SlideShare uma empresa Scribd logo
1 de 16
Baixar para ler offline
Pica
In
Pregnancy
• Dr Muhammad El Hennawy
• Ob/gyn Consultant
• 59 Street - Rass el barr –dumyat - egypt
• www. mmhennawy.co.nr
• Cravings are something that are commonly associated
with pregnancy.
• The old standard being pickles and ice cream.
• The truth is that as many as 68% of all pregnant women
will experience cravings, usually due to hormonal
changes.
• Throughout pregnancy, as the different hormones
fluctuate, women may find that they are sensitive to the
smells of certain foods, actually to the point of nausea
in some cases.
• Others may find that their once favorite food is no
longer tolerated, or that a food that was always a least
favorite is now top on the list.
What do pregnant women crave?
• Almost 40 per cent 'something sweet'.
• Slightly fewer (33 per cent) opted for salty snacks.
• Fans of spicy food came in third (17 per cent).
• Trailing behind (at 10 per cent) were those who craved
citrus fruit, green apples and other lip-puckering tart or
sour foods.
• PICA is eating disorder
• It is abnormal and very misunderstood problem
• PICA is defined as persistent compulsive
Bizarre Craving (abnormal appetite ) of ,
Mouthing of or
Eating (ingesting ) of
Non-food (clay, dirt, sand, stones, pebbles, hair, feces, lead, vinyl gloves, plastic, pencil
erasers, fingernails, plaster, wax, paper, paint chips, coal, chalk, wood, light bulbs, needles,
string, cigarette butts, wire, burnt matches and ashes) ,
Or Non-nutritive items (some things that may be considered foods, such as
food ingredients (e.g., flour, raw potato, starch , cornstarch, laundry starch, dry milk of
magnesia, paraffin, coffee grounds or ice)
for a period of at least 1 month
How long ?
• In order for these actions to
be considered pica, they
must persist for more than
one month
• The word pica comes from the
Latin word magpie which is a
bird that will eat anything on
whatever it finds or comes
across.
Types of Pica
• Amylophagia (consumption of starch and paste)
• Coprophagia (consumption of excrement)
• Geophagy (consumption of soil, clay, or chalk)
Consumption of dust or sand has been reported among
iron deficient patients.
• Hematophagy (ingestion of blood)
• Hyalophagia (consumption of glass)
• Pagophagia (pathological consumption of ice)
• Self-cannibalism (rare condition where body parts may be
consumed
• Trichophagia (consumption of hair or wool)
• Urophagia (consumption of urine)
• Xylophagia (consumption of wood)
• Cautopyreiophagia (ingestion of burnt match heads).
Commonly
• Pica commonly occurs in pregnant women
who are:
- experiencing their first pregnancy
- have a history of pica in their family
- under the age of 20
- have suffered from pica as a child
Causes
• While the exact cause for pica is still uncertain,
• Nutritional Deficiency One of the theories for the cause of pica
in pregnant women is they have a mineral deficiency and their
bodies crave substances that contain that mineral. There is no
research that supports this theory, Still, the link between what
body needs and what crave seems weak.
• Cultural Factors: Cultural factors do play a role in some cases
of pica. Pica is accepted in some cultures as a way of
increasing spirituality or treating certain physical illnesses, like
morning sickness.
• Psychological Reasons: Mental illness or psychological trauma
can trigger pica in some people. Pica is often a hallmark of
extreme stress, fear, or abuse
• Factors such as emotional deprivation, poverty, poor nutrition,
anemia, neglect, lack of parental supervision, or developmental
delay increase the risk for a person developing this eating
disorder
Symptoms
• Craving and eating non-food substances Or
Non-nutritive items
Associated With
• pica practices are associated with
significantly lower maternal hemoglobin
levels at delivery but are not associated
with pregnancy outcomes. Dietitians
should ask pregnant women with anemia
about pica and should counsel women
who report pica regarding the health risks
associated with it.
Lab Studies
No specific laboratory studies are indicated in the evaluation
of pica.
• Laboratory studies may be indicated to assess the
consequences of pica, depending on the characteristics
and nature of the ingested materials and the resultant
