Minor Discomforts during pregnancy presentation

1. Minor Discomfort
During Pregnancy
Obstetric and Gynecological nursing department
Division 3 - Group 1
Cairo University
Faculty of Nursing
2022
-
2023

2. Prepared by:
 Ibrahim Hassan Abdel-Fattah
 Aya Atya Gomaa
 Merna Abu Al-Saad Mikhael
 Hajar Ragab Bayoumi
 Omnya Ismail Muhammad
 Eman Ramadan Muhammad
 Ahmed El sayed Abdullah
 Mariam Mahmoud Abdel Salam
 Menna Gaber Samir
 Hassan Dawood
 Ayat Ibrahim Ismail El-Sayed
 Al-Shaimaa Shaaban Abdul Muttalib

3. At the end of the lecture, our colleagues will be able to:
 Identify minor discomfort during pregnancy in 1st Trimester
 Discuss minor discomfort during pregnancy in 2nd Trimester
 Explain minor discomfort during pregnancy in 3rd Trimester
 List causes of each one
 Describe nursing care for each one
Objectives

4. Minor Discomfort
During Pregnancy
“2nd Trimester”
Minor Discomfort
During Pregnancy
“1st Trimester”
Causes & Nursing
care for each one
Minor Discomfort
During Pregnancy
“3rd Trimester”
PRESENTATION OUTLINES

5. INTRODUCTION
Pregnancy is a normal process that results in a series of both physiological and
psychosocial changes in the women.
Some of these are temporary changes that occur only during pregnancy Most
pregnant women suffer from minor discomforts during their pregnancy period.
These minor discomforts are due to hormonal change and metabolic change
Symptoms of discomforts are different from women to women through the
different months of pregnancy.
The prevalence of minor discomforts is varying according to its type. Nausea and
vomiting (morning sickness) are of the most common discomforts of the early
pregnancy.

6. First
Trimester
 Nausea and vomiting
 Urinary frequency
 Breast tenderness and enlargement
 Increased vaginal discharge (Leukorrhea)
 Nasal stuffiness and epistaxis
 Ptyalism(excessive salivation)
 Fatigue
 Dizziness (drowsiness)
 Headache

7. Nausea and vomiting
• About half of all pregnant women experience nausea and
sometimes vomiting in the first trimester. This is also called
morning sickness because symptoms are most severe in the
morning. Some women may have nausea and vomiting
throughout the pregnancy. Morning sickness may be due to
the changes in hormone levels during pregnancy.
.
• If vomiting is severe, causing a woman to lose fluids and
weight, it may be a sign of a condition called hyperemesis
gravidarum.
• Hyperemesis can lead to dehydration and may need
hospitalization for intravenous fluids and nutrition.

8. Nausea and vomiting
Causes of nausea and vomiting:
High levels of human chorionic gonadotropin (HCG) or
progrsterone.
Emotional factors
Hypoglycemic reaction as a result of increased metabolism
due to the 24- hour a day fetal and maternal body functions,
especially after a period of fasting (from night to morning)
.

9. Nausea and vomiting Nursing care
 Reassure the mother that nausea and vomiting is one of the
minor discomfort that occured during pregnancy.
 provide an emesis basin within easy reach of the mother.
 Eliminate strong odor from the surrounding such as : perfumes,
dressing, emesis.
 maintain fluid balance in the mother
 use nonpharmaclogical nausea control techniques such as:
relaxation, guided imagery,music therapy, distraction, or deep
breathing exercises.
 Give frequent , small amounts of foods and to eat 6 small meals
a day instead of 3 large meals.

10. Nausea and vomiting Nursing care
 Encourage patient to eat Dry food like crackers or toast, Bland simple
foods like broth,rice,bananas, or Jell-o.
 Tell patient to avoid foods and smells that trigger nausea.
 position the patient upright while eating and for 1 to 2 hours post-meal
 keep rooms well- ventilated if possible, assist the mother to go outside
to get some fresh air.
 Eat a high- protein snack at bedtime if it's a hypoglycemic attack.
 Reduce fatty and fried containing foods and spicy foods.
 Rest
 sip a hot drink before arising.
 smell fresh-smelling , pleasant scents such as lemon, orange, or mint.

12. Urinary frequency
• Frequent urination is one of the most common early
symptoms of pregnancy that starts in the first trimester,
around week 4 .
.
•Causes of frequent urination:
After an implantation in the uterus the body produces
progesterone and HCG, both of which are pregnancy
hormones that can lead to urgency.
Compression of the bladder and uterus by the growing
uterus and increase the urge to urinate.
Increased blood volume that increase kidney production
of more urine.
.

