PREPARED BY:

INTRODUCTION:
Many women experience some minor
disorder during pregnancy.

These disorder should be treated adequately as

they may escalate and become life-threatening.

Minor disorder may occur due to hormonal

changes, accommodation changes,
metabolic changes and postural changes.

Every system of body may affected by pregnancy.

 DIGESTIVE SYSTEM

Nausea and vomiting

Constipation
Acidity and heartburn
Excessive salivation(Ptyalism)
Pica
NAUSEA AND VOMITING

Especially in the morning,

soon after getting out of bed
Usually common in
primigravidae
50% women have both
nausea and vomiting, 25%
have nausea only and 25%
are unaffected
Most commonly occurs
during the first 10 weeks
Related to higher levels of
hcg
 MANAGMENT
Dietary changes
Hospitalization may be necessary to
correct fluid and electrolyte imbalance
Explanation, reassurance, and symptomatic relief
are sufficient.
Avoid: Disagreeable odors and rich, spicy, or
greasy foods
Drink water or other fluids between meals to avoid
dehydration and acidosis
Medication: well-known over-the-counter drugs
should be administered only when absolutely
indicated and prescribed.
 CONSTIPATION:

Quite common ailment

Atonicity of the gut due to the effect of
progesterone, diminished physical activity and pressure
of the gravid uterus on the pelvic colon, sluggish bowel
function are the possible explanations.
 MANAGMENT
Regular bowel habit may be restored
Emphasize more fluids and laxative foods
and prescribe a stool softener
Exercise and good bowel habits are helpful
Mineral oil is contraindicated because it absorbs fat-soluble
vitamins from the bowel and leaks from the anus.
HEARTBURN
Due to relaxation of the esophageal
sphincter & hiatus hernia
Heartburn (pyrosis, acid
indigestion) results from
gastroesophageal reflux disease
(GERD) in almost 10% of all
gravidas
In late pregnancy, this may be
aggravated by displacement of the
stomach and duodenum by the
uterine fundus
Most likely to occur when the
patient is lying down or bending
over
 MANAGMENT
To avoid over eating and not to go to bed
immediately after the meal.
Liquid antacids may be helpful
Sleeping in semi-reclining position with high pillows
change of posture are helpful.
Calcium-containing antacids & the histamine H2-
receptor antagonists are pregnancy category B
(e.g., Tums) to reduce gastric irritation

• Fried and fatty food should be avoided .

 EXCESSIVE SALIVATION
(PTYALISM)
Increased secretion of saliva is observed
during pregnancy. It may be associated with
increased intake of starch, though actual cause is
not known.

Management:
This problem is usually self-limiting and may be
overcome by decreasing intake of
carbohydrates.
outcome.
It is not associated with any adverse pregnancy
 PICA
This is term used when the
mother craves certain food
or unnatural substances
such as coal.
The cause is unknown but
hormones and changes in
metabolism are thought to
contribute to this.
If the substance craved
are harmful to the unborn
baby, the mother must be
helped to seek medical
advice.
MUSCULO-SKELETOL
SYSTEM

Fatigue
Backache
Leg cramps
Round ligament pain
 FATIGUE

The pregnant patient is more

subject to fatigue during the last
trimester of pregnancy
because of altered posture and
extra weight carried.

Management:
Anemia and other systemic
diseases must be ruled out.
Frequent rest periods are
recommended.
 BACKACHE
Common problem (50%) in pregnancy
Physiological changes that contribute to
backache are: joint ligament laxity
(relaxin, estrogen), weight gain, hyperlordosis and
anterior tilt of the pelvis.
May be due to faulty posture and high heel shoes, muscular spasm,
urinary infection or constipation.
Fatigue, muscle spasm, or postural back strain most often is responsible
 MANAGMENT
Excessive weight gain should be avoided.
Rest with elevation of the legs to flex the
hips may be helpful.
Improvement in posture is often achieved by the wearing of
low-heeled shoes.
Massaging the back muscles, analgesics and rest
Recommend sleep on a firm mattress.
Apply local heat and light massage to relax back
muscles.
. Avoid long period of standing
Proper body mechanics
 LEG CRAMPS
Quite common, usually in the leg.
Worse at night.
The cause of leg cramps in pregnancy is
not known but it may be due to deficiency vitamin
b1 and of diffusible serum calcium or elevation of
serum phosphoru.
 MANAGEMENT
Supplementary calcium therapy in tablet or s yrup
after the principal meals may be effective.
Massaging the leg, application of local heat and
intake of vitamin B1 (30 mg) daily may be effective.
Sleep with the foot end elevation by 20 to 25 cm.
once the cramps is occur gentle kneading is
effective.
ROUND LIGAMENT PAIN
Stretching of the round
ligaments during
movements in
pregnancy may cause
sharp pain in the groins.
This pain may be
unilateral or bilateral.
It is usually felt in second
trimester onwards. This is
more common in right side
as a result of dextrorotation
of uterus.
Pain may be awakening
at night time because of
sudden roll over
movements during sleep.
 MANAGEMENT

