Routine Problems of Pregnancy

Question 1

What causes back pain?

Answer 1

Change in center of gravity (Tx: Tylenol. Not Ibuprofen, ASA, NSAIDs.)

Question 2

What causes constipation?

Answer 2

Progesterone –> decreased bowel motility

Question 3

What causes increased contractions?

Answer 3

Dehydration (Drink 10-14 glasses of H2O/day)
Regular contractions (q10 min + cervical change)

Question 4

What causes dehydration?

Answer 4

Expanded intravascular space and increased 3rd spacing of fluid

Question 5

What causes edema/hemorrhoids?

Answer 5

Increased hydrostatic pressure secondary to uterine compression of IVC and pelvic veins

Question 6

What causes GERD?

Answer 6

Relaxation of lower esophageal sphincter and increased transit time in stomach (Tx: antacids, multiple small meals, PPIs, H2 blockers)

Question 7

What causes round ligament pain?

Answer 7

Rapid expansion of uterus and stretching of ligamentous attachments

Question 8

What causes urinary frequency?

Answer 8

Increased intravascular volume, elevated GFR, compression of the bladder, UTI

Question 9

When does N&V general stop? What would suggest hyperemesis gravidarum?

Answer 9

14-16 wks.

Weight loss >5% of pre-pregnancy weight, ketonuria, metabolic alkalosis