Minor discomfort during pregnancy (2nd trimester)

 Minor discomfort during pregnancy (2nd trimester)

At the second trimester of pregnancy the pregnant woman will notice some physical changes in her body, at this time the woman experience some discomforts, - but not like the first trimester – this because of the progressive hormonal changes during pregnancy. 

1- Heart burn

Heartburn is a burning pain in the throat or chest, behind the breastbone, caused by stomach acid coming up the esophagus and irritating the lining

What Causes Heartburn during Pregnancy?

Pregnancy hormones are largely responsible for the heartburn that plagues many women. High levels of progesterone cause the muscle that sits between the esophagus and stomach to relax. "When this happens, acids from your stomach can move upward more easily,"

In pregnant women, indigestion and heartburn can be caused by:

1. Eating a big meal

2. Eating high-fat foods

3. Eating chocolate or peppermint

4. Drinking fruit juice or caffeinated beverages (coffee, tea, cola drinks)

5. Doing physical activity soon after eating

6. Bending over

7. Feeling anxious

Strategies for Pregnancy Heartburn Relief

1-Eat Less, More Often Overeating exacerbates heartburn Sitting upright while eating, and not lying down after a meal 

2-Eliminate Trigger Foods 

-Identify the foods that intensify your heartburn common heartburn triggers include acidic foods, such as citrus fruits and tomatoes, greasy or fried foods, spicy foods, chocolate, coffee and carbonated beverages.

3-Stop smoking 

4-Chewing gum, produce more saliva to help neutralize the acid 

5-Focus on Fluids 

6-Look for liquids that offer plenty of protein, such as milk and drinkable yogurt.

7-Sleep Smart: 

-To avoid nighttime heartburn during pregnancy, don't eat anything for at least three hours before bedtime. 

-Elevate the head of your bed 

-Sleep on your left side 

8-Take Antacids:

-Antacids can help neutralize the acid in your stomach and bring relief to your heartburn fast.

-Avoid antacids that list aluminum (such as aluminum hydroxide or aluminum carbonate) as an ingredient; it can cause constipation and can even be toxic in large doses.

2- Indigestion 

 It’s called dyspepsia, it’s a mild discomfort in the upper abdomen. 

Causes:

1. Trouble swallowing 

2. Bleeding 

3. Weight loss 

4. Rarely, the discomfort of a heart attack is mistaken for indigestion 

5. Indigestion may be triggered by: 

- Eating spicy, fatty, or greasy foods 

- Eating too much 

- Eating too fast 

- Stress or being nervous 

- Drinking too much caffeine 

- Smoking tobacco 

- Eating high- fiber foods 

6. Baby push up the stomach 

7. Hormonal changes 

Changing the way you eat may help your symptoms, steps you can take:

1 -Allow enough time for meals

2 -Chew food carefully and completely

3 - Avoid argument during meals

4- Avoid exercise right after meals

5- Relax and take rest if indigