As the physiological changes occurring in the body,the female experiences certain discomforts during pregnancy. The common systemic discomforts are as follows :
(A) DIGESTIVE SYSTEM –
- Nausea & Vomiting – Specially in the morning, soon after getting out of bed are usually common in primigravida commonly known as “morning sickness”. The hormone that can be responsible for this are hCG, oestrogen, progesterone . it is seen in 50% women during first trimester.
– Light snacks, take dry toast, biscuit or protein rich meal. Do not empty stomach.
– Eat small frequent meals. Avoid fatty or spicy foods.
– Behaviour modification to avoid personal triggering factor.
- Bleeding from gums – Because of red blood supply to the gums and response of higher blood level of progesterone.
- Constipation & Flatulence – It is common complain due to the effect of progesterone which relaxes the smooth muscle, causing decreased peristalsis of the gut.
Haemorrhoids is a condition in which the veins at the lower end of the intestine become congested, swollen or dilated. Diminished physical activity or pressure of the gravid uterus on the colon are also possible cause.
– Eat food rich in fibre, green leafy vegetables and fruits.
– Eat frequent, small meals throughout a day.
– Eat foods low in fat,as high fat food are hard to digest.
– Take a glass of warm water in the morning to activate the gut for regular bowel movement.
- Heartburn – Is the condition in which the digested food from the stomach goes back into the oesophagus and the acid from stomach causing burning sensation in the middle of the chest. It is due to the effect of progesterone which relaxes the cardiac sphincter during pregnancy.
- Eat small and frequent meal.
- Avoid fatty of spicy food which causes heartburn.
- Avoid lying flat immediately after eating.
- Avoid eating late at night, or over eating.
- Avoid drinking lots of liquid with meals.
- Antacids may be helpful.
- Pica – It is a craving for certain foods or unnatural substances such as chalk, coal, mud etc.
(B) CIRCULATORY SYSTEM –
- Dizziness & Fainting – It occurs because fall in BP as progesterone relaxes the muscle of blood vessels. In later period, mother may feel faint, while lying on her back as gravid uterus put pressure on the inferior venacava and diminishes blood return to heart.
– Advice the mother not to lie on her back in later month of pregnancy and to avoid long period of standing.
- Ankle Oedema – Excessive fluid retention as evidence by marked gain in wt as evidence of pre-eclampsia has to be excluded. No treatment is required for physiological oedema. It subsides on rest with slight elevation of the limbs. There is venous or lymphatic stasis.
-Advice the mother not to sit with the feet hanging down and elevate legs. Diuertics should not be prescribed.
- Varicose Vein – Varicose Vein in the legs and vulva and rectum may appear for the first time during pregnancy, due to obstruction in the venous return by pregnant uterus. Elastic crepe bandage during movement and elevation of the limbs during rest can give symptomatic relief. It disappears following delivery. Haemorrhoids may cause bleding so regular use of laxatives to the bowel soft.
(C.) MUSCULOSKELETAL SYSTEM –
- Leg Cramps – It may be due to deficiency of diffusible serum calcium or elevation serum phosphorus.
-Supplementary Ca therapy in tablet or syrup after the principal meals may be effective. Massaging the leg, application of local heat and vitamin B1 daily may be effective.
- Backache – Physiological changes that contribute to backache are joint ligaments laxity (relaxin, oestrogen) weight gain, hyperlordosis and anterior tilt of the pelvis . Other factor may be faulty posture and high heel shoes, muscular spasm.
Rest and elevation of legs to flex the hips may be helpful. Improvement of posture well fitted pelvic girdle belt which correct the lumbar lordosis during walking and rest in hard bed often relieve the symptom. Massaging the back muscle , analgesics and rest relieve the pain due to muscle spasm.
(D.) GENITOURINARY SYSTEM
- Frequency of Micturition – The size of uterus grows and therefore presses against urinary bladder, so urge for passing urine, kidney begins to function more efficiently, so the volume of urine produced increases. As a result small amount of urine may leak out involuntarily , specially during coughing, sneezing laughing (stress incontinence)
- Leucorrhea / Vaginal discharge – During pregnancy there is increased white, non irritant vaginal discharge present.
– Advice to mother to frequently wash the Vulva for presence of any infection (trichomonas, candida) should be treated with vaginal application of metronidazole.
(E.) NERVOUS SYSTEM
There is fluid retention in pregnancy, which creates oedema and pressure on median nerve. Mother feels numbness in fingers and hands.
-Advice the mother to restrict salt intake in diet, rest the hand on pillows and wear splint at night.
- Insomnia –It result as the mother fells more discomfort during later month of pregnancy, such as uncomfortable posture, frequency of micturition, fetal movements etc.
-Advice the mother to have a glass of warm milk at bed time, lie in lateral position with the support of pillows, take rest in afternoon.