Health Promotion & Maintnance: Dangers vs Discomfort in pregnancy

1st Trimester

Developments task: accepting fact of pregnancy “I am pregnant.”:

• Increased leukorrhea (normal within vaginal secretions)

• Nasal stuffiness

• Urinary frequency begins

• Fatigue

• Epistaxis (nose bleeds)

• Nausea & vomiting

• Breast changes (tenderness-pain-tingling-fulness)

• Ptyalism (perceived increase in salivation)

• Gingivitis

2nd Trimester:

Developmental task: accepting growing fetus as distinct from self and as a person to nurture, “I am going to have a baby”.:

• Heartburn

• Striae gravidarum

• Linea Nigra

• Urinary frequency LESSENS

• Pruritis

• Joint pain & joint mobility

• Pelvic pressure

• Pigmentation deepens (areola, vulva)

• Palmar erythema

• Chloasma “mask of pregnancy” (begins after 16 weeks & increases until delivery)

• Supine hypotension (when supine, weight of uterus presses against inferior vena cava, decreasing blood return to the heart, leading to decreased cardiac output.)

• Hemorrhoids

• Backache

• Varicose veins appear

• Round ligament pain

• Carpal tunnel syndrome

• Oily skin and acne

• Constipations

• Palpitations

• Headaches

• Faintness

• Food cravings

• Pica (craving non-food items such as: starch, dirt, clay)

• 3rd Trimester:

Developmental task: preparing realistically for birth and parenting; “ I’m going to be a mother”. Pregnant woman fears possible defects in the baby.

Pregnant woman fears labor and delivery—possible mutilation, pain, loss of control

• SOB & dyspnea.

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• Urinary frequency returns

• Insomnia

• Braxton-Hicks cobtractions

• Ankle edema (non-pitting)

• Leg cramps

• Perineal pressure

Others:

• Mood swing—common throughout pregnancy

• Ambivalence (mixed feelings regarding pregnancy, labor & delivery, parenting, etc.) — all 3 trimesters

• Spider neck appear neck, thorax, face arms — 2nd or 3rd trimester.

DANGER SIGNS:

→ Severe headaches

→ UTI (mixed feelings regarding pregnancy, labor and delivery, parenting, etc.) — all 3 trimesters

→ Epigastric pain (signals impending convulsion [pre-eclamptic])

→ Severe abdominal pain

→ seizures

→ decreased fetal movements or absent fetal movement

→ fetal movement 1st felt around week 16 to 20, any change of pattern or abrupt cessation of fetal movement is ominous.

→ blurry vision (sign of preeclampsia)

→ vaginal bleeding

→ Persistent, severe vomiting (can lead to dehydration and electrolyte imbalance).

→ Edema of face or fingers (possible HTN, pre-eclampsia).