Common complaints during pregnancy
ParentsCentre's expert Dr Stuart Flanagan continues his series of articles by highlighting how to deal with various health issues you may experience during pregnancy. Dr Flanagan is an experienced physician who also works as a contributor and medical adviser for a number of BBC projects - you can download his biography at the bottom of this page. He will be writing monthly articles for the site, including bedwetting, Sudden Infant Death Syndrome, discussing contraception with teenagers, acne in adolescence and common diseases in childhood.
Common complaints during pregnancy
This month I'm looking at some of the most common complaints during
pregnancy. These will be familiar to almost every mum and can be easily dealt
with by your pharmacist or family doctor. However, some mums do develop more
complicated problems, which may require admission to hospital or close
follow-up at the antenatal clinic.
Morning sickness
Feeling nauseous and sick in the early stages of pregnancy is extremely
common, affecting about 80 per cent of women. Morning sickness usually occurs
during the first three months of pregnancy, although for a few women it may
persist for longer.
Although it is usually referred to as morning sickness, the symptoms can also
last throughout the day. Symptoms can vary in severity - most sufferers will
feel nauseous but may not be sick, whereas some women may find they are unable
to keep any foods down. This form of morning sickness occurs rarely and is
called Hyperemesis Gravidarum. It will require hospital admission to settle the
symptoms.
Morning sickness is caused by the hormones of pregnancy which are helping in the development of the baby and placenta. Although the symptoms are unpleasant, the sickness won't harm the developing foetus. There are a few tried and tested tips which have should alleviate morning sickness:
- eat small frequent meals - an empty stomach will make you feel nauseous.
- dry carbohydrate snacks and nibbles will help throughout the day - dry crackers, toast and plain biscuits.
- don't jump out of bed too quickly - take your time.
- keep well rested throughout the day when you can.
- keep well hydrated with water or juices - avoid alcohol and caffeine as they will dry you out.
- If your symptoms persist and you continue to feel unwell, see your doctor.
Constipation
Although it's something not many women like to discuss, constipation is
actually one of the most common complaints in pregnancy, affecting around half
of pregnant women. The growing uterus puts pressure on the lower bowel (or
rectum) and the hormones of pregnancy reduce the transit time of food in the
gut.
The result of this is that your food takes longer to travel to your rectum, so
when it does arrive, the stool is hard and difficult to pass. As a consequence
you may find bowel motions more infrequent, and may suffer from lower abdominal
pains.
Although it's something not many women like to discuss, constipation is actually one of the most common complaints in pregnancy, affecting around half of pregnant women.
To prevent constipation, try to include plenty of high fibre foods in your
diet. These include fresh fruit and vegetables, cereals and wholegrain
bread. If you are suffering from constipation, prunes can be a very effective
laxative. Drink plenty of water, which will help to keep the stools soft.
Regular exercise will help to stimulate the bowel and aid
digestion.
Some over-the-counter agents are safe to use in pregnancy - Fybogel will help
to bulk the stools, and Senna is a well-tolerated stimulant laxative. If you
still have problems, see your GP, who will be able to advise regarding
prescribed laxatives.
General aches and pains
Like everyone else, pregnant mums can suffer from headaches and other aches
and pains. However, before you reach for your usual painkillers, you should be
aware that not all analgesics can be used in pregnancy.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen are not safe
to use in pregnancy. They may cause miscarriage in the early stages, or induce
early labour in the later pregnancy, and may interfere with kidney function.
Aspirin is not recommended for pain relief as it can increase the risk of
bleeding.
Codeine-based analgesia can cause breathing problems for baby in later stages
of pregnancy and should only be taken in the early stages under a doctor's
supervision. However, Paracetamol is safe for short-term use throughout
pregnancy. Always consult your pharmacist regarding painkillers if you think
you may be pregnant. Don't forget that a warm bath or gentle upright
massage can be soothing for a sore back or aching muscles.
Colds and coughs
If you come down with a cold during your pregnancy, be sure to consult your pharmacist before taking any over-the-counter preparations. Many will contain antihistamines or Codeine, which are not advised in pregnancy. Try some simple therapies such as gently inhaling a salt water steam preparation to reduce congestion, or simple linctus for persistent coughs. Paracetamol will help to relieve headaches.
Skin changes/rashes
Pregnant mums can also be affected by the rashes which affect any patient, such as eczema and psoriasis.
Many women will experience changes in their skin during pregnancy - most of these changes are termed 'physiological', which means they are entirely normal and indeed associated with being pregnant. These include:
- hyperpigmentation - or darkening - of the nipples and genital area.
- Linea Nigra - a dark, sometimes hairy, line which runs from the belly button to the pubic area.
- Striae Gravidarum -stretch marks around the abdomen as it expands. These usually start off pink and become white or shiny after delivery.
- varicose veins on the legs.
Pregnant mums can also be affected by the rashes which affect any patient,
such as eczema and psoriasis. Moisturiser creams such as Calamine lotion are
safe to use to sooth the skin. Your doctor will advise regarding steroid
creams.
There are a few distinct rashes which occur only in pregnancy and are termed
specific dermatoses of pregnancy. These include:
PUPPP (Pruritic Urticarial Papules and Plaques of
Pregnancy)
This is the most common skin condition in pregnancy and essentially the name
refers to red, raised itchy bumps which appear on the abdomen and thighs. It
usually occurs late in pregnancy, but causes no harm to mother or baby. Topical
steroid cream will help to reduce the inflammation and itch.
Prurigo Gestationis
This rash appears as red itchy dots mostly spread across the arms, legs and trunk. The rash can appear in mid- or late pregnancy. Simple antihistamine therapy will relieve the itch and the rash will disappear within a few weeks after delivery.
Mum can also suffer from itching without a rash - this is called pruritis and can occur as a result of mild jaundice. Mum may notice some yellow discolouration of the eyes and skin. This is due to intrahepatic cholestasis - the liver does not process bile quite so efficiently in pregnancy and so the breakdown products can build up in the skin, causing jaundice and itch.
If you have any unusual rashes or skin changes it is always best to seek medical attention.
Dr Stuart
Flanagan's biography
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