health programs, such as in India, recommend starting prophylactic IFA tablets after the first trimester for a course of at least 100 days.
Why Other Options Were Wrong
- Option A: Starting IFA tablets in the third trimester is too late for effective prevention of anemia. Iron stores should be built up before the peak demand in the late stages of pregnancy.
- Option C: This is incorrect for combined IFA tablets because the iron component can worsen the nausea and vomiting common in the first trimester. However, folic acid alone is essential during this period.
- Option D: This is incorrect for combined IFA tablets. The need for iron supplementation is related to pregnancy itself. Folic acid, not iron, is recommended before conception.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Timing of Iron and Folic Acid (IFA) supplementation during pregnancy as background academic context rather than a clinical decision trigger.
- Preventing maternal anemia is a critical nursing goal in antenatal care, as it is linked to premature birth, low birth weight, postpartum hemorrhage, and puerperal sepsis.
- Nurses must educate patients on the difference between folic acid for NTD prevention and IFA for anemia prevention to ensure correct timing and improve compliance.
- Patient counseling on managing side effects (like taking tablets with food) and dietary advice (avoiding tea/coffee with iron) is key to successful supplementation.
How to Approach the Question
- First, identify the specific supplement mentioned in the question: 'IFA tablets', which stands for Iron and Folic Acid combined.
- Recall the different nutritional needs during pregnancy. Folic acid is critical very early for neural development, while iron needs increase later for blood volume expansion and fetal growth.
- Consider the common side effects of the supplements. Iron is known to cause gastric upset and can worsen the morning sickness of the first trimester.
- Synthesize this information: Folic acid should be started early (pre-conception/first trimester), but to improve tolerance and meet physiological demand, combined IFA is best started after the first trimester has passed.
- Evaluate the options: 'Second trimester' aligns perfectly with this clinical reasoning, making it the correct choice.
Concept Tested & Keywords
- Concept Tested: Timing of Iron and Folic Acid (IFA) supplementation during pregnancy.
- Stem keywords: pregnant woman, IFA tablets, start
- Lead-in keywords: from?
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
QofIPDAWrHy9DOBYECS7lB
Reference Book
E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 202-204
E6 Obstetrics Williams p. 80-94
Practise the full PGIMER Sangrur NO - 2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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