13.  No fluid restriction. Advise the mother not to restrict her
fluids to diminish the frequency of urination, instead;
caffeine intake should be diminished.
 Offer assurance. Assure the mother that voiding frequently
is a normal occurrence during pregnancy.
 Limiting intake during late evening and at bedtime.
 Recommend use of cranberry juice and vitamin c.
.
Urinary frequency Nursing care

14. Urinary frequency Nursing care
Pelvic floor exercises, also known as Kegel exercises, can strengthen the muscles of the
pelvis and urethra and support the bladder. Performing Kegel exercises during pregnancy
may help some people regain control over their urine flow.
Kegel exercises are safe to perform during pregnancy and after childbirth.
To perform Kegel exercises, empty the bladder and then follow these steps:
1) Relax the abdomen, chest, thighs, and buttocks.
2) Tighten the pelvic floor muscles and hold for 5 to 10 seconds.
3) Relax the muscles for 5 to 10 seconds.
4) Repeat 10 times.

16. Breast tenderness and enlargement
• breast tenderness is one of the earliest symptoms of pregnancy Due to produce
pregnancy hormonen amely estrogen, progesterone, and prolactin.
• changes to the breasts are usually one of the early signs of pregnancy.
.
•Nursing management for Breast Tenderness During Pregnancy
•Wear a more supportive bra.
•Opt for loose fitting clothes. As your breasts expand during
pregnancy,
•Try a cold compress. Lay a towel over your chest and apply an ice
pack to the area.
•Take warm showers. Not everyone responds to cold therapy, so if you
don't find relief from an ice pack, try spending some time in a steamy
shower.
•Doctor approved pain relief.
•Wear a comfortable bra during sleeping and during exercises to

17. leukorrhea
caused by high levels of estrogen and progesterone.
• An increase in blood volume and blood flow can also contribute
to increased vaginal discharge.
• Pregnancy discharge should be thin and white, .
• Increase inwhite creamy discharge early in prgnancy.
.
Nursing management forvagainal discharge(leukorrhea) in pregnancy
• Bathe regularly and wear underpants with breathable cotton liners.
• Keeping clean and dry down there helps keep bacteria in balance and prevent vaginal infections.
• Wear pads or panty liners. ...
• Leave the douches at the drugstore. ...
• Don't bother with wipes.
• wear perineal pads.
• Do not wach inside your vagaina (douche)
.

18. Nasal Stuffiness &Epistaxis
Causes:
• Increase blood flow to mocous membrane
• Some cases caused by allergies affect
• change hormone in pregnancy (increase estrogen)
.
Nursing management
• control environment and avoid allergens
• Avoid supine position because it increase nasal congestion and
should be
• raise the head of bed 30 to 45 degree to maintain patency of
airway.
• saline lavage may provide some relief ofor allergy pregnancy rhinitis
• sit-down and firmly pinch the soft part of your nose, just above your
nostril , for 10 to15 minutes without releasing pressure.
• place ice pack or cold compress on her nose help to reduce blood
flow

19. Ptyalism
Caused by
- Nausea/ vomiting.
- Hyperemesis gravidarum (extreme morning sickness).
-Hormonal changes.
- Other causes include heartburn, which is common in pregnancy, and
irritants like smoke, toxins and some medical conditions
Nursing management
• Eating small frequent meals.
• Chewing sugarless gum or sucking hard sweets. Taking frequent,
small sips of water.
• If swallowing saliva makes you feel nauseated, spit out the excess
into a tissue,
• washcloth, or cup. Just like nausea or morning sickness, it can last
throughout pregnancy for a small number of women.

20. Fatigue
Caused by
• Hormonal changes as the progesterone increases in first trimester
and blood volume increases to supply the developing placenta and
fetal circulation, So the heart pumps faster and stronger.
• Increased blood supply creating and pumping extra blood to
supply baby with nutrients and oxygen can make mother feel
fatigued.
Nursing management
• Assess for nutritional status.
• A dvise her to take naps during the day. -Take breaks and
rest from work.

21. Dizziness
Caused by
• Hypotension because the uterus compresses major arteries.
• Low blood sugar.
• Anemia for mothers who don't take enough amount of iron.
• Changing hormones
• Hyperemesis gravidarum
• Sleeping in the wrong position.
Nursing management
• Protect from falling by advising her that when she stand up to
make that slowly and hold on with something to support her.
• Eat healthy food frequently to avoid low blood sugar.
• Drink plenty of fluids to avoid dehydration.
• Take iron and folic acid supplementation.
• Wear loose, comfortable clothing to avoid restricting circulation.
• Limit long periods of standing.