medical sequelae
• Various imaging studies may be used to identify ingested
materials and aid in the management of GI tract
complications of pica. These may include the following:
• Abdominal radiographs
• Upper and lower GI barium examinations
• Repeated imaging at regular intervals to track changes in
location of ingested materials
• Upper GI endoscopy to diagnosis bezoar formation, identify
associated lesions, or both
Dangers of Pica
• Though pica is common and often harmless, it can be very dangerous.
• The nature and amount of the ingested substance determine the medical
sequelae.
• Pica can cause a number of serious conditions including iron-deficiency
anaemia
• Pica has been shown to be a predisposing factor in accidental ingestion of
poisons, particularly in lead poisoning.
• The ingestion of bizarre or unusual substances also has resulted in other
potentially life-threatening toxicities, such as hyperkalemia following
cautopyreiophagia (ingestion of burnt match heads).
• Exposure to infectious agents via ingestion of contaminated substances is
another potential health hazard associated with pica, the nature of which
varies with the content of the ingested material. In particular, geophagia (soil
or clay ingestion) has been associated with soil-borne parasitic infections,
such as toxoplasmosis and toxocariasis.
• Gastrointestinal (GI) tract complications, including mechanical bowel
problems, constipation, ulcerations, perforations, and intestinal obstructions,
have resulted from pica.
• Eating non-food items can actually prevent body from absorbing the proper
minerals and nutrients. This could mean that baby is not receiving the proper
nutrition, increasing the risk for a variety of complications, including low birth
weight, preterm labor, and stillbirth
Prevention
There are no known methods of preventing pica.
However, once pica is known or suspected, measures
can be taken to reduce further ingestion of non-food
substances.
Removing the particular substance from readily
accessible areas can be helpful.
Close observation of the individual with pica may limit
inappropriate eating behaviors
Treatment
• Treatment emphasizes psychosocial, environmental, and family guidance
approaches.
• Treatment of pica will often depend on the cause and type of pica.
• Conventional medical treatment may be appropriate in certain situations. For
example, supplementation with iron-containing vitamins has been shown to cause the
unusual cravings to subside in some iron-deficient patients.
• Medical complications and health threats, including high lead levels, bowel
perforation or intestinal obstruction, will require additional medical management,
beyond addressing the underlying issue of pica.
• behavior therapy , Treatment options include:
- discrimination training between edible and nonedible items,
- self-protection devices that prohibit placement of objects in the mouth
- sensory reinforcement involving screening (covering eyes briefly), contingent
aversive oral taste (lemon), contingent aversive smell sensation (ammonia),
contingent aversive physical sensation (water mist),
- brief physical restraint, and overcorrection (correct the environment, or practice
appropriate or alternative responses).
• Medications may be helpful in reducing the abnormal eating behavior if pica occurs
in the course of a developmental disorder, such as mental retardation or pervasive
developmental disorder. These conditions may be associated with severe behavioral
disturbances, including pica. These medications enhance dopaminergic functioning,
which is believed to be associated with the occurrence of pica.
Prognosis
• The prognosis for individuals with pica varies greatly,
• according to the type and amount of substance ingested,
the extent of presenting side effects, and the success of
treatment.
• Pica frequently spontaneously remits in young children
and pregnant women; however, it may persist for years if
untreated, especially in individuals with mental retardation
and developmental disabilities.
• Many of the side effects and complications of pica can be
reversed once the behavior is stopped,
• while other complications, including infection and bowel
perforation, pose significant health threats and if not
successfully treated may result in death.

