Definition of pregnancy
Minor disorders of pregnancy

Pregnancy is the fertilization and Development of one or more off spring, known as an embryo or fetus, in a women’s uterus.
            Pregnancy can also be defined as being with child, the condition form conception to the expulsion of the fetus. The normal period is 280 days or 40 weeks counted from the first day of the last normal menstrual period.
    Pregnancy test is used to demonstrate whether conception has occurred. There detect the human chorionic gonadotrophin (HCG) produced by the embryo 8 days after the first missed period.
            Immunological laboratory tests are more accurate and less likely to give false positive result than an over the counter kit.
            In a pregnancy, there can be multiple gestations as in the case of twins or triplets. Childbirth usually occurs about 38 weeks after conception, in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period (LNMP).
            Conception can be achieved through sexual intercourse or assisted reproductive technology. An embryo is the developing offspring during the first 8 weeks following conception and subsequently the term fetus is used hence forth until birth.
            In many societies, medical or legal definitions, human pregnancy is some what arbitrarily divided into three trimester periods, as a means to simplify reference to the different stages of prenatal development. The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). During the second trimester, the development of the fetus can be more easily monitored and diagnosed. The beginning of the third trimester often approximates the point of viability, or the ability of the fetus to survive, with or without medical help outside the uterus.
            Although pregnancy begins with implantation, the process leading to pregnancy occurs earlier as the result of the female gamete, or oocyte, merging with the male gamete, spermatozoon. In medicine, this process is referred to as fertilization, in lay terms, it is more commonly known as “conception”. After the point of fertilization, the fused product of the female and male gamete is referred to as a zygote or fertilized egg. The fusion of male and female gametes usually occurs following the act of sexual intercourse, resulting in spontaneous pregnancy. However, the advent of assisted reproductive technology such as artificial insemination and in vitro fertilization have made achieving pregnancy possible with out engaging in sexual intercourse. This approach may be under taken as a voluntary choice or due to fertility.
Minor disorder of pregnancy
            During pregnancy, a woman’s body changes in many ways. There changes can sometimes be uncomfortable, but most of the time they are normal. They can occur at any time during the pregnancy.
            Therefore obstetric and gynecological conditions are these conditions that occur due to pregnancy, labour or puerperium or diseases affecting the female genital trait. They are conditions that do not endanger life but may undermine the women’s health and they include:
-           Morning sickness
-           Heartburn
-           Backache
-           Pruritus vulvae
-           Varicose veins
-           Constipation
-           Fainting attacks
-           Oedema
-           Hemorrhoids (pile)
-           Vaginal discharge
-           Insomnia
-           Itching of the skin
-           Frequency of Urination
-           Dysnoea (shortness of breath)
-           Emotional factors
-           Fatigue

This comprises nausea, anorexia and slight vomiting that usually occurs immediately after getting up in the morning, when retching (strong voluntary effort or vomit) and vomiting of mucus. Sometimes bile-stained, takes place. About 50% of women vomit between the 4th and 5th week of pregnancy. If the condition is not nipped in the bud hyperemesis gravidarum occurs as a complication.
-           Hormonal-progesterone relaxes the muscles and makes the sphincter weak and everything is ejected into the abdomen.
-           Sensitive nervous system
-           Disturbance in the metabolism of glucose with increased production of ketone bodies or low intake of glucose at night.
-           Psychological- loves petting.
Take light diet before going to bed to aid easy digestion
Take biscuits or freshly made tea preferably brought by the husband in the morning before getting out of bed.
-           Avoid getting out of bed quickly
-           Avoid taking of heavy meals or much fried food to avoid irritation of the GIT
-           keep a way from oily food
-           Drink extra glucose
-           Psychotherapy
-           Seek medical aid if condition gets worse example hyperemesis gravidarum.

