OKEDELE DEBORAH DOYINSOLA

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MINOR
DISORDER IN
PREGNANCY
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INTRODUCTION
 Pregnancy brings about a lot of changes which are as a result of
hormonal changes during pregnancy, these hormones prepare the
body to adapt to and nurture pregnancy to term.

 This physiological demands( changes) causes minor disorders,

ailments or discomfort in the pregnant woman.

 These changes can sometimes be uncomfortable, but most of the time

they are normal. They can occur at any time during the pregnancy

 Most of the minor ailments or disorder in pregnancy will spontaneously

subside after delivery
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INTRODUCTION CONT.

 The pregnant woman should be health educated on the most

common minor disorders of pregnancy, and ways of relieve or
at least to stop worrying about them. also the woman should be
informed when a woman’s discomfort may be a sign a problem
that may requires further investigation and management and
when changes felt that could be dangerous to her and her baby.

 Most of the minor disorders during pregnancy can be minimized

with good education and prompt treatment.
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1. NAUSEA AND VOMITTING

 Nausea is very common in the early weeks of pregnancy (first three month),
Severe vomiting may result in dehydration and electrolyte imbalance, it is
often called morning sickness. It happens commonly in the morning when
the woman gets out of bed. Excessive salivation is an infrequent but
troublesome complaint which is associated with a condition called
hyperemesis gravidarum.

 In severe cases such as when she cannot eat any food in 24 hours, weight
loss, concentrated urine or no urine output in 8 hours, severe discomfort,
weakness, dizziness, confusion or fits, severe abdominal pain, fever,
vomiting blood, she must immediately seek medical help to get
replacements for nutrition, body fluids that has been lost, and receive
preventive treatment to avoid further occurrence.
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MANAGEMENT

 Advice the woman to:

 Get up from bed slowly in the morning

 Keep windows open for good ventilation

 Get plenty of rest and sleep

 Avoid brushing of teeth and tongue immediately after meal.

 Avoid large mounts of food but several small meals

 Non to stop eating unless vomiting is severe

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MANAGEMENT CONT.

 To take plenty of tolerated fluids, ginger tea two or three times a day,
before meals. She should avoid coffee

 To take some dry food like bread, biscuit, low-fat food, carbohydrate-rich
food (e.g. rice, noodle, mashed potatoes) and can take sour drink (e.g.
lemon).

 She should avoid eating deep-fried or greasy food, garlic and other spices

 Stay away from odor that nauseat her

 Advise to take crackers, nut, dry bread, or other grain food upon waking
up in the morning.
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FOOD CRAVING/ DISLIKE

 It is normal for a pregnant woman to dislike a particular food and

develop interest for another, but she should be informed that her
diet must be nutritious.

 A food craving (also known as pica) is a strong desire to eat a

certain food, or even something that is not food at all, like black
soil, chalk or clay.(diff btw craving and pica)

 If a woman crave for nutritious foods (like beans, eggs, fruits or

vegetables), it is good and she can take as much as she want
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FOOD CRAVING/ DISLIKE CONT.

 Advice woman not to eat crave things that are not food, e.g. soil
or clay, ache, these things can poison her and her baby. This
may predispose her to parasite infection, e.g. worms, that can
make her sick.

 Encourage her to eat iron-rich and calcium-rich foods instead.

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HEART BURNS AND INDIGESTION

 This is a painful, burning sensation in the chest caused by the

regurgitation of stomach acidic contents into the throat, the
symptoms of indigestion, including heartburn, are common
during pregnancy and are caused by hormonal changes(The
relaxation effect of progesterone on the oesophageal sphincter
results in reflux of acidic fluid to the oesophagus, causing
irritation and heartburns) and the growing uterus which presses
on the stomach
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MANAGEMENT

 Advice the woman to:

 Eat small frequent meals, chew food well, avoid spicy and greasy or fat
diet and refrain from drinking large amounts of liquid before bedtime,
also alcohol, coffee and chocolate may aggravate the problem.

 Take milk and fruit to aid digestion

 Sit as upright as possible and avoid lying flat or bending after a meal.

 Prop up with pillows at night

 If the symptoms are not relieved with diet and lifestyle changes, antacid
may prescribed
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CONSTIPATION

 Constipation is normal during pregnancy. The consumption of iron-

containing prenatal vitamins, hormonal changes which decreases
the rhythmic muscular movements of the gut (peristalsis), that
pushes food along the intestines. This results in increase in bowel
‘emptying time’ and digestion time. The pressure of the uterus on
the rectum can aggravate constipation.

