Minor Pregnancy Complications

Nausea and vomiting in pregnancy

Nausea with or without vomiting is a common issue in pregnancy with most women experiencing at least some nausea and/or aversion to certain foods/smells. For most women, nausea gets better after 12 weeks and resolves by 20 weeks.

• Lifestyle and home remedies may be helpful in relieving morning sickness in some women.
• Salty food or food containing ginger may be helpful at times. Snack at regular intervals throughout the day instead of having large meals.
• Eating plain sweet biscuits or dry crackers after waking up in the morning and before getting out of bed may help reduce the nauseous feeling.
• Avoid food that triggers nausea or makes it worse, like greasy and spicy food. Eat carbohydrate-rich, easily digestible foods.
• Consume plenty of fluids. Small amounts of fluids more frequently are usually better tolerated.
• Sucking on ice cubes or hard candy may be beneficial.
• Take walks and try and get plenty of fresh air.
• Cease pregnancy multivitamins and take only iodine and folic acid

Over the counter medicines:

• Pyridoxine (Vitamin B6) at 50mg twice a day is safe and helpful for some women.
• Restavit (Doxylamine) is an antihistamine that is on the market in Australia as a sleeping tablet. It is very safe and is usually taken as one or two tablets a day. The drowsiness caused by it can be a problem so it is best taken at night.

Other Medicines:

• Metoclopramide (Maxolon)
• Ondansetron
• Rarely used: Prednisone, some antidepressants

Other Treatments:

Acupuncture and hypnosis are both safe and helpful for some women.

Hyperemesis Gravidarum

It is a condition of excessive vomiting during pregnancy. If you are concerned, very thirsty or unable to keep fluids down, you have to seek medical attention. We sometimes have to admit women for treatment with intravenous fluids.

Heartburn

Is common in pregnancy due to slower stomach emptying caused by pregnancy hormones, pressure of the pregnant uterus on the stomach and relaxation of the valve around the gullet. Avoiding spicy or fatty foods may help and anti-acids such as Gaviscon, works well. If it is a persistent issue, speak to your doctor as there are very effective and safe prescription-only medications available.

Back pain

Back pain is a common complaint during pregnancy. Most women experience back pain at some point during pregnancy, usually in the later months. Back pain is related to a change in posture and hormones that cause ligament laxity

Caring for your back  During Pregnancy

• Maintain a reasonable amount of activity and include exercises to strengthen your back and abdomen as recommended by your physician or physiotherapist.
• If prolonged sitting is required, take frequent breaks to stretch your legs and back.
• Practice good posture to reduce the strain in the lower back. Choose a chair with good back support or use a small pillow for support and change the position frequently.
• To pick up things you should squat down using your knees and keep the back straight. Avoid positions that require twisting and bending movements and also any activities that cause pain.
• Wear  ‘sensible shoes' with low heels and good arch support.
• A support belt under your lower abdomen may help later in your pregnancy.
• Get a sufficient amount of sleep. Practice relaxation techniques to keep your stress level down. Sleep on your sides with your knees bent. If needed, place a pillow around the abdomen for extra support and between the knees to keep the spine aligned.

Managing Back Pain During Pregnancy

Simple remedies like Paracetamol, a warm bath, hot packs or ice packs may be helpful. Physiotherapists are skilled and experienced in treating back pain during pregnancy. Treatments they use include massage therapy, special exercises, posture instruction, stretches and other pain-relieving techniques. 

Constipation

Is common in pregnancy due to the high levels of progesterone (that slows the bowel), dehydration (due to vomiting) and pressure from the pregnant uterus on the bowel.  Increasing fluid and fibre intake may be enough. If not, stool softeners such as Movicol, Coloxyl without senna (senna is an irritant and best avoided) or glycerine suppositories should help. 

Constipation may also lead to or worsen haemorrhoids (dilated and inflamed blood vessels protruding from the anus).  It can be very painful and  also cause rectal bleeding. There are over the counter and prescription medications available to help relieve symptoms.

Skin pigmentation

Increased pigmentation around the nipples,  belly button and in a line below the belly button, is very common in pregnancy. Some women may also get increased pigmentation of the face.  There is no treatment available during pregnancy but sunscreen and a hat may help.

Gingivitis

Also called periodontal disease or gum disease, is a bacterial infection that destroys the soft tissues and bones that support the teeth. Pregnancy causes hormonal changes that can increase the risk of dental problems, which in turn can affect the health of your developing baby.

It is essential to maintain good oral hygiene throughout your pregnancy. Periodontal diseases can be prevented by following good oral hygiene such as daily brushing and flossing, using anti-gum disease mouth washes, and visiting your dentist if you notice  problems with your gums or teeth

PUPPPS (Pruritic Urticarial Papules and Plaques of Pregnancy)

Is an itchy rash in the later stages of pregnancy. It usually starts around the belly button or in the stretch marks on the abdomen and can spread to the thighs, buttocks and upper arms. It usually resolves very soon after delivery.  Treatments include moisturizer, corticosteroid creams and antihistamines.