Pregnancy brings both psychological and physical changes to a woman. Although occurring gradually, the physiologic changes of pregnancies affect all organ systems of a woman’s body. These changes are necessary for both the woman and the growing fetus. Through these changes the fetus is provided with oxygen and nutrients and the woman’s increased metabolism during pregnancy is met.
EDEMA OF THE LOWER EXTREMITIES AND VARICOSITIES OF VULVA AND RECTUM
Impairment of blood flow to the lower extremities during the third trimester takes place. This is due to the pressure of the expanding uterus on veins and arteries. Decreased blood flow in the venous system can lead to edema and varicosities of the vulva, rectum and legs.
Important reminder: Edema of the lower extremity is not a sign of toxemia. It is a normal physiologic change during pregnancy. However, edema of the upper extremity needs further evaluation.
- Elevate legs above hip level for edema of lower extremities.
- To promote venous flow, the pregnant woman should wear or use support hose or elastic stockings. This also prevents stasis in the lower extremities.
- Elastic bandage application. The principle involved in bandaging is the fact that blood flow in the tissues of the lower extremities is decreased by applying excessive pressure on blood vessels. To do this, start at the distal end of the extremity and work towards the trunk to avoid congestion and impaired circulation of the distal part. To determine the adequacy of circulation, the toes should not be wrapped.
- Use of constricting garters should be avoided.
- A modified knee-chest position is advisable for varicosities of the vulva and rectum.
About 50% of pregnant women experiences nausea and vomiting during the early stage of pregnancy. Sometimes this sensation is even noticed even before the first missed menstrual period. As one of the first sensation apparent in pregnancy, a woman may suspect she is pregnant by noticing the occurrence of it. Known as the morning sickness, it is most apparent early in the morning, on rising, or if the woman becomes fatigued during the day.
Nausea and vomiting begin to be noticed at the same time the levels of HCG and progesterone are elevated in the pregnant woman’s body. It results from the following conditions:
- Systemic reaction to increased estrogen levels
- A drop in the glucose level – since large quantities of glucose are being used by the growing fetus.
- High progesterone level
- Lack of pyridoxine or Vitamin B6
- Diminished gastric motility
- Sensitivity to high levels of HCG produced by trophoblast cells
PREVENTION OF NAUSEA AND VOMITING
To prevent nausea and vomiting in pregnancy the following ways are effective:
M – Make missed-up meals at some other time of the day to maintain nutrition.
O – Offering a snack before bedtime is advisable so that delaying breakfast will not cause the woman to go a long time between meals.
R – Recommend to the woman that keeping dry crackers, toast or sourball at bedside and eating a few before getting out of bed in the morning would be helpful in preventing nausea as it increases the woman’s carbohydrate intake.
N – Notify the woman that nausea usually disappears spontaneously as a woman enters her fourth month of pregnancy. Or if it persists during the second trimester of pregnancy, it may indicate the development of pregnancy complication known as the hyperemesis gravidarum and should be reported to the physician immediately.
I – Increasing carbohydrate intake relieves nausea better than any other nutrition remedy. The woman should eat small but frequent meals rather than large infrequent ones.
N – Note sudden movements and fatigue. These events should be avoided because these may cause or increase the occurrence of nausea.
G – Greasy and highly seasoned foods should be avoided. The pregnant woman’s diet should be low in fat and spices.