Mais conteúdo relacionado

Mais procurados

Management of lbw low birthweight babies
Management of lbw low birthweight babiesManagement of lbw low birthweight babies
Management of lbw low birthweight babiesVarsha Shah
 
Bulimia Nervosa
Bulimia Nervosa Bulimia Nervosa
Bulimia Nervosa Amit Newton
 
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid Low Birth Weight LBW - Presented By Mohammed Haroon Rashid
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid Haroon Rashid
 
Notes on nutritional needs of children & infants
Notes on nutritional needs of children & infantsNotes on nutritional needs of children & infants
Notes on nutritional needs of children & infantsBabitha Devu
 
Protein energy malnutrition among children
Protein energy malnutrition among children Protein energy malnutrition among children
Protein energy malnutrition among children Sushma Oommen
 
LOW BIRTH WEIGHT BABY
LOW BIRTH WEIGHT BABYLOW BIRTH WEIGHT BABY
LOW BIRTH WEIGHT BABYSachin Gadade
 
Sexual disorder
Sexual disorderSexual disorder
Sexual disorderNeha Bhatt
 
Psychological disorders during puerperium
Psychological disorders during puerperiumPsychological disorders during puerperium
Psychological disorders during puerperiumjagadeeswari jayaseelan
 
Baby Friendly Hospital Initiatives (BFHI)
Baby Friendly Hospital Initiatives (BFHI)Baby Friendly Hospital Initiatives (BFHI)
Baby Friendly Hospital Initiatives (BFHI)Mohammad Aslam Shaiekh
 
Nutrition in pregnancy and lactation
Nutrition in pregnancy and lactation Nutrition in pregnancy and lactation
Nutrition in pregnancy and lactation SKYFALL
 
Supplementary Feeding Program(SFP) in BINP
Supplementary Feeding Program(SFP) in BINPSupplementary Feeding Program(SFP) in BINP
Supplementary Feeding Program(SFP) in BINPMohammad Hasan Chowdhury
 
Nutrition assessment in children- dr harivansh chopra
Nutrition assessment in children- dr harivansh chopraNutrition assessment in children- dr harivansh chopra
Nutrition assessment in children- dr harivansh chopraHarivansh Chopra
 
Protein energy malnutrition
Protein energy malnutritionProtein energy malnutrition
Protein energy malnutritionArifa T N
 
Immediate Nursing care of a newborn
Immediate Nursing care of a newbornImmediate Nursing care of a newborn
Immediate Nursing care of a newbornAnamika Ramawat
 

Mais procurados (20)

Management of lbw low birthweight babies
Management of lbw low birthweight babiesManagement of lbw low birthweight babies
Management of lbw low birthweight babies
 
Bulimia Nervosa
Bulimia Nervosa Bulimia Nervosa
Bulimia Nervosa
 
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid Low Birth Weight LBW - Presented By Mohammed Haroon Rashid
Low Birth Weight LBW - Presented By Mohammed Haroon Rashid
 
Notes on nutritional needs of children & infants
Notes on nutritional needs of children & infantsNotes on nutritional needs of children & infants
Notes on nutritional needs of children & infants
 
Protein energy malnutrition among children
Protein energy malnutrition among children Protein energy malnutrition among children
Protein energy malnutrition among children
 
What is Pica (Eating Disorder)?
What is Pica (Eating Disorder)?What is Pica (Eating Disorder)?
What is Pica (Eating Disorder)?
 
LOW BIRTH WEIGHT BABY
LOW BIRTH WEIGHT BABYLOW BIRTH WEIGHT BABY
LOW BIRTH WEIGHT BABY
 
Sexual disorder
Sexual disorderSexual disorder
Sexual disorder
 
Psychological disorders during puerperium
Psychological disorders during puerperiumPsychological disorders during puerperium
Psychological disorders during puerperium
 
Baby Friendly Hospital Initiatives (BFHI)
Baby Friendly Hospital Initiatives (BFHI)Baby Friendly Hospital Initiatives (BFHI)
Baby Friendly Hospital Initiatives (BFHI)
 
Nutrition in pregnancy and lactation
Nutrition in pregnancy and lactation Nutrition in pregnancy and lactation
Nutrition in pregnancy and lactation
 
Type 1 diabetes in children
Type 1 diabetes in childrenType 1 diabetes in children
Type 1 diabetes in children
 
Supplementary Feeding Program(SFP) in BINP
Supplementary Feeding Program(SFP) in BINPSupplementary Feeding Program(SFP) in BINP
Supplementary Feeding Program(SFP) in BINP
 
Nutrition assessment in children- dr harivansh chopra
Nutrition assessment in children- dr harivansh chopraNutrition assessment in children- dr harivansh chopra
Nutrition assessment in children- dr harivansh chopra
 
