Discomforts and Illnesses During Pregnancy

ACNE

Cetaphil cleanser, Clindagel, Benzoyl peroxide.

Allergies

Over-the-counter medications are safe. For example – Claritin, Zyrtec, Benadryl, and Allegra. Chlor Trimeton 4mg every 4-6 hours (max 24mg/day)

Backache

Applying heat to your lower back, back massage, and the use of a firm mattress may offer relief. Avoid lifting and bending. Wear a supportive bra, try stretching, pelvic rocking, wearing a maternity belt, and Tylenol. Wear supportive shoes with low heels.

Bleeding gums

Practice good oral hygiene. Use a soft toothbrush and floss regularly. Try warm saline mouthwashes.

Braxton-Hicks contractions

These are mild contractions that aren’t labor. Rest on your left side and relax. Empty your bladder frequently. Drink at least three glasses of fluids for possible dehydration. Call the office if they are regular and/or intense.

Breast pain

Perform a breast exam, avoid caffeine, and try Vitamin E 800 IU daily. Wear a supportive bra constantly.

Carpal Tunnel Syndrome

Decrease your salt intake. Wear a wrist splint while sleeping. This usually disappears post-partum.

Chickenpox

Chickenpox is caused by a virus called varicella-zoster and it can be transmitted across the placenta to the fetus. If you have had chickenpox, you don’t have to worry about being exposed as you have life-long immunity. Women who contract chickenpox during their pregnancies, have been known to have a higher incidence of miscarriage or to deliver babies with congenital malformations. If you have not had chickenpox, avoid contact with anyone who has chickenpox or shingles. If you are exposed, please call us. If you become infected, there may be treatment, but it may not protect the fetus from infection.

Colds/Sinus Infections

If fever is higher than 100.4 for 24 hours, please call our clinic. No medications will cure a cold, so take medications to help symptoms if you want. Antibiotics are drugs that fight bacteria, but colds are caused by viruses. Colds tend to last longer in pregnancy – a few weeks is not unusual. A decongestant (Sudafed) can help you breathe if your nose is blocked. You shouldn’t take this in the first trimester or if you have high blood pressure. You can take Tylenol Cold Daytime, but not in the first trimester. A steam vaporizer or Saline nasal spray may make you feel better. A cough suppressant (such as Robitussin DM) can help suppress your cough and help you sleep at night. Lots of water helps loosen secretions. Other options are Mucinex or Coricidan HBP. Tylenol can help aches, sore throat, and feverish feelings. Throat spay and lozenges can soothe your throat. So can frequent sips of warm liquids and salt water gargles. You can take an antihistamine if you need something to help you sleep, but otherwise they are for allergies. There is no good medicine to stop a runny nose – that’s your immune system trying to flush out the virus.

Constipation

Drink at least eight glasses of water daily. Eating more roughage (fresh fruits and vegetables) and whole grain foods may help prevent constipation. Maintain a regular exercise program. Try Colace, Citrucel, or Metamucil twice a day.

Diarrhea

Drink liquids to avoid dehydration. Electrolyte drinks (example Gatorade) can replace electrolytes lost through diarrhea. Avoid dairy products. Try rice, bananas, toast, Kaopectate, or Imodium. Call our office if it is severe.

Difficulty breathing

Shortness of breath is common in pregnancy. Avoid restrictive clothing. Use pillows to elevate your back and rest.

Dizzy spells

Avoid rapid breathing. Get up slowly – sit first. Lie on your side, not flat on your back. Eat small frequent meals. Sometimes a cold cloth on your neck or cool place can help.

Fatigue

Take frequent rest periods or naps. Avoid caffeine before bed. Try warm milk and relaxation. Make sure you’re getting enough nightly sleep.

Fifth Disease

Parvovirus 19 causes a common childhood disease that in rare cases could cause miscarriage, fetal anemia or fetal death. If you have been exposed (the risk is highest from your own children), a blood test can determine whether you are protected because you already had the disease. If you have not had the disease before, a later blood test can determine whether you developed the disease during pregnancy, since symptoms can be minimal. If you have been infected, we may need to follow your baby with ultrasound examinations.

Headaches

Common in pregnancy. Do not use aspirin or ibuprofen type products. You may take Tylenol. Rest, hydration, and a high protein diet will help. Caffeine may help. Acupuncture and massage of the back, neck, and shoulders can be helpful as well. Headaches unrelieved with these measures could be a warning sign of something more serious and you should call the clinic.

Heartburn

This is a common problem. Limit spicy food, large meals, and eating right before lying down. Tums, Rolaids, Zantac, Gaviscon, and Prevacid or Protonix are all safe in pregnancy, and are available over the counter. If you have severe heartburn associated with significant headaches, please call our office or doctor on call.

Hemorrhoids

Anusol, Anusol HC, Preparation H, and Tucs pads are safe to use during pregnancy.

Immunizations

Yes, pregnant women should have the flu vaccine as they are at a much higher risk of complications from influenza infection. TDaP is recommended in the third trimester to give mom (and this baby) protection against infection with whooping cough (Pertussis). Avoid live virus vaccines during pregnancy such as MMR.

Itching

Try an Aveeno bath, moisturizing lotion, and drink fluids. Try Benadryl cream, Caladryl, Calamine lotion or Aveeno anti-itch cream. Inform your provider about significant itching in the third trimester.

