Dr Karuna Raja

Problems during pregnancy

Nausea and Vomiting

Commonly known as morning sickness, it affects about 50% of all pregnant women. It is usually wore in early pregnancy and improves or resolves by the 16th week of the pregnancy. The following are some principles and remedies that may be helpful in relieving symptoms: Avoid over eating, and eat small amounts of food every 2-3 hours. Drink liquids such as water and soup between meals rather than with meals and about an hour after solids. This helps prevent distension of the stomach.

Avoid fried and spicy foods and avoid strong food aroma. Sitting upright after meals helps reduce gastric reflux. A night time snack such as a yogurt, milk or bread may help reduce nausea in the morning. It also helps to eat some dry cereal or crackers before getting out of the bed in the morning. Herbal teas can help as well. In some cases, medicines called ‘antiemetics’ may be required to treat your condition. Vitamin supplements may be required.

 

Sex During Pregnancy

This should be individual preference and there is no real contraindication for it except in some situations such as low placenta or tendency to premature labour. Some positions may be more uncomfortable. Please discuss with me if you have questions or concerns.

 

Pelvic Floor in Pregnancy

The pelvic floor consists of a group of muscles that run in many directions between the lower boarders of the pelvic bones. It is bounded in front by your pubic bones, at the back by your tailbone and runs to either side of your pelvis.

The function of these muscles is to support the pelvic contents, including the bladder and stopping “leaks” when you cough, sneeze, laugh and run (stress incontinence). Women who have one baby are nearly 3 times more likely to leak urine and wet themselves than women who have not had a baby. The risk of leakage increases with every pregnancy and a caesarean section is not necessarily protective.

Pelvic floor muscles are weakened during the pregnancy due to the increasing weight of the baby as well as the effects of the relaxin hormone, which softens muscles and ligaments of the pelvic floor in preparation for the birth. This weakening may lead to stress incontinence, urinary frequency and varicose veins of the vulva and anus.

Doing pelvic floor exercises may minimize these effects. Pelvic floor muscles like other skeletal muscles of the body can be made stronger with exercise.

 

Insomnia

It is a very common problem, mainly towards the end of the pregnancy. Avoid tea, coffee and carbonated soft drinks in the evening. A warm bath or hot milk can help. Try different positions and avoid sleeping flat on your back. Many women find lying on their side with a pillow under the belly most comfortable. Even if you can not go to sleep, resting with your feet up is also good.

 

Heartburn and Indigestion

Pregnancy hormones relax in the stomach muscles and the increasing size of the uterus can interfere with normal woking of the stomach can lead to heart burn and indigestion. Avoid spicy, fatty food and eat frequent, small, well balanced meals. Cold meal and antacid preparations can help. Sleeping with an extra pillow will elevate your head so the acid is less likely to rise up.

 

Constipation

Constipation is more common in pregnancy and related to pregnancy hormones. Eat plenty of roughage (i.e: whole meal bread, brans and fruits). Regular exercise can help as well. Avoid taking strong laxatives.

 

Itchy Skin

Many women experience itchy skin, especially during the last two months of the pregnancy. The itch can be anywhere but is often on your lower abdomen and on your back. Try not to scratch. This causes a release of chemical histamines which in turn causes more itching. make sure your bath water isn’t too hot. Luke warm is best. Unscented bath oils and body lotions can sooth dryness and itching, as well as calamine lotion. Some times itching can indicate pregnancy related liver problems and you should always mention it to your doctor if you experience significant itching.

 

Expected Weight Gain During Pregnancy

There is an increase in weight during pregnancy equivalent to about 25% of the non-pregnant weight (i.e: approximately 12.5 kg in the average patient). The increase is due to the growth of the baby, growth of the maternal organs such as the uterus, maternal storage of fat and protein, as well as increase in the maternal blood volume and in interstitial fluid. Expected increase is 2.0 kg in the first 20 weeks and 0.5 kg per week until term. Many factors influence weight gain including dietary intake and smoking.

 

Leg Problems During the Pregnancy

In pregnancy, many women will complain of tiredness, restlessness, heaviness and tension in the legs. This is usually a tingling sensation and muscular cramps in the calf during the night. Some women will have swollen feet and varicose veins. These can impair a woman’s sense of well being. Varicose veins can be unsightly and constitute a risk of phlebitis and thrombosis. During the pregnancy, avoid standing still as much as possible. Do not sit too low down and avoid the hard edges of chairs. Be active and continue your regular exercise such as walking and swimming.

If you need to stay in one position for a prolonged period of time, try to move your legs as often as possible. Stand up from time to time and wear medical compression stockings. Avoid very hot baths and sunbathing. At night or when resting during the day, lie comfortably with the legs slightly raised. medical compression stockings can help you to relieve and prevent leg problems during pregnancy.

Class II stockings of calf (CC 2), half thigh and thigh type (CC 1) are most suitable and can be purchased from Morris Surgical Pty Ltd, Suit G04W, Carillon West, 138-140 Carillon Ave, Newtown 2042. Phone: 02 9519 3100 Fax: 9565 1097

 

 

Piles/Hemorrhoids

 

 

It is common to develop hemorrhoids towards the end of your pregnancy. Typical symptoms are itching and feeling lumps near your back passage. Sometimes piles bleed but don’t assume that the bleeding from the bottom is caused by piles unless you have checked with your doctor. Piles become much worse by constipation.

Keep your bowels regular, use soft toilet paper and wipe very gently. Try to not strain when going to the bathroom and do not sit there for too long. Avoid pushing for long periods. Simple hemorrhoid preparation can help.

 

 

 

 

 

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