Postpartum depression
Postpartum depressionPostpartum depression
Postpartum depression
 
Preterm
PretermPreterm
Preterm
 
IMNCI
IMNCIIMNCI
IMNCI
 
Protein energy malnutrition
Protein energy malnutritionProtein energy malnutrition
Protein energy malnutrition
 
Breastfeeding ppt
Breastfeeding pptBreastfeeding ppt
Breastfeeding ppt
 
Immediate Nursing care of a newborn
Immediate Nursing care of a newbornImmediate Nursing care of a newborn
Immediate Nursing care of a newborn
 

Destaque (20)

What is pica
What is picaWhat is pica
What is pica
 
Síndrome de pica
Síndrome de picaSíndrome de pica
Síndrome de pica
 
Síndrome de pica
Síndrome de picaSíndrome de pica
Síndrome de pica
 
Transtorno de Pica
Transtorno de PicaTranstorno de Pica
Transtorno de Pica
 
Trastorno de Pica
Trastorno de PicaTrastorno de Pica
Trastorno de Pica
 
Pica pica
Pica   picaPica   pica
Pica pica
 
Transtorno PICA
Transtorno PICATranstorno PICA
Transtorno PICA
 
Feeding and eating disorder - dsm V
Feeding and eating disorder - dsm VFeeding and eating disorder - dsm V
Feeding and eating disorder - dsm V
 
Pravotin Medical Knowledge for PNA 12material
Pravotin Medical Knowledge for PNA 12materialPravotin Medical Knowledge for PNA 12material
Pravotin Medical Knowledge for PNA 12material
 
Síndrome de pica o alotriofagia
Síndrome de pica o alotriofagiaSíndrome de pica o alotriofagia
Síndrome de pica o alotriofagia
 
Potomania y diabulimia
Potomania y diabulimiaPotomania y diabulimia
Potomania y diabulimia
 
Drunkorexia
DrunkorexiaDrunkorexia
Drunkorexia
 
Trastornos alimenticios.
Trastornos alimenticios.Trastornos alimenticios.
Trastornos alimenticios.
 
Los tics
Los ticsLos tics
Los tics
 
A menina no pais das maravilhas (SÍNDROME DE TOURETTE)
A menina no pais das maravilhas (SÍNDROME DE TOURETTE)A menina no pais das maravilhas (SÍNDROME DE TOURETTE)
A menina no pais das maravilhas (SÍNDROME DE TOURETTE)
 
Trastornos de la eliminacion en la infancia
Trastornos de la eliminacion en la infanciaTrastornos de la eliminacion en la infancia
Trastornos de la eliminacion en la infancia
 
Tics
TicsTics
Tics
 
Síndrome de Tourette
Síndrome de TouretteSíndrome de Tourette
Síndrome de Tourette
 
Síndrome de Tourette
Síndrome de TouretteSíndrome de Tourette
Síndrome de Tourette
 
Sindrome de Tourette
Sindrome de TouretteSindrome de Tourette
Sindrome de Tourette
 

Semelhante a Pica

Feeding and eating disorders in infancy
Feeding and eating disorders in infancyFeeding and eating disorders in infancy
Feeding and eating disorders in infancyVivian Olgah Kudda
 
2.-Maternal-Nutrition.pptx
2.-Maternal-Nutrition.pptx2.-Maternal-Nutrition.pptx
2.-Maternal-Nutrition.pptxRonaldTrinidad3
 
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017Kemi Dele-Ijagbulu
 
Infectious-diarrhea. ppt
 Infectious-diarrhea. ppt  Infectious-diarrhea. ppt
Infectious-diarrhea. ppt UVAS
 
Nutritional care in cancer patients
Nutritional care in cancer patientsNutritional care in cancer patients
Nutritional care in cancer patientsDrArindam Bhaumik
 
Feeding and eating disorder
Feeding and eating disorderFeeding and eating disorder
Feeding and eating disorderDan Andrei Bagao
 
food word (1).docx
food word (1).docxfood word (1).docx
food word (1).docxNeeraj Ojha
 
