SEMINAR ON

MINOR AILMENTS
IN PREGNANCY

Submitted To- Submitted By-

MISS. NEETI ASHI RAWAT
NURSING TUTOR MSc (N) 1ST YEAR
COLLEGE OF NURSING COLLEGE OF NURSING
LLRM MEDICAL COLLEGE LLRM MEDICAL COLLEGE
MEERUT MEERUT
Objectives
General objectives
At the end of the seminar the participants will be able to gain in depth knowledge regarding
minor ailments in pregnancy.

Specific objective – at the end of the seminar the participants will be bale to -:
 Define minor ailments in pregnancy
 Enlist the causes of minor ailments
 Explain the minor ailments with management.
Terminologies
Pregnancy - Pregnancy is the term used to describe the period in which a fetus develops
inside a woman's womb or uterus.

Minor – it is defined as something which can be self treated or are uncomplicated thus
not requiring further investigation.

Ailment - An aliment is an illness, especially one that is not very serious.

INTRODUCTION
Pregnancy is a unique and transformative experience for women, marked by various physical
and hormonal changes. While many women go through pregnancy without major
complications, some may experience minor ailments or discomforts. These are typically
considered normal aspects of pregnancy but can vary from woman to woman.

The desire for children is usually an essential part of a couple`s love. All women have
ambivalent feelings about pregnancy. Some gravidas pass through minor ailments and so
should have the proper knowledge about these ailments and their treatment is important.

Many women experience some minor ailments during pregnancy. These disorders should be
treated adequately as they may cause life threatening conditions in progress of pregnancy.

Minor ailments may occur due to hormonal changes, accommodation changes, metabolic
changes & postural changes. Every system of the body is affected by pregnancy. The mother
needs knowledge to cope with the experience of pregnancy.

These ailments of pregnancy are those presentations and conditions that result from pregnancy
but do not significantly interfere with the activities of daily living or any significant threat to
the health of the mother or baby, in contrast to pregnancy complications.

During the course of pregnancy period many changes occur in a women`s body as a result of
hormonal influences and adaptation to the gestational process. Thereby, they experience a
variety of physiological and psychological symptoms such as nausea, vomiting, backache,
heartburn and anxiety. These are termed as minor ailments or discomforts of pregnancy.

DEFINITION
“The minor ailments of Pregnant woman that occur due to physiological alterations of
hormones ( oestrogen, progesterone, Prolactin ) and other causative factors which can be
managed without medical interventions”.
Minor Ailments

DIGESTIVE SYSTEM

MUSCULOSKELETAL SYSTEM

CIRCULATORY SYSTEM

GENTIOURINARY SYTSTEM

INTEGUMENTARY SYSTEM

RESPIRATORY SYSTEM
Causes of minor ailments
 Hormonal Fluctuations: Pregnancy hormones, such as human chorionic
gonadotropin (hCG), progesterone, and estrogen, undergo significant changes to
support the development of the fetus. These hormonal shifts can contribute to nausea,
mood swings, and other symptoms.
 Increased Blood Volume: The body's blood volume increases during pregnancy to
supply nutrients and oxygen to the growing fetus. This can lead to changes in blood
pressure, fluid retention, and swelling in extremities.
 Uterine Growth: As the uterus expands to accommodate the developing baby, it puts
pressure on surrounding organs and structures. This pressure can cause back pain,
frequent urination, and digestive issues.
 Relaxation of Muscles and Ligaments: Hormonal changes, particularly the hormone
relaxin, cause muscles and ligaments to relax in preparation for childbirth. This can
result in joint pain and increased susceptibility to strains.
 Digestive System Changes: Hormonal influences on the digestive system can lead to
issues such as heartburn, indigestion, and constipation.
 Increased Energy Expenditure: The body requires more energy to support the
developing fetus, leading to increased fatigue and tiredness.
 Fluid Retention: Hormonal changes and increased blood volume can cause fluid
retention, leading to swelling in the hands, feet, and ankles.
 Changes in Blood Circulation: Changes in the circulatory system can contribute to
conditions like varicose veins, especially in the legs.
 Breast Changes: Hormonal preparations for breastfeeding can result in breast
tenderness and sensitivity.
 Emotional and Psychological Factors: The emotional and psychological aspects of
pregnancy, including stress and anxiety, can contribute to mood swings and other
minor ailments.
DIGESTIVE SYSTEM
1. Nausea &vomiting:

Nausea is a stomach distress with distaste for food and an urge to vomit. It is a common
disorder seen in about 50%women between 4th& 16th week of gestation. Hormonal
influences are thought to be the most likely cause. Human chorionic gonadotropin that is
present in large amounts in the 1st trimester, oestrogen& progesterone are all contribute to
this. The sickness is confined to “early morning” but can occur at any time in the day. The
smell of certain cooking food will cause the symptom. 50% women have nausea and
vomiting 25% have nausea and 25% are unaffected.

