11 Common Complaints of Pregnancy

1. Nausea

due to estrogen, twins (more estrogen), if nauseous w birth control

Hyperemesis gravidarum
-persistent vomiting w
>5% weight loss
Tx: grazing (snacking instead of big meals)
bland food, avoid problem foods.
mints
fluids
avoid odors
stay rested
Accupressure
Ginger 250 QID
Continue Folic Acid.
Vit B6 25 q6-8
 max 200/day

Complication: Ketoacidosis. Be sure to check Ketones in urine. Zofran if necessary.

2. Blurring of vision
r/o stroke, gestational DM, preeclampsia, but
often normal effect of pregnancy, will go away after pregnancy
do NOT get eyeglass Rx at this time.
Tx: OMT for orbital restriction

3. Intense B/L lower pelvic pain
Tylenol helps
Dx: round ligament pain
Usually 2nd trimester
Txs: heat pads, hot baths, downward-facing dog yoga position, pregnancy support belt.
OMT: hold up belly, release the pelvic floor.

4. Dark patches of skin over forehead
Dx: Cloasma, the melisma of pregnancy
Tx: hydroquinone cream

5. Acid Reflux
Tx: lifestyle modifications, smaller meals, NPO 3h QHS, elevate bed, sucralfate, Ca Carbonate, H2 blockers, proton pump inhibitors, OMT to ease fascial restrictions

6. Highly Pruritic Lesions all over body
Dx: PUPPP
Hives, primigravidas, 3rd trimester, pruritis/skin lesions.
Tx: Pine Tor Soap, Topical steroid, if not then oral steroid, if not then oral antihistamines (Benadryl, or famotidine)
Not a dangerous condition, just uncomfortable.

7. Numbness and Tingling in fingers, especially in the morning
35-40% of pregnant women get it. Resolves post-partum
Tx: Open the thoracic inlet, cross-thumb technique, long axis traction, lymphatic drainage, carpal tunnel pump

8. Intrahepatic cholestasis of pregnancy (IHC)
Very itchy, no rash
Tx: ursodeoxycholic acid or cholestyramine
Bilirubin normal, Coags, U/S normal.
Increased risk of NRDS, fetal demise, prematurity, consider sending to hospital with NICU for birth.

9. Lower Extremity Edema (d/t progesterone)
Tx: elevate legs, salt restriction, compression socks
OMT: open the pelvic diaphragm!, pedal pump, effleurage
r/o DVT, Pre-eclampsia,.

10. Meralgia Paresthetica
Tingling numbness in thigh, entraps lateral femoral cutaneous nerve.
Tx: release tight fascia, prolotherapy?

11. Low Back Pain (LBP)
d/t relaxin, estrogen, progesterone
Tx: stretch, Tylenol, swimming, yoga, Do NOT give motrin as will inhibit the closing of the Ductus arteriosus.