Feeding and eating disorders of infancy and early childhood 2
Feeding and eating disorders of infancy and early childhood 2Feeding and eating disorders of infancy and early childhood 2
Feeding and eating disorders of infancy and early childhood 2Nilesh Kucha
 
Approach to a child with failure to thrive
Approach to a child with failure to thriveApproach to a child with failure to thrive
Approach to a child with failure to thriveSingaram_Paed
 
ruminationdisorder-221110184445-880f7d1e.pdf
ruminationdisorder-221110184445-880f7d1e.pdfruminationdisorder-221110184445-880f7d1e.pdf
ruminationdisorder-221110184445-880f7d1e.pdfMuhammadAsif295491
 
Common Health Problem during childhood_01.pptx
Common Health Problem during childhood_01.pptxCommon Health Problem during childhood_01.pptx
Common Health Problem during childhood_01.pptxABHIJIT BHOYAR
 
Constipation in children
Constipation in childrenConstipation in children
Constipation in childrendiponkar poddar
 

Semelhante a Pica (20)

Pica disorder
Pica disorder Pica disorder
Pica disorder
 
Feeding and eating disorders in infancy
Feeding and eating disorders in infancyFeeding and eating disorders in infancy
Feeding and eating disorders in infancy
 
2.-Maternal-Nutrition.pptx
2.-Maternal-Nutrition.pptx2.-Maternal-Nutrition.pptx
2.-Maternal-Nutrition.pptx
 
ranjan.pptx
ranjan.pptxranjan.pptx
ranjan.pptx
 
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017
Acute & Chronic Diarrhea and Constipation: Approach to Management 2 Oct 2017
 
Infectious-diarrhea. ppt
 Infectious-diarrhea. ppt  Infectious-diarrhea. ppt
Infectious-diarrhea. ppt
 
PICA
PICAPICA
PICA
 
Nutritional care in cancer patients
Nutritional care in cancer patientsNutritional care in cancer patients
Nutritional care in cancer patients
 
Obesity1.pptx
Obesity1.pptxObesity1.pptx
Obesity1.pptx
 
Feeding and eating disorder
Feeding and eating disorderFeeding and eating disorder
Feeding and eating disorder
 
Failure to thrive
Failure to thriveFailure to thrive
Failure to thrive
 
food word (1).docx
food word (1).docxfood word (1).docx
food word (1).docx
 
Feeding and eating disorders of infancy and early childhood 2
Feeding and eating disorders of infancy and early childhood 2Feeding and eating disorders of infancy and early childhood 2
Feeding and eating disorders of infancy and early childhood 2
 
constipation.pptx
constipation.pptxconstipation.pptx
constipation.pptx
 
Approach to a child with failure to thrive
Approach to a child with failure to thriveApproach to a child with failure to thrive
Approach to a child with failure to thrive
 
DIARRHEA
DIARRHEADIARRHEA
DIARRHEA
 
ruminationdisorder-221110184445-880f7d1e.pdf
ruminationdisorder-221110184445-880f7d1e.pdfruminationdisorder-221110184445-880f7d1e.pdf
ruminationdisorder-221110184445-880f7d1e.pdf
 
Common Health Problem during childhood_01.pptx
Common Health Problem during childhood_01.pptxCommon Health Problem during childhood_01.pptx
Common Health Problem during childhood_01.pptx
 
Constipation in children
Constipation in childrenConstipation in children
Constipation in children
 
Eating disorders CNT Premnath march 2015
Eating disorders CNT Premnath march 2015Eating disorders CNT Premnath march 2015
Eating disorders CNT Premnath march 2015
 

