Minor Disorders in Pregnancy

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Pregnancy is a time when a woman’s body will go through numerous adaptations in order to accommodate the fetus. During these physiological adaptations, the organs such as spleen and liver and systems such as the endocrine and circulatory systems will be affected. A woman can experience minor disorders that are most likely the result of hormonal changes on the smooth muscle and connective tissues. This paper endeavours to describe some of the minor disorders in pregnancy in particular, heartburn (reflux oesophagitis), constipation, haemorrhoids, dermatoses and epistaxis. The major physiological reason for heartburn (reflux oesophagitis) in pregnancy is due to the relaxation of the LES(lower esophageal sphincter) and the decreased tone and mobility of the smooth muscles, which is caused from increased progesterone. As the fetus increases in size, pressure in the abdomen compounds, decreasing the angle of the gastroesophageal junction. This allows for oesophageal regurgitation, less time for the stomach to empty and reverse peristalsis (Blackburn 2007; Stables & Rankin 2010). The main symptoms of heartburn are a “burning sensation” in the chest or back of the throat. Other symptoms may include eructation, difficulty in swallowing, and an acid or metal taste in the mouth. In terms of advice, there are some standard measures that can alleviate symptoms. These include examining the woman’s diet and eliminating foods that might aggravate, eating smaller portions and more frequently, sleeping in upright positions and avoidance of eating closer to bedtime (Law et al. 2010; Vazquez 2010).

Constipation is known to affect more that 40% of women during their pregnancy (Derbyshire, Davies & Detmar 2007). In looking at the physiological reason for constipation, increasing levels of progesterone affects bowel motility and reduces the peristaltic movement of the gastrointestinal tract. This is turn then increases the time food is passed through the gut causing increases in electrolyte and subsequent absorption of water in the large intestine. Motilin a hormone that assists faeces to pass through the colon is also decreased by the levels of progesterone (Derbyshire, Davies & Detmar 2007). Constipation could also be the result of hyperemesis gravidarum (pernicious vomiting in pregnancy), or ingestion of prescribed iron tablets for anaemia (Tiran 2003). A diet rich in fibre and increasing fluid intake can help to ease some of the associated problems with constipation. Laxatives should only be used when dietary changes do not assist. In addition women should be advised that ignoring signs for defecation will compound symptoms (Jewell & Young 1996; Vazquez 2010). The levels of fibre and fluid consumed should be noted by healthcare professionals when attending to women (Derbyshire, Davies & Detmar 2007).

Haemorrhoids occurs in pregnancy in 25 – 35% of women and in some populations it can reach 85% (Staroselsky et al. 2008). Haemorrhoids occur due to progesterone causing vasodilation in the ano-rectal area. In some cases there is a direct relationship between constipation and the formation of haemorrhoids. Main symptoms are itching, burning, swelling around the anus and bleeding. Pain with bowel movements and bleeding are often the first signs of haemorrhoids. As there is a close relationship between constipation and haemorrhoids, the advice given to women with regards to treatment would be similar to constipation. In (Staroselsky et al. 2008) it is stated that topical treatments and the use of laxatives can reduce symptoms.

The integumentary system is no different to any of the other systems affected by physiological changes in pregnancy. There are a number of skin irritations that can cause discomfort to a woman during her pregnancy, but these do not harm the fetus. Melanocyte-stimulating hormone is increased by progesterone and oestrogen levels. Chloasma or “pregnancy mask” is one of the conditions to...
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