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  Minor ailments in Middle and Late Pregnancy and their Management Download

Minor ailments in Middle and Late 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. - 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. Oedema - The rapidly rising estrogen during pregnancy results in water retention. - Due to gravity, most of the water will accumulate in the lower limbs and 80% of pregnant women have ankle oedema. Estrogen level will return to normal after delivery and the accumulated water will then be excreted from the body. - However, if ankle oedema appears suddenly or progressively increase in severity within a short time (a few days), it may suggest pre-eclampsia. Urgent medical intervention is then required. Management tips for oedema: - Wear comfortable shoes with slightly bigger size than that before pregnancy. - Elevate the legs comfortably on a foot stool or pillows while resting. - Avoid taking diuretics because these medications will lower the blood pressure. The placental blood flow will be decreased and the oxygen and nutrient supply to the fetus will be impaired. Low Back Pain: - The gradually growing fetus and the enlarging uterus exert greater and greater pressure on the spine and the pelvic bone. Low back pain is very common as pregnancy advances. Management tips to relieve musculoskeletal pain: - Wear comfortable footwears and avoid high heel shoes. - Keep the spine straight and maintain correct postures while sitting and standing. - Sleep with the body lying laterally and rest the back on a wedge to support the lower back. - Practise antenatal exercise to relax the trunk muscle and the spine. (Please refer to the pamphlet on 'Antenatal Exercise') - Physiotherapy and pelvic corset can help to reduce low back pain. Please consult doctor if the pain is severe.
Haemorrhoid - As the uterus grows larger in later pregnancy, pelvic pressure increases and haemorrhoid may be resulted. - Pelvic pressure is even higher during vaginal delivery and the haemorrhoid may become bigger. - Very often, the haemorrhoid will subside spontaneously a few months after delivery. Management tips for haemorrhoid: - Drink adequate fluid every day and consume a high fiber diet to avoid constipation. - Apply local application to sooth the pain. - Consult doctor if there is large amount of bleeding while opening the bowel. Frequency in urination - Progesterone has relaxation effect on smooth muscle resulting in dilatation of ureters. At the same time, renal blood flow increases 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 of urination and pain 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. Striae - Commonly develop during the second half of pregnancy and affect most women especially those bearing heavier fetus or with multiple pregnancies. -Striae appear pink in colour on the skin of abdomen, breasts and thighs. After delivery, striae turn whitish in colour but never completely disappear. Practical tips Up till now, no cream is found to be effective in preventing striae completely. Keeping the skin well moisturised by applying lotion or olive oil helps to decrease the severity of striae.

 
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Last revision date: 01 September 2006