OBSTETRICS & GYNAECOLOGICAL NURSING- MINOR AILMENT DURING PREGNANCY- INTRODUCTION-Many women experience some minor disorder during pregnancy. These disorder should be treated adequately as they may escalate and become life-threatening. DEFINITION-“The minor complaints of pregnant women that occur due to physiological alterations of hormones and other causative factors which can be managed without medical interventions.” - Every system of body may affected by pregnancy.

2. MINOR AILEMENTS
DURING PREGNANCY
ANDITSMANAGEMENT
PRANATI PATRA

3. At the end of study students will be :
Able to define minor ailments.
Able to explain minor ailments related to Cardio-vascular system.
Able to explain minor ailments related to Gastrointestinal system.
Able to explain minor ailments related to Respiratory system.
Able to explain minor ailments related to Musculoskeletal system.
Able to explain minor ailments related to Neurological system.
Able to explain minor ailments related to Uro-genital system.
Able to explain minor ailments related to Integumentary system.
OBJECTIVES OF PRESENTATION

4. INTRODUCTION:
 Many women experience some minor
disorder during pregnancy.
 These disorder should be treated adequately as
they may escalate and become life-threatening.

5. “The minor complaints of pregnant women that occur due
to physiological alterations of hormones and other
causative factors which can be managed without medical
interventions.”
- Every system of body may affected by pregnancy.
DEFINITION

6. CARDIO-VASCULAR
SYSTEM
SUPINE HYPOTENSION SYNDROME
VARICOSE VEINS & HAEMORRHOIDS
OEDEMA

7. 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).
SUPINE HYPOTENSION
SYNDROME

8. SUPINE HYPO TENSION
SYNDROME
MANAGEMENT :
•Place patient in left lateral position
•High flow oxygen via non-rebreather.
•Treat for shock if other signs of shock are
present.

9. VARICOSE VEINS
 - Varicosities may develop in up to 40% of pregnant
women. In the legs and vulva (varicosities) or rectum
(hemorrhoids) may appear for the first time or aggravate
during pregnancy.
 Due to obstruction in the venous return by the pregnant
uterus.

10. MANAGEMENT
 Water immersion or compresses may alleviate symptoms or
spraying legs with hot& cold water.
 Reflexology may provide relief
 Avoid prolonged standing or immobility..
 Avoid tight clothing.
 Regular exercise improves calf muscle pump. Encourage
ankle flexion exercise for at least 30 minutes per day.

11. MANAGEMENT
 If resting for long periods women are advised to lie on their
left side which decreases pressure on the veins in the
legs and feet.

12. HAEMORRHOIDS
Haemorrhoids occur in up to 85% of women in late pregnancy and for many will
resolve soon after birth .
The aetiology of haemorrhoids is similar to varicose veins, with veins becoming
distended as the walls stretch, from increased blood volume, gravid uterus, and
reduced venous return, resulting in haemorrhoids.
Progesterone and the gravid uterus also decrease intestinal motility, further
affecting haemorrhoid formation.

13. MANAGEMENT
 Prevent / treat constipation,
high fibre diet, increased fluid
intake, exercise,
 Stool softeners; avoid straining during defecation, and
encourage defecating with a strong urge in the morning and
after meals when colonic activity is highest.

14. SYNCOPE(FAINTNESS)
 The woman presents with
dizziness or light headedness
on standing for a prolonged
period.
 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

15. 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 cardiological evaluation.
 Encourage the patient to eat six small meals a day rather
than three large ones.

16. ANKLE EDEMA
 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

17. MANAGEMENT
 No treatment is required for physiological edema or orthostatic
edema.
the limbs. Edema subsides on rest with slight elevation of
 Diuretics should not be prescribed.
 Restrict excessive salt intake and provide elastic support for
varicose veins.
 Diuretics may reduce edema temporarily but may be harmful
to the mother or fetus.