Mais de muhammad al hennawy

Loop (device orsystem) insertion during cesarean section
Loop   (device orsystem) insertion  during  cesarean  sectionLoop   (device orsystem) insertion  during  cesarean  section
Loop (device orsystem) insertion during cesarean sectionmuhammad al hennawy
 
platelet rich plasma intimate female ttt
platelet rich plasma intimate female   tttplatelet rich plasma intimate female   ttt
platelet rich plasma intimate female tttmuhammad al hennawy
 
platelet rich plasma urogynecology
platelet rich plasma urogynecologyplatelet rich plasma urogynecology
platelet rich plasma urogynecologymuhammad al hennawy
 
platelet rich plasma obestetrics
platelet rich plasma obestetricsplatelet rich plasma obestetrics
platelet rich plasma obestetricsmuhammad al hennawy
 
platelet rich plasma infertility
platelet rich plasma  infertilityplatelet rich plasma  infertility
platelet rich plasma infertilitymuhammad al hennawy
 
Salpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionSalpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionmuhammad al hennawy
 
Prophylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancerProphylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancermuhammad al hennawy
 
Hennawy glove tamponade balloon catheter 2018
Hennawy glove tamponade balloon catheter 2018Hennawy glove tamponade balloon catheter 2018
Hennawy glove tamponade balloon catheter 2018muhammad al hennawy
 
Enhanced recover after cesarean section
Enhanced recover after cesarean sectionEnhanced recover after cesarean section
Enhanced recover after cesarean sectionmuhammad al hennawy
 
Thromboprophylaxis Of Venous ThromboEmbolism (VTE ) In Obstetrics And Gy...
Thromboprophylaxis Of  Venous ThromboEmbolism (VTE )In Obstetrics And Gy...Thromboprophylaxis Of  Venous ThromboEmbolism (VTE )In Obstetrics And Gy...
Thromboprophylaxis Of Venous ThromboEmbolism (VTE ) In Obstetrics And Gy...muhammad al hennawy
 
Thrombocytopenia during pregnancy
Thrombocytopenia during pregnancyThrombocytopenia during pregnancy
Thrombocytopenia during pregnancymuhammad al hennawy
 

Mais de muhammad al hennawy (20)

Unnecessary obgyn
Unnecessary obgynUnnecessary obgyn
Unnecessary obgyn
 
Loop (device orsystem) insertion during cesarean section
Loop   (device orsystem) insertion  during  cesarean  sectionLoop   (device orsystem) insertion  during  cesarean  section
Loop (device orsystem) insertion during cesarean section
 
Wedding sexua lgenita ltrauma
Wedding sexua lgenita ltraumaWedding sexua lgenita ltrauma
Wedding sexua lgenita ltrauma
 
Vip or recommendoma syndrome
Vip  or recommendoma syndromeVip  or recommendoma syndrome
Vip or recommendoma syndrome
 
platelet rich plasma gynecology
platelet rich plasma gynecologyplatelet rich plasma gynecology
platelet rich plasma gynecology
 
platelet rich plasma intimate female ttt
platelet rich plasma intimate female   tttplatelet rich plasma intimate female   ttt
platelet rich plasma intimate female ttt
 
platelet rich plasma urogynecology
platelet rich plasma urogynecologyplatelet rich plasma urogynecology
platelet rich plasma urogynecology
 
platelet rich plasma obestetrics
platelet rich plasma obestetricsplatelet rich plasma obestetrics
platelet rich plasma obestetrics
 
platelet rich plasma infertility
platelet rich plasma  infertilityplatelet rich plasma  infertility
platelet rich plasma infertility
 
Prp cosmotic gynecology
Prp cosmotic gynecologyPrp cosmotic gynecology
Prp cosmotic gynecology
 
Cervical stitches
Cervical stitchesCervical stitches
Cervical stitches
 
Labial adhesion
Labial adhesionLabial adhesion
Labial adhesion
 
Salpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reductionSalpingectomy for ovarian risk reduction
Salpingectomy for ovarian risk reduction
 
Prophylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancerProphylactic salpingectomy for reducing risk of ovarian cancer
Prophylactic salpingectomy for reducing risk of ovarian cancer
 
Hennawy glove tamponade balloon catheter 2018
Hennawy glove tamponade balloon catheter 2018Hennawy glove tamponade balloon catheter 2018
Hennawy glove tamponade balloon catheter 2018
 
Enhanced recover after cesarean section
Enhanced recover after cesarean sectionEnhanced recover after cesarean section
Enhanced recover after cesarean section
 
Thromboprophylaxis Of Venous ThromboEmbolism (VTE ) In Obstetrics And Gy...
Thromboprophylaxis Of  Venous ThromboEmbolism (VTE )In Obstetrics And Gy...Thromboprophylaxis Of  Venous ThromboEmbolism (VTE )In Obstetrics And Gy...
Thromboprophylaxis Of Venous ThromboEmbolism (VTE ) In Obstetrics And Gy...
 
