Question

What are the complications and discomforts of pregnancy, (at least 5) and their causes and also the management for each complication.

Answer 1

Common complications of pregnancy -

1.GESTATIONAL HYPERTENSION
• Refers to hypertension during pregnancy. Diagnostic criteria - systolic blood pressure greater than or equal to 140mmhg and diastolic blood pressure greater than or equal to 90 mmHg.
• usually develops during second half of pregnancy.
• causes - pre existing hypertension , previous history of hypertension during pregnancy , kidney disease , multiple fetus pregnancy or in females above 40 yrs
• management - focuses on prolonging the pregnancy safely.
A) regular monitoring of blood pressure.
B)Drugs - antihypertensives like methyldopa and nifedipine.
C) ACE inhibitors are avoided since they are fetotoxic.

2.GESTATIONAL DIABETES
✓it is a form of diabetes seen in a pregnant women, who was non diabetic before conceiving.
✓ causes - hormonal changes during pregnancy causes the body to develop insulin resistance. Since insulin is not there, blood sugar increases leading to diabetes.
✓ management -
•regular monitoring of blood sugar.
• goal is to maintain a fasting blood glucose level of less than 95 mg/dl.
• dietary restrictions - limit carbohydrates to 30 to 40% of total calories.
• insulin therapy in case blood glucose rises more than 105 mg per dl.

3.HYPEREMESIS GRAVIDARUM
✓persistent nausea and vomiting during pregnancy.
✓it usually occurs during first trimester of pregnancy.
✓causes - rising levels of hormones such as hcg and estrogen during pregnancy are known to be the causes.
✓ risk is higher in first time mothers, obese females and in pregnancies with multiple fetus.
✓ management -
•diet modification - smaller amounts of food at multiple times during day.
•asking the female to avoid stress.
•in severe cases - rehydration therapy is provided.
•antiemetics are used after 12-14 weeks of gestation.

4.IRON DEFICIENCY ANEMIA
✓ occurs when hemoglobin is lower than 10.5 g/dl.
✓ occurs when the increased demand for iron is not met.
✓ causes - improper diet , nutritional deficiency, parasitic infestations, uterine bleeding ,etc.
✓ management -
• prenatal vitamins containing iron are recommended before conceiving.
• management depends on the cause of anemia.
• if dietary deficiency - supplemental iron is used.

5.URINARY TRACT INFECTIONS
✓infections in urinary tract are common in pregnancy.
✓ causes - growing fetus puts pressure on the bladder and ureters. This leads to changes in bladder and ureterodilation. These physical changes make urine more still , which increases chances of bacterial growth.
✓ hormonal changes also contribute to this.
✓ management -
•early recognition of bacteriuria is recommended. It prevents complications.
•female is advised to pee more frequently and to wear a cotton underwear.
•wide spectrum antibiotics are used.