Common Disorders during pregnancy

Question 1

Why does vomiting and nausea occur?

Answer 1

increased levels of hCG, oestrogen and progesterone

Question 2

How is nausea and vomiting managed?

Answer 2

• maintain blood sugar/hydration
• drink water
• eat little and often
• spontaneous resolution typically by 16-20 weeks

Question 3

What are the non-pharmacological treatments for nausea and vomiting?

Answer 3

• ginger

- acupressure

Question 4

What is the pharmacological treatments for nausea and vomiting?

Answer 4

antihistamines

Question 5

Why does constipation occur?

Answer 5

• dehydration
• poor diet, lack of fibre
• increased progesterone
• pressure of gravid uterus decreases mobility of small intestine
• increased transit time of food, higher water absorption = hard stools

Question 6

What is the management for constipation?

Answer 6

• discuss diet and water intake
• increase fibre intake - wheat, bran fibre etc
• ensure hydration

Question 7

Why do haemorrhoids occur?

Answer 7

• constipation
• increased blood flow
• reduced venous return

Question 8

What is the management for haemorrhoids?

Answer 8

• diet modification

- haemorrhoid cream - pharmacy

Question 9

Why does heartburn occur?

Answer 9

• lower oesophageal sphincter displaced into intrathoracic cavity with enlarging uterus increasing abdominal pressure
• relaxing effects of progesterone decreased gastrointestinal transit
• reflux of acidic gastric contents to oesophagus

Question 10

What is the management for heartburn?

Answer 10

• lifestyle and diet modification - small, frequent meals, don’t eat and drink too late, sleep semi-recumbent
• antacids if symptoms persist

Question 11

Why do varicose veins occur?

Answer 11

• effects of progesterone and relaxin on smooth muscle of vein walls
• reduced venous return and increased venous pressure
• increased blood flow to lower body regions

Question 12

What is the management for varicose veins?

Answer 12

• inform women they are not harmful

- compression stockings can improve symptoms but will not prevent

Question 13

Why does backache occur?

Answer 13

• changes in load and body mechanics
• stretched abdominal muscles
• lower back supports body weight
• progesterone and oestrogen increase joint mobility
• effects of relaxin result in pelvic laxity

Question 14

What is the management for backache?

Answer 14

• exercise in water
• massage
• heatpads
• back care classes/exercises
• pelvic girdle belts

Question 15

Why does vaginal discharge (leucorrhoea) occur?

Answer 15

• increased blood flow to vagina - venous engorgement

- increased cervical mucus production and vaginal discharge

Question 16

What is the management for leucorrhoea?

Answer 16

• inform women about increased vaginal discharge during pregnancy
• reassure of normality if smell is offensive, normal consistency/colour (thick/white)

Question 17

What is gingivitis and why does it occur?

Answer 17

• inflammation of gingivae (gums). A mild form of gum disease resulting in redness, swelling and soreness.
• gum health tends to worsen during pregnancy
• bleeding gums due to plaque build up on the teeth
• increased vascularity

Question 18

What is the management for gingivitis?

Answer 18

• good oral care advice
• free treatment antenatally
• check fears and phobias