Common antenatal complaints

Question 1

What is the treatment for nausea in pregnancy? Pharmalogical/non-pharma?

Answer 1

Non-pharma:
Small meals, maintain fluids
Bland foods
ginger tea/tablets
Nei Kuan acupressure- wristband such as seaBand

Pharma:
Pyridoxine alone or with Doxylamine (Restavit)
Promethazine (Phenergan)
Dimenhydrinate
If not improving add Metoclopromide 10mg oral
If severe Ondansetron 4mg

Question 2

Cause and management for heart burn?

Answer 2

Cause:
Pregnancy hormones
Relaxation of oesophageal sphincter

Non-pharma:
Small meals, avoid spicy foods, eat at least 3 hours before bed

Pharma:
Ant-acid- Gaviscon/mylanta- can interfere with iron absorption
Ranitidine (Zantac) H2 antagonist
Pantoprazole PPI

Question 3

Cause and management of constipation?

Answer 3

Cause:
Progesterone causes slow peristalsis

Non-pharma:
Increase fluid and fibre in diet
Excersise
Natural laxatives- oats, coffee, sweeteners

Pharma:
Coloxyl (stool softener)
Some laxatives not recommended

Question 4

Cause and management of haemorrhoids in pregnancy?

Answer 4

Cause:
As women prone to constipation, straining can cause haemorrhoids

Haemorrhoid cream from chemist or surgery

Question 5

Cause and management of carpel tunnel?

Answer 5

The carpal tunnel is a small passage in the wrist where nerves and tendons pass from your arm
into your hand and ngers. During pregnancy hormones cause you to retain uid, they also soften the ligament that forms the roof of the tunnel. When this happens the nerve running through the tunnel may become squashed

Manage:
Avoidheavylifting.
• Avoidrepetitivetasks.
• Elevateyourhand(s).
• Run cold water over the wrist.
• Wear a compression bandage or tubigripTM. • Wearawristsplint,especiallyatnight,
to keep your wrist (neutral) straight.
• Perform regular fluid drainage massage

Question 6

Cause and management of back pain in pregnancy?

Answer 6

Cause:
Weightgain
Posture changes with changing centre of gravity
Hormone relaxin causes ligaments in pelvis to relax
Separation of rectus abdomens muscle worsen back pain
Stress- increased muscle tension

Non-pharma:
Exercise 
Heat pack
Improve posture
Physio/massage

Question 7

Symptoms of Symphysis pubic dysfunction (SPD)?

Answer 7

Pain in the front center of the pubic bone
Pain in lower back on one or both sides
Perineal pain
May feel or hear a grinding or clicking
Some things make it worse: walking, using stairs, turning over in bed

Question 8

Cause and management of SPD?

Answer 8

Cause:
Relaxin causing relaxation in ligaments and muscles in pelvis, stomach and pelvic floor to increase pelvic inlet for birth

Management:
Referral to physio
Pelvic binder
TENS machine
Paracetamol
Codeine

Question 9

Cause and management of gum bleeding/oral health problems?

Answer 9

Pregnancy hormones and decreased calcium levels can cause gingivitis. Also vomiting, eating surgery foods can also increase risk
This causes swelling and bleeding of the gums and increase risk of tooth decay.
Treatment-
Good oral health, salt gargle, calcium, Vitamin D- increase calcium utilisation, dentist- removal of buildup of plaque, oral antibiotics

Question 10

Cause and management of varicose veins?

Answer 10

Cause:
Increased blood volume, hormones, blood stasis

Manage:
don't cross legs
exercise
Compression stockings
Decrease salt intake
surgery

Question 11

Prevention and management vaginal thrush?

Answer 11

Cause:
Increased oestrogen make environment more favourable

Prevention:
Avoid restricting clothing
Avoid douching

Manage:
Clotrimazole 1% cream per vaginal for 6 days