Cause

The cause is not clear and is through to be due to increase chorionic gonadotropin hormone
and change in carbohydrate metabolism.

Management:

The midwife should encourage the mother to look positively towards the resolution of the
problem.

• Salads & light snacks are given than full meals.

• Carbohydrate snacks at bed time can prevent hypoglycaemia.
• Dry toast or biscuits are given on waking up &breakfast after half an hour.

• Antiemetic drugs with plenty of glucose drink are given if the simple measures fail.

*If vomiting becomes severe the mother may lose weight& becomes dehydrated this condition
is called hyperemesis gravidarum& specialized care & appropriate referral should be needed.
2.Constipation:
Constipation is a condition in which individual have fewer than three bowel movements a
week. It is quite common ailment during pregnancy. This is due to smooth muscle relaxant
effect of progesterone causing decreased peristalsis of gut and diminished physical activity. It
is usually overcome by adjusting diets.

Causes

 It results from decreased intestinal motility, displacement of the intestines.

 Its is also due to intake of iron supplements.
 Diminished physical activity can lead to constipation.
 Pressure of gravid uterus on the pelvic colon.

Management:

The women may be advised to:

 Increase the intake of water.

 Add green leafy vegetables, fruits & bran cereals to her diet.
 Take a glass of warm water in the morning before tea or breakfast which would
activate the gut & help regular bowel movements. Do exercise by regular walking.

2. Acidity & heartburn:

Acidity is a common condition caused by the stomach acid flowing back up into the food pipe
and heartburn is a burning pain in chest. This burning pain in the mediastinal position caused
by reflux of stomach contents into the oesophagus. It occurs because the cardiac sphincter
relaxes during pregnancy due to the effect of progesterone. The condition tends to worsen as
pregnancy advances because the stomach is displaced upward by the enlarging uterus.

Heart burn is most troublesome at about 30th to 40th week of gestation because at this stage the
stomach is under pressure from the growing uterus.
Causes

 This acidity and heartburn results from increased progesterone levels,

 decreased gastrointestinal motility esophageal reflux
 Displacement of displaced stomach by the enlarged uterus.

Management:

The advice given according to the severity of the condition:

 If the heartburn is occasional the reflux can be prevented by avoiding bending &
kneeling while doing household works.
 Advice to take small meals which will be more easily digested.
 Fried & fatty foods should be avoided.
 Sleeping with more pillows & lying on right lateral side can be helpful.
 For persistent heartburn antacids may be prescribed by the physician.

3. Ptyalism
Ptyalism is a condition that causes the overproduction of saliva. It is also known as
hypersalivation or sialorrhea. This occurs from 8th week of gestation

Causes

Hormones of pregnancy.

Hyperactivity of parotid gland.

Pregnancy sickness

Management:

• This problem is usually self-limiting and may be overcome by decreasing intake of

carbohydrates.
• It is not associated with any adverse pregnancy outcome.
4. Abdominal discomfort:

 Abdominal pain is defined as pain from inside the abdomen or the outer muscle wall,
ranging from mild and temporary. It is common due to couple of reasons.
Causes
 Due to Pressure, pelvic heaviness, is caused by the weight of the uterus on the pelvic
supports and the abdominal wall.
 Round ligament tension, tenderness along the course of the round ligament (usually
the left) during late pregnancy, is due to traction on this structure by the uterus,
which is displaced by the large bowel to be rotated slightly to the right.
  Flatulence and distention can be due to large meals, gas-forming foods, and chilled
beverages. These are poorly tolerated by pregnant women.

Management:

 Provide rest frequently, preferably in the lateral recumbent position.

 Local heat should be applied and change of position frequently.
 Dietary modifications should be needed.
 Regular bowel function should be maintained, and exercise is beneficial.
 Acetaminophen 0.3–0.6, 2–3 times daily may be given to reduce discomfort.
 Intra abdominal disorders must be diagnosed and treated appropriately.