            A burning feeling or pain in the stomach, or between the breast, is called indigestion or heart burn. Heart burn happens because the growing baby crowds the Mothers stomach and pushes it higher than usual. The acids in the Mothers stomach that help digest food are pushed up into her chest, where they cause a burning feeling. Reassure her that this is not dangerous and usually goes away after the birth.
-           keep her stomach less full by eating smaller meals more often, and by eating foods and drinking liquids separately.
-           Avoid eating spicy or greasy foods, drinking coffee, or smoking cigarettes, as all of them can irritate the stomach.
-           Regularly eat papaya or pineapple, which have enzymes (special chemicals) that help the stomach to digest food.
-           Keep her head higher than her stomach when lying down or sleeping. This will keep her stomach acids in the stomach and out of her chest.
-           Calm the acids in the stomach by drinking milk, or taking a low-salt antacid (stomach-calming liquid or tablets) that contains no aspirin, but advise her to try other methods before using drugs like antacids.
Any pain in the back, usually the lower part.

-           Stretching of the back when progest erone relaxes the muscles and tissue causing pain.
-           The increased lumber curve (which causes Lordosis) gives rise to strain of the muscles of the back, leading to fatigue and backache (therefore the growing uterus presses on the sciatic nerve causing pain).
-           Lax abdominal muscles produce anterior obliquity of the uterus which throw the shoulders too far back in order to support the uterus and to keep her balance.
-           Explain the condition to the patient to allay her anxiety and reassure her.
-           Teach her different postures to sit, stand, lie down and get up (good posture).
-           Not to walk for a long distance
-           Rest is needed
-           Put on a firm supporting maternity corset.
-           put on good shoes
-           lie in a comfortable bed that does not sag.
-           seek medical advice if backache is severe and persistent
This is itching in the vulvae owing to the action of progesterone on the secretary organs. Most of the excess fluids are passed via the vulvae.
-           Irritation form vaginal discharge
-           Lack of cleanliness
-           Glycosuria (Common in diabetic patients
-           Vaginal thrush (monoliasia) or trichomoniasis.

-                     Investigate and treat the cause. Take history, test urine, if diabetic, treat it or any other infection”
-                     Advise on personal hygiene especially if no pathological cause.
-                     Take vaginal swab to laboratory
-                     Apply Nystatin ointment
There are swollen, dilated, twisted (tortuous) veins of the legs mostly (varicosities of the Legs) also of vulva, anus, abdomen, ankles, popliteal areas, vagina and groins. About 10% of pregnant mothers have this especially varicosities of the legs. Parturition subsides it but succeeding pregnancy aggravates it.
Action of progesterone on the blood vessels causing relaxation, making them more circular with sluggish blood flow.
-     Advise patient on rest and raising her legs on pillow while lying on bed or chair while sitting down on the same level with the body always to encourage, venous drainage or return.
-     Do not put tight bands that would impede cancellation to the lower limbs.
-     Avoid standing for a long period
-     wear elastic stockings or tight to support the column of blood, relieve aching and give comfort.
-     The venous return from the lower limbs is impeded in the common iliac veins by the increased flow of blood form the uterus
-           Dull aching pain in her limbs
-           Engorgement of the superficial veins
-           Oedematous limbs in severe cases.
-           Rupture of the blood vessels causing hemorrhage
-           Infection can lead to ulceration
-           Injury can cause bleeding
-           Vein thrombosis
-           Protect the patient from in jury
-           Do not apply elastic or tight bandage
-           Give patient a crepe bandage on discharge,
-           Teach her how to apply it for equal pressure
-           She should apply it while on standing and not while on bed.
-           In server cases, doctor does legation of legs.
Incomplete or frequent action of the bowels with consequent fitting of the return with hard stool.
-           Pressure of the enlarged uterus
-           Effect of progesterone causing relaxation of and relaxation of and retarded peristaltic movement of hard stool and strain
-           Take increased amount of fruits vegetables and roughage in diet.
-           If condition is not improved, give mild aperient example Senokot, Dulcolax.
-           Seek medical aid if severe or persistent.
They are veins around the anus. They may burn, hurt, or itch. Some times they bleed when the woman passes a stool, especially if she is constipated. Sitting or standing a lot can make hemorrhoids worse,

