A client presents in the second trimester with polyhydramnios.
Which of the following is a cause of polyhydramnios?

Choice A rationale

Consuming raw sushi is not the primary concern regarding mercury exposure; rather, it is the type of fish itself. Larger predatory fish at the top of the food chain, such as shark or swordfish, accumulate higher levels of methylmercury, which can be neurotoxic to the developing fetus. The risks associated with raw fish consumption during pregnancy are primarily related to bacterial or parasitic infections like Listeria or Toxoplasmosis.

Choice B rationale

Large, predatory fish like shark, swordfish, king mackerel, and tilefish are known to have high levels of mercury due to bioaccumulation. The FDA recommends pregnant individuals avoid these fish to minimize exposure. High mercury levels can lead to neurodevelopmental issues in the fetus, including impaired cognitive function and motor skills, as mercury readily crosses the placenta and blood-brain barrier.

Choice C rationale

Canned tuna, particularly light tuna, is considered a lower mercury fish. The FDA and EPA's guidelines on fish consumption for pregnant women include canned light tuna as a "best choice" fish that can be consumed 2-3 times a week. However, albacore (white) tuna has higher mercury levels and its consumption should be limited to once a week.

Choice D rationale

The American College of Obstetricians and Gynecologists (ACOG) and the FDA recommend that pregnant women consume 8 to 12 ounces of a variety of low-mercury fish per week. This amount provides essential omega-3 fatty acids, such as DHA, which are crucial for fetal brain and eye development. Salmon and canned light tuna are examples of low-mercury fish that fit within these guidelines.

Choice E rationale

Swordfish and king mackerel are on the "avoid" list for pregnant women due to their very high mercury content. Consuming 12 ounces of these fish per week would significantly exceed safe mercury exposure levels and pose a risk of neurodevelopmental harm to the fetus. The recommendation is to select fish from the "best choices" list.

Choice F rationale

Avoiding all fish during pregnancy is not recommended as it deprives the mother and fetus of valuable nutrients. Fish provides high-quality protein, vitamin D, and crucial omega-3 fatty acids, particularly DHA and EPA, which are vital for the development of the fetal nervous system and vision. The current guidelines emphasize choosing low-mercury fish.

Choice A rationale

While raw fruits and vegetables can be a source of various infections, such as Listeria or E. coli, they are not the primary cause of toxoplasmosis. The infectious agent, Toxoplasma gondii, is a parasite. It is more commonly found in specific sources like raw or undercooked meat and contaminated water, as well as the feces of infected cats. Proper washing of fruits and vegetables is important but does not directly address the main vectors for this specific parasitic infection.

Choice B rationale

Cooked sushi, or any fully cooked food, generally eliminates the risk of bacterial or parasitic infections like Toxoplasmosis. The high temperatures involved in the cooking process are effective at killing the Toxoplasma gondii parasite. Therefore, consuming cooked sushi would be considered a safe dietary practice during pregnancy in terms of avoiding this specific infection. The primary risk of toxoplasmosis comes from consuming raw or undercooked meat.

Choice C rationale

Raw meat, particularly pork, lamb, and venison, is a significant source of the Toxoplasma gondii parasite. The cysts of the parasite can be found in the muscle tissue of infected animals. Consuming raw or undercooked meat is one of the main ways humans, including pregnant women, can become infected with toxoplasmosis. Therefore, pregnant women are advised to avoid raw meat and to cook all meat thoroughly to a safe internal temperature to kill any potential parasites.

Choice D rationale

Toxoplasmosis is caused by the parasite Toxoplasma gondii. The parasite's oocysts are shed in the feces of infected cats. Humans can become infected by handling contaminated cat litter, gardening in contaminated soil, or ingesting food or water contaminated with cat feces. The parasite then forms cysts in human tissue. The risk to the fetus is highest if the mother contracts the infection during pregnancy, leading to potential congenital anomalies. *.