MINOR DISORDERS OF

PREGNANCY
BY MWANANGOMBE K.CHARITY
GENERAL OBJECTIVE
At the end of this session, students should be able to
understand the minor disorders of pregnancy, their
management and advice.
SPECIFIC OBJECTIVE
At the end of this discussion students should be able to;
• Define some terms.
• Know how these disorders come about.
• State some minor disorders of pregnancy and their
management.
• Describe the prevention of these disorders.
INTRODUCTION
• Pregnancy is a unique experience to a woman. This is why it is
important for the midwife/nurse to have the knowledge and
understanding of the common disorders of pregnancy in order to
advise the woman on strategies and measures that will help her to
cope with the condition and minimize the effects she experiences
(Myles, 2003).
• Some women may not complain about these conditions and do not
know whether they are worth mentioning if they are not troubling
them too much. The midwife/nurse however should not ignore any of
these conditions
LIST OF MINOR DISORDERS OF
PREGNANCY
• Epistaxis
• Varicose veins
• Supine hypotension
• Haemorrhoids
• Pruritus
• Ankle oedema
• Insomnia
• Carpal tunnel syndrome
MINOR DISORDERS OF
PREGNANCY……
• Flatulence with bloating and belching
• Spider naive
• Ankle oedema
• Emotional factors (Psycho social dynamics)
• Urgency and frequency of micturition
• Ptyalism
• Heart palpitations
• Pica and cravings
DISORDERS OF PREGNANCY…..
• Heart burn
• Fainting
• Morning sickness (Nausea and vomiting)
• Breast changes
• Backache
• Headache
• Fatigue
• Constipation
MORNING SICKNESS
• It is also called nausea and vomiting
• About 50-75% of the pregnant women are affected by the disorder.
Fathers also may have symptoms (Wilson and Lowdermilk , 2006)
• Psychological adjustments, hormonal change and neurological factors
are thought to be the cause of more serious condition known as
hyperemesis gravidarum develops in a small proportion of people.
MANAGEMENT
• Eating dry carbohydrate on awakening or before going to bed.
• Avoiding spicy or greasy foods
• Eating small frequent meals
• Reassurance to the woman that the condition disappears after the
first trimester
• If the condition persists, the doctor may prescribe an antiemetic
medication
• Avoiding an empty or overloaded stomach
BREAST TENDERNESS

• Breasts become enlarged and fuller because of hormonal changes and

fat stores that are laid pricking, tingling and pain are experienced
• MANAGEMENT
• Reassurance to the woman
• finding a good supportive bra with pads to absorb discharge in case of
any.
• Local warmth may be used to relieve tenderness.
BACKACHE AND JOINT PAINS
• May spun all three trimesters and may continue in the postnatal
period

• Increased lumbar curve (lordosis), with the woman having to hold

her shoulders back in order to counterbalance the enlarged uterus in
front
CAUSE
• Increased lumbar curve (lordosis), with the woman having to hold her
avoid high heeled shoes
• Sleeping on a firm mattress
• Taking a warm bath and massaging
• Refer to physiotherapy
• Shoulders back in order to counterbalance the enlarged uterus in
front
MANAGEMENT

• Resting frequently
• Avoid high heeled shoes
• Sleeping on a firm mattress
• Taking a warm bath and massaging
• Refer to physiotherapy
• May spun all three trimesters and may continue in the postnatal
period
HEADACHE

• Can occur at any age of gestation

• caution :If it occurs in the third trimester together with an increase in

blood pressure or proteinuria or both, then medical aid should be
sought urgently.
• Cause-effects of oestrogen and progesterone on the circulatory
system particularly the intra cranial vascular system
Management
• Reassurance
• If headache persists, the proteins, blood pressure should be checked
to rule out pre-eclapmsia.
FATIGUE

General feeling of lassitude(state of tiredness,laziness,or lack of interest)

CAUSE
• General slowing down of maternal metabolism
• In the first trimester can be related to the hormonal changes and
organogenesis
• In the postnatal period, it can be attributed to the stress of labour and
the physical demand of caring for a new baby.
• Effort of carrying around the increased weight of the enlarged
CONSTIPATION

