Common Maternal Complaints During Pregnancy

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Some common maternal complaints during pregnancy are detailed on this page. Please note that a number of treatments recommended on this page are methods of minimizing, not alleviating, discomfort.

Contents

Heartburn

What is it - burning sensation in the upper body, occurs in 30-70% of pregnancies

What causes it - acidic contents leaking from stomach into lower esophagus. Cause inflammation of esophageal lining

How is it aggravated by pregnancy - lower esophageal sphincter muscle tone is reduced, stomach is displaced upwards by expanding uterus, motility in esophagus and gut is reduced

How can it be treated - eat smaller meals, maintain good posture after eating (avoid bending over or lying down), antacids for serious cases (although these can interfere with iron absorption)[1]

Constipation

What is it - difficulty passing stools

What causes it - various factors including composition of stool and tone of anal sphincters

How is it aggravated by pregnancy - increased motility time through gut increases water absorption and therefore hardens stools (due to increased levels of progesterone which relaxes intestinal muscles) and mechanical compression of rectum by expanding uterus

How can it be treated - increased fluid and fiber intake, increased exercise, laxatives in extreme cases[2]

Nausea

What is it - feelings of sickness and vomiting, 16% of pregnant women will suffer from it

What causes it - various factors

How is it aggravated by pregnancy - higher levels of estrogen and human chorionic gonadotrophin, gastric reflux, changes in gastrointestinal tract motility, primarily occurs in first 16 weeks

How can it be treated - eating small meals, drinking often but in small amounts, rest[3]

Abnormal Urinary Output

What is it - changes in frequency and volume of urination, 60% of women feel they have to visit the bathroom more often during pregnancy

How is it aggravated during pregnancy - there are a number of factors at work, including an increased glomerular filtration rate (increases by 50%), anatomical compression of the bladder (eased when uterus lifts higher in the abdominal cavity) and the bladder becoming more irritable due to hyperaemia (increased blood flow, ~30%). The excretion of sodium at night, heightened due to the trapping of ions in the lower body due to venous pressure (which is relieved by lying down) explains why frequency increases moreso at night.

How can it be treated - drinking less water at night[4]

Varicose Veins

What is it - pooling of blood in the lower veins of the body

What causes it - failure of blood to return to heart, due to weak cardiac output or weakened veins which fail to prevent backflow of blood

How is it aggravated by pregnancy - progesterone weakens valves and dilates veins, mechanical compression of uterus on iliac vein and inferior vena cava

How can it be treated - avoid supine position (elevate legs), exercise regularly, drink water

Are there any associated complaints - yes

  • swelling of ankles and feet (also due to reduction in colloid osmotic pressure)
  • hemorrhoids (varicosation of rectal veins, aggravated by expanding uterus and gut (due to reduced motility)
  • fainting (due to reduced cardiac output and a drop in blood pressure, lowering the upper body produces a reflex that restores normal circulation)[5]

Anemia

What is it - lowering of concentration of red blood cells, which in turn reduces the concentration of oxygen in the blood

How is it aggravated by pregnancy - during pregnancy there is an increase in total blood volume of around 1.5L (40%), however plasma levels increase more than red blood cell mass (45% vs. 30%). This results in what is known as dilutional anemia (the hematocrit, or concentration of red blood cells in plasma, falls from 40% to 31%).

How can it be treated - taking iron supplements, which aids the production of red blood cells

Are there any associated conditions - dyspnea (shortness of breath) due to the reduction in oxygen carry capabilities of the blood[6]

Body Pains

Where are they found - generally in the back region and pelvic bones

What causes them - compression due to the expansion of the uterus and an alteration in posture and the mother's centre of gravity which puts strain on muscles and the spine

What can be done to treat it - good posture, providing support while resting[7]

Gingivitis

What is it - pain and bleeding associated with the teeth

What causes it - inflammation of the gum tissue

How does pregnancy aggravate it - increased blood flow to the mouth increases the inflammatory response, can be affected by vomiting

How can it be treated - proper dental care can reduce bacterial infection which in turn can reduce inflammation and long term damage[8]

Gestational Diabetes

What is it - reduced ability to break down sugars

What causes it - inability to produce insulin

How does pregnancy aggravate it - placenta produces human placental lactogen, which increases peripheral insulin sensitivity

How can it be treated - low sugar diet and regular exercise, insulin injections in some cases[9]

References

See Also

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