5.Flatulence
It is quite common in pregnancy. It is due to reduced GI motility because of hormones, allowing
time for bacterial action which produce gas.

Management

 To help relive this, eat small amounts and try to establish a daily bowel action.
 Avoid foods that cause bloating and gas such as cabbage, beans, cauliflower etc.
 Sit straight while eating to take the pressure off the stomach.

MUSCULO-SKELETAL SYSTEM
1. Fatigue:
Fatigue is defined as overall feeling of tiredness or lack of energy. The pregnant patient is more
subjected to fatigue during the last trimester pregnancy because of altered posture & extra
weight carried.

Causes

 It results from hormonal changes.

 Extra weight carried

Management:

a. Frequent rest period should recommended.

b. Anemia & other systemic diseases should be ruled out.

2. Backache:
Backache is defined as the pain in the lumbar region of the back .The gradual weight gain &
the changes in the body’s center of gravity combined with the stretching of weak abdominal
muscles often lead to hollowness of lumbar spine.
Causes

 There is a tendency for back muscles to shorten as the abdominal muscles stretched &
extra strain is put on the ligaments this results in backache.

Management:

 Excessive weight gain should be avoided.

 Rest with elevation of legs to flex the hips may be helpful.
 Improvement of posture with well fitted pelvic girdle belt may be reduce the pain.
 Advice the mother to wear low healed shoe.
 Apply local heat or light massage is helpful.
 Recommended sleep on a firm mattress.
 Provide back exercise under the supervision of physician.
 Give acetaminophen 0.3-0.6 g orally.


3. Leg cramps:
Leg cramps are sudden involuntary contraction of one of more muscles often in the legs. It is
also known as charley horse. These are quite common & worsen at night.

Causes

 The cause is not known but has been attributed to deficiency of vit-B1 & decreased
level of calcium.
 It may be due to ischemia or changes in pH or electrolyte level.

Management:

 Make gentle leg movements, massage the leg & also apply local heat which may be
beneficial.
 Sleep with foot end of the bed elevated by 20-25cm.
  Take Vit-B complex & calcium supplements.

4. Round ligament pain:

Stretching of the round ligament during movement in pregnancy may cause sharp pain in the
groins which may be unilateral or bilateral. It is usually felt in 2nd trimester onwards. This is
more common in right side as a result of dextro-rotation of uterus. Pain may be awaking at
night time because of sudden roll over movements during sleep.

Cause

It generally happens when the uterus and surrounding ligaments stretch to make room for baby,
it cause short, painful spasms.

Management:

 Pain may be reduced by making movements gradual instead of sudden.

 Local heat application is helpful.
 Analgesics may be needed.

CIRCULATORY SYSTEM
1. Varicose vein:
Varicose vein are twisted, enlarged veins that lie just under the skin. Progesterone relaxes the
smooth muscles of veins & results in slow circulation, the valves of the dilated veins become
inefficient & varicosities results. It generally occurs in legs, anus& vulva.
Causes
Family history of varicose vein
Doing work with long period of standing & sitting usually develop varicose veins.
Management:

 Exercising the calf muscles by rising onto the toes or making circular movements with
the ankles.
 Resting with the legs vertical against the wall for a short time.
 Wearing support tights before rising or after resting with legs elevated.
 Avoid forceful massage & point-pressure over legs.
 2. Hemorrhoids:
Hemorrhoids or piles are swollen veins in the anus and lower rectum. It may cause due to any
complications like bleeding & get prolapsed that produce severe pain. In pregnancy, up to 85%
of pregnancies are affected by hemorrhoids in the third trimester.

Causes

It occurs when the external hemorrhoidal veins become varicose (enlarged and swollen), which
causes itching, burning, painful swellings at the anus, dyschezia (painful bowel movements)
and bleeding.

Management:

 Prevent constipation first for that use laxatives.

 Apply hydrocortisone ointment to reduce pain & swelling.
 Advice for sitz bath.

3. Syncope (Fainting):
Syncope is also known as fainting. This is a temporary loss of consciousness with a quick
recovery. In early pregnancy fainting may occur due to vasodilation under the influence of
progesterone. It may subside following the compensatory increase in blood volume.

Causes

 Hormonal changes
 Increased blood volume
 Anemia
 Fatigue
 Lying in supine position
Management:

 Avoid long period of standing as well as sitting or lying down when she feels slightly
faint.
 In later pregnancy advice the mother not to sleep with her back except during abdominal
examination because this can cause vena cava compression which leads to slow return
of blood to heart.
 Encourage the mother to eat small meals rather than large one.

