1 Back pain
(1) Reason: In the late pregnancy, the enlarged uterus protrudes forward, which causes the body's center of gravity to move backward, and the lumbar spine protrudes forward, so that the extensor back muscles are in a state of continuous tension. Mild low back pain often occurs.
1) Mild low back pain in the middle and late pregnancy.
2) No history of bladder irritation, fever, and trauma to the back and back.
3) There is no obvious abnormality in lumbar and back visual, palpation, and percussion.
4) There is no abnormality in blood and urine routine, and no abnormality in kidney B-ultrasound. If necessary, after 12 weeks of pregnancy, lumbar X-ray, CT, or MRI can be performed after obtaining the consent of the pregnant woman and her family members to exclude lumbar and intervertebral disc diseases.
1) Mild low back pain does not affect the living, so reduce work appropriately, and rest in bed if necessary.
2) When severe back pain affects life and sleep, a small amount of analgesics can be used.
1 Ibuprofen (Fenbid) 100mg×10 tablets, orally, 1 tablet at a time, if necessary.
2 Voltaren ointment, q6h, apply locally to the affected area.
2 Varicose veins of lower extremities and vulva
(1) Cause: In the middle and late stages of pregnancy, the increased pelvic blood vessels and decreased vascular smooth muscle tension, and increased uterine compression of the internal iliac veins resulted in increased pressure in the lower extremities and pelvic veins, obstruction of lower extremity venous blood return, and varicose veins in the lower extremities, pelvis, vulva, and vagina. It also occurs in early pregnancy, more common in those with a family history, often due to congenital vein wall weakness and congenital venous valve defects.
(2) Diagnosis: Varicose veins of the lower limbs and vulva appear during pregnancy, and the varicose veins are generally free of soreness and pain. Pregnant women often feel heavy, swollen lower limbs, swelling of the vulva and vagina, and the above symptoms are aggravated every afternoon.
1) Rest in bed, avoid standing for a long time, and raise the affected limb during night sleep to reduce the pressure of varicose veins.
2) Use elastic bandages or wear elastic tights, etc.
3) The perineum should be protected during childbirth, the appropriate incision should be selected to avoid bleeding from varicose vein rupture, and cesarean section can be selected to terminate pregnancy if necessary.
4) It is not advisable to perform great saphenous vein ligation or partial resection during pregnancy.
5) When combined with local skin eczema or ulcers, topical medication can be used for treatment, or the dermatologist and general surgery department can coordinate diagnosis and treatment.
3 Lower limb edema
(1) Reason: In the third trimester of pregnancy, the enlarged uterus compresses the inferior vena cava, resulting in obstruction of lower limb venous and lymphatic drainage, and mild edema of the lower leg and ankle, which usually disappears naturally after rest, which is a normal phenomenon. If the edema is severe and does not relieve after rest, the cause of the edema should be investigated.
1) Mild edema of both lower limbs appears in the third trimester of pregnancy, which can be completely or partially subsided after rest.
2) No symptoms such as headache, dizziness, vertigo, and palpitations.
3) The vital signs are stable, the cardiopulmonary examination has no obvious positive signs, and there is no percussion pain in the kidney area.
4) There is no moderate or higher anemia, urinary protein positive, etc. in blood and urine routine, no heart failure in ECG, and normal renal function.
5) It is necessary to exclude pathological pregnancy conditions such as hypertension in pregnancy, chronic nephritis and heart failure during pregnancy.
1) Patients with mild edema should pay attention to rest, lying on the left side, and raising the affected limb by 15°.
2) After the above treatment, if there is no remission or complicated with pathological pregnancy, it should be hospitalized.
4 Constipation and hemorrhoids
1) Due to the influence of a large number of sex hormones during pregnancy, bowel motility and bowel tension are weakened.
2) Pregnant women have reduced activity, refined diet and lack of crude fiber.
3) The enlarged uterus and fetus are exposed to compress the rectum.
4) In the third trimester of pregnancy, due to the enlargement of the pregnancy uterus and the increase of abdominal pressure, the hemorrhoidal vein reflux is blocked and the pressure increases, leading to hemorrhoidal varicose veins.
1) Develop the habit of defecation on time every day during pregnancy.
2) Drink a glass of boiled water every morning, a glass of honey water before going to bed, eat more fresh fruits and vegetables rich in fiber, and eat less spicy food.
3) If necessary, the fruit guide tablet can be taken orally, one tablet a day, before going to bed. If you have a bowel movement but the stool is dry, you can use a bottle of Kaisailu to treat the anus. When constipation is combined with hemorrhoids, in order to prevent infection, you can use Mayinglong hemorrhoid ointment or potassium permanganate sitz bath.
4) Magnesium sulfate and senna leaf are forbidden, and enema is forbidden to avoid miscarriage or premature delivery.
5) When the internal hemorrhoids are prolapsed, the hemorrhoids can be quickly returned by hand.
5 Supine hypotension syndrome
(1) Reason: In the third trimester of pregnancy, when pregnant women lie on their backs for a long time, the enlarged uterus compresses the inferior vena cava and abdominal aorta, and at the same time compresses the diaphragm, causing the vagus nerve to excite, reducing the return blood volume and cardiac output, and hypotension , Called supine hypotension syndrome.
(2) Treatment: After excluding hypoglycemic shock and severe anemia, change to the left side to relieve.