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  Minor ailments in Early Pregnancy and their Management Download

Minor ailments in Early Pregnancy and their management
During pregnancy, the rapidly rising estrogen, progesterone and prolactin change the maternal body into a suitable environment for the nourishment of the fetus. Most of these changes are normal.
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- Lots of the minor ailments in pregnancy will spontaneously subside after delivery. Therefore pregnant women do not need to worry.
- Herbs and medicines should be avoided especially during early pregnancy because they can enter the fetal circulation through the placenta. Some medications exert toxic or teratogenic effect on the fetus.  One should always seek doctor's advice before taking any medications.
Nausea and Vomiting
- Both are extremely common during the first half of pregnancy. Alteration in dietary habits may help to ease the discomfort.
- Medical diseases and pregnancy complications like thyrotoxicosis, multiple pregnancies and molar pregnancy can lead to severe vomiting.
- Severe vomiting results in dehydration and electrolyte imbalance. In case when fluid diet is not tolerable, or when weight loss, cramp or confusion occurs, hospitalization for prompt treatment is required immediately.
Tips to relieve gastrointestinal upset:
- Eat a piece of bread or a few crackers before getting up in the morning, must take breakfast. Take small meals every 2 to 3 hours. Do not skip meal and avoid hunger. Drink fluids in between rather than with meals to avoid stomach fullness.
- Eat cold foods to avoid strong odour, dry foods like soft bread, tart or sour food like pickles and lemonade, and carbohydrate-rich food like bland mashed potatoes, bread, rice and noodles. Avoid high fat and fried food, coffee, garlic and other spices. 
- Get out of bed slowly and avoid sudden movements. Avoid brushing teeth and tongue immediately after eating. Have enough rest and avoid fatigue. Open windows to ensure good ventilation.
- Avoid smoking. Quit smoking and preferably ask family members to stop smoking as well.
Heartburn
- It is very common during pregnancy.  The relaxation effect of progesterone on the oesophageal sphincter results in reflux of acidic fluid to the oesophagus, causing irritation and heartburn feeling. 
- Fatty diet worsens the condition because dietary fat lowers the oesophageal sphincter tone further.
Tips to relieve heartburn:
- Eat small, low-fat meals frequently. Chew the food well and eat slowly.
- Avoid spicy food.

- Avoid lying down, bending and stooping after eating. Elevate the head of the bed. Wear loose-fitting clothing.
- Do not take any antacids without consulting a doctor.	

Leg Cramp
- Usually occurs at rest and therefore affects sleep.  It is usually resulted from muscle tension. 
- Sometimes severe vomiting can lead to low level of calcium and potassium in blood, resulting in cramps.
Tips to relieve cramps
Leg exercise: Lie on the back and rest the feet on two pillows, move the ankles up and down, inward and outward, then combine these movements by making a circle. Repeat 10 times.  (Please refer to the leaflet on 'Antenatal Exercise')
- If severe vomiting presents at the same time, hospitalization for electrolyte replacement may be necessary. 

Constipation
- It affects 10-40% of pregnant women.  Progesterone lowers the intestinal muscle tone and the peristaltic movement of the colon.  Additive effect of the increase in reabsorption of water from the bowel mucosa results in constipation.
Tips to relieve constipation during pregnancy:
- Drink at least 8-12 cups of fluid everyday in the form of water, milk, juice or soup.  - Warm or hot fluid is particularly helpful.
- Increase fiber intake by eating more whole grain breads and cereals, vegetables, fruit and legumes such as beans, split peas and lentils.
- Maintain an active lifestyle with regular exercise such as walking and swimming.
- Avoid all laxatives except those prescribed by doctors. 

Frequency in urination
- It is due to the relaxation effect of progesterone on smooth muscle, resulting in dilatation of ureters as well as the increase of the renal blood flow by 50% by the end of the first trimester. 
- Urinary tracts of the pregnant women can easily be infected.  Without proper treatment, it may result in nephritis and preterm delivery.
Practical tips 
- Never restrict fluid intake because this will only increase the chance of urinary tract infection.
- Please consult a doctor as soon as possible if symptoms of urinary tract infection including frequency and pain in urination occur.  In case when infection has been confirmed, a full course of antibiotics prescribed by doctor must be taken.
-Recurrent or persistent urinary tract infections may be due to an underlying congenital anatomical problem of the urinary tract. Ultrasound and radiological examinations should be arranged not earlier than 3 months after delivery.

 
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Last revision date: 01 September 2006