NAUSEA AND VOMITING
These are the most frequent complications of pregnancy, their cause is unknown; it is noted that most often nausea and vomiting occur in multiple pregnancies. Nausea is found in 80-85% of all pregnancies, vomiting frequency reaches 52%. Very rarely (3-4 cases per 1000 pregnancies) a woman may have excessive vomiting, leading to dehydration and electrolyte disorders; this complication already requires hospital treatment.
You can recommend ginger as a non-drug therapy in the form of powders or syrup 250 mg 4 times a day - a positive effect is observed after 4 days of taking. In particularly severe cases, you can apply metoclopramide (cerucal *), but it can not be recommended as a first-line drug, since the safety of its use in pregnant women has not been studied.
HEARTBURN
The pathogenesis of heartburn is unclear, the frequency of occurrence depends on the gestational age: in I trimester in 22% of pregnant women, in the II trimester - in 39%, in III - up to 72%. Like nausea, heartburn has no effect on the outcome of pregnancy and fetal development, but significantly impairs the quality of life of a pregnant woman.
Allowed drugs - antacids (almagel*, phosphalugel*), take the doctor's prescription.
CONSTIPATION
During pregnancy, especially in the second half, the intestine is subjected to compression by an enlarged uterus, which complicates the movement of feces. In addition, hormonal changes in pregnancy lead to a decrease in the activity of the intestine. The more stools remain in the intestines, the harder they harden and the more painful becomes defecation. In cases where the feces are very hard, the risk of injury and bleeding from the hemorrhoidal vessels increases. Thus, constipation during pregnancy is one of the factors in the development of hemorrhoids. According to various data, the prevalence of constipation during pregnancy ranges from 11 to 62%.
When physiological methods do not help, it is advisable to use laxatives with proven safety when used during pregnancy and lactation.
HEMORRHOIDS
Hemorrhoids occur in 26% of pregnant women and in 50% of women in the early postpartum period - the incidence of this disease increases with age.
Symptoms such as pain, burning, foreign body sensation in the anus, periodic discharge of blood in the process of bowel evacuation may disturb. The main method of preventing hemorrhoids during pregnancy and lactation is the normalization of intestinal motility.
The main method of treating hemorrhoids during pregnancy is conservative (drug) therapy. It is necessary to use only those drugs that are allowed for use during pregnancy and feeding, which must be indicated in the instructions for use of the drug.
For example, Natalside® - a preparation containing sodium alginate and obtained from seaweed, has anti-inflammatory, reparative and hemostatic effect. In addition, the active ingredient Natalside® softens the contents of the intestines and facilitates the excretion of fecal matter, thereby improving the work of the intestines, which is especially important for pregnant women.
The drug is approved for use at any period of pregnancy and during lactation, which is especially important, since systemic phlebotrophic therapy for hemorrhoids during breastfeeding is contraindicated.
Surgical interventions in pregnancy and in the puerperium are carried out only if the medication is ineffective.
PHLEBEURYSM
Varicose veins are a fairly common symptom of varicose veins. This condition requires additional examination (coagulation, vascular dopplerometry). In addition to aesthetic problems and feelings of general discomfort, in rare cases itching, with uncomplicated course of the disease there.
Compression elastic stockings can reduce leg swelling and the severity of varicose veins.
BACK PAIN
Recommendations for pain in the back:
- wear shoes without heels;
- Avoid lifting weights; at forced lifting of weights to bend knees, instead of a back;
- perform gymnastics for pregnant women (exercises in water, massage, individual or group classes in special groups);
- to wear a bandage.
FISSILE IN FEET
Convulsions concern almost 50% of pregnant women, more often at night in the last weeks of pregnancy.As a rule, they do not serve as signs of any disease, but cause considerable concern for women. The effectiveness of preparations of magnesium, sodium, calcium is not proven, so their appointment is impractical.
VAGINAL EXTRACTIONS
When there are complaints about pathological discharge, itching, burning, the following studies are shown:
■ bacterioscopic examination;
■ bacteriological research;
■ polymerase chain reaction only for the detection of gonococcus, chlamydia, trichomonads.