-           Doctor gives anusol suppository or mild a patient to avoid strain on defecation.
-           Take warm site baths of magnesium sulphate crystals to reduce engorgement
-     Avoid constipation
-     Nupercainal ointment is effective when painful
-     Ice packs may be used.
-     Prolapsed Haemorrhoids, are cleaned with antiseptic lotion (Salvon or habitant in water) and lubricated and pushed back gently into the rectum via the anus.
Fainting attack (syncope)
A simple faint or temporary loss of consciousness due to cerebral ischemia caused by dilatation of the peripheral blood vessels and a sudden fall in B.P.
-           Instability of the vaso-motor centre in the medulla which controls arterial tone.
-           Rapid fall in blood pressure
-           Pressure of the uterus on the inferior vena cava (spine hypotensive syndrome) reducing venous return to heart.
-           Sudden changes in posture example recumbent to upright position.
-           standing for long periods mostly in ho weather
-           Fatigue or excitement
-           Stuffy room or crowdy halls
-           Wearing of light corsets
-           Overacting or overloading the stomach on meals that cause flatulence.
-           Get up slowly from bed and change position
-           Avoid dorsal position but lie laterally
-           avoid wearing tight corsets
-           Avoid meals that over load the stomach or that causes flatulence.
An excessive amount of fluid in the body tissues characterized by putting of an affected part on pressing.
Pressure of the uterus haemo-dilution (addition of water to dilute the blood).
-           Avoid long standing
-           Elevate (raise legs while sitting or ling down).

Excessive increase in normal leucorrhea (a viscid, whitish discharge from the vagina)
Effect of progesterone which make the secretory organs to secret/produce more fluid which flows via the vulva.
-           Good personal hygiene
-           Vulval swabbing to prevent infection
-           Vulval swab to the laboratory and treat any infection
The is when the woman or the pregnant woman is unable to sleep at night
-           Discomforts
-           Active fetus at right with many fetal kicks
-           Heavy uterus
-           Cramps
-           Treat cause
-           Warm drink and warm bath are needed
-         Reassurance
Skin irritation especially that of the abdomen, breasts which may become generalized over the whole body.
-           Idiopathic (unknown)
-           Endocrine
-           Toxic
-           Nervous element
-           Reassurance
-           Application of lanoline or cold cream
-           Soothing substances such as calcimine solution is helpful.
-           Wear non-irritating clothing next to the skin
-           Take water freely
-           Keep bowel open.
Frequency of urination
Urinary frequency is a common compliant through out pregnancy, especially in the first and last months this happens because the growing fetus and uterus presses against the bladder. It will stop once the body is born. If urinating hurts, itches, or burns, the woman may have bladder infection.
DYSPNOEA (shortness of breath)
Many women get short of breath (can not breath as deeply as usually) when they are pregnant. This condition is called dyspnoea.
Reassure women who are breathless near the end of pregnancy that this is normal. But if a woman is also weak and tire, or if she is short of breath all of the time, she should be checked for signs of sickness, heart problems, anemia, or poor diet. Get medical advice if you think she may have any of these problems.
            A woman’s body charges during pregnancy. These changes can sometimes cause discomfort, but mostly they are normal and will resolve themselves after the baby is born. You can minimize most of the minor disorders during pregnancy with advice on diet, exercise and with simple home remedies that are known to be safe and help women feel better. Some times these minor problems may become more serious, or signal a serious underlying health problem that needs referral to a health facility.
            Some remedies (e.g migraine medicine) are dangerous for pregnant women and may hurt the baby as well as the mother. Minor disorders of pregnancy that you may encounter in dealing with pregnant women can be categorized according to which of the body system is involved.
            Gastrointestinal disorders include nausea and vomiting, dislike of some foods, heart burn, pica (food cravings), constipation and hemorrhoids (piles).
            Cardiovascular disorder includes varicosities, and dyspnoea (shortness of breath). Genitourinary disorders include frequency of urination and vaginal discharge (wetness from the vagina). Nervous system disorders include insomnia, headaches, emotional changes worry and fear.

Embryo definition, medicine Net, Inc. 27 April 2011
Gynecology Department of, al obstetrics, the Johns Hopkins university school of medicine, Baltimore, mary land, editors K. Joseph Hurth—(et (2010-1221). The johns Hopkins manual of gynecology and obstetrics.
Uwa. N. (2009) a-z of material and child health (MCH) Nursing, page 92
Myles textbook for midwifes, 14th edition.
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