Leg Cramps

Wear comfortable flat-heeled shoes. Avoid crossing your legs and elevate them whenever possible. If you experience a leg cramp, flex your foot back and pull your toes toward your head. Take extra calcium and potassium and don’t get dehydrated. Soak your legs in a warm tub before bed. Try calf stretches before bed.

Listeriosis

Listeriosis is an infectious disease caused by bacteria that is transmitted by some foods. Unpasteurized dairy products should be avoided because of risk of listeriosis. Symptoms include sudden onset of fever, headache, muscle cramps, abdominal pain, nausea, diarrhea, and vomiting. The listeria bacteria can infect the fetus during pregnancy, causing a spontaneous abortion, stillbirth, or an infected newborn.

Nasal Congestion

Some increased stuffiness is usual with pregnancy. Use a humidifier, drink fluids, try saline nasal drops or spray and gargle with salt water. Sudafed may help. Afrin nasal spray should not be used for more than a week, so it is best reserved for colds.

Nose Bleeds

Common in pregnancy. Treat with finger pressure on the side of the nose that is bleeding. Avoid overheated air, excessive exertion and medicated nasal sprays. Blow your nose gently. Saline spray, a room humidifier, and Vaseline or Mentholatum may help.

Pain (MILD, MUSKULOSKELETAL)

You may use Tylenol. Please do NOT take any aspirin or ibuprofen type products (this includes Motrin, Aleve, naproxyn or any product containing any of these pain medications). A heating pad, stretching, and massage may also help.

Prescription Medications

Whenever a medication is prescribed to you during your pregnancy, please be certain the doctor prescribing it knows that you are pregnant.

Rash

Aveeno soothing bath, Caladryl lotion, Cortaid.

Rubella (German Measles)

This disease can cause birth defects if you get infected during your pregnancy. If you had rubella disease in the past, you are immune. We test for immunity routinely with your first lab tests in pregnancy. If your immunity is low, we suggest you receive the vaccine just after delivery. If you are not immune and you have been exposed, you should talk with your doctor. Fever, rash, and swollen glands would not show up for two weeks or more after exposure. The risk is higher to your baby if you develop the disease in the first trimester.

Swollen hands/feet

Avoid restrictive clothes and long periods of standing. Elevate your legs throughout the day. Wear support hose. Walk for ten minutes every one to two hours. Drink at least eight glasses of water daily. Limit salt intake.

TB Test

TB testing is fine anytime in pregnancy.

Vaginal Discharge

An increase in daily vaginal discharge is common. Cervical mucous increases as pregnancy progresses. Call the office if you have an odor or itch indicating infection, leaking water, or bleeding.

Varicosities

Avoid long periods of standing and crossing legs. Wear support hose. Elevate legs. Walk. Take rest periods.

Tips to Help Prevent Nausea During Pregnancy

  • Before getting out of bed in the morning, eat a few crackers, a handful of dry cereal, or a piece of toast or dry bread. Put these within reach of your bed the night before.
  • Get up slowly in the morning and sit on the side of the bed for a few moments before standing up. Avoid any sudden movements.
  • Eat six to eight small meals during the day. Never go for long periods of time without food.
  • Eat foods that are high in long acting proteins such as milk, yogurt, cheese, peanut butter, and nuts. Drink fluids, including soups, between rather than with meals.
  • Avoid greasy, highly seasoned, and fried foods. These include butter, margarine, bacon, gravies, piecrust, pastries, fried meats, and french fries.
  • Avoid unpleasant smells. When you cook, open windows or use the exhaust fan to get rid of odors. After cooking, wait for a short period of time before eating.
  • Always eat a snack high in protein before bedtime.
  • Be sure to have plenty of fresh air/good ventilation in the bedroom while sleeping.
  • If the nausea is severe, avoid drinking citrus juice, coffee, and tea.
  • Try eating popsicles if you are having difficulty keeping down liquids.
  • Doxylamine 25 mg tablet (Unisom tablet) one at bedtime combined with vitamin B6 25 to 50 mg twice a day. This combination works best as a preventive, so take it routinely. You may add 1/2 tablet in the morning and 1/2 tablet in the afternoon if needed.
  • Ginger is an over-the-counter supplement that may be helpful.
  • If you are vomiting frequently or are unable to keep solids or liquids down, please call the office. You may need a prescription medication for nausea or to go in for IV hydration.

Disability During Pregnancy

Your pregnancy may easily affect your work. These comments were written to prevent the misunderstanding that may occur between a pregnant woman, her physician, and employer.

The usual pregnancy discomforts, e.g., nausea, tiredness, back and low abdominal pain, do not qualify as an illness requiring disability. A complication of pregnancy may qualify for a disability. Illnesses unrelated to pregnancy may qualify for disability. This needs to be reviewed with the provider treating that illness.

If you are unable to carry out certain tasks necessary for your work, first speak to your employer. Your physician may authorize physical restrictions on your work after they have received a complete and specific job description from your employer.

If the restrictions written for your employment prevent you from performing your job, it is then the responsibility of your employer either to find you a less demanding position, or, if no such position is possible, to give you disability. If you become too uncomfortable to work, you may want to discuss a leave of absence with your employer.

The decision to grant medical disability in pregnancy will be made honestly, carefully, and only with proper justification. Disability will be granted only for medical illnesses that may jeopardize a mother’s ability to safely nurture, protect and promote the development of her unborn child. Disability will not be granted for symptomatic complaints that stem from the normal physical or emotional changes of pregnancy.