Minor ailments of pregnancy and its treatment

1. MINOR AILEMENTS
DURING PREGNANCY
Mrs.Jagadeeswari.J
M.Sc Nursing

2. *
*“The minor complaints of pregnant
women that occur due to physiological
alterations of hormones ( oestrogen,
progesterone, prolactin) and other
causative factors which can be managed
without medical interventions.”

3. *
SUPINE HYPOTENSION SYNDROME &
SYNCOPE
VARICOSE VEINS & HAEMORRHOIDS
OEDEMA

4. *
Supine hypotensive syndrome is caused when the inferior vena cava is
compressed by the weight of a pregnant female’s uterus, fetus, placenta and
amniotic fluids while lying in the supine position.
 These condition can develop as early as the second trimester but is
maximal during the third trimester (36-38 weeks).
*The woman presents with dizziness or light headedness on standing upright
abruptly or following standing for a prolonged period.
*Following prolonged standing or standing upright abruptly
*Due to pooling of blood in the veins of the lower extremities & compression
of the pelvic veins by the gravid uterus
* Other causes may be dehydration, hypoglycemia or overexertion

5. *
MANAGEMENT :
*Syncope usually resolves rapidly on
lying in left lateral position.
* Syncope in supine position is also managed by
resting in lateral recumbent position.
*Recurrent syncope needs cardio logical evaluation.
* Encourage the patient to eat six small meals a day
rather than three large ones.
*Stimulants (spirits of ammonia, coffee, tea) are
indicated for attacks due to postural hypotension.

6. *In the legs and vulva (varicosities) or rectum (hemorrhoids) may
appear for the first time or aggravate during pregnancy
*Usually in the later months
*Due to obstruction in the venous return by the pregnant uterus.
*Due to smooth muscle relaxation, weakness of the vascular walls,
and incompetent valves.
*CAUSES:
Increased volume of circulating blood during pregnancy
Pressure of pregnant uterus on larger veins.
Obstruction in venous return by pregnant uterus.
Due to raised progesterone level causing walls of vein to relax.
Due to progestin hormone, which cause veins to be more dilated or
open.
Multiple pregnancy.
Tendency to constipation.

7. *

8. *
*Management:
• Exercise daily.
• Elevate feet higher to the level of heart and legs on
regular time interval.
• Don’t cross legs or ankle when sitting.
• Don’t sit or stand for long periods without taking.
• Sleep on left side- use a pillow to keep body tilled to the
left and elevate feet with pillow since inferior vena cava
is on right side.
*For leg varicosities, elastic crepe bandage during
movements and elevation of the limbs during rest can
give symptomatic relief.
*Avoid forceful massage (especially downward, i.e.,
against venous return) and point-pressure over the legs.
*Injection or surgical correction of varicose veins usually
is not recommended during pregnancy.

9. *
* Edema occurs when body fluids increase to nurture both mother and fetus and
accumulate in tissues due to increase blood flow. It starts around 22-27 weeks of
pregnancy.
* Evidenced by marked gain in weight or evidences of preeclampsia
* Develops in at least two thirds of women in late pregnancy
* Due to water retention and increased venous pressure in the legs
* Generalized edema, always serious, must be investigated
* CAUSES :
 Increase in body fluids as a result of increase blood flow.
 Pressure of growing uterus on pelvic veins and vena cava.
* MANAGEMENT :
* Avoid long period of standing and sitting.
 Elevate feet.
 Perform appropriate pregnancy exercises. Walking, swimming, etc
 Avoid tight elastic socks or stockings.
 Wear comfortable shoes.
 Limit salt intake.
 Massage the swelling area.
 Try to sleep on left side.