22. Headache
Caused by
Hormonal changes
• Not getting enough sleep
• Withdrawal from caffeine (e.g.coffee, tea or cola drinks)
• Low blood sugar
• Dehydration
• Stress, fatigue, eyestrain
Nursing management
• Getting more sleep or rest and relaxation
• Pregnancy yoga classes or other exercise
• .Reduce stress level.
• Eating regular, well balanced meals
• Putting a warm facecloth on your eye and nose area

23. Second
Trimester
 Heartburn
 Indigestion
 Constipation and hemorrhoids
 Flatulence
 Braxton hicks contractions
 Palmar erythema and spider angiomas

24. Heartburn
Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat.
Caused by
• Hormonal changes.
• gastric reflux
• uterus enlarging
• poor food habits
• unhealthy diet & lifestyle
• stress and lack of sleep
Nursing management
• Eat several small meals throughout the day instead of three large ones.
• Eat slowly.
• Avoid fried, spicy or fatty foods.
• -Avoid citrus fruits and juices.
• Limit caffeine.
• Sit up straight when you eat.
• Don’t eat late at night.
• Don’t lie down right after eating.
• Keep the head of your bed higher than the foot of the bed. Or try placing pillows under your shoulders.

26. Symptoms of indigestion come when the acid in your stomach irritates your
stomach lining or your gullet. This causes pain and a burning feeling.
Caused by
• hormonal changes
• the growing baby pressing on your stomach
• the muscles between your stomach and gullet relaxing, allowing stomach
acid to come back up
Nursing management
• Do cut down on tea, coffee, cola or alcohol
• raise your head and shoulders up when in bed – this can stop stomach acid
coming up while you sleep
• lose weight if you're overweight
• Don’t do not eat 3 to 4 hours before going to bed
• do not have rich, spicy or fatty foods
• do not take ibuprofen or aspirin – this can make indigestion worse
• do not smoke
Indigestion

27. Constipation ,a common problem during pregnancy, causes less frequent and more
strained bowel movements.
Hemorrhoids Hemorrhoids are swollen veins in and around the anus. and
Constipation is the main cause of hemorrhoids.
Caused by
• Progesterone, your body makes more of the hormone progesterone when you
are pregnant, progesterone relaxes your intestines,or bowel,so they don't work
as hard to squeeze waste out through your body.
• The iron from your prenatal vitamins.
• Lifestyle
Nursing management
• -Eat a high-fibre diet (lots of whole fruits, vegetables, and whole grains).
• -Drink plenty of fluids, especially water.
• -Don't strain (push hard) during a bowel movement.
• -Increase the amount of exercise you get every day.
• - ask healthcare provider about stool softener and laxative.
• - Don't delay going to the bathroom when you feel the urge.
• - Don't sit on the toilet longer than necessary because this puts pressure on your
rectal area
Constipation and hemorrhoids

30. Caused by
As the enlarging uterus compresses the bowel, it delays the passage of food through
the intestines, thus allowing more time for gas to be formed by bacteria in the colon.
The woman usually reports increased passage of rectal gas, abdominal bloating, or
belching.
Nursing management
• Instruct the woman to avoid gas forming foods, such as beans, cabbage, and
• onions .
• Adding more fiber to the diet and foods that have a high content of white
• sugar.
• Increasing physical exercise are also helpful in reducing flatus.
• Decreasing the amount of swallowed air, if chewing gum, will reduce gas
• build up.
• The knee chest position may also help with discomfort from unrepelled gas.
• Eating mints can also help reduce flatulence during pregnancy
Flatuance

32. Caused by
They may come and go at random and may feel irregular in their
rhythm and strength. These muscle contractions often cause
discomfort more than pain.
Nursing management
• Teach the mother breathing techniques for labor to help yourself relax.
• Take a warm bath, sip some warm herbal tea, or Drink more water.
• Change your body’s position.
Braxton hicks contractions

33. Caused by
Palmar erythema is caused because of dilated capillaries, which are the smallest blood vessels in your
body. How red your palms get seems to vary.
Spider angiomas are very common. They often occur in pregnant women and in people with liver
disease. They can appear in both children and adults. They get their name from an appearance similar to
a red spider.
Nursing management
• There’s no way to prevent palmar erythema during pregnancy,
but it’s best to stay away from potential irritants that could
make symptoms worse.
• If the spider angiomas are associated with pregnancy, they
may resolve after childbirth. In women taking oral
contraceptives, they may resolve after stopping these
contraceptives
Palmar erthymea & Spider angiomas

34. Third
Trimester
 Shortness of breath (dyspnea)
 Ankle edema
 Varicosities
 Leg cramp
 Round ligament pain
 Carpal tunnel syndrome
 Backaches

