Health Problems During Pregnancy

Various health problems can occur during pregnancy, ranging from minor discomfort and inconvenience through to potentially life threatening issues. Following is a brief overview of the more common conditions as well as some of the less common but more serious illnesses.

Morning Sickness
Morning sickness affects more than 70% of women during pregnancy. Often it is one of the first indicators that you are pregnant. It can be experienced at any time of the day, or all through the day. In its milder form it can sometimes be allayed by eating one or two dry, plain biscuits. Ginger has also been found to be helpful, whether as tea, in dried crystallised form as a snack, or fresh grated into your main meals. Ensure you are drinking plenty of water, juices or other liquid. Usually the symptoms begin to ease naturally from around the 12th week of pregnancy.

Talk to your doctor: Medications are available to alleviate the symptoms – Talk to your doc if you feel you need these. If you become more seriously affected by morning sickness, eg with severe nausea and substantial vomiting, it is important that you let your doctor know. In some instances dehydration can result, requiring a stay in hospital.

Problems with eating during pregnancy
As well as the nausea of morning sickness, other factors contribute to disruption of your normal eating patterns during pregnancy. These can include sudden, unexpected craving for specific, and sometimes unusual, food items and equally sudden and intense dislike of other foods. Your sense of smell can be far more sensitive and acute than usual, which can make it difficult to eat certain foods that you once enjoyed. As well as your own hormonal changes, your baby’s growth and development can impact on your organs and metabolism. Heartburn and indigestion can sometimes be a problem, and your entire digestive tract may slow down. If your normal ‘3 main meals’ now seem too difficult to consume, you may try eating a variety of mini-meals instead, set throughout the day. Fresh fruit is often helpful.

Talk to your doctor: Weight concerns, with anxiety about gaining too much or too little weight, can distort an otherwise healthy eating pattern. Any specific weight questions you have during pregnancy may be discussed with your doctor, who can advise about adjustments to your diet. If you have swelling in parts of your body such as your feet, hands or ankles, this may indicate a fluid retention problem which should be referred to your doc.

Cramping, Aches and Pains During Pregnancy
Mild cramping can occur at various times throughout your pregnancy, right from the beginning. These may be accompanied by slight bleeding or spotting. If you have sharper, more serious cramping or heavier bleeding, you need to refer to your doctor. Your breasts will also be changing and at times they may feel slightly painful. This is normal. Backache, similarly, is felt by pregnant women at different stages of their pregnancy. Massage, warm baths and hot water bottles can all be helpful. Aching legs and feet are more common in the later months as your pregnancy progresses. Regular light exercise such as walking may help. If you have been working long hours, now is a good time to introduce change. Avoid either standing or sitting for long in one position. If your legs continue to ache even when they get sufficient rest, and particularly if this is a problem when you are trying to sleep at night, you may want to discuss it with your doctor.

Talk to your doctor: If you experience serious or prolonged lower abdominal pain or cramping, pelvic pain or any significant flow of blood, you need to inform your doctor as soon as possible.

Fatigue During Pregnancy
The level of fatigue you may experience can vary considerably from one pregnancy to another. Your health, lifestyle, work, diet and family situation can all be contributing factors, as can the size and weight of the baby. Usually however, somewhere in the course of your pregnancy you will become aware of the need for increased rest and a decreased workload. If you prepare for this in advance it need not be a problem. Lighten your workload where you can, allow your family to help where they can, and schedule quality rest time for yourself. Keep cool in summer, and try and eat for quality nutrition with ample fresh fruit, salads and green vegetables. If something in your environment is impeding a good night’s sleep on a regular basis (eg heat, noise, stress, an uncomfortable bed), take steps to resolve this as you will need the rest.

Talk to your doctor: If fatigue starts to become a serious problem during pregnancy or if it is accompanied by faintness or dizziness, discuss this with your doctor. You may need blood tests to be taken, eg for pregnancy related anemia.

Mood Swings and Emotional Sensitivity During Pregnancy
Acute emotional sensitivity is another experience that can vary from one pregnancy to another. It is a normal aspect of the hormonal changes that are taking place in the woman’s body and is often felt most keenly during the first Trimester. You may be more impressionable than usual. This time of heightened sensitivity need not cause a significant problem, particularly when you are prepared for it. As much as possible, avoid stressful situations. If possible, keep one place in your home as your own personal sanctuary during pregnancy, somewhere you can retreat to and not be harrassed by anyone else. Also, having a trusted friend to call on, someone who has been through similar experiences, can be very helpful.

Talk to your doctor: Sometimes depression can become a problem during pregnancy. Other times, your own moods may trigger aggressive behaviour in others. If either of these happen to you, it is strongly recommended that you talk to your doctor.

Frequent Urination
Frequency of urination is normal during pregnancy and it increases as your baby develops. Caffeine aggravates this, so it is helpful to avoid coffee, tea, colas and other caffeinated drinks. If it is a problem at night when you’re trying to sleep, drink more fluids earlier in the day and less in the evenings. If leakage also becomes a nuisance, sanitary pads or panty liners can be helpful. There are exercises that you can do that some women find helpful (Kegel exercises).

Talk to your doctor: If urination becomes painful or burning, if there is blood in your urine, or if you have a high temperature, talk to your doc. These can be signs of urinary tract infection, which is fairly common during pregnancy. Left untreated it can lead to more serious infection and preterm labour.

Headaches
Headaches are also fairly common during pregnancy, particularly during the first trimester and then during the final weeks. Caffeine withdrawal can cause headaches if you suddenly stop drinking coffee but these are temporary and should soon fade. Dehydration can be a cause, so ensure you are drinking plenty of water or juices. Other contributing factors include heat and humidity (keep cool in summer), fatigue and lack of sleep, a clogged digestive system (salads and fresh raw fruit can help), and stress. Take time out for rest and relaxation, including light exercise. Neck-and-shoulder massage can be remarkably helpful. If you feel you need to take painkillers speak to your doctor about this first.

Talk to your doctor: If you have a migraine for the first time or if you have a headache that is more severe than usual, talk to your doctor. If you get a very sudden and severe headache, if it wakes you from sleep, if you have a temperature and neckache with it or if it just keeps getting worse, call your doctor urgently.

Preclampsia & High Blood Pressure
In the 2nd or 3rd trimester, headaches can be a sign of pre-eclampsia, a serious condition that includes high blood pressure. Contact your doctor immediately if your headache:

Recurs frequently or just does not go away
Is sudden and very severe
Is accompanied by blurred vision, dizziness, sudden weight gain, pain in the abdomen, and swelling in the face or hands
Is accompanied by nausea and vomiting
If you have had problems with high blood pressure, call your doctor even if you have a fairly mild headache.
Listeria; Listeriosis
This from NSW Health:

Listeria is an illness usually caused by eating foods contaminated with the bacteria known as Listeria monocytogenes. Listeriosis is a serious disease in pregnant women and people with weakened immune systems. Infection is treated with antibiotics.

Infections may cause septicaemia (blood poisoning), meningitis (inflammation of the brain) and miscarriage in pregnant women. Symptoms include: fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea and diarrhoea. In the more severe form, symptoms also include collapse and shock. If infection spreads to the central nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, convulsions and coma can occur. About a third of these patients may die. Infection during pregnancy can lead to miscarriage, stillbirth and infection of the newborn.

To prevent listeriosis:

thoroughly cook raw food from animal sources, such as beef, lamb, pork, or poultry
wash raw vegetables and fruit thoroughly before eating
keep raw meat separate from vegetables, cooked foods, and ready- to-eat foods (that is, do not allow the blood from raw meat to come into contact with other food)
use separate cutting boards for raw meat and foods that are ready to eat (for example, cooked foods and salads)
avoid unpasteurised milk or foods made from unpasteurised milk (for example, soft cheeses)
wash your hands before and after preparing food
wash knives and cutting boards after handling uncooked foods
wash your hands after handling animals
perishable foods should be stored in a cold (less than 5 degrees Celsius) refrigerator and be washed and eaten as soon as possible.
More information at: www.health.nsw.gov.au/factsheets/infectious/

Toxoplasmosis
Toxoplasmosis is a disease caused by a parasite that lives in cats, and is transmitted through their faeces. In most people of normal health the effects are mild, or there may be no symptoms. However in pregnant women the parasite can infect the placenta and cause serious harm to your baby. Effects include miscarriage, stillbirth, and neurological and other damage to your baby. About 85% of pregnant women have no immunity to the disease, though only a few become infected with it. About half of all toxoplasmosis infections are caused by eating raw or undercooked infected meat, but you can also get the parasite by eating other contaminated produce, drinking contaminated water, or handling contaminated soil or kitty litter.

If you have a cat, safety precautions include:

Have someone else change the kitty litter tray, and ensure it is changed daily. (It becomes infectious after 24 hours.) If you have to do it yourself, wear gloves and wash your hands very well afterwards. Avoid breathing it in.
Keep your food areas very clean and keep the cat well away from these.
Cook your meat thoroughly. If the only meat that you eat during pregnancy has been very well cooked, this reduces the chance of infection considerably. Wash or peel all fruit and vegetables.

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