10. *
MORNING SICKNESS
HEART BURN & ACIDITY
CONSTIPATION
PICA
PTYLISM

11. *
It appear following the first or second missed period (around 6th week) and subside by
the end of first trimester( 12th week).
It can continue for longer or return at around 32 weeks.
Especially in the morning, soon after getting out of bed
Usually common in primigravidae
50% women have both nausea and vomiting, 25% have nausea only and 25% are unaffected
Most commonly occurs during the first 10 weeks
Related to higher levels of hcg
* Causes-
i. Increase level of HCG hormone.
ii. An enhanced sense of smell and sensitivity to odors.
iii. A sensitive stomach ( mainly empty stomach)
iv. Psychological stress
v. Multiple pregnancy ( Twin or more )

12. *Management –
1. Eat small amounts of food often rather than several large meals to avoid empty stomach.
2. Quit smoking and ask family members to stop smoking as well as.
3. Keep window open for good ventilation.
4. Get plenty of rest and sleep whenever you can. Avoid lying down after eating.
5. Dietary changes
6. Behavior modification
7. Hospitalization may be necessary to
8. correct fluid and electrolyte imbalance
9. Explanation, reassurance, and symptomatic relief are sufficient.
10. Avoid: Disagreeable odors and rich, spicy, or greasy foods
11. Drink water or other fluids between meals to avoid dehydration and acidosis
12. Try to avoid foods and smells that trigger nausea of someone.
13. Try to eat food cold or at room temperature because food tends to have stronger smell
when hot.
14. If possible eat some dry food like bread, biscuit, low-fat food, carbohydrate rich food
(e.g – Rice, noodles, mashed potatoes)
15. Try some sour drink ( e.g. Lamonade, plum juice etc)
16. Avoid eating deep fried, greasy food, garlic and other spices and avoid drinking coffee.

13. *
*Due to relaxation of the esophageal sphincter & hiatus hernia
*Heartburn (pyrosis, acid indigestion) results from gastroesophageal
reflux disease (GERD) in almost 10% of all gravidas
*In late pregnancy, this may be aggravated by displacement of the
stomach and duodenum by the uterine fundus
*Most likely to occur when the patient is lying down or bending over
*Causes :
I. Relaxation of oesophagal sphincter.
II. Decrease frequency of stomach contraction, making digestion sluggish
and leading to acidity.
III. Enlarged uterus can crowd the abdomen, pushing stomach acid upward.

14. *
*To avoid over eating and not to go to bed
immediately after the meal.
*Liquid antacids may be helpful
*Sleeping in semi-reclining position with high pillows
*This hernia is reduced spontaneously after delivery
*Symptomatic treatment, not surgery, is
recommended
*Hot tea and change of posture are helpful.
*Calcium-containing antacids & the histamine H2-
receptor antagonists are pregnancy category B
(e.g., Tums) to reduce gastric irritation

15. *
*Quite common ailment
*Atonicity of the gut due to the effect of
progesterone, diminished physical activity and pressure of the gravid
uterus on the pelvic colon, sluggish bowel function are the possible
explanations.
*Causes:
 Emotional stress :
 Minimal physical exercise :
 Relaxation of intestinal muscle due to pregnancy hormone :
 Pressure of expanding uterus on intestine :
 Sometimes due to iron tablet

16. *
*Management:
* Regular bowel habit may be restored
* Emphasize ample fluids and laxative foods
and prescribe a stool softener
* Purgatives should be avoided because of the possibility of inducing
labor.
* Exercise and good bowel habits are helpful
* Mineral oil is contraindicated because it absorbs fat-soluble vitamins
from the bowel and leaks from the anus.
Drink plenty of fluid at least 8-12 glasss every day in form of water,
milk, juice, soup etc.
Increase dietary fiber ( e.g. wheat, fresh fruit and vegetables,
legumes)
Low impact exercises such as swimming, walking or yoga.
Maintain active lifestyle.
Find natural way to get iron.

17. *
* Increased secretion of saliva is observed
during pregnancy. It may be associated with
increased intake of starch, though actual cause is
not known.
Management:
*This problem is usually self-limiting and may be
overcome by decreasing intake of carbohydrates.
*It is not associated with any adverse pregnancy
outcome.

18. *
*This is term used when the mother craves
certain food or unnatural substances such as
coal.
*The cause is unknown but hormones and
changes in metabolism are thought to
contribute to this.
* If the substance craved are harmful to the
unborn baby, the mother must be helped to
seek medical advice.