 Aside the effect of progesterone in lowering intestinal muscle tone

and movement of colon. There is also additive effect of increase in
reabsorption of water from bowel mucosa resulting into hard stool.

 Constipation affects 10-40% of pregnant women.

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MANAGEMENT

 Advice pregnant women to:

 Take adequate amounts of fibre in diet by eating more whole grain

breads and cereals, vegetables, fruits and legumes such as beans,
split peas and lentils.

 Drink at least 8-12 cups of fluid everyday in the form of water, milk,
juice or soup.

 Maintain an active lifestyle with regular exercise such as walking

and swimming.

 Avoid all laxatives

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HAEMORRHOIDS

 Haemorrhoids (also known as piles) are swollen veins around the anus. They
may burn, hurt, or itch. Sometimes they bleed when the woman passes a stool,
especially if she has constipated.

 Sitting or standing a lot can make haemorrhoids worse.

 MANAGEMENT:

 Avoid constipation by eating a lot of fruit and vegetables and drinking plenty of
fluids.

 Avoid prolonged sitting

 Straining to pass hard stools makes haemorrhoids worse.

 Sitting in a cool bath can be of help

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FREQUENT URINATION

 Urinary frequency is a common complaint throughout

pregnancy, especially in the first and last months.

 This is because the growing fetus and uterus presses against

the bladder, there is also an increase in blood flow to kidneys by
50% during pregnancy and the relaxation effect of progesterone
on smooth muscle of the urinary tract

 It will stop once the baby is born.

 If urination hurts, itches, or burns, the woman may have UTI.

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MANAGEMENT

 Advice pregnant women to:

 Never restrict fluid intake because this might increase the

chance of urinary tract infection.

 To urinate as frequently as her system demands

 Increase fruit intake

 In case you have a urinary tract infection, she should seek

medical consultation early.
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BACK ACHE

 Almost all pregnant women complain of back pain and this is

caused by the weight of the baby, the uterus and the amniotic
fluid, this changes her posture and puts a strain on the woman’s
back bones and muscles.

 Longer period of standing, sitting, leaning forward, or strenuous

physical activities, can cause back pain.

 Back pain are normal in pregnancy, but it could also be caused

by a kidney infection.
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MANAGEMENT

 Advice the woman to:

 Avoid lifting heavy weights, wearing high-heeled shoes or standing for

too long.

 Encourage the woman’s husband, children, other family members or

friends to massage the woman’s back. A warm cloth or hot water bottle
on her back may also feel good.

 Rest( bed rest) to relieve severe back pain.

 Sleep with side and put a pillow between legs

 Sit with back straight and well-supported with a cushion

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FAINTNESS

 This can be as a result of long standing period, low PCV or BP

hypoglycemia.

MANAGEMENT: advice to:

 Avoid long periods of standing,

 Do not rush up off bed

 Avoid overcrowding and excessive heat

 Eat well

 Ensure regular ante natal visit.

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INCONTINENCE

 This can be due to the extra weight and pressure of the uterus
on the bladder and pelvic floor, especially during laughter,
sneezing or cough.

 MANAGEMENT:

 Advice to do regular pelvic floor exercise

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LEG ACHES AND CRAMPS

 The extra weight of conception causes leg ache, this is mostly

common in the last months of pregnancy.

 MANAGEMENT:

 Simple stretching and exercises may help in alleviating these

aches and cramps.

 Avoid long curvation of the lower extremities

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JOINT PAIN

 Joint pain is a usual complain of pregnant women in the third

trimester, this also is as a the effect of progesterone that causes
relaxation of joint’s ligaments causing soft and loose joints.

 This makes the joints more flexible, including the joints of the
bones in pelvis and it produces pain and discomfort, especially
at the hips.

 Joint pain is not dangerous, but the woman can more easily
sprain her ankles or other joints.
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ABDOMINAL CRAMPS

 This is normal (like mild monthly menstrual cramps) during the

first trimester of pregnancy. The cramps is from the growing
uterus.

 However, a very strong or painful cramps that are regular, or

constant, or with spotting or bleeding from the vagina, is a
warning signs.

 Reassure and encourage to eat and get enough rest

 This will subside or stop once the uterus grows out of the pelvis
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HEADACHES

 Headaches and migraines headaches are common in pregnancy, but

are usually harmless.

 It can stop with resting and relaxation more

 Encourage to drinks more juice or water, or gently massages her

temples.

