MINOR AILMENTS IN PREGNANCY
Definition:
” The minor complaints of pregnant women that occurs due to physiological alteration of hormones (oestrogen , progesterone , prolactin ) and other causative factors which can be managed without medical intervention “
MINOR AILMENTS IN PREGNANCY :
- Nausea and vomiting
- Backache
- Constipation
- Leg cramp
- Acidity and heartburn
- Varicose vein
- Hemorrhoids
- Carpal tunnel syndrome(10%)
- Round ligament pain
- Ptyalism
- Syncope
- Ankle edema
- Vaginal discharge
Minor ailments in pregnancy and its management :
- NAUSEA AND VOMITING : Nausea and vomiting especially in the morning, soon after getting out of bed, are usually common in primigravidae . They usually appears following the first or second missed period and subside by the end of first trimester . About 50% have both nausea and vomiting , 25% have nausea only and 25% are unaffected .
Management of nausea and vomiting : Three main measures can reduce the problem……
- Dietary changes : To take dry toast , biscuit and protein rich meals . Frequent small foods are help full . Fatty foods are avoided.
- Behavior modification : To avoid personal triggering factor . The women can identify her self , this factors . Initial supplementation with vitamin B1 and B6 is started.
- Medication : Medication such as antiemetics prescribe by physician .
- BACKACHE :
- It is common problem (50%) in pregnancy.
- Physiological changes that contribute to back ache are – joint ligament laxity (relaxin, estrogen ), weight gain , hyperlordosis and anterior tilt of the pelvic .
- other factor may be faulty posture and high heel shoes , muscular spasm , urinary infection or constipation.
- excessive weight gain should be avoided
Management of Backache :
- Rest with elevation of the legs to flex the hips may be helpful
- Improvement of posture , well-fitted pelvic girdle belt which corrects the lumbar lordosis during walking and rest in hard bed often relives the symptoms
- Massaging the back muscles , analgesics and rest relief the pain due to muscle spasm
CONSTIPATION :
- It is quite common ailments during pregnancy .
- Atonicity of the gut due to the effects of progesterone , diminished physical activity and pressure of the gravid uterus on the pelvic colon due are the possible explanation
- Regular bowel habit may be restored with advice mentioned earlier .
LEG CRAMPS :
- It may be due to deficiency of diffusible serum calcium or elevation of serum phosphorus .
Management of leg cramp :
- Supplementary calcium therapy in tablet or syrup after the principal meals may be effective
- Massaging the leg , application of local heat and intake of vitamin B1 daily may be effective
ACIDITY AND HEARTBURN :
- Heartburn is common in pregnancy due to relaxation of the esophageal sphincter.
- hiatus hernia which is common during pregnancy can also produce heartburn, especially when the patient is lying down position
Management :
- Patient is advice to avoid overeating and not to go to bed immediately after the meals
- Sleeping in semi reclining position with high pillows relives the symptoms of hiatus hernia
- Liquid antacid may be helpful
VARICOSE VEINS :
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- Varicose vein in the legs and vulva (varicosities) or rectum (hemorrhoid ) may appears for the first time or aggravate during pregnancy , usually in later month
- It is due to obstruction in the venous return by the pregnant uterus
Management :
- Elastic crepe bandage during movements and elevation of the limbs during rest can give symptomatic relief
- Specific therapy is better to be avoided
- Varicosities usually disappears following delivery
HEMORRHOIDS :
- It may cause annoying complications like bleeding or may gets prolapsed
Management :
- Regular use of laxatives to keep the bowel soft ,
- Local application of hydrocortisone ointment and replacement of the piles if prolapsed are essential
- Surgical treatment is better to withheld as the condition sharply improves following delivery
PTYALISM :
- Increase secretion of saliva is observe during pregnancy
- It may be associated with increased intake of the starch ,through actual cause is unknown
Management :
- This problem is usually self-limiting and may be overcome by decreases intake of carbohydrates
- It is not associated with any adverse pregnancy outcome
ANKLE EDEMA :
- Excessive fluid retention as evidenced by marked gain in weight or evidences of pre-eclampsia has to be excluded
Management :
- No treatment is required for physiological edema or orthostatic edema
- Edema subsides on rest with slight elevation of the limbs
- Diuretics should not be prescribed
VAGINAL DISCHARGE :
- Assurance to the patient and advice for local cleanliness are all that are required
