Common symptoms to expect

Pregnancy is a happy occasion. Many women truly enjoy the experience.

However, a number of unwelcome symptoms can appear, and some can prove rather taxing for mum’s to be. While annoying, none are dangerous for the baby.

• Morning sickness

  Nausea and vomiting are very common in early pregnancy. They tend to subside by around 14 weeks gestation.

  For some unlucky ones, vomiting can persist throughout the entire pregnancy. If this is you, be reassured you can look forward to the nausea finally settling down within hours of birthing your baby.

  Try eating smaller meals more frequently and avoid foods that make the nausea worse, such as spicy or greasy foods. Do try to keep up your fluids.

  It is also sensible to start taking a pregnancy multivitamin as you may not be able to eat a balanced diet.

  Taking vitamin B6 (pyridoxine) may help some women relieve their nausea.

  If you are still feeling rather queasy there are safe anti-nausea medications you can take, such as maxalon or ondansetron (Zofran). These need to be prescribed by a doctor.

  For some women, the vomiting is really serious. If untreated, it can cause significant dehydration. If you are not able to keep any food or fluids down for a long time and feeling really unwell please contact the Mercy Hospital emergency department (or Stephen) to be assessed.

• Reflux (or heartburn)

  Those affected by reflux typically feel an unwelcome lurch of stomach acid mixed with your last meal shoot up your oesophagus. Besides leaving a rather nasty putrid taste in the mouth (the meal is invariably nicer the first time), it can give you a horrid burning sensation in the chest.

  To deal with this annoying problem, first try eating small frequent meals and avoid rich or spicy meals.

  Antacids such as mylanta and gaviscon are safe and can help ease reflux. They work by neutralising the stomach acid, decreasing their effects. You also might have to resort to sleeping a little more upright (if you can).

  If you are still getting significant reflux then drugs such as ranitidine (Zantac) or esomeprazole (Nexium) are often highly effective. These drugs work by actively suppressing the secretion of stomach acids. If they work for you, you should take them regularly until the end of the pregnancy.

  Reflux happens during pregnancy because the hormones of pregnancy cause the ring of muscle around the esophagus to relax. In addition, the growing womb pushes upwards against the stomach, making matters worse.

• Weight gain

  The amount of weight gain in pregnancy that is recommended differs according to your starting weight, or body mass index (BMI) at the beginning of pregnancy. Women who are of average weight should expect to put on around 11-16 kg over the course of pregnancy.

  If you are overweight at the start of the pregnancy you then you should aim to put on less weight on than this. Stephen will discuss targets with you.

• Swelling of the ankles

  Fluid retention is particularly common in pregnancy and because of gravity, it tends to build up around the ankles (called ’oedema’). It is worse towards the end of pregnancy, and is worse during summer.

  As long as your blood pressure is normal (Stephen will measure this at every visit) you can be reassured that ankle swelling is not dangerous.

  If it is really bothersome you could try wearing compression stockings (TED stockings) as they may help. They may be purchased from the chemist.

• Thrush

  Thrush is common and can be treated with canesten cream. It is safe to gently apply canesten cream into the vagina.

   

• Constipation

  To deal with constipation, firstly try increasing the amount of fibre in your diet by eating more vegetables, fruits, whole grains, nuts, or seeds. You should also increase your fluid intake.

  Next you could take medications that help relieve constipation. These are all safe in pregnancy.

  Start by taking regular Metamucil or fibrogel which are simply stool softeners.

  Next, you could try lactulose (Actilax). You could also try movicol sachets (which apparently comes in a refreshing chocolate flavour, although Stephen is unsure how authentically chocolatey they really taste).

  Make sure you also keep up some exercise as this can also help.

  If the constipation is not responding well to any of this, Stephen can have a chat about what to do next.

• Haemorrhoids

  If you suffer from haemorrhoids, just note they can get worse over the course of your pregnancy. After birth, they often improve afterwards.

  To manage haemorrhoids, you should avoid constipation by trying the measures suggested above.

  If they are painful you can use topical treatments such as rectinol ointment.

• Ligament, back and pelvic pain.

  It is extremely common to get pain anywhere in the pelvis and the lower back. It is explained by the fact that as the pregnancy continues, your poor pelvis has to lift many extra kilograms of baby, womb, placenta and amniotic fluid.

  It can also manifest as shooting pains within the vagina, or a persistent pain on the pubic bone in the middle of the pelvis (right at the front).

  Occasionally, some report a sensation of immense pressure in the vagina, and this can make women worry that the baby could fall out. But be reassured that by late pregnancy, the baby will not tumble out in the absence of significant labour/contraction pains.

  If you do get significant ligament or pelvic girdle pain, the first thing is to try to keep active. Remaining immobile will only make things worse.

  On days where it is particularly bad, a heat pack or even a few doses of panadol might help.

  If the symptoms are significant, Prof Tong highly recommends you pay a visit to a physiotherapist. They can help by teaching you exercises to strengthen your abdominal muscles, pelvic muscles and back.

  Often a hip brace can help and the physiotherapist can fit you with this.

• Carpel tunnel Syndrome

  Carpel tunnel syndrome happens when the median nerve in the hand is compressed by fluid retention of pregnancy. It can cause numbness, pins and needles or tingling of the thumb and the adjacent three fingers.

  If you are suffering from carpel tunnel syndrome you should avoid repetitive movements as much as possible, or sustained positioning of your hands. Squeezing items with the affected fingers can make it worse. Try carrying things using your forearms instead of your wrists, or hands.

  You could also try sleeping with the affected hands slightly raised on pillows relative to the rest of your body. The hope is that by doing this, gravity will drain the fluid out of the hands downwards into your body, providing relief.

  If it is severe you could try hand splints that can be purchased from chemists – they can provide very significant and welcome symptomatic relief.

• Urine symptoms

  Unfortunately, the bladder sits right in front of the growing uterus and women can experience a few symptoms.

  Some women get urinary frequency where have the sensation that they need to go to the toilet often. And when they do, they find not much urine comes out. This can be highly irritating during the night time. This happens because the pressure of the uterus onto the bladder gives the false sensation that it needs emptying.

  If you are getting other symptoms of a urine infection – such as painful urination, or smelly/cloudy urine – then let Prof Tong know. He will arrange a urine test.

  Some women can get a leaking with sneezing and coughing, a condition called stress incontinence. If this happens, Stephen highly recommends pelvic floor exercises. If you are unsure how to do them, a visit to a physiotherapist is an excellent way to learn how.

• Leaking breast milk while still pregnant

  If this happens, don’t be alarmed - it is perfectly normal. Also, you can sometimes get lumps in your arm pits as your breasts prepare for breastfeeding.

  Of course, continue to be vigilant for abnormal single breast lumps even while pregnant. These are not expected.

• Itchy abdomen and stretch marks

  Both are also normal. If you get a severe itch all over your body (and especially one that is worse on the palms and the soles of your feet) without a rash then let Stephen know. He will need to rule out a condition called cholestasis of pregnancy.

  Applying creams just might help decrease the risk of stretch marks although the evidence is perhaps rather thin. If you decide to try this, it is Stephen’s hunch that the creams will be more effective if lovingly rubbed into the skin daily by a doting partner.