Minor symptoms in pregnancy and abdominal pain

Question 1

Common antenatal problems

Answer 1

• Backache
  
  • ​Occurs as ligaments relax
• Carpal tunnel syndrome
  
  • ​Oedema of carpal tunnel
• Haemorrhoids
  
  • ​Weight of gravia uterus, decreased venous return and predisposes to haemorrhods
• Itching
  
  • ​Could be intrahepatic cholestasis of pregnancy
• N+V
  
  • ​Commonly starts at 6 weeks, settling at 12-16 weeks
• Varicose veins
  
  • ​Weight of gravid uterus impairs venous return
• Pelvic girdle pain
  
  • ​Asymmetrical movement of pelvic bone
• Constipation​
• Heartburn
  
  • ​Relaxation of smooth muscle by high circulation or pregnancy hormomes esp progesterone
• Leg cramps
  
  • ​Affects 1/3rd, elevate end of bed
• Vaginal discharge
  
  • ​If excessive could be infection

Question 2

What clinical features are often seen in the first 12 weeks of pregnancy?

Answer 2

• Amenorrhoea
• Nausea
• Vomiting
• Bladder irritability
• Breast engorgement/nipple enlargement

Question 3

Why do pregnant women get urinary frequency?

Answer 3

Due to pressure of the foetal ead on the bladder in later pregnancy. GFR also increases, increasing urine output

Question 4

What GI problems are common in pregnancy?

Answer 4

• Constipation
• GORD

Question 5

Why does GORD occur more commonly in pregnancy?

Answer 5

Progesterone-mediated pyloric sphincter relaxation allows irritant bile to reflux into the stomach, which is worsened by increasing foetal pressure on upper GI tract

Question 6

What musculoskeletal problems can commonly occur in pregnancy?

Answer 6

• Symphysis pubis dysfunction
• Carpal tunnel syndrome
• Mechanical back pain

Question 7

What is the cause of carpal tunnel syndrome in pregnancy?

Answer 7

Due to fluid retention

Question 8

What are causes of abdominal pain in pregnancy at <24 weeks gestation?

Answer 8

• Miscarriage
• Ectopic pregnancy
• Constipation
• Round ligament pain
• UTI
• Fibroids

Question 9

What are causes of abdominal pain after 24 weeks of pregnancy?

Answer 9

• Labour
• Braxoton-hicks contractions
• Symphysis pubis dysfunction
• GORD
• Uterine rupture
• Pre-eclampsia/HELLP
• Placental abruption

Question 10

What are specifically bowel related causes of abdominal pain in pregnancy?

Answer 10

• Appendicitis
• Intestinal obstruction
• Adhesions
• Volvulus
• Intussuception
• Hernia
• Neoplasma
• Acute cholecytsitis
• Pancreatitis