18. GASTRO-INTESTINAL
SYSTEM
MORNING SICKNESS
HEART BURN & ACIDITY
CONSTIPATION
PICA
PTYLISM ( SIALORRHOEA)

19. It appearfollowing the first orsecond missed period (around 6th week) and
subside by the end of first trimester( 12th week).
Causes-
i. Increase level of HCG hormone.
ii. Asensitive stomach ( mainly empty stomach)
iii. Psychological stress
iv. Multiple pregnancy ( Twin or more )
MORNING SICKNESS

20. Management –
1. Eat small amounts of food often rather than several large meals to avoid empty
stomach.
2. Drink plenty of fluids in between meals to avoid stomach fullness.
3. Quit smoking and ask family members to stop smoking as well as.
4. Keep window open for good ventilation.
5. Get plenty of rest and sleep whenever you can. Avoid lying down after eating.
6. If possible eat some dry food like bread, biscuit, low-fat food, carbohydrate rich
food.
7. Avoid eating deep fried, greasy food, garlic and other spices and avoid drinking
coffee.
CONT....

21. ACIDITY AND HEARTBURN
 Heartburn (pyrosis, acid
indigestion) results from
gastroesophageal reflux disease
(GERD)
 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

22. MANAGEMENT
Clinical History
 Obtain a current history of symptoms and any
previous history of reflux-type symptoms.
 Symptoms of heartburn can be similar to
epigastric pain associated with pre- eclampsia.
 Eat small frequent meals
 Avoid eating and drinking at the same time to
reduce stomach volume.

23. Positioning
 Elevate the head of the bed by 10-15cm.
 Lying on the left side has been cause less frequent reflux

24. PHARAMACOLOGY INTERVENTION
 Ranitidine 150mg twice daily can effectively treat oesophageal reflux.
 Intermittent use of metoclopramide is safe in pregnancy.
 For severe symptoms, Omeprazole can be prescribed after medical review.

25. CONSTIPATION:
 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, are the possible
explanations.

26. Management:
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.
Find natural way to get iron.
CONSTIPATION

27. PICA
 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 are
harmful to the unborn
baby, the mother must be
helped to seek medical
advice.

28. EXCESSIVE SALIVATION
(PTYALISM)
 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.

29. RESPIRATORY SYSTEM
BREATHLESNESS
NASAL STUFFIENESS

30. Causes:
Body’s adaption to carry fetus.
Upward shifting of ribcage due to pregnant uterus..
Enlargement of uterus.
Pressure of gravid uterus on lungs.
Management:
Sits up straight and keep shoulders back to
give space to the lungs to expands.
BREATHLESSNESS

31. CONT.....
Stands up, this will relieve some of pressure on diaphragm.
Yoga and light exercise with rest in between them.
Use extra pillows while sleeping

32. Causes:
•Estrogen and progesterone.
•Allergies and infections.
Management:
Use right blow techniques means use thumb
to close one nostril and blow gently out the
other side.
NASAL STUFFINESS

33. CONT...
Put warm humidifier in room
Use petroleum jelly in each nostril to smoothen.
Vitamin c , reduce chances of nose bleed.

34. MUSCULOSKELETAL
SYSTEM
BACK ACHE
LEG CRAMPS

35. BACKACHE
 Common problem (50%) in pregnancy
 Physiological changes that
contribute to backache are: joint
ligament laxity, weight gain.
 May be due to high heel shoes, muscular spasm, urinary
infection or constipation.

36. MANAGEMENT
 Excessive weight gain should be avoided.
 Rest with elevation of the legs to flex the
hips may be helpful.
 Apply local heat and light massage to relax tense.
 Give acetaminophen 0.3–0.6 g orally or equivalent

37. LEG CRAMPS
 Quite common, usually in the leg.
The cause of leg cramps in pregnancy is
not known but it may be due to deficiency
vitamin b1 and of diffusible serum calcium or
elevation of serum phosphorus.
 Compression of blood vessels in legs

38. MANAGEMENT
yrup Supplementary calcium therapy in tablet or s
after the meals may be effective.
 Massaging the leg, application of local heat and
intake of vitamin B1 (30 mg) daily may be effective.
 Analgesics are rarely needed.