Abnormal Invasive Placenta
Abnormal Invasive PlacentaAbnormal Invasive Placenta
Abnormal Invasive Placenta
 
Thrombocytopenia during pregnancy
Thrombocytopenia during pregnancyThrombocytopenia during pregnancy
Thrombocytopenia during pregnancy
 
Preeclampsia
PreeclampsiaPreeclampsia
Preeclampsia
 

Último

Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communicationskatiequigley33
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 

Último (20)

Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communications
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 

Pica

  • 1. Pica In Pregnancy • Dr Muhammad El Hennawy • Ob/gyn Consultant • 59 Street - Rass el barr –dumyat - egypt • www. mmhennawy.co.nr
  • 2. • Cravings are something that are commonly associated with pregnancy. • The old standard being pickles and ice cream. • The truth is that as many as 68% of all pregnant women will experience cravings, usually due to hormonal changes. • Throughout pregnancy, as the different hormones fluctuate, women may find that they are sensitive to the smells of certain foods, actually to the point of nausea in some cases. • Others may find that their once favorite food is no longer tolerated, or that a food that was always a least favorite is now top on the list.
  • 3. What do pregnant women crave? • Almost 40 per cent 'something sweet'. • Slightly fewer (33 per cent) opted for salty snacks. • Fans of spicy food came in third (17 per cent). • Trailing behind (at 10 per cent) were those who craved citrus fruit, green apples and other lip-puckering tart or sour foods.
  • 4. • PICA is eating disorder • It is abnormal and very misunderstood problem • PICA is defined as persistent compulsive Bizarre Craving (abnormal appetite ) of , Mouthing of or Eating (ingesting ) of Non-food (clay, dirt, sand, stones, pebbles, hair, feces, lead, vinyl gloves, plastic, pencil erasers, fingernails, plaster, wax, paper, paint chips, coal, chalk, wood, light bulbs, needles, string, cigarette butts, wire, burnt matches and ashes) , Or Non-nutritive items (some things that may be considered foods, such as food ingredients (e.g., flour, raw potato, starch , cornstarch, laundry starch, dry milk of magnesia, paraffin, coffee grounds or ice) for a period of at least 1 month
  • 5. How long ? • In order for these actions to be considered pica, they must persist for more than one month
  • 6. • The word pica comes from the Latin word magpie which is a bird that will eat anything on whatever it finds or comes across.
  • 7. Types of Pica • Amylophagia (consumption of starch and paste) • Coprophagia (consumption of excrement) • Geophagy (consumption of soil, clay, or chalk) Consumption of dust or sand has been reported among iron deficient patients. • Hematophagy (ingestion of blood) • Hyalophagia (consumption of glass) • Pagophagia (pathological consumption of ice) • Self-cannibalism (rare condition where body parts may be consumed • Trichophagia (consumption of hair or wool) • Urophagia (consumption of urine) • Xylophagia (consumption of wood) • Cautopyreiophagia (ingestion of burnt match heads).
  • 8. Commonly • Pica commonly occurs in pregnant women who are: - experiencing their first pregnancy - have a history of pica in their family - under the age of 20 - have suffered from pica as a child
  • 9. Causes • While the exact cause for pica is still uncertain, • Nutritional Deficiency One of the theories for the cause of pica in pregnant women is they have a mineral deficiency and their bodies crave substances that contain that mineral. There is no research that supports this theory, Still, the link between what body needs and what crave seems weak. • Cultural Factors: Cultural factors do play a role in some cases of pica. Pica is accepted in some cultures as a way of increasing spirituality or treating certain physical illnesses, like morning sickness. • Psychological Reasons: Mental illness or psychological trauma can trigger pica in some people. Pica is often a hallmark of extreme stress, fear, or abuse • Factors such as emotional deprivation, poverty, poor nutrition, anemia, neglect, lack of parental supervision, or developmental delay increase the risk for a person developing this eating disorder
  • 10. Symptoms • Craving and eating non-food substances Or Non-nutritive items
  • 11. Associated With • pica practices are associated with significantly lower maternal hemoglobin levels at delivery but are not associated with pregnancy outcomes. Dietitians should ask pregnant women with anemia about pica and should counsel women who report pica regarding the health risks associated with it.
