The majority of discomforts experienced during pregnancy can be related to either hormonal or physical changes related to the growing fetus.
Every pregnancy is a unique experience for a woman and each pregnancy experienced by the woman will be new and uniquely different. Hormones such as estrogen, progesterone, and prolactin rapidly rise during pregnancy. When a woman conceives, her uterus provides a suitable environment for the baby to grow and develop; at the same time, the mother starts to experience discomforts during early pregnancy.
Most of these discomforts are normal in pregnancy. As the pregnancy advances, these disorders subside. It is very important for a health care provider or a midwife to have knowledge and understanding of these disorders in order to advise the woman to cope with the condition and initiate appropriate management for the woman.
Nausea and Vomiting
- Nausea and vomiting are very common in early pregnancy and affect over 50% of pregnancies. It occurs especially in the morning, soon after getting out of bed. They usually appear in the first three months and subside by the end of the first trimester.
- The exact cause is unknown, could be due to an increase in the hormonal level (chorionic gonadotrophin), psychological and neurological factors.
- 2% of women could develop a more serious condition known as hyperemesis gravidarum (severe vomiting) which requires urgent referral to a doctor; otherwise, it may result in dehydration and electrolyte imbalance.
Management
- Assurance of the pregnant woman is very important and advise her to move her limbs before getting out of bed for a few minutes.
- Eat a dry toast, biscuit, or cracker with a drink before rising in the morning.
- Avoidance of fatty, spicy, and deep-fried foods; liquid in an empty stomach.
- Eat a small amount of food rather than large meals and drink more water in between meals.
- Brushing teeth could trigger a vomiting reflex, so avoid brushing soon after having food.
- Take enough rest and sleep.
Backache
- Backache is a common disorder that is not only restricted to the pregnancy but also continues to the postnatal period.
- Most women experience this during the later months of pregnancy.
- During pregnancy, a woman’s body undergoes many changes and these changes cause a change in the posture; relaxation of the pelvic joints and ligaments, sometimes high heel shoes also lead to an increase in lumbar lordosis and cause backache.
- Other probable reasons include muscular spasms, urinary tract infections, and constipation.
Management
- Mother is advised to maintain or improve her posture to alleviate the discomfort.
- Wearing of supporting Maternity girdle belt is also beneficial.
- Always rest in a hard bed to relieve the symptoms.
- Massaging of back muscles and rest can relieve the pain due to muscle spasms.
- In some cases, analgesics may be prescribed by the physician to alleviate the pain.
- A healthy diet and regular exercises such as walking or swimming will help to minimize this condition.
Constipation
- Constipation is a quite common disorder and a very distressing and uncomfortable condition.
- It occurs due to the effect of progesterone lowering the intestinal muscle tone and movement of the colon, reduced physical activity, and pressure of the growing uterus on the colon are some probable reasons.
Management
- Regular bowel movement may be facilitated by regulation of diet by taking plenty of fluids in the form of milk, water, fruit juices or soup; vegetables, and fruits.
- Maintain an active lifestyle by regular exercise such as walking.
- Mild laxatives at bedtime may be prescribed by the doctor or Isafgul can be taken.
Leg cramp
- Cramp is a sudden contraction of the calf muscles that occur more frequently during the third trimester of pregnancy.
- The cause is thought to be due to deficiency of serum calcium or elevation of serum Phosphorus level.
Management
- A mother may be advised to do some leg stretching exercises before going to bed to prevent cramps.
- When the woman is troubled by cramps then she should be advised to flex the foot in the opposite direction.
- Supplementary calcium therapy in the form of tablets or syrup and vitamin B12 may be effective.
- Messaging of the leg and local heat application are effective means to get relief.
Heartburn and Acidity
- This is very common in pregnancy and occurs due to the relaxation effect of the progesterone on the oesophageal sphincter resulting in backflow of acidic fluid which causes irritation, acidity, and heartburn.
- A diet containing fats can worsen the condition.
Management
- A small and frequent diet with a low-fat meal is recommended.
- Avoidance of spicy and oily foods.
- Do not lie immediately after having meals and elevate the head end of the bed to prevent irritation.
- Antacids can be prescribed to relieve the symptoms.
Varicose veins
- Varicose veins in the legs, vulva or rectal (hemorrhoids) may appear for the first time or aggravated during pregnancy usually in the later months.
- The reason behind its occurrence is an obstruction in the venous return by the pregnant uterus.
Management
- Elastic Crepe bandage during movements can be applied.
- Elevation of the legs during rest can provide relief.
- It usually disappears following delivery.
Ankle edema
- It results from excessive fluid retention by a marked gain in weight.
- It is also a symptom of pre-eclampsia.
- It can be either physiological or pathological in nature.
Management
- There is no need of treatment for physiological edema, which usually subsides on rest with slight elevation of the legs.
- Pathological edema in the case of pre-eclampsia requires immediate consultation and treatment.
Frequency of micturition (urination)
- It is a quite troublesome symptom during the early and later weeks of pregnancy.
- It is due to congestion of the bladder mucosa, relaxation effect of progesterone on smooth muscles of the urinary tract, resting of the growing uterus on the bladder, increased kidney blood flow due to physiological changes, increased thirst, and polyuria.
- During pregnancy, a woman is more susceptible to urinary infections.
Management
- To prevent urinary infections, never restrict fluid intake.
- Consult a doctor when an infection occurs, and antibiotics may be prescribed to treat the infection.
- The symptom usually disappears as the pregnancy advances.
Some other ailments in pregnancy
- Breast discomfort in the form of a feeling of fullness and prickling sensation.
- Haemorrhoids
- Vaginal discharges
- Fatigue
- Emotional factors
Conclusion
In the above post, we have discussed minor disorders of pregnancy and their management.