After identifying the causative factor of the appearance of pathological discharge, etiotropic treatment is prescribed. When detecting bacterial vaginosis, nonspecific colpitis, antiseptics are prescribed, since these are broad-spectrum drugs, for example chlorhexidine (Gexicon).
If, however, vulvovaginal candidiasis is detected during the examination, local antifungal medications that have minimal effect on the body of pregnant women are prescribed. Preference is given to drugs with a wide spectrum of action, which provide reliable treatment of vulvovaginal candidiasis.
THREAT OF PREVENTION OF PREGNANCY
When threatened with termination of pregnancy, a woman complains of pulling or cramping pains in the lower abdomen and in the waist, a feeling of pressure and raspiraniya in the vaginal area, often a symptom of low location of the prevailing part is frequent urination. With premature rupture of membranes, the pregnant woman complains of liquid discharge from the genital tract. With ascending infection of the amniotic cavity, there are symptoms of intoxication: a feeling of chills, an increase in body temperature, there are discharge with a sharp, unpleasant odor. In this case, it is necessary urgent hospitalization of a pregnant woman in a hospital.
DELAY OF DEVELOPMENT OF FRUIT
The delay in development is said in those cases when the growth and weight of the fetus do not correspond to the term of pregnancy and its dimensions are smaller than with normal pregnancy. The main cause of such a delay is usually a violation of uteroplacental blood flow, but it is impossible to exclude problems directly related to the fetus - malformations of the fetus and intrauterine infection. Often delayed fetal growth is noted in pregnant women taking drugs, smokers, alcohol users.
ANEMIA
Anemia of pregnant women (decrease in hemoglobin content) is diagnosed mainly in the II and III trimesters. Anemia can develop due to early toxicosis; with a deficiency of iron in the diet or a violation of its absorption; deficiency in the dietary intake of proteins, magnesium and phosphorus, participating in hematopoiesis; genetic disorders (a group of congenital anemia). The highest risk of anemia with multiple pregnancy, small interval between births.
Symptoms of anemia: pallor of the skin, increased fragility of nails and hair, increased fatigue, a sense of weakness.
With the progression of anemia and the absence of treatment, fetoplacental insufficiency grows, leading to hypoxia and fetal development retardation. Compensatory capabilities of the mother's body are gradually depleted, the work of the immune system is disrupted.
When the concentration of hemoglobin is reduced, a full-value protein or therapeutic diet should be prescribed, preparations containing iron, recommend and organize additional studies designed to clarify the nature of anemia. With anemia of moderate to severe severity, hospitalization of a pregnant woman in a hospital for active treatment.
GESTOSIS
This complication of pregnancy, often occurs in the second half of pregnancy (after 16 weeks). Gestosis is characterized by functional insufficiency of organs and systems, manifested by a triad of basic symptoms: edema, proteinuria, hypertension. In modern obstetrics along with the term "gestosis" the terms "nephropathy", "hypertension of pregnant women", "pre-eclampsia", etc. are used. The frequency of gestosis varies on the average from 7 to 22%.
The easiest form of gestosis is dropsy of pregnant women, which is manifested by edema. Treatment of this form of gestosis can be performed on an outpatient basis, but with the increase in the severity of edemas, the pregnant woman is hospitalized in a hospital. Dropsy of pregnant women can pass to the next stage of gestosis - nephropathy of pregnant women.The next stage of gestosis development is preeclampsia. In addition to signs characteristic of nephropathy, there are symptoms of cerebral circulation, increased intracranial pressure and cerebral edema: headache, visual disturbances, epigastric pain, nausea, vomiting, drowsiness, decreased response to external stimuli or, conversely, arousal and euphoria. The duration of preeclampsia may range from several hours to several minutes.
The most severe form of gestosis is eclampsia. Its main manifestation is convulsions with loss of consciousness against a background of vasospasm, hemorrhages and edema of the brain. Seizures can occur suddenly, but often develop against the background of symptoms of preeclampsia. All forms of gestosis, with the exception of dropsy pregnant, require additional examination, usually in a hospital.