Tuesday, September 3, 2013

Pregnancy - Common Complaints - 1

Young married woman who misses her regular menstrual period will suspect pregnancy.  Since the day of missed periods she will be having many doubts.  In a joint family mother-in-law or other elders will guide her or reassure her for certain routine problems.
The common complaints in pregnancy are
Nausea and vomiting:  (Morning Sickness)  More than 50% of women may have this complaint in various degrees.  Some may have occasional nausea or vomiting while others have persistent nausea which may continue rarely till delivery.  Most of the time, it will subside by the completion of third month.  Even vomiting in pregnancy, though troublesome in first three months, may continue in a lesser degree, rarely, to term.    
Indians have a habit to tickle the throat at the time of brushing teeth in the morning and bringing out all the contents of stomach.  Usually the stomach is empty in normal condition.  In pregnancy due to physiological changes the stomach emptying is delayed and there may be some digestive fluids in the stomach.  At the time of brushing and cleansing process when throat is tickled, this fluid, white or light yellowish or greenish sour fluid, is vomited out.  This is of no consequence.  The woman should stop this forcible vomiting.
Minor degrees of nausea and vomiting may respond with counseling, reassurance, change in diet with easily digestible nonspicy foods.  Sometimes gravida (pregnant woman) may
have intolerance to certain odours and sight of certain foods.  The sight and odour of the food itself induces nausea and vomiting.  In such conditions it is best to avoid such foods.  When nausea and vomiting are interfering with nutrition of the patient, simple medication like doxylamine succinate with pyridoxine tablet is advised.  If persistent, more powerful pregnancy safe anti-emetic like phenergan tablets will be administered.  Rarely a gravida may have persistent vomiting and will be unable to retain anything taken orally resulting in deterioration of health.  In such conditions she is hospitalized and parenteral treatment is initiated.  Gravida should be investigated for her health status and to rule out any obstetric or medical condition resulting in intolerable vomiting – Hyperemesis gravidarum.  Correction of electrolyte balance and IV fluid administration and anti-emetic inject:ions will generally restore the health of the woman.  Usually nausea and vomiting will subside and general appetite is restored by 12th to 14th week of pregnancy.
 Excessive Salivation: Sometimes woman may have excessive salivation - always wanting to spit. This will subside by the end of third month.  Rarely medication is required.   
Heart Burn: Some women may also have heartburn – burning pain in the middle of the chest.  For relief of this gravida is advised not to lie down immediately after taking food.  Avoiding spicy foods and eating curds or drinking buttermilk can reduce the symptom to a great extent.  After having food it is better to be in reclined position for some time than to lie down.  In occasional cases antacid liquid may be used.
As the pregnancy progresses some women may feel fullness with small quantity of food.  In such condition she should have frequent meals in small quantities. 

Constipation: Another significant problem in pregnancy is constipation.  This may become the cause of manifestation of piles – bleeding with defecation.  Constipation can be corrected by taking foods having more fibre – vegetables and fruits and drinking plenty of water. 
                                                                                                    ......contd

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