Advice the mother to wear perineal pad.

Advice the mother to report any pain or burning sensation to primary health Care provider .

Nausea vomiting morning sickness

About half of the pregnant women experience nausea and vomiting during the first 12 weeks of
pregnancy.

While morning sickness in more common first thing in the morning it can strike at any time of the day or
night.

Sickness occurs in 5o%_70percentage of pregnant women.

It starts between first and second missed periods and lasts until about 4th missed period.

Causes

Causes is unknown.

IT results from hormonal changes possibly in secreting human chorionic gonadotropin hormone.

It may be partially emotional.

If HCG secretion peak if both at around 12 to 14 weeks.

Management

Eat foods that are low fat and energy to digest.

BRATT diet

B-banana

R_ rice

A _ apple Sauce

T _ toast

T_ tea

Eat small frequent meals instead of three large once many people find that an empty stomach triggers
nausea so try not to let yourself become hungry.

Keep some dry biscuit by your bed. eat one before you get up in the morning eat 5 - 6 miles per day.

Avoid rich fatty food , tobacco , fumes and alcohol.

Avoid foods and odours that make you feel sick.

Ginger is thought to help easenausea,fry ginger biscuit , Ginger ale or Ginger tea provide cold drinks.

If you can manage it take regular gentle exercise.

Try acupressurewrist , hands which are used to prevent seasickness.

Get as much rest as possible.

Drug treatment is often necessary however if symptom for severe or prolonged but it minor cause we
should not administer.

It high dose antiemetic drug admitted this related to of linked to a number of congenital defect. so , we
should not administer but some drugs reduce this congenital problem so the following drug we can be
used.

Example pyridoxindoxylamineq and combined this drug highly successful in the management of nausea
and vomiting.

Psychosocial dynamics mood swings and mixed feelings:

causes

hormonal and metabolic adaptation feeling about female role , sexuality , timing of pregnancy and
resultant changes in life and Lifestyle.

Management

participate in pregnancy support group

communicate concerns to partners family

health care providers request referral for supportive services if needed (financial assistant)

Second trimester

Supine Hypertension

supine hypotension otherwise called as venacavasyndrome and bradycardia

it is mainly due to ,

induced by pressure of gravid uterus on ascending Vena cava when women in supine.

reduced uteroplacental and renal perfusion.

management

maintaining side lying position or semi sitting position with knee slightly flexed.
Supine Hypertension signal symptoms

Dizziness , faintness , breathlessness , tachycardia , cool skin sweating

monitor vital signs

food cravings

it is due to cause unknown.

cravings and going off certain foods are most common in the first trimester of pregnancy and are
probably due to the high hormonal levels most cravings and aversions disappear by the fourth month

heartburn burning sensation occasionally with purping and regurgitation of a little sour fasting fluid.

it is mainly due to progesterone slow gastrointestinal tract motility and digestion , reverses peristalsis ,
reflexes cardiac sphincter and delays emptying time of stomach , stomach displaced upward and
compressed by enlarging uterus.

Faintness and rarely syncope

orthostatic hypotension may persist throughout pregnancy

it is mainly due to vasomotorlability or postal hypertension from hormones

if late pregnancy may be caused by Venus state in lower extremities

faintness due to not enough blood is getting to the Brain.Ifthe oxygen level gets too low

it may occur due to stand still for too long for get up too quickly from a chair or hotbath.

it also Mayhappen more often when you are lying on your breast

management

try to get up slowly after sitting or lying down.

Encouragethe patient to do moderate exercise

advised to do deep breathing exercise

avoid vigorous leg movements

avoid sudden change in position

avoid warm crowded area move slowly and deliberately

keep cool and environment

advice patient to take 5 or 6 small meals per day because to avoid hypoglycemia.
if symptoms are serious contact Primary Health Care provider

palpitation

it is mainly due to unknown should not be accompanied by persistent cardiac irregularity.

management

it is the Not preventable , contact Primary Health provider if accompanied by symptoms of cardiac
decompensation

constipation

it is mainly due to gastrointestinal tract motility should because of progesterone , resulting in increase
reabsorption of water drying of stool.

Intestine compressed compressed by enlarging uterus proportion to constipation because of oral iron
supplementation

management

advice the patient to dring 8 to 10 glasses water per day include roughage in diet

