MINOR DISORDERS OF PREGNANCY 1 Causes Hormonal Changes

MINOR DISORDERS OF PREGNANCY 1

Causes Hormonal Changes Accommodation Changes Metabolic Changes Postural Changes 2

Gastrointestinal System 1. Nausea and Vomiting Causes: § § § Not known Increased HCG, estrogen and progesterone Emotional factors Irregular eating habits Decreased gastric secretion Management § § Light snacks, avoid fatty , spicy food Fresh air 3

2. Heart Burn Causes: Progesterone Clinical Features: v Burning sensation v Right quadrant pain Management: Ø Avoid bending over Ø Avoid lying flat after food Ø Monitor food intake Ø Avoid large amounts of water with meals Ø Relaxation techniques 4

3. Ptyalism Causes: Ø Hormones Ø Increased production of saliva Ø Decreased swallowing secondary to nausea Management Ø Explanation Ø Chew candy Ø Drink lemon juice 5

4. Pica Causes: § Not known § Changes in metabolism Management: § Explanation § Seek help in case ingestion of harmful substances 6

5. Constipation and flatulence Causes: q Progesterone relaxes intestinal muscles q Pressure from uterus q Iron supplements Management: q Fibre diet q Plenty of fluids q Exercises 7

6. Haemorroids Causes: § Prolonged sitting § Straining at stool Management: § Regular bowel habits § Sitz bath § Cool compresses with witch hazel 8

Musculoskeletal System Upper Back ache Lower back ache Cramps 9

Genitourinary System 10

Circulatory System 1. Fainting Causes: Vasodilatation due to progesterone Management: q Turning mother to one side rapidly q Avoid lying supine q Avoid overcrowding q Keep environment cool q Avoid hypoglycaemia 11

2. Varicose veins Causes: ÔGenetic predisposition ÔIncrease in blood volume and pressure from uterus Clinical Features: ÔSwollen, engorged ÔPurple in colour ÔDull aching pain in limbs ÔEasily tired extremities Management: ÔElastic bandages ÔElevation of limbs at rest ÔExercising calf muscles ÔAvoid long standing 12

3. Palpitations and supine hypotension Causes: In supine position, uterus presses on the inferior venacava reducing venous return to heart reducing cardiac output. Clinical features ¤ Weakness ¤ Lightheadedness ¤ Nausea ¤ Dizziness and syncope Management: ¤ Rest and deep breathing exercises ¤ Avoid overexertion ¤ Avoid supine position ¤ Suggest lateral recumbent position. 13

4. Fatigue Causes: èIncreased demands of cardio pulmonary system èNeed for more sleep èIncreased demands in work èCare of other children Management: èAssess calorie intake and haemoglobin èReassurance èRegular exercise èFrequent rest periods 14

5. Dependent edema Causes: Increased sodium and fluid retention Increased venous pressure and decreased venous return from legs Manifestations: Swelling on the hands, legs and feet Management Reassurance Rest on the side Elevation of feet 15 Normal intake of salt

Respiratory system 1. Hyperventilation of pregnancy Causes: Elevation of the diaphragm Management: ü Reassurance ü Deliberate regulation of speed and depth of breathing ü Periodic standing and raising arms above the head and taking deep breath ü Maintain good posture 16

2. Nose bleed and nose congestion Causes: Engorged capillaries in the nose become edematous and hyperemic leading to epistaxis Management: v Blowing the nose gently v Sleeping in cool air v Use of saline drops 17

Nervous system 1. Carpel Tunnel Syndrome Causes: Fluid retention that creates edema and pressure on median nerve on wrist Clinical Features: ¯ Pain and numbness ¯ Tingling of fingers ¯ Feeling of pins and needles in hands Management: ¯ Elevate arm 18

2. Insomnia Causes: ³ Physical reasons ³ Increased blood supply to uterus ³ Dreaming of having monsters ³ Hormonal changes Management: Ø Go to bed early Ø Psychological support Ø Frequent periods of rest Ø Conscious relaxation exercises Ø Back massage Ø Warm bath 19 Ø Warm drink

Integumentary System 1. Striae gravidarum 2. Pruritis gravidarum ÿThin bands of atrophic Intense pruritis tissue Localized skin ÿAppear on stretched skin excoriation on on breast, thighs or abdomen caused by abdomen scabies, ÿPurplish red in colour pediculi, ÿProgressively fade to white thrush etc silvery scar 20

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