19. *
DYSPONEA & BREATHLESNESS
NASAL STUFFIENESS

20. *
*Causes:
Body’s adaption to carry fetus.
Upward shifting of ribcage due to pregnant uterus.
Progesterone hormone help in adaptation by absorbing oxygen in blood
stream via lungs.
Enlargement of uterus.
Pressure of gravid uterus on lungs.
Stair climbing.
*Management:
Sits up straight and keep shoulders back to give space to the lungs to
expands.
Stands up, this will relieve some of pressure on diaphragm.
Stay hydrated and maintain body weight.
Yoga and light exercise with rest in between them.
Use extra pillows while sleeping

21. *
*Causes:
• Estrogen and progesterone.
• Allergies and infections.
• Season
*Management:
Use right blow techniques means use thumb to
close one nostril and blow gently out the other side.
Put warm mist humidifier in room
Use petroleum jelly in each nostril to smoothen.
Vitamin c , reduce chances of nose bleed.

22. *
BACK ACHE & LORDOSIS
LEG CRAMPS

23. *
*Causes –
*1. Hormone change
*2. Anterior tilt of pelvis
*3. Weight gain
*4. Posture change
*5. Muscle separation
*6. Stress
*7. Hyperlordosis

24. *

25. *
*Excessive weight gain should be avoided.
*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
*Improvement in posture is often achieved by
the wearing of low-heeled shoes. To achieve
proper posture, the abdomen should be
flattened, the pelvis tilted forward, and the
buttocks tucked under to straighten the back.

26. *
*Causes:
Deficiency of diffusible calcium and magnesium ions.
Increase serum phosphorus.
Compression of blood vessels in legs.
Due to fatigue from carrying pregnancy weight.
*Management:
Stretch and massage affected muscle to disperse the builds up of
acids.
Apply a warm peck to affected muscle.
Walk around.
Leg exercises.
Stay active with regular physical activity.
Stay hydrated.
Choose proper footwear, flat soles.
Take calcium and magnesium supplement. Warm bath before going to
bed.

27. *
SLEEP DISTURBANCE
CARPEL TUNNEL SYNDROME
FAINTING

28. *
*Causes:
Urgency of urination.
Physical and emotional stress.
Excess daytime sleepiness.
Pressure of growing fetus.
Heart burn, cramps, congestion in nose.
Caffeinated drinks.
Over exertion.
*Management:
 Avoid caffeine.
 Daily work out .
 Take warm bath.
 Deep breathing exercises.
 Meditation & yoga.
 Noise free atmosphere.
 Wear loose cotton clothes.
 Stay stress free

29. *Causes:
Pressure of extra fluid on median nerve.
Repetitive wrist movements such as typing.
*Management:
Try to sleep with hands slightly raised up on pillow.
Avoid repetitive movements and sustained positions.
Carry things with forearms, not with arms.
Massage wrist.
Hold hands on pillow to distribute body’s weight while sleeping.
Light exercises-
Hold fingers stretched out and then relax.
Make a fist and straighten out fingers.
Move hands slowly up and down, side to side, in round circle.

30. *
FREQUENCY OF
URINATION

31. *
*Causes:
Increase in blood flow to kidneys by 50%.
Hcg hormone.
Extra weight during pregnancy causes pressure on bladder and pelvic floor.
Relaxation effects of progesterone on smooth muscle of urinary tract.
Urinary tract infection.
*Management:
Never restrict fluid intake because this might increase chance of UTI.
Regular pelvic exercise during pregnancy and after pregnancy will help.
Stay away from caffeinated drinks.
Avoid drinking fluid right before bed time.
Empty bladder completely.
Wear sanitary pads or panty shield.

32. *
*Some warning signs that should not be ignored because theses
may results in life threatening complications are as follows:
 Excess nausea vomiting.
High fever.
Foul vaginal discharge or infection.
Pain or burning during urination.
Slowed or stopped fetal movements less than usual.
Spotting or bleeding more than usual along with camps.
Excess swelling.
Shortness of breath.
Severe or persistent abdominal pain & tenderness.
Pelvic pressure( feeling of pushing down of fetus)
Persistent leg cramps.
Trauma to abdomen.

33. *THANK YOU