4. Ankle Oedema:
Ankle oedema is defined as abnormal buildup of fluid in the ankles ,feet and legs can cause
swelling. It develops in at least two thirds of women in late pregnancy but mainly occur in
2nd&3rd trimesters.

Causes

 It is the results of venous & lymphatic stasis, as well as occurs due to changes in
osmotic pressure of blood & tissue fluids & altered capillary permeability.

Management:

 No treatment is required for physiological or orthostatic oedema.

 Elevate the legs while sleeping & sleep in left lateral position & avoiding sitting
with the feet hanging down.
 Restrict excessive salt intake & provide elastic support for varicose veins.
 Diuretics should not be given.

NERVOUS SYSTEM
1. Insomnia:
Insomnia is a trouble faaling and\ or staying asleep.t is relatively common in late pregnancy
owing to discomfort .

Causes

 Fetal movements
 Frequency of micturition
 Difficulty in finding a comfortable position.
 It may also be due to some deep seated anxiety or fear.

Management:

 Take rest in afternoon.

 Drink a glass of warm milk at bed time.
 Tuck a pillow under the abdomen when lying in a lateral position.
  Talk about her fears & anxieties so that she can have a sense of normality &
lightness.

2. Headache:
Headache in pregnancy is common and usually due to tension. Refractive errors and ocular
imbalance are not caused by normal pregnancy. Severe, persistent headache in the third
trimester must be regarded as symptomatic of pre-eclampsia and eclampsia.

Management:

 Advice the mother to take adequate rest.

 If there is any pregnancy induced hypertension then symptomatic management should

be done.
 3. Carpal tunnel syndrome:
Carpal tunnel syndrome, also called median nerve compression, is a condition that causes
numbness, tingling or weakness in hand. Mothers complain of numbness & pins & needles in
their fingers & hands. This usually happens in the morning, but it can occur at any time of the
day.

Cause

It is caused by fluid retention which creates oedema& pressure on the median nerve.

Management:

 Wearing a splint at night with the hands resting on 2or 3 pillows.

 Restriction of salt intake & flexing the fingers while the arm is held above the head.
 It usually resolves spontaneously.

GENITO URINARY SYSTEM

1. Leucorrhoea
Leucorrhoea refers to the natural secretions that are released from a woman`s vagina. This is
the increased white non irritant vaginal discharge in pregnancy. If the mother finds the
discharge disturbing, it needs management.

Causes

 Yeast infection
 Pelvic inflammatory disease
 Vaginitis
  Increase estrogen level

Management:

 Advice her to maintain personal hygiene.

 Frequently wash the vulva i.e.3-4 times per day with plain water.
 Advice her to wear cotton underwear & avoid tights.
 Educate her about the possibility of infections such as Thrush & Trichomonas.

2. Urinary symptoms/ frequency of micturition

This occur in the 1st trimester when there is pressure on the gravid uterus on the urinary bladder.
It is spontaneously relieved when the uterus rises up in the abdomen. It may recur in late
pregnancy when the fetal head descends into pelvis.

Causes

 It is caused by pressure of the uterus on the bladder.

 It is sometimes also caused by cystitis.

Management:

 Advice her to take adequate rest.

 Advice her to maintain proper perineal hygiene.

RESPIRATORY SYSTEM
1. Breathlessness
Dyspnea is defined or labored breathing. It is not actual dyspnea which is occurs due to
progesterone effects. It occurs as early as in 12th week of pregnancy & most women have it up
to 30th week.

Management

 There is no effective management but rest will helping reducing the condition.
 Breathing exercise is adviced.
INTEGUMENTARY SYSTEM
1. Skin

Some mothers complain of generalized itching that starts over the abdomen. This occurs due
to livers response to certain hormones in pregnancy & with raised bilirubin level.

Management

 It clear soon after the baby is born & comfort can be gained from local application.
 An anti-histamine can be prescribed.
 If the mother complain irritation or infection then washing with mild soap & cotton
underwear might help to reduce the irritation.
Research input
1.Minor ailments in pregnancy are not a minor concern for pregnant women: a
morbidity assessment survey in rural Sri Lanka

Suneth Buddhika Agampodi et al (2013)

Introduction : Although maternal mortality has become a major focus on global public
health agenda, maternal morbidity is a neglected area of research. The purpose of this paper is
to present the burden of acute maternal illness during pregnancy.

Methods: A cross sectional study was carried out in Anuradhapura district, Sri Lanka.
Pregnant women residing in the Anuradhapura district with a gestational age more than 24
weeks through 36 weeks were recruited to the study using a two-stage cluster sampling
technique. All pregnant women who consented participated in a detailed interview using a
structured questionnaire. Self reported episodes of acute illness during pregnancy were the
main outcome measures. Secondary outcomes were utilization of medical services and
frequency of hospitalizations.

Results: Nausea and vomiting during pregnancy (NVP) was experienced by 325 (69.7%) of
the 466 pregnant women studied. Other common symptoms were backache (152, 32.6%),
dizziness (112, 24.0%) and heartburn/regurgitation (107, 23.0%). Of the 421 pregnant women
who reported ill health conditions 260 (61.8%) women sought medical treatment for these
illnesses. Total number of episodes that needed treatment seeking were 373. Hospitalizations
were reported by 83 (17.8%) pregnant women and the total number of hospitalizations was
109. The leading cause of hospitalization was NVP which accounted for 43.1% of total
admissions and 49.1% of total days spent in hospitals.

Discussion : Minor maternal ill health conditions affecting day-to-day life have a major
burden on pregnancy period. Evidence based management guidelines and health promotion
strategies are needed to control and prevent these conditions, in order to provide
comprehensive, good quality maternal health care.

2.Knowledge and practices regarding management of minor ailments of pregnancy

among antenatal mothers: a descriptive study from Rajasthan
Ankita Sharma et al (2020)

Introduction: Pregnancy is considered as one of the most beautiful events in every female
life which brings a lot of physiological and hormonal changes to prepare women for
motherhood. Even though these changes are not dangerous, still they are bothersome. Women
use number of homemade remedies to alleviate these discomforts. Objective: The objective
of this study was to assess knowledge and practices regarding management of minor ailments
of pregnancy among antenatal mothers.

Methods: This study was conducted at obstetrics OPD of All India Institute of Medical
Sciences, Jodhpur, Rajasthan. 368, 3rd trimester pregnant mothers were recruited by
convenient sampling technique. Self- structured knowledge questionnaire, checklist for
practice were used for data collection using face to face interview method.
Results: Most common health problems as reported by pregnant women were increased urine
frequency and fatigue. Nearly 61% of mothers had fair knowledge levels. Majority of the
antenatal mothers used one or another home remedy to alleviate their symptoms. 86.6% ate
small and frequent meals followed by 74.3% avoided strong odors to prevent nausea and
vomiting.

Discussion : Increased urine frequency is the most evident minor ailment faced during
pregnancy. Overall antenatal mothers had fair knowledge regarding management of minor
ailments and varied practices have been performed by antenatal mothers to relieve their
problems. There is a need to conduct aggressive and comprehensive health promotion and
awareness sessions for the expectant mothers so as to manage these ailments and prevent
further complications.

Summary
Today we have discussed about

 Minor ailments
 Causes of minor ailment
 Different types of minor ailments with management

CONCLUSION
During pregnancy, hormones including oestrogen, progesterone and Prolactin rise rapidly. It
turns the womb into a suitable environment for the baby’s growth and at the same time, it
could cause discomfort to the mother. Most of these changes are normal. Most of the minor
ailments in pregnancy will spontaneously subside after delivery, therefore mother do not need
to worry too much. minor ailments encompass a wide range of common health issues that,
while not life-threatening, can significantly impact daily life. Management strategies often
involve self-care, lifestyle adjustments, and over-the-counter medications. However, it's
essential to seek professional medical advice if symptoms persist, worsen, or if there are
concerns about a more serious underlying condition. Taking proactive steps to address minor
ailments can contribute to overall well-being and quality of life.

Recapitulation
Q1. What do you understand by minor ailments in pregnancy ?

Q2. What are the causes of minor ailments ?

Bibliography
 Dutta DC. Obstetrics. 8th edition . New Delhi: Jaypee; 2015.
 Jacob Annamma. 6th edition. New Delhi : Jaypee;2023.
 Magon Shally. Midwifery and obstetrics. Punjab: Lotus Publishers;2021.
 www.ncbi.nlm.nih.gov (national institute of health )
 https:\\www.ijcmph.com (international journal of community medicine and
public health )