Common Concerns during Pregnancy Table

Question 1

Missed periods: what trimester and due to?

Answer 1

ALL trimesters
high levels of estrogen, progesterone, and HCG build up in the endometrium and prevent menses (which causes missed periods)

Question 2

Heartburn: what trimester and due to?

Answer 2

ALL trimesters
progesterone decreases tone of lower esophageal sphincter which allows gastric contents to reflux into esophagus (gravid uterus also puts pressure on stomach, causing reflux)

Question 3

Urinary frequency: what trimester and due to?

what two complaints should be investigated for UTI?

Answer 3

ALL trimesters
Increased blood volume and filtration rate lead to increased urine output, plus uterus presses on bladder;
dysuria or suprapubic pain

Question 4

Vaginal discharge: what trimester and due to?

Answer 4

ALL trimesters
asymptomatic milky white discharge (leukorrhea) results from increased cervical and vaginal secretions. Should investigate any foul smelling or pruritic discharge

Question 5

Constipation: what trimester and due to?

Answer 5

ALL trimesters

slowed GI transit, dehydration from N/V, and iron supplementation from prenatal vitamins causes constipation

Question 6

Hemorrhoids: what trimester and due to?

Answer 6

ALL trimesters

may be caused by constipation, decreased venous return from increasing pelvic pressure and changes in activity level

Question 7

Backache: what trimester and due to?

Answer 7

ALL trimesters
hormonally induced relaxation of joints/ligaments contribute to aches; lordosis of pregnancy contributes to lower back strain; breast growth might lead to upper back pain

Question 8

Nausea and vomiting: what trimester and due to?

Answer 8

First trimester
poorly understood, but may arise from hormonal changes, slowed GI transit, alterations in smell and taste, and sociocultural factors

Question 9

Breast tenderness/tingling: what trimester and due to?

Answer 9

first trimester
pregnancy hormones stimulate the growth of breast tissue (swelling might cause aching, tenderness, and tingling); increased blood flow might also result in veins becoming visible

Question 10

fatigue: what trimester and due to?

Answer 10

first and third trimesters
related to rapid changed in energy requirements, sedative effects of progesterone, changes in body mechanics or sleep disturbance (2nd trimester = increased energy and well being)

Question 11

lower abdominal pain: what trimester and due to?

Answer 11

second trimester
rapid growth in this trimester causes tension and stretching of round ligaments (causes sharp or cramping pain with movement or positions)

Question 12

abdominal striae: what trimester and due to?

Answer 12

second or third

stretching of skin and tearing of collagen in dermis, may persist or fade over time after the pregnancy ends

Question 13

contractions: what trimester and due to?

Answer 13

third trimester
irregular and unpredictable uterine contraction are rarely associated with labor (Braxton hick’s contractions); contractions that become regular or painful should be evaluated for onset of labor

Question 14

loss of mucous plug: what trimester and due to?

Answer 14

third trimester
passage of mucus plus often occurs during labor but may happen prior to the onset of contractions; as long as there’s no regular contractions, bleeding, or loss of fluid, the plug is still intact

Question 15

edema: what trimester and due to?

Answer 15

third trimester
decreased venous return, obstruction of lymphatic flow, and reduced plasma oncotic pressure cause lower extremity edema (hand and face edema may signal preeclampsia)