 Prescribed analgesic( paracetamol 1g once in a while) can be taken

 However, headaches in late pregnancy can be a warning sign of pre-

eclampsia, especially if there is high blood pressure, and oedema
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SLEEPLESSNESS AND TIREDNESS

 This is a common complain of many pregnant women, especially

during early pregnancy period(frequent micturition) and during
pregnancy period(heavy pregnancy).

 This can also be due to anxiety, heartburn, causing difficulty in

getting good night’s sleep.

 MANAGEMENT:

 A warm milky drink and warm shower will help get sleep and aid
relaxation

 Avoid drinks containing caffein

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STREACH MARK/ STRIAE

 These are raised, red, pink or purple venous network on the breasts, abdomen,
thighs or bottoms and are usually permanent.

 Stretch marks happen whenever the skin is stretched. Affect up to around 80% of
the pregnant women.

 MANAGEMENT:

 Encourage to avoid tight clothing and underwear

 Avoid bruising the marks with sponge

 Exercise and been active will reduce excess weight

 Over time, the skin will shrink and the stretch marks will fade into white-coloured
scars.
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OEDEMA

 Swelling of the feet and ankles is very common in pregnancy, especially in the afternoon, or in
hot weather. It is due to the retention of fluids in the body tissues.

 Under the force of gravity, the retained fluid tends to sink down the body and collect in the
feet.

 Swelling of the feet is usually not dangerous, but severe swelling when the woman wakes up in
the morning, or swelling of the hands and face at any time, can be signs of pre-eclampsia,
which is very serious and life-threatening.

 Resolve after delivery

 MANAGEMENT: Advice the woman to:

 Sit with her feet raised as often as possible, to allow the fluid to be absorbed back into the
circulatory system..

 Avoids eating packaged foods that are very salty, and drinks more water or fruit juices.
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VAGINA DISCHARGE

 Vaginal discharge during pregnancy is normal. The discharge is usually

clear and white, without unpleasant odor.

 If discharge is coloured or smells strange, or you feel itchy or sore,

medical help should be sought for

 MANAGEMENT: advice on

 Personal hygiene

 Use of cotton underwear

 Reassure
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VERICOSE VEIN

 Swollen blue veins that appear in the legs are called varicose
veins, these veins can get twisted and hurt causing cramps.

 The pressure of the enlarged uterus on the veins that return

blood to the heart from the legs is a major factor in the
development of varicosities in the leg veins.

 Rarely, swollen veins may develop in the external genitalia and

these are very painful.
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MANAGEMENT

 Advice the pregnant woman to:

 Have regular exercise to reduce weight

 Elevate leg while siting or lying down

 Avoid crossing legs

 Strong stockings or elastic stocking can be of help, If the swollen

veins are around the genitals, a panty-girdle or sanitary pad may
help to support.

 Avoid injury to the varicose veins

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DIFFICULTY IN GETTING UP

 it can be difficult for a pregnant woman to get up after lying down,

on her back, the weight of the uterus presses on the big blood
vessels that return blood to the heart.

 This can temporarily reduce the supply of oxygen to her brain, and
she may feel dizzy.

 Advice the woman to use cushion behind her back and under her
knees so she is not lying completely flat Instead

 To exercise patients before standing up for few minutes

 she should roll to the side and push herself up with her hands
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CHLOASMA

 Chloasma: This is referred to as the mask of pregnancy, most pregnant women

becomes dark in complexion.

 Chloasma is triggered by hormonal changes that occur during pregnancy

 Chloasma is thought to be due to stimulation of pigment-producing cells by female

sex hormones so that they produce more melanin pigments (dark coloured
pigments) when the skin is exposed to sun.

 it can affect 50-70% of pregnant women. 

 may start at any point in your pregnancy, though it most commonly begins in the
second or third trimester.

 it typically goes away after delevery, or for some people, once after breastfeeding.
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MANAGEMENT

 MANAGEMENT:

 Reassure the woman that the dark colouration is not harmful

and that usually most of the colour goes away after the birth.

 A woman may be able to avoid developing dark areas on her

face by wearing a hat when she goes out in the sun.
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EMOTIONS

 Pregnancy can make women very emotional. Some women laugh or cry for no
clear reason. Some feel depressed, angry, or irritable. Odd laughing or crying,
and other sudden mood changes or strong feelings, are normal. They usually
pass quickly. But do not ignore a woman’s feelings simply because she is
pregnant. Her feelings are real.

 MANAGEMENT:

 Give listening hear and believe her

 Encourage husband or relative to give moral support to the woman

 Reassure her

 Alleviate her fear and build her hope

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Strange dreams and nightmares

Others are:

Feeling of hotness or heat

Feeling about sex

Strange dreams

worries