• Can be a very distressing and uncomfortable condition

CAUSE
• GIT motility is slowed down.
• Progesterone resulting in increased reabsorption of water, hard and
small stool
• Compressed intestines by the enlarging uterus
MANAGEMENT
• Adequate fluid intake
• High roughage
• low carbohydrate and sugar are important (carbohydrate and sugar
slow down the passage of food)
• Moderate exercises such as short walks
• Use of relaxation techniques and deep breathing to aid in bowel
movement
URGENCY AND FREQUENCY OF
MICTURITION
• Increased excretion of water by the kidneys in early pregnancy which
leads to especially nocturnal frequency
• Reduced bladder capacity by pressure of enlarging uterus
MANAGEMENT
• fluid intake before bed time
• Empty bladder regularly
• Wear perineal pad
• Contact the health care provider if there is dysuria.
PTYALISM (EXCESSIVE SALIVATION)
CAUSES
• High oestrogen levels
• May be related to reluctance to swallow because of nausea
• Increased vascularity and proliferation of connective tissue
from oestrogen stimulation
MANAGEMENT
• Chewing gum
• Eat hard candy as a comfort measure
• Mouth washes are useful.
• Brush teeth gently and observe good dental hygiene.
HEART PALPITATIONS
• CAUSE
• Unknown
• Increased blood volume, stress and the hormonal effect of
progesterone are the predisposing factors
• MANAGEMENT
• Not preventable.
• Contacting the health care provider if accompanied by
symptoms of cardiac decompessation
• N.B: should not be accompanied by severe irregularity
PICA
• Pica is the persistent craving and compulsive eating of nonfood
substances
CAUSE:
• Unknown (though the cravings are determined by culture or
geographical area)
MANAGEMENT
• Not preventable
• Craving must be satisfied unless it interferes with a well
balanced diet and general health.
HEART BURN
• It is discomfort or pain that is felt behind the breast bone and often
appears to rise from the abdomen to the throat (Oxford Medical,
2006)
CAUSE
• Relaxing effects of hormones of pregnancy causing incompetence of
the cardiac sphincter combined with the pressure on the stomach
from the enlarging uterus
• Progesterone slows gastrointestinal tract motility and digestion, it
reverses peristalsis, and relaxes the cardiac sphincter, and delays
emptying time of the stomach.
MANAGEMENT
• Small frequent meals, avoid spice, oil, fats and indigestible meals
• Avoid late meals
• sip milk for temporal relief
• Use pillows when resting or sleeping for a good posture
FAINTING

• May persist throughout pregnancy

CAUSE
• This is due to vasomotor lability or postural hypotension (fall of blood
pressure due to change in posture) from hormones
MANAGEMENT
• Moderate exercise
• Deep breathing, vigorous leg movements.
• Avoid sudden changes in position, warm clouded areas and
hypoglycaemia
• Keep the environment cool.
• Sit as necessary
• If serious contact the primary health care provider
VARICOSE VEINS
• These are associated with aching legs and tenderness.
• They may be present in the legs and vulva.
• CAUSE
• Hereditary predisposition
• Relaxation of smooth muscle walls of veins because of hormones
causing pelvic vaso-congestion and tortuous dilated veins
• MANAGEMENT
• Avoid obesity, lengthy standing or sitting, constrictive clothing,
constipation and bearing down with bowel movement
• Moderate exercises.
• Rest with legs and hips elevated
• Wear supporting stockings on arising while in bed.
• Relieve swelling and pain with warm Sitz’ baths
LEUCORRHOEA
• It is often noted throughout pregnancy
CAUSE
• The hormonally stimulated cervix becomes hypertrophic and hyperactive producing
abundant amounts of mucus
MANAGEMENT
• It is not preventable
• Do not douche
• Maintain good hygiene
• Wear peri-anal pads
• Report to the primary health care provider if accompanied by pruritis, foul odour or
change in character
INSOMNIA

• This is common in late weeks of pregnancy

CAUSE
• Fetal movements
• Muscle clamping
• urinary frequency
• shortness of breath
• other discomforts
MANAGEMENT OF INSOMIA
• Reassurance
• Conscious relaxation
• Back massage
• Supporting of body parts with pillows.
• Warm milk or warm shower before retiring to bed
VARICOSE VEINS
This is the enlargement or engorgement of the blood veins especially in
the lower limbs

CAUSE
• Prolonged standing or prolonged sitting
• lack of exercises
• constrictive clothing or by hot weather.
VARICOSE VEINS CONT….

MANAGEMENT
• Increase fluid intake for natural diuretic effect.
• Supportive stockings before arising
• Resting periodically with legs and hips elevated
• Moderate exercises
CONCLUSIONS
• The care providers need to understand normal physiology of
pregnancy, minor disorders and complications if they are to give
correct information and intervene accordingly.
• It is an important responsibility of the care givers to alert the
pregnant woman to signs that indicate a potential complication of
pregnancy
• Pregnant women are confronted with symptoms and much of these
discomforts are fairly specific to each trimester
• Nurses can do much to allay a first-time mother’s anxiety about such
symptoms by telling her about them in advance
END