Encourage in moderate exercise

maintain regular schedule for bowel movements

use relaxation techniques and deep breathing

administer laxatives makes the stool of softness

administer Mineral oil Other Drugs or enema , according to physician order

provide plenty of fibre diet

flatulence with bloating and bleaching

it is mainly reduced gastrointestinal motility because of hormones

Allowing time for bacterial action that produces gas swallowing air

management

Chew foods slowly and thoroughly

avoid gas producing foods , fatty foods and large meals exercise

maintain a regular bowel habits

varicose vein (varicosities)

it may be associated with arhing legs and tenderness. it may be present in legs and vulva , hemorrhoids
arevaricosities in perineal area

due to

hereditary, predisposition , relaxation of smooth muscle walls of veins because of hormone causing
tortuous dilated veins in legs and pelvic vasocongestion. condition aggravated by enlarging uterus
gravity and bearing down for bowel movements thrombi from leg various rare but may occur in
hemorrhoids

management

avoid obesity

avoid lengthy standing or sitting

constructive clothing and constipation and bearing down with bowel movements

moderate exercise rest with legs and hips elevated

wear support stockings

thrombossed hemorrhoid maybe evacuated

relieve swelling and pain with warm sitzboth , local applications of astringent compress

Leukorrhea

Leukorrheaoffen noted through pregnancy due to ,

hormonally stimulated cervix become hypertrophic and hyperactive producing abundant amount of
mucus

management

not preventable

not douche given

maintain good hygiene

wear perennial pad

report to Primary Health Care provider if accompanied by pruritis fecal oder or change in character or
colour

headache (through 26 weeks)

it may be due to emotional tension (more common than vascular migraine headache)
eye strain( refractory errors)

vascular engorgement and congestion of sinuses resulting from hormonal stimulation

management

conscious relaxation techniques example yoga

contact Primary Health Care provider for constant “splithing” headache to assess for preeclampsia

carpal tunnel syndrome

carpal tunnel syndrome involves thump second and third finger lateral side of the little finger

it may be due to compression of median nerve resulting from change in surrounding tissues, pain
numbness , tingling , burning , loss of skilled movements (typing) dropping of objects

management

not preventable elevates affected arm’ssplinding of affected hand may helpful.

after pregnancy surgery is curative

periodic numbness , tingling of fingers

periodic numbness tingling fingers occur in 5 percentage of pregnant women

it may be due to brachialplexes traction syndrome resulting from dropping of shoulders during
pregnancy (occurs especially at night and early morning)

management

maintain good posture

wearsupportive Maternity bra

condition will disappear if lifting and carrying baby does not aggravate it

joint pain back egg and pelvic pressure hypermobility of joints

it may be due to relaxation of symphegal and sacroiliac joints because of hormones resulting in unstable
pelvis ,exaggreatelumbar and cervicothoracic curve caused by change in centre of gravity resulting from
enlarging abdomen

management

maintain good posture and body mechanics

avoid fatigue wear low heeled shoes

abdominal support may be useful

conscious relaxation yoga , sleep in firm mattress

apply local heat or Ice get backrubs , do pelvic filting exercise

Take rest condition will disappear 6 to 8 weeks after birth

Third trimester

shortness of breath

shortness of breath or dyspnea occur in 60 percentage pregnancy women

it occurs mainly 31 to 34 weeks of pregnancy (affect strong muscles that aids in breathing)

due to

expansion of diagram

limited by enlarging uterus

Diaphragm is elevator 4 cm

management

it relief after lightening will occur

maintain good posture

make it comfortable position mainly in fowler’s position

during sleep provides with extra pillows

avoid overloading stomach

stop smoking

contact Health Care provider if symptoms worsen

to rule out anaemia emphysema and asthma

Insomnia (later weeks of pregnancy)

during late pregnancy it can be difficult to get a good night sleep

many women have strange dreams or rightness about the body and the birth

due to
fetal movement , muscle cramping , urinary frequency shortness of breath or other discomforts.

management

take care shower bath or warm bath at time

reassurance conscious relaxation back massageor efflurage

supports of body parts with pillows

give warm milk or warm shower before retiring

give general exercise

some restful music before bedtime May help

Urinary frequency and urine return

due to

vascular engorgement and altered bladder function caused by hormones , bladder capacity reduced by
enlarging uterus and fetal presentation part

management

empty bladder regularly

give pelvic floor exercise

provide limit fluid intake before bedtime

reassurance of the patient

wear perennial pad

contact Healthcare provider for pair of burning sensation

psychosocial responses , mood swings mixed feelings , increased anxiety

hormonal and maternal adaptation

feeling about and impending labour birth and parenhood

Management

Reassurance and support from significant others and health care provider.

improved communication with partners , family and others.

perineal discomfort and pressure

pressure from enlarging uterus , especially when standing walking , multifetal gestation

management

to promote rest

give conscious relaxation (pelvic floor exercise)

maintain good posture

contact Health Care provider for assessment and treatment of pain is present

braxton Hicks contraction

due to

intensification of uterine contamination in preparation for work of labour

management

reassurance of the patient

provide rest

change of position

breathing technique when contraction

differentiate from perform labour

leg cramps

it is sudden sharp pain usually in calf muscle or feet

due to

compression of nerve supplying lower extremities because of enlarging uterus reduced level of serum
calcium or elevation of serum phosphorus

management

Stretching and massaging the muscle may help it relax

applying heat or cold to the area may also help