39. NEUROLOGICAL SYSTEM
H HEAD ACHE
SLEEP DISTURBANCE
CARPEL TUNNEL SYNDROME

40. INSOMNIA
 This is relatively common in late
pregnancy to the discomfort caused by
the fetal movements,
frequency of mituration, and difficulty
in finding a comfortable position.
 It may also due to some deep- seated
anxiety or fear.

41. MANAGEMENT
 Take rest in the afternoon
 Drink a glass of warm milk at bed time
 Tuck a pillow under the abdomen when lying in a
lateral position
 Talk about her fear and anxiety so that she can
have a sense of normality and lightness.

42. HEADACHE
 Headache in pregnancy is common and
usually due to tension.
 Refractive errors and ocular imbalance are not
caused by normal pregnancy.
 Severe, persistent headache in the third trimester
must be regarded as symptomatic of preeclampsia-
eclampsia until proven otherwise

43. CARPAL TUNNEL
SYNDROME
(10%)
 Pain and numbness in the thumb,
index and the middle finger.
 Physiological changes in pregnancy with retention
of excess fluid are the common cause.

45. 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.
CARPELTUNNEL SYNDROME

46. CONT....
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.

47. UROLOGICAL SYSTEM
FREQUENCY OF URINATION
LEUKORRHOEA

48. LEUCORRHEA
 Gradual increase in the amount of nonirritating
vaginal discharge due to estrogen stimulation of
cervical mucus is normal during pregnancy.
 Such vaginal fluid is milky, thin, and nonirritating
unless infection has occurred.

49. MANAGEMENT
 Reassure the patient, and suggest protective
perineal pads.
 Excessive leukorrhea accompanied by pruritus or
discoloration of the secretion may indicate bleeding
or infection, requiring treatment.
 The area of the vagina needs to be kept dry and
clean

50. 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.
.
FREQUENCY OF URINATION

51. Management:
Never restrict fluid intake.
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 .

52. INTEGUMENTARY
SYSTEM
ITCHING
STRETCH MARKS

53. INTEGUMENTARY SYSTEM
SKIN:
 Some mothers complaints of generalized
itching, which often starts over the abdomen.
 Due to have some connection with the hormones in
pregnancy and with raised bilirubin levels.
STRETCH MARKS;

54. MANAGEMENT
 It clean soon after the
baby is born and comfort
can be gained from local
applications.
 An anti-histamine is often
prescribed.
 If a mother complaint of
vulvar irritation, infection
such as thrush, and
glycosuria as a result of
diabetes must be
excluded.
 Washing with mild soap
and cotton underwear
might help to ease the
irritation.

55. 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 cramps.
Excess swelling.
Shortness of breath.
Severe or persistent abdominal pain & tenderness.
Pelvic pressure( feeling of pushing down of fetus)
Persistent leg cramps.
Trauma toabdomen.
WARNING SIGNS OF MINOR
AILMENTS DURING PREGNANCY

57. SUMMARY
 Minor disorders during pregnancy
 Digestive system
 Musculoskeletal system
 Circulatory system
 Nervous system
 Genitourinary system
 Respiratory system
 Integumetary system
o Disorder that require immediate action

58. CONCLUSION
Pregnancy is a wonderful milestone in the life of a woman. It
is the origin of human life. Pregnancy is a time of physical
and hormonal changes and of emotional and psychological
preparation for motherhood. During pregnancy most of the
women experience some common minor ailments such as
nausea, vomiting, back pain, heartburn, constipation leg
cramps etc. that are spontaneously subside after delivery.

59. BIBILIOGRAPHY
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61. JOURNALS
•Affendi Raja Ali R, Egan LJ. Gastroesophageal reflux in pregnancy. Best
Practice & Research Clinical Gastroenterology. 2007;21(5):793-806.
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62. THANK YOU 4 YOUR
COOPERATION &
ATTETION