Dizziness

Dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness,

weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they
may be mild or severe with abrupt or gradual onset. Dizziness may be aggravated by standing
up quickly and alleviated by lying down and by rest.

Is it unusual to feel lightheaded during pregnancy?

It's not uncommon to feel lightheaded or dizzy occasionally. When you're pregnant, your
cardiovascular system undergoes dramatic changes: Your heart rate goes up, your heart pumps
more blood per minute and the amount of blood in your body expands by 40 to 45 percent.

During a normal pregnancy, your blood pressure gradually decreases in the beginning, reaching
its lowest point in the middle of your pregnancy. It then begins to rise, returning to its regular
level by the end of pregnancy.

Most of the time, your cardiovascular and nervous systems are able to adjust to all these
changes, but occasionally they don't, which can leave you feeling lightheaded or a bit dizzy. If
you actually faint, it could be a sign that something is wrong, and you should call your
practitioner.

What causes dizziness or lightheadedness?

• Standing up too fast when you sit blood pools in your lower extremities (your feet and lower
legs). If your body isn't able to adjust when you stand up, not enough blood returns to your heart
from your legs. As a result, your blood pressure drops quickly, which can leave you feeling faint.
This can happen to people who aren't pregnant as well.

To prevent lightheadedness, avoid springing up from your chair or bed. When you're lying down,
sit up slowly and stay sitting for a few minutes with your legs dangling over the side of the bed
or couch. Then slowly rise from sitting to standing.

When you need to stand in one place for a long time, move your legs to promote circulation.
Wearing support stockings can also help circulation in the lower half of your body.

• Lying on your back In your second and third trimesters, your growing uterus can slow the
circulation in your legs by compressing the inferior vena cava (the large vein that returns blood
from the lower half of the body to the heart) and the pelvic veins.

Lying flat on your back can make this problem worse. In fact, about 8 percent of pregnant
women in their second and third trimesters develop a condition called supine hypotensive
syndrome: When they lie on their back, their heart rate increases, their blood pressure drops,
and they feel anxious, lightheaded, and nauseated until they shift their position.

To avoid this problem, lie on your side instead of flat on your back. Either side is better than
your back, although the left side is best. A pillow placed behind you or under your hip can help
you stay on your side — or at least tilted enough to keep your uterus from compressing the
vena cava.
• Not enough food and drink When you don't eat enough, you can end up with low blood
sugar (hypoglycemia), which can make you feel dizzy or faint. This can happen much more
easily when you're pregnant.

Dehydration can have a similar affect. Make sure you stay well hydrated by drinking eight to ten
glasses of water a day — more if you're exercising or if it's hot.

Try to keep your blood sugar from getting too low by eating small, frequent meals during the day
instead of three large ones. Carry healthy snacks so you can eat when you get hungry.

• Anemia If you're anemic, you have fewer red blood cells to carry oxygen to your brain and
other organs, which can leave you feeling lightheaded. Iron deficiency is the most common
cause of anemia, so be sure to eat an iron-rich diet and take a prenatal vitamin with iron,
especially in your second and third trimesters. If you become anemic, your caregiver will
probably prescribe a separate iron supplement as well.

• Getting overheated Spending time in a very hot room or taking a hot bath or shower can
cause your blood vessels to dilate, lowering your blood pressure and making you woozy.

If you feel dizzy when you get too hot, avoid stuffy crowded places and dress in layers so you
can shed clothes as necessary. Take warm showers or baths instead of hot ones, and try to
keep the bathroom cool.

• Hyperventilation Excessive exercise or anxiety can sometimes cause you to hyperventilate

and feel faint. Although exercise can help your circulation, be careful not to overdo it if you're
feeling tired or not well. Start out slowly. If you start to feel lightheaded or dizzy while exercising,
stop and lie down.

• Vasovagal syncope Some people get dizzy when they strain to cough, pee, or have a bowel
movement. These actions can prompt a vasovagal response (that is, an effect on your
circulatory system by your vagus nerve) — a decrease in blood pressure and heart rate, leading
to dizziness and fainting. (The word syncope means fainting.)

Dehydration, anxiety, and pain can also trigger this type of reaction, and pregnant women are
more vulnerable to it. Lightheadedness and warning signs such as a feeling of warmth,
paleness, sweating, nausea, yawning, and hyperventilation often precede vasovagal syncope.
Pay attention to these signs and lie down immediately to help keep you from fainting.

What remedies exist to prevent dizziness during pregnancy?

There are a number of things you can do to reduce the amount of dizziness you may
experience. Here are some helpful suggestions to reduce dizziness during pregnancy:

 Avoid standing for long periods. If you must stand, make sure that you keep your feet
moving to help increase circulation
 Get up slowly from either sitting or lying down (This is very important when you are
getting out of the bath)
 Eat regularly. Avoid long periods between meals; it is better to snack throughout the day
 Avoid hot baths or showers
  Avoid lying on your back once you reach the middle of your second trimester
 Wear loose, comfortable clothing to avoid restricting circulation

Nursing Intervention:

If the patient complains of dizziness, first ensure his safety by providing a safe environment to
prevent falls. Then determine the severity and onset of the dizziness. Ask the patient to
describe it. Is the dizziness associated with headache or blurred vision? Next, take the patient’s
blood pressure while he’s lying, sitting, and standing to check for orthostatic  hypotension. Ask
about a history of high blood pressure. Determine if the patient is at risk for hypoglycemia. Tell
the patient to lie down, and recheck his vital signs every 15 minutes. Start an I.V. line, and
prepare to administer medications as ordered.

Sources:

http://www.babycenter.com/0_dizziness-and-fainting-during-pregnancy_228.bc

http://www.americanpregnancy.org/pregnancyhealth/dizziness.html