Tuesday, 9 June 2015

Common Problems You May Encounter 16 - 20 Weeks

Q   I am now 16 weeks pregnant and have low back pain. Is this common and what can I do to prevent this? 

Although backache is more common in the last trimester, it may occur at any time in the pregnancy. The physiological changes in pregnancy result in a relaxation of the ligaments and muscles that support the joints. The increasing weight of the pregnancy means that there is extra strain on these ligaments. Avoid using high heels, and always keep an upright posture. Your centre of gravity when standing should be slightly behind. This way your back muscles will not need to work so hard to hold up the extra weight in front.

Q  I am 16 weeks pregnant and feel persistently breathless. Why is this so?

Breathlessness is common and by 16 weeks 25% of women will feel so. This is due to the effect of the pregnancy hormone progesterone on the breathing muscles. You should of course have yourself checked for lung or heart problems such as asthma, bronchitis, valve prolapse of the heart etc all of which may cause you to be breathless.

Q  I have been having frequent headaches. Is this normal and what can I take?

Headaches in pregnancy are common. It is often due to the increased circulation in the brain. Tension headaches and migraine are also more common. Should the headache be mild, simple painkillers may suffice. However should the headaches be persistent or severe, then brain blood vessel malformations and hypertension needs to be ruled out by your doctor.

Q  I was standing at the bus stop when I suddenly felt feint. Is this normal and what can I do to prevent this?

Feeling giddy and feint is very common and is due to the haemodynamic changes of the body during the early stages of pregnancy. There is a fall in the normal blood pressure of pregnant women which only returns to its normal level at about 28 weeks. Avoid standing in a queue for too long, getting up too fast from a sitting or sleeping position. Should you encounter this problem, raise your arms above your head and the blood from the arms will go to your head. When you feel better sit down and slowly put your head between your legs. You will feel less of this problem when you are in your third trimester.

Q  I am 16 weeks pregnant and have noticed that my ankles are swelling. Is it normal to swell so early in pregnancy?

In the early pregnancy swelling is due to the increased hormone oestrogen. This causes the blood vessels to be more permeable and water seeps out through them to surrounding tissues especially the ankles due to gravity. It affects about 1:3 pregnancies. It is considered as normal. However watch your salt intake as this may also cause more water retention and eventually high blood pressure. Swollen ankles early in pregnancy may also indicate impending pre-eclampsia, a condition that occurs in first pregnancies. have your blood pressure monitored regularly that it is not increasing. Avoid standing for long periods and raise your legs at night when sleeping.

Q  I have been having frequent leg cramps. How can I avoid these?

Leg cramps may be due to several factors. It may be due to a deficiency of certain minerals such as calcium, magnesium, or sodium. The more common reason is due to pooling of blood in the legs as a result of too much standing during the day and poor circulation. Your doctor may want to do your blood mineral levels and replace them with supplements. To reduce poor circulation, you may want to have your husband massage your calfs before sleeping and also sleep with your legs raised on two pillows.

Q  I have been having frequent palpitations. Is this normal and what needs to be done?

A fast heartbeat that lasts one or two hours is considered normal in pregnancy. It is related to the changes in the circulation of blood. However if it persists and lasts longer and more frequent than that, you should check with your doctor to exclude any problem with the heart. Irregular and fast heartbeats require urgent assessment by your doctor and perhaps a referral to a cardiologist to exclude certain conduction defects of the heart.

Q  I am always leaking urine when I cough, sneeze or run after a bus. Is this normal?

About 60% of pregnant women will develop stress incontinence, a condition in which the normal structures of the bladder outlet which prevents leakage are altered due to the hormonal changes taking place. You should be rest assured that it is normal and will improve after delivery. However, if your delivery is difficult or assisted with either a forceps or vacuum, there is a chance that these tissues will be weakened and the stress incontinence may persist after pregnancy. Kegel excercises during the pregnancy and after may help. This problem does not usually arise in those having caesarean section delivery.

Q  Why can't I get a good sleep at night?

It is common in pregnancy to have poor and broken sleep. You do not need to worry that it will affect your baby if you have insufficient sleep. However do try to rest more during the day if the sleep at night is broken. You may have a problem with having to get up due to more frequent urination, cramps, backache, an uncomfortable large uterus, or due to anxiety. Dreams seem to be more common in pregnancy perhaps due to the hormonal changes. It is not advisable to take sleeping tablets. Instead try taking a leisurely walk in the evening followed by a hot cup of milo or any beverage. Avoid all caffeine after 3 o'clock, spicy food for dinner, television, and bright lights in your bedroom.

Q  I have a pain in the outer portion of my thigh when I walk but gets better when lying down. Is this normal?

During pregnancy the swollen ligaments of the groin may press on a nerve called the lateral cutaneous nerve which supplies the outer portion of the thigh and skin. There will be pain and numbness. Rest assured that this is temporary and will disappear after delivery.

Q  I have numbness and pain in my fingers when I wake up in the morning. What is this due to and how can I relieve this?

The numbness and pain is due swelling and compression of the nerve known as the median nerve which runs under the ligament of the wrist. There may be tingling , numbness or pain in one or both hands. It is known as carpal tunnel syndrome. This is usually a temporary problem in pregnancy and will resolve after delivery. It may be mild in which case no treatment is required. If it is distressing medication to reduce water retention may be prescribed. Surgery is not usually required for this condition in pregnancy.

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