Fluid retention: Increased circulating steroid levels and decreased serum
albumin results in edema in over half of pregnant women. Edema is not a
criterion for preeclampsia. Management is elevating legs and using support
hose.
Hair and nails: Hair shedding decreases in pregnancy. Telogen effluvium is
the excessive shedding of hair occurring 1−5 months after pregnancy. Telogen
effluvium occurs in 40−50% of women. Nails may become more brittle.
Management is conservative.
Headaches: Muscle contraction and migraine headaches are more common in
pregnancy, probably because of increased estrogen levels. Management is
physical therapy (e.g., ice packs, massage) with medication only as a last
resort.
Leg cramps: Lower extremity muscle cramps are frequent in pregnancy.
Management is hydration, stretching exercises, and calcium
supplementation.
Morning sickness: Nausea and vomiting are common in early pregnancy and
are probably mediated by elevated hCG levels. Management is eating small
meals (with emphasis on crackers and carbohydrates).
Nosebleeds: Vasodilation and increased vascular supply results in more
frequent nosebleeds. Management is saline drops and the avoidance of nasal
sprays.
Stretch marks: Genetic predisposition and pregnancy can result in striae
gravidarum. Women with stretch marks have increased risk of delivery
lacerations. Management is conservative.
Stress incontinence: Pressure on the bladder with an enlarging uterus
frequently results in an involuntary loss of urine. Management is
strengthening the pelvic diaphragm with Kegel exercises.
Varicose veins: Increased blood volume, the relaxing effect of progesterone
on smooth muscle, and an increased lower-extremity venous pressure often
result in lower-extremity varicosities. Management is discouraging
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