This document discusses common minor ailments that can occur during pregnancy, organized by body system. It outlines digestive issues like nausea and vomiting in early pregnancy, heartburn, and constipation. Musculoskeletal problems covered include backache and leg cramps. Circulatory conditions like syncope, ankle edema, and varicose veins are also described. The nervous system section addresses carpal tunnel syndrome. Reproductive system changes like vaginal discharge are also noted. For each issue, the causes and management approaches are summarized.

1. MINOR AILMENTS IN
PREGNANCY
INDIRA VEMURI
MSc(N) OBG

2. DIGESTIVE SYSTEM
Nausea and vomiting
 Specially in the morning
 Common in primigravidae
 Appear following 1st or 2nd missed period
 Subsides by end of 1st trimester
 50% have both N&V , 25% have only nausea and 25%
are unaffected.
Management
 Dietary changes: dry toast, biscuits, protein rich meals.
 Small frequent meals.
 Avoid fatty foods.
 Medications: anti-emetics such as promethazine 25mg,
prochlorperazine 5mg

3. Heartburn and acidity
 Heartburn is common in pregnancy
 due to relaxation of the esophageal sphincter.
Management
 Patient is advised to avoid over eating and not to go to
bed immediately after the meal.
 Liquid antacids may be helpful.
 Avoid fried and fatty foods
 Sleeping in semi-reclining position with high pillows
relieves the symptoms of hiatus hernia.

4. Ptyalism
 Occurs from 8th week of gestation
 Hormonal influence
 May accompany heartburn
Pica
 Mother craves certain foods or unnatural substances
 Hormonal influence and changes in metabolism.
Constipation:
 Quite common ailment
 Atonicity of the gut due to the effect of progesterone,
 diminished physical activity
 pressure of the gravid uterus on the pelvic colon are the
possible explanations.
Management
 Regular bowel habit may be restored.

5.  Hemorrhoids
 May cause annoying complications like bleeding or
may get prolapsed.
Management
 Regular use of laxative to keep bowel soft
 Local application of hydrocortisone
 Replacement of piles if prolapsed.
 Withhold surgical treatment.

6. MUSCULOSKELETAL SYSTEM
Backache
 common problem (50%) in pregnancy.
 Physiological changes that contribute to backache are: joint
ligament laxity (relaxin, estrogen), weight gain, hyperlordosis
and anterior tilt of the pelvis.
 Other factors may be faulty posture and high heel shoes,
muscular spasm, urinary infection or constipation.
Management
 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
 rest in hard bed often relieve the symptom.
 Massaging the back muscles,
 analgesics and rest relieve the pain due to muscle spasm.

7. Leg cramps
 due to deficiency of diffusible serum calcium or elevation
of serum phosphorus.
Management
 Supplementary calcium therapy in tablet or syrup after the
principal meals may be effective.
 Massaging the leg, application of local heat
 intake of vitamin B1 (30 mg) daily may be effective.

8. CIRCULATORY SYSTEM
Syncope
 prolonged standing or standing upright abruptly
 due to pooling of blood in the veins of the lower
extremities.
 There is the effect of compression of the pelvic veins by
the gravid uterus also.
 Other causes may be dehydration, hypoglycemia or
overexertion.
 dizziness or light headedness on standing upright abruptly
or following standing for a prolonged period.
Management
 resolves rapidly on lying in left lateral position.
 resting in lateral recumbent position.
 Recurrent syncope needs cardiological evaluation.

9. Ankle edema:
 Excessive fluid retention as evidenced by marked gain in weight
or evidences of preeclampsia 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
Varicose veins:
 legs and vulva (varicosities) or rectum (hemorrhoids)
 It is due to obstruction in the venous return by the pregnant
uterus.
Management
 For leg varicosities, elastic crepe bandage
 elevation of the limbs during rest.
 Specific therapy is better to be avoided. Varicosities usually
disappear following delivery

10. NERVOUS SYSTEM
Carpal tunnel syndrome (10%)
 Woman presents with pain and numbness in the thumb,
index and the middle finger.
 weakness in the muscles for thumb movements.
 due to compression effect on the median nerve.
 Physiological changes in pregnancy with retention of
excess fluid are the common cause.
Treatment
 mostly symptomatic.
 A splint is applied during sleep time
 Corticosteroid injection or surgical decompression is
rarely needed.
 It resolves spontaneously following delivery.

11. REPRODUCTIVE SYSTEM
 Vaginal discharge
 Assurance to patient
 Local cleanliness
 Infection to be treated with vaginal applicantion of
metronidazole or muconazole.

12. THANK YOU