  • 12. Lab Studies No specific laboratory studies are indicated in the evaluation of pica. • Laboratory studies may be indicated to assess the consequences of pica, depending on the characteristics and nature of the ingested materials and the resultant medical sequelae • Various imaging studies may be used to identify ingested materials and aid in the management of GI tract complications of pica. These may include the following: • Abdominal radiographs • Upper and lower GI barium examinations • Repeated imaging at regular intervals to track changes in location of ingested materials • Upper GI endoscopy to diagnosis bezoar formation, identify associated lesions, or both
  • 13. Dangers of Pica • Though pica is common and often harmless, it can be very dangerous. • The nature and amount of the ingested substance determine the medical sequelae. • Pica can cause a number of serious conditions including iron-deficiency anaemia • Pica has been shown to be a predisposing factor in accidental ingestion of poisons, particularly in lead poisoning. • The ingestion of bizarre or unusual substances also has resulted in other potentially life-threatening toxicities, such as hyperkalemia following cautopyreiophagia (ingestion of burnt match heads). • Exposure to infectious agents via ingestion of contaminated substances is another potential health hazard associated with pica, the nature of which varies with the content of the ingested material. In particular, geophagia (soil or clay ingestion) has been associated with soil-borne parasitic infections, such as toxoplasmosis and toxocariasis. • Gastrointestinal (GI) tract complications, including mechanical bowel problems, constipation, ulcerations, perforations, and intestinal obstructions, have resulted from pica. • Eating non-food items can actually prevent body from absorbing the proper minerals and nutrients. This could mean that baby is not receiving the proper nutrition, increasing the risk for a variety of complications, including low birth weight, preterm labor, and stillbirth
  • 14. Prevention There are no known methods of preventing pica. However, once pica is known or suspected, measures can be taken to reduce further ingestion of non-food substances. Removing the particular substance from readily accessible areas can be helpful. Close observation of the individual with pica may limit inappropriate eating behaviors
  • 15. Treatment • Treatment emphasizes psychosocial, environmental, and family guidance approaches. • Treatment of pica will often depend on the cause and type of pica. • Conventional medical treatment may be appropriate in certain situations. For example, supplementation with iron-containing vitamins has been shown to cause the unusual cravings to subside in some iron-deficient patients. • Medical complications and health threats, including high lead levels, bowel perforation or intestinal obstruction, will require additional medical management, beyond addressing the underlying issue of pica. • behavior therapy , Treatment options include: - discrimination training between edible and nonedible items, - self-protection devices that prohibit placement of objects in the mouth - sensory reinforcement involving screening (covering eyes briefly), contingent aversive oral taste (lemon), contingent aversive smell sensation (ammonia), contingent aversive physical sensation (water mist), - brief physical restraint, and overcorrection (correct the environment, or practice appropriate or alternative responses). • Medications may be helpful in reducing the abnormal eating behavior if pica occurs in the course of a developmental disorder, such as mental retardation or pervasive developmental disorder. These conditions may be associated with severe behavioral disturbances, including pica. These medications enhance dopaminergic functioning, which is believed to be associated with the occurrence of pica.
  • 16. Prognosis • The prognosis for individuals with pica varies greatly, • according to the type and amount of substance ingested, the extent of presenting side effects, and the success of treatment. • Pica frequently spontaneously remits in young children and pregnant women; however, it may persist for years if untreated, especially in individuals with mental retardation and developmental disabilities. • Many of the side effects and complications of pica can be reversed once the behavior is stopped, • while other complications, including infection and bowel perforation, pose significant health threats and if not successfully treated may result in death.