Pain may be reduced by making

movements gradual instead of
sudden.
Local heat application is helpful.
Analgesics are rarely needed.
CIRCULATORY SYSTEM
Varicose veins
Hemorrhoids
Faintness
Ankle edema
 VARICOSE VEINS
In the legs and vulva
(varicosities) or rectum
(hemorrhoids) may appear for
the first time or aggravate during
pregnancy
Usually in the later months
Due to obstruction in the venous
return by the pregnant uterus.
Due to smooth muscle
relaxation, weakness of the
vascular walls, and incompetent
valves.
 MANAGEMENT
during
For leg varicosities, elastic crepe bandage ing
movements and elevation of the limbs during
rest can give symptomatic relief.
Elevate legs above the level of her body
and control excessive weight gain.
Avoid forceful massage (especially downward, i.e.,
against venous return) and point-pressure over
the legs.
Avoidance of constipation by including fiber in the diet
and adequate fluids intake
 HEMORRHOIDS
May cause considerable discomfort.
Straining at stool often causes hemorrhoids,
especially in women prone to varicosities.
Management:
Regular use of laxative
Local application of hydrocortisone ointment
Surgical treatment is better to be withheld as the
condition improves following delivery.
Treat constipation early.
(FAINTNESS)
The woman presents with
dizziness or light headedness
on standing upright abruptly
or following standing for a
prolonged period.
Following prolonged standing or
standing upright abruptly
Due to pooling of blood in the
veins of the lower extremities &
compression of the pelvic
veins by the gravid uterus
 MANAGEMENT
usually resolves rapidly on lying in
left lateral position.

Encourage the patient to eat six small meals a

day rather than three large ones.
 ANKLE EDEMA
Evidenced by marked gain
in weight or evidences of
preeclampsia
Develops in at least two
thirds of women in late
pregnancy
Due to water retention and
increased venous
pressure in the legs
Generalized edema, always
serious, must be
investigated
 MANAGEMENT
No treatment is required for physiological
edema or orthostatic edema.
Edema subsides on rest with slight elevation of the limbs.
The patient should elevate her legs frequently.
Restrict excessive salt intake and provide elastic support for
varicose veins.
 NERVOUS SYSTEM

Headache
 HEADACHE

Headache in pregnancy is common and

usually due to tension.
Severe, persistent headache in the third trimester
must be regarded as symptomatic of
preeclampsia- eclampsia until proven otherwise
GENITOURINARY SYSTEM
Leucorrhea
Urinary symptomps
 LEUCORRHEA

Gradual increase in the amount of nonirritating

vaginal discharge due to estrogen stimulation
of cervical mucus is normal during pregnancy.
Such vaginal fluid is milky, thin, and nonirritating
unless infection has occurred.
Persistent external moisture due to mucus may
cause mild pruritus, but itching is rarely severe
without infection.
 MANAGEMENT

Reassure the patient, and suggest protective

perineal pads.
Frequent washing of vulva with plain water.
Advice mother to wear cotton underwear and
avoid tight.
Presence of infection should be treated with
vaginal application of metronidazole and
meconazole.
 URINARY SYMPTOMPS
Urinary frequency, urgency, and stress inco ntinence
in multiparas are common, especially in
advanced pregnancy.
Due to increased intra abdominal pressure and
reduced bladder capacity.
Suspect urinary tract disease if dysuria or
hematuria is present.
 MANAGEMENT
When urgency is particularly troublesome,
limit caffeine, spices, and popular beverages.
An 8 oz glass of cranberry juice assists in
both maintaining urinary acidity as well
as decreasing urinary tract infections.
RESPIRATORY SYSTEM
Dyspnea:
Management:

Proper posture
Use pillows behind head and shoulders at night
Semi fowlers position
THANK YOU FOR
YOUR ATTETION