35. Dyspnea
Is that a symptom or a disease ?
- The pressure caused by the uterus expanding against the diaphragm
decreases lung capacity.
- The diaphragm is moved up about 4 centimeters from its normal position.
- The diaphragm, which is more stretched, then loses some of its elasticity,
resulting in shortness of breath.
- The expanding uterus also causes the contents of the abdomen (for example,
the stomach) to move against the diaphragm, making it harder for the lungs to
stretch.
N.B : woman may experience a decrease in shortness of breath in the last few
weeks before giving birth. At this stage, the baby settles into the mother’s
pelvis, thus reducing pressure on the diaphragm.

36. Dyspnea Nursing care
Nursing management
• Watch for posture and keep the back straight.
• Elevate the head of bed slightly or use an extra pillow to sleep in a semi-
seated position with the head and chest elevated.
• Repeat the following exercise to breathe more easily:
- Stand with feet on the floor or lie on the back with legs bent.
- Inhale slowly while raising and stretching arms over head. This movement
stretches the rib cage.
- Exhale slowly while bringing arms back down to sides.
• Avoid places where people smoke whenever possible because
secondhand smoke can be harmful to health and that to the baby.
• Limit activities during the day to prevent exertional dyspnea.

37. Ankle edema
- Some fluid accumulation during pregnancy is normal, particularly during the 3rd
trimester. It is called physiologic edema.
- Fluid accumulates during pregnancy because the adrenal glands produce more of the
hormones that make the body retain fluids (aldosterone and cortisol).
- Fluid also accumulates because the enlarging uterus interferes with blood flow from
the legs to the heart. As a result, fluid backs up in the veins of the legs.
N.B: close monitoring for Ankle edema is required especially if the pregnant woman
has eclampsia or DVT.

38. Ankle edema
Nursing management
• Lying on the left side, which moves the uterus off the large vein that returns
blood to the heart (inferior vena cava)
• Resting frequently with the legs elevated
• Wearing elastic support stockings
• Wearing loose clothing that does not restrict blood flow, particularly in the
legs (for example, not wearing socks or stockings that have tight bands around
the ankles )
• Drinking six to eight glasses of water daily to replace fluids lost.
• Avoid foods high in sodium

39. Varicosities
causes
• Increased blood flow to your pelvis. More blood flows to your pelvis when
you’re pregnant. More blood volume means that your veins have to do
more work to carry that extra blood to your heart. Sometimes, your veins
swell because they can’t handle all the extra blood flow.
• Increased uterus size. Your uterus gets bigger during pregnancy to support
a growing fetus. This new weight adds pressure to your pelvic area,
including the veins in your vulva. The veins can become squeezed, which
makes it harder for them to carry blood back to your heart.
• Hormone changes. Hormone levels change during pregnancy, and some of
these changes can affect the lining of your veins. The lining can become
more stretchy and less able to contain the blood flowing inside them. Your
veins can get bigger and twisted as a result.

42. Varicosities
Nursing managment
• Encourage the client to wear support hose and teach her how to apply them
properly.
• Advise her to elevate her legs above her heart while lying on her back for 10
minutes before she gets out of bed in the morning, thus promoting venous
return before she applies the hose.
• Instruct the client to avoid crossing her legs and avoid wearing knee-high
stockings. They cause constriction of leg vessels and muscles and contribute to
venous stasis
• Exercise daily. Even just a brisk walk around the block can improve your
circulation.
• wear low-heeled shoes; and to avoid long periods of standing orsitting,
frequently changing her position.
• If the client has vulvar varicosities,suggest she apply ice packs to the area when
she is lying down
• ✓Stay within the recommended weight range for your stage of pregnancy.

45. Carpal tunnel syndrome
Carpal tunnel syndrome is a condition that occurs as a result of swelling
around the nerves of the wrist. It can cause numbness, tingling or pain in
one or both of the hand.
Causes
During pregnancy, The blood volume doubles. That extra fluid increases
pressure and swelling in the blood vessels throughout the body. In tight
spaces such as the carpal tunnel area of the wrist – through which nine
tendons and one nerve pass the swelling can compress the median
nerve, which runs to the hand.
The median nerve gives sensation to the palm-side surface of thumb,
index, and middle fingers, and half the ring finger. It's also responsible
for helping to move the muscles in the hand that bend the fingers.
The condition is more common in the third trimester, but it can also
happen in the first and second trimesters or after giving birth. In most
cases, symptoms will go away after your baby is born.

46. Carpal tunnel syndrome
Nursing management
• Elevating the hands when resting or not using them.
• Keeping the wrists in a neutral position (not bent forwards or backwards) during the day, and as much as possible
while sleeping
• Avoiding activities that strain the wrist.
• Keep the hands elevated as much as can..
• Sleep on the side of less affected hand.
• Put an ice pack on the wrist or run cold water over the hand.
Treatment options include physiotherapy or occupational therapy. This may involve fitting with a splint to keep the
wrist in the best position to reduce strain. The splint must be adjusted to fit the wrist in order to be protective and
supportive. should wear the splint at night to keep the wrist in the right position while sleeping .
Some things should avoid:
✓Avoid any repeated movements that make pain worse.
✓Avoid lifting heavy objects.
✓Avoid tasks where do the same movement repeatedly
✓Don’t bend wrist as far as it can go.

47. Round ligament pain
Causes of Round ligament pain :
A woman’s body makes hormones during pregnancy to make ligaments
loose and stretchy. This helps the body adjust to the growing baby. As a
baby grows in the womb, it stretches the uterus and the round ligaments.
This stretching can cause spasms in the round ligaments, leading to the
pain.
Management of Round ligament pain:
• Elastic belly band to support The baby bump
• Avoid lifting heavy things and standing for long periods of time
during pregnancy. This will help lessen the stress on the uterus and
round ligaments
• change positions slowly (such as standing up or sittingdown)
• Get plenty of exercise to keep stomach muscles strong
• Apply warmth. A heating pad or warmbath may be helpful
• Flex hips. Bend and flex hips before coughing, sneezing, or laughing
to avoid pulling on the ligaments.

49. Leg cramp
Causes of leg cramp :
Leg cramps during pregnancy might be caused by fatigue, the uterus pressing
on certain nerves, or decreased circulationin the legs from the pressure of the
baby on bloodvessels. They might also be caused by calcium or magnesium
deficiency, ordehydration. could be the pregnancy affecting on metabolism,
too little or too much exercise, electrolyte imbalances or vitamin deficiencies.
Management of leg cramp:
• Drink between 8 and 12 cups of water perday. _Staying active can prevent
excess weight gain, promote circulation by Try doing these exercises three
times a day.
• Stretch out calf muscles by _Massaging the area performing a self-massage
may help ease the pain. Use one hand to gently massage calf or wherever
leg is cramping
• stretching the muscle by pulling the toes hard up towards the front of ankle
• having a warm bath
• Eat a balanced diet with calcium-and magnesium-rich foods like yogurt, leafy
greens, whole grains, dried fruit, nuts, and seeds

51. Backpain
Is very common to get backache or back pain during pregnancy.
During pregnancy, the ligaments in the body naturally become
softer and stretch to prepare for labour. This can put a strain on
the joints of lower back and pelvis, which can cause back pain.
Increased levels of progesterone during pregnancy relax the joints
and muscles to accommodate the growing uterus and enhance
flexibility in the pelvis so the baby can pass through the birth canal
more easily. However, this also can cause pain.

53. Backpain
Nursing management
Practice good posture
1. Standing up straight and tall.
2. Holding the chest high.
3. Keeping shoulders back and relaxed.
• using wide stance for the best support , when standing.
• Good posture also means sitting with care. Choose a chair that supports the back, or place a small
pillow behind the lower back.
• Get the right gear
• Wear low-heeled not flat shoes with good arch support. Avoid high heels, which can further shift the
balance forward and cause falling.

54. Backpain
Nursing management
• Lift properly
• When lifting a small object, squat down and lift with the legs. Don't bend at the
waist or lift with the back. It's also important to know the limits. Asking for help.
• Sleep on the side
• Sleep on the side, not the back. Keep one or both knees bent. Consider using
pregnancy or support pillows between the bent knees, under the abdomen and
behind the back.

55. Backpain
Nursing management
• Try heat, cold or massage
• Massage or the application of a heating pad or ice pack to the back might
help.
• . Include physical activity in daily routine
• Regular physical activity can keep the back strong and might relieve back pain
during pregnancy.
• Medication used to treat inflammation.
• Using support devices.
• Getting enough sleep

56. CONCLUSION
Most pregnant women suffer from minor discomforts during their
pregnancy period. These minor discomforts are due to hormonal change.
The common of minor discomforts are nausea and vomiting ,fatigue
,constipation ,heart burn, backache ,Dyspnea, leg cramps varicose vein,
insomnia, urerinary frequency, and leucorrhea.

57. Thank you!
Any Questions?

58. References
 Susan.s Esentials of Maternity, Newborn, & Women's Health Nursing 4thEdition
 Joanne.Maternal & Child Health Nursing Ninth, International Edition