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Monday, May 20, 2013
- Weight gain?
- Sciatic nerve pain or backache?
- Fatigue during the first trimester?
- Being so thirsty?
- Stretch marks?
- Light brown spots and red blotches on my face?
- Sinus problems?
- Morning sickness with natural remedies?
- Terrible leg cramps (charlie horses) at night?
- Bed rest?
- Thickened saliva and a bad taste all of the time?
Weight gain (and losing the weight after delivery) is a common concern of expectant mothers. The recommendations concerning expected weight gain during pregnancy vary by pre-pregnancy weight and from doctor to doctor. In general you can expect to gain between 25 and 35 pounds. If you gain more or less, it is not necessarily a bad sign. The doctor measures the height of the uterus (fundal height) each visit and this is a more direct measure of growth of the baby.
Gaining weight in your hips and buttocks is typical. The time to return to your pre-pregnancy weight will depend upon how much weight you gain, breast feeding versus bottle feeding (breast feeding will help you lose weight faster) and your diet and exercise regimen after you deliver.
During pregnancy, backaches are very common. As the uterus grows it places stress on the curvature of spine. If your abdominal muscles are lax (as they often are during and after a pregnancy) the muscles are unable to fully support the uterus. Here are some ideas on how to decrease your pain:
What you are experiencing is normal. There are major changes in energy use in your body. In the first trimester, women tend to feel the most tired. It sounds like you are doing all you can do to help. Plenty of rest and a good diet is the best advice I can give. Every person and every pregnancy is different. Things will get better with time.
Thirst may be normal as the body increases its blood volume around 50-60%. There are other medical causes for an increased thirst like diabetes, so you should share this with your healthcare giver. You will be tested for diabetes at around 24-28 weeks, but if you are at high risk, you may be tested earlier.
Although a lot of treatments have been proposed to prevent stretch marks, none have been proven to work. The changes in hormones during pregnancy promote these skin changes more than the actual mechanics of stretching of the skin. It seems that stretch marks are a genetically predetermined trait. That means women are either going to get them or not, no matter what they try to do (i.e. aloe, Vitamin E, cocoa butter). These measures may lessen the degree of the stretch marks, however.
Skin pigment changes are common during pregnancy, especially on the face. Ninety percent of women have some pigment changes especially around the nipples or the line extending down from the belly button. Fifty percent of women have some type of darkening of the skin of the face. This is sometimes worsened by exposure to sunlight or UV light. Sunscreens may help prevent this darkening. Most women experience spontaneous resolution following pregnancy. For the minority of women who do not experience improvement, treatment with topical medications under the care of a dermatologist may help with resolution.
It is normal for the nasal passages to be more swollen during pregnancy. The hormones of pregnancy increase the size of the blood vessels in the sinuses of the nose, leading to the stuffy nose feeling. If you use a nasal spray, most of the effect is in the lining of the nose and sinuses and very little, if any, is absorbed into your system. The few studies that have been done on nasal decongestants show that when the drug was self-administered at the recommended dosing interval, there were no changes in the baby's heart rate or blood flow. The bigger problem is that with continued use of nasal sprays, your nasal passages require larger amounts of medicine to unstuff your nose. This continues to the point that little can be done to relieve your stuffiness. Women with any complications during pregnancy, especially those related to an abnormal placenta or hypertension, should consult their physician before using this type of medication.
Vitamin B6 can help with nausea associated with pregnancy. The mechanism is unknown but we have experience with the vitamin that was one part of a medication called Bendectine. B6 can be helpful with nausea. There is no standard recommended dose but I have good success with 50 mg three times a day maximum.
There are other "natural remedies". One of the newest is a device called the "Relief Band". It is a small bracelet like device that fits on your wrist. The device sends small electronic pulses to pressure points that aid in decreasing nausea.
Ginger is an old remedy used in the form of ginger ale and tea. It can be comforting to sip over ice or with a little sugar in hot tea. Different ginger preparations have varying doses. It is recommended that the pregnant woman not consume over 1 Gram of ginger per day which is the total amount in 12 ounces of ginger ale. As with all food products, both natural and synthetic, the consumer should use moderation in dosages.
Many times leg cramps in pregnancy are due to dehydration or low calcium. It is important to drink plenty of fluids and to take prenatal vitamins. Adding large doses of extra calcium is usually not necessary.
Bed rest can be a difficult situation but there are some resources to try. Try the web link, Bed Rest Resources, for some useful books and websites. You might also try to contact your hospital or the closest regional perinatal center (typically the closest teaching hospital).
The large amounts of Progesterone in a pregnant woman's body presumably cause the effects you have listed. Sometimes thick saliva can be a sign of dehydration. Try to drink more water...it might help.
Frequently, dehydration and stress play a large role in headaches in early pregnancy. Suggest to your daughter to sleep well and drink plenty of fluids, preferably water or juice. Tylenol, not exceeding 1500 mg a day is safe in pregnancy.
Last Reviewed: May 28, 2002
Arthur T Ollendorff, MD
Associate Professor of Obstetrics and Gynecology
College of Medicine
University of Cincinnati