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STRENGTH : 4
DURATION: 1 hr.
GENERAL OBJECTIVES : At the end of the class the group will be able to acquire some knowledge regarding the minor
disorders of pregnancy & its management.
Sl Time Specific objectives Content Teaching learning activity Evaluation
no.
1. 3min. Introduce the INTRODUCTION: Student teacher will able to explain
topic. the introduction by lecture method.
Many women experience some minor
disorders during pregnancy. These
disorders should be treated adequately as
they may cause life threatening conditions
in progress of pregnancy.
Minor disorders may occur due to
hormonal changes, accommodation
changes, metabolic changes& postural
changes. Every system of the body is
affected by pregnancy. The mother needs
knowledge to cope with the experience of
pregnancy.
2. 15min. List out the minor MINOR DISORDERS ACCORDING TO Student teacher will able to explain What are the
ailments of DIFFERENT SYSTEMS the minor ailments by lecture method minor ailments
pregnancy? DIGESTIVE SYSTEM through showing chart. during pregnancy?
1. Nausea & vomiting:
It is a common disorder seen in about
50%women between 4th & 16th week
of gestation. Hormonal influences are
thought to be the most likely cause.
Human chorionic gonadotropin that is
present in large amounts in the 1st
trimester, estrogen & progesterone are
all contribute to this. The sickness is
confined to “early morning” but can
occur at any time in the day. The smell
of certain cooking food will cause the
symptom.
Management:
The midwife should encourage the
mother to look positively towards the
resolution of the problem.
Salads & light snacks are given
than full meals.
Carbohydrate snacks at bed
time can prevent
hypoglycaemia.
Dry toast or biscuits are given
on waking up &breakfast after
half an hour.
*If vomiting becomes severe the mother
may lose weight& becomes dehydrated
this condition is called hyperemesis
gravidarum& specialized care &
appropriate referral should be needed.
2. Constipation:
This is due to smooth muscle relaxant
effect of progesterone causing decreased
peristalsis of gut. Pressure of the gravid
uterus on the colon near term makes it
worse as the colon gets displaced. It is
usually overcome by adjusting diets.
Management:
The women may be advised to:
Increase the intake of water.
Add green leafy vegetables, fruits
& bran cereals to her diet.
Take a glass of warm water in the
morning before tea or breakfast
which would activate the gut &
help regular bowel movements.
Do exercise by regular walking.
3. Acidity & heartburn:
This is a burning pain in the mediastinal
position caused by reflux of stomach
contents into the esophagus. It occurs
because the cardiac sphincter relaxes
during pregnancy due to the effect of
progesterone. The condition tends to
worsen as pregnancy advances because
the stomach is displaced upward by the
enlarging uterus.
Heartbern is most troublesome at about
30th to 40th week of gestation because at
this stage the stomach is under pressure
from the growing uterus.
Management:
The advice given according to the severity
of the condition:
If the heartburn is occasional the
reflux can be prevented by avoiding
bending & kneeling while doing
household works.
Advice to take small meals which
will be more easily digested.
Fried & fatty foods should be
avoided.
Sleeping with more pillows & lying
on right lateral side can be helpful.
For persistent heartburn antacids
may be prescribed by the
physician.
4. Excessive salivation (Ptyalism):
This occurs from 8th week of gestation
which is caused due to the hormones of
pregnancy.
Management:
This problem is usually self-limiting
and may be overcome by
decreasing intake of carbohydrates.
It is not associated with any
adverse pregnancy outcome.
5. Abdominal discomfort:
Due to Pressure, pelvic heaviness,
is caused by the weight of the
uterus on the pelvic supports and
the abdominal wall.
Round ligament tension,
tenderness along the course of the
round ligament (usually the left)
during late pregnancy, is due to
traction on this structure by the
uterus, which is displaced by the
large bowel to be rotated slightly to
the right.
Flatulence and distention can be
due to large meals, gas-forming
foods, and chilled beverages. These
are poorly tolerated by pregnant
women.
Management:
Provide rest frequently,
preferably in the lateral
recumbent position.
Local heat should be applied
and change of position
frequently.
Dietary modifications should be
needed.
Regular bowel function should
be maintained, and exercise is
beneficial.
Acetaminophen 0.3–0.6, 2–3
times daily may be given to
reduce discomfort.
Intra abdominal disorders must
be diagnosed and treated
appropriately.
6. Pica:
This the term used when the mother
craves certain foods or unnatural
substances such as coal. The cause is
unknown but hormones & changes in
metabolism are thought to contribute to
this. If the substances craved are harmful
to the unborn baby, the mother must be
helped to seek medical advice.
13min. MUSCULO-SKELETAL SYSTEM What are the
1. Fatigue: ailments of
The pregnant patient is more subjected to musculoskeletal
fatigue during the last trimester pregnancy system?
because of altered posture & extra weight
carried.
Management:
Frequent rest period should
recommended.
Anemia & other systemic diseases
should be ruled out.
2. Backache:
The gradual weight gain & the changes in
the body’s center of gravity combined with
the stretching of weak abdominal muscles
often lead to hollowness of lumbar spine.
There is a tendency for back muscles to
shorten as the abdominal muscles
stretched & extra strain is put on the
ligaments this results in backache.
Management:
Excessive weight gain should be
avoided.
Rest with elevation of legs to flex
the hips may be helpful.
Improvement of posture with well
fitted pelvic girdle belt may be
reduce the pain.
Advice the mother to wear low
healed shoe.
Apply local heat or light massage is
helpful.
Recommended sleep on a firm
mattress.
Provide back exercise under the
supervision of physician.
Give acetaminophen 0.3-0.6 g
orally.
3. Leg cramps:
These are quite common & worsen at
night. The cause is not known but has
been attributed to deficiency of vit-B1 &
decreased level of calcium. It may be due
to ischemia or changes in pH or electrolyte
level.
Management:
Make gentle leg movements,
massage the leg & also apply local
heat which may be beneficial.
Sleep with foot end of the bed
elevated by 20-25cm.
Take vit-B complex & calcium
supplements.
4. Round ligament pain:
Stretching of the round ligament during
movement in pregnancy may cause sharp
pain in the groins which may be unilateral
or bilateral. It is usually felt in 2nd trimester
onwards. This is more common in right
side as a result of dextrorotation of uterus.
Pain may be awaking at night time because
of sudden roll over movements during
sleep.
Management:
Pain may be reduced by making
movements gradual instead of
sudden.
Local heat application is helpful.
10min. Analgesics may be needed.
5. 2min. Conclusion
Minor disorders are the common disorders
that occur during pregnancy which needs
home management and these are
common so advice the mother not to
worry about this in depth these are mainly
disappear after the pregnancy is complete.
Bibliography:
1. Jacob Annamma; A Comprehensive Textbook Of Midwifery And Gynecological Nursing; jaypee publishers, 3rd edition 2012,Pg.102-105.
2. Dutta D.C ;Text Book Of Obstertrics ; New Central Book Agency Ltd. Sixth Edition 2004.page no.-151-52.