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Nine Months : Common Concerns in Pregnancy

Backache

Causes: The hormones in pregnancy ensure that the ligaments and joints of the pelvis soften and become loose to enable the baby to pass through easily during delivery. Your increased weight and modified posture to accomodate that weight all add to the already loose joints and result in a deeply curved lower back, starined back muscles and pain.

Prevention: Backache can be avoided to some extent:

* Avoid lifting heavy loads and even if you have to, ensure that you bend your knees and not your back.

* Never bend over from a standing position.

* Try to maintain your weight within the given parameters of weight gain.

* Avoid standing for long periods of time.

* Wear comfortable shoes - no high heels or flat shoes.

* Use a smart posture for sitting with your back straight and well supported.

* Stand and walk smartly with your buttocks tucked in and bak straight.

* Avoid stooping, if you can.

* Avoid turning around by twisting your spine. Use your feet instead.

* Roll over to your side to get up from a lying position.

Treatment: Backache in pregnancy cannot be made to disappear completely. The symptoms and pain can only be alleviated:

* Back massage

* Use of hot water bottle on the affected area.

* Warm bath twice a day followed by local heat application.

* Certain stretching exercises may help.

* Application of pain relief ointments on the affected area.

* Use a firm mattress.

* Taking pregnancy safe pain killers like paracetamol.

If your back pain persists or is very severe, you must consult a doctor.

Bleeding

Causes: In early pregnancy, before 24-28 weeks, severe bleeding is commonly associated with miscarriage or ectopic pregnancy and hence, must be brought to the notice of the doctor at once.

Other non-worrying causes include normal implantation of the embryo in the womb wall which sometimes causes slight bleeding in early pregnancy.

Light bleeding in mid or late pregnancy is generally due to trauma to the highly sensitive cervix either through an internal examination or by sexual intercourse and is not serious. However, it must be reported to the doctor as soon as possible. More worrying reasons for heavy bleeding in mid or late pregnancy are placenta praevia and abruptio placentae and need immediate medical attention.

Show is another cause of bleeding in late pregnancy which is an indication that the cervix is getting ready for labour. Although nothing to worry about, it must be brought to the knowledge of the midwife or doctor because it means that either labour has started or is a few days away.

Treatment: Any kind of bleeding in pregnancy is a concern and must be communicated to the midwife or doctor without delay. In most instances, an internal examination will be done followed by a scan to ensure that the baby is doing fine. Provided everything is alright, you will be sent home and told to take it easy for a while and abstain from sexual intercourse for some time. If there is a concern regarding the placenta, you may be admitted straightaway and probably stay there till the birth of the baby. Depending on the severity, the doctor may induce labour or perform a Caesarean. In some cases, the doctor may even wait for labour to start naturally if it is close to term.

Blood transfusion may be carried out if you have lost a lot of blood.



Gums

Causes: Bleeding gums are caused by the build-up of plaque or bacteria on the teeth. During pregnancy, this build-up increases and gums become swollen, softer and bleed more easily. This can also lead to gum disease and tooth decay.

Prevention: Ensure that you brush and floss your teeth carefully twice a day and avoid snacking on snacks and sugary drinks. It is a good idea to visit the dentist but remember that you shouldn't have any X-rays taken.

Dental treatment in UK is free for women during pregnancy and upto one year after your child's birth.

Blood Clot (Thrombosis)

Cause: In pregnancy, the clotting ability of the blood is increased greatly to protect against bleeding during childbirth. This can, however, have a negative effect sometimes, in that the blood in the lower part of the body fails to return completely to the heart because of the enlarged womb in the middle. As a result, clots may form in the legs. The risk of having thrombosis is greatly increased if you smoke, are overweight, lead a sedentary lifestyle or have a family history of the condition.

When?: It is more common in late pregnancy. Symptoms: Pain in calf or thigh. Swelling and redness of the affected area. Difficulty walking because of the pain. In extreme cases, when part of the clot passes to the lungs(pulmonary embolus), you may experience chest pain while breathing in; increased heartbeat; frothy, blood-stained sputum on coughing. A blood clot on its own is painful but pulmonary embolus tends to be a very serious condition and requires immediate medical attention.

Prevention: If you are prone to blood clots: Wear support hose. Stretch your legs from time to time especially if you've been sitting for quite a while. Try not to sleep on your back.

Treatment: Once diagnosed, the treatment depends on the severity of the clot. Generally, blood thinning injections are given which are withdrawn during labour and resumed later after delivery.

Braxton Hicks Contractions

What are they? Also called 'rehearsal contractions', they are the painless (but uncomfortable) contractions that are responsible for training the pregnant uterus.

When? These contractions may start around week 20 or even earlier if this is not your first pregnancy.

How do they feel? It feels as if the uterus is tightening and then relaxing. They may last for about 30 seconds or even longer which gives you enough time to practice your breathing techniques. As pregnancy progresses, Braxton Hicks contractions may become even more frequent, intense and uncomfortable.

What to do? To relieve discomfort, try to relax or lie down. Sometimes changing your position stops the contractions completely.

Breathlessness

Causes: Breathlessness is caused by the swelling of the respiratory tract capillaries and relaxation of the lung muscles. As pregnancy progresses, the uterus grows in size and puts pressure on the diaphragm making it difficult for the lungs to expand or breathe freely. Anaemia may sometimes be the reason for breathlessness, especially in early pregnancy when the uterus is not alarmingly large.

Symptoms: Feeling short of breath on overdoing things or even otherwise.

What to do? Try to rest as much as possible Use an extra pillow at night and sleep in a semi-propped-up position Try to sit up straight Avoid overdoing things Severe shortness of breath, chest pain, blue fingertips and lips need immediate medical attention.

Risk: Although it may seem that shortness of breath may be depriving your baby of oxygen, it is not so. On the contrary,pregnancy ensures that your baby gets more oxygen by making changes to your respiratory system.

How long? Breathlessness may become a problem from second trimester onwards but seems to pick up in the last trimester when the uterus is growing and pushing up against the diaphragm. Relief comes when the baby's head engages in the pelvis (about 2-3 weeks before term in first time pregnancies).

Women who carry their pregnancy low may never suffer from breathlessness.




               

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