Discomforts of Middle to Late Pregnancy

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    Discomforts of

    Middle to LatePregnancy

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    Backache

    As pregnancy advances, a lumbar lordosis occurs and

    postural changes necessary to maintain balance maylead to backache

    Wearing shoes with low to moderate heels reducesamount of spinal curvature necessary to maintainupright position

    Backache can be initial sign of a bladder or kidneyinfection

    To avoid back strain, advise a women to squat ratherthan bend over to puck up objects

    Sliding a board under the mattress is a cost-effectivealternative for achieving a firmer sleeping surface

    Backache can be initial sign of a bladder or kidneyinfection

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    Headache

    Many women experience headache duringpregnancy, apparently from their expandingblood volume, which puts pressure oncerebral arteries.

    Although a few women who have migraineheadaches find these worsen duringpregnancy

    If a headache is unusual intense or continuousit may be a danger sign of pregnancy cause byhigh blood pressure

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    Dyspnea

    As the expanding uterus puts pressure on thediaphragm, it causes lung compression and

    shortness of breath.

    A woman will notice this primarily at nightwhen her body is flat.

    To relieve night time dyspnea, advise her to:

    1. Sleep upright2. Sleep with two or more pillows

    3. Limit her activities

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    Ankle Edema

    Most women experience some welling of the anklesfeet during late pregnancy, most noticeably at the endof the day.

    As long as proteinuria and hypertension are absent,ankle edema of this nature is normal occurrence of

    pregnancy. It is probably caused by reduced blood circulation in

    the lower extremities due to uterine pressure andgeneral fluid retention.

    This simple edema can be relieved best by resting in aleft side-lying position because this increases thekidneys glomerular filtration rate and allows goodvenous return.

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    Braxton Hicks Contraction

    Beginning as early as 8

    th

    to 12th

    week ofpregnancy, the uterus periodically contractsand then relaxes again.

    By middle or late pregnancy, the contractionsbecome stronger, and a woman who tenses atthe sensation may even experience someminimal pain, similar to hard menstrual

    cramp. A rhythmic pattern of even very light

    contractions can be a beginning sign of labor.

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    Vaginal Bleeding

    A woman should report vaginal bleeding, nomatter how slight, because some of theserious bleeding complications of pregnancybegin with only slight spotting.

    If she discovered it on toilet paper following abowel movement, shes probably reportingspotting from hemorrhoids

    Until the bleeding is found to be innocent,however, all women with spotting needfurther evaluation.

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    Persistent Vomiting

    Once-or-Twice daily vomiting is notuncommon during the first trimester ofpregnancy.

    Frequent vomiting is not normal

    Vomiting that continues past the 12

    th

    week of pregnancy is also extendedvomiting

    Persistent or extended vomiting

    depletes the nutritional supply availableto a fetus and is a danger to thepregnancy

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    Chills and fever may indicate an

    intrauterine infection, a serious

    complication for both a woman and a

    fetus.

    These also may be a symptoms of a

    relatively benign gastroenteritis

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    Sudden escape of clear fluid from the vagina

    When a gush of clear fluid is discharged suddenly

    from the vagina, it means the membranes haveruptured and mother and fetus are now boththreatened, because the uterine cavity is nolonger sealed against infection.

    If a fetus is small and the head does not fit snuglyinto the cervix, the umbilical cord may prolapsefollowing membrane rupture.

    If the cord is then compressed by the fetal head,

    oxygenation is compromised and a fetus will be inimmediate and grave danger.

    Occasionally, a woman confuses stressincontinence for this.

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    PHI refers to a potentially severe and even fatalelevation of blood pressure that occurs duringpregnancy

    Symptoms:

    1. Rapid weight gain (over 2 lb per week in the 2nd

    trimester, 1 lb per week in the 3rd trimester)

    2. Swelling of the face or fingers

    3. Flashes of light or dots before the eyes

    4. Dimness or blurring of vision5. Severe, continuous headache

    6. Decreased urine output

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    Increase or Decrease Fetal

    Movement

    A fetus normally moves more or less the

    same amount everyday, an unusual

    increase or decrease in movementsuggests that a fetus is responding to the

    need for oxygen.