References:
- Dr. RPS Maternal and Newborn Care: A Comprehensive Guide and Source Book for Teaching and Learning, 2nd Edition, ISBN 978-971-98-2265-3, by Rosalinda Parado Salustiano (Ch. 5, pp. 95–96)
| Discomfort | Cause | Relief Measures |
|---|---|---|
| Morning Sickness | Progesterone effect | - Eat dry crackers (or toast) 30 minutes before arising in the morning. - Eat small, frequent meals and avoid fatty, acidic, and highly seasoned foods. - Drink adequate fluids between meals. |
| Pyrosis | Progesterone effect, gastric compression by the gravid uterus | - Bend at the knees when picking things up off the floor. - Remain upright for 3 to 4 hours after eating. - Avoid taking sodium bicarbonate. Take aluminum-bearing antacids as ordered. |
| Constipation | Progesterone effect, particularly of GI relaxation and decreased motility. | - Increase fluids and fiber. - Increase activity/exercise. - Establish a bowel movement routine/schedule. - Drink warm water in the morning. |
| Hemorrhoids | Progesterone effect, particularly of GI relaxation. | - Avoid constipation and other forms of straining. - Promote comfort: sitz bath, warm compresses. - Reinsert hemorrhoids, upon the physician’s recommendation. |
| Flatulence | Progesterone effect, particularly of GI relaxation. | - Eat small, frequent meals. - Avoid gas-forming foods. |
| Urinary Frequency | Pressure on the bladder by the gravid uterus, relieved during the second trimester. | - Increase fluids to replace losses, except for bed time to prevent nocturia. |
| Vena Caval Syndrome | A.K.A. Supine Hypotension Syndrome. Caused by vena caval pressure from the gravid uterus, decreasing cardiac output and dropping systolic blood pressure by ~30 mm Hg. | - Avoid sudden changes in position. - Avoid staying supine. - Arise from the bed gradually, with a lateral position. - Avoid staying in one position for long periods. - Assume frequent left-lateral positions in bed. |
| Edema | Increased aldosterone (salt-saving, water-retention) due to progesterone and pressure on the inferior vena cava. | - Assume a left-lateral position or elevate the legs frequently to promote venous return. Avoid prolonged standing. - No round/constricting garters. -Report swelling of the hands and face. Edema should predominantly be pedal. |
| Shortness of Breath | Pressure on the diaphragm by the gravid uterus. | - Maintain good posture. - Avoid fatigue. - Elevate the head with several pillows; avoid supine position. - Avoid constricting clothing and brassieres. - Report increasing dyspnea at rest prior to 36 weeks. |
| Varicosities | Pressure on the femoral vein and inferior vena cava by the gravid uterus. | - Avoid round garters around the abdomen and legs (knee-high stockings). - Wear a supportive (hip-high) panty hose. - Frequent elevation of the legs and hips is advised. |
| Leg Cramps | Calcium-phosphorus imbalance from fetal bone ossification (7th month). | - Increase dietary calcium, with Vitamin D. - Avoid prolonged standing and sitting. - Dorsiflex the foot, extend the knee to hyperextend the involved muscle. |
| Backache | Forward-shifting of the center of mass results in lordosis, and pressure on the bones and ligaments. | - Maintain good posture. Avoid prolonged standing. -Wear flat shoes. -Engage in regular, gently physical activity. - Use a supportive mattress. - Wear a maternity girdle in selected situations as recommended. |
| Fatigue | Due to increased metabolic rate | - Adequate rest and sleep - Avoid prolonged standing - Practice good body mechanics (posture). - Report increasing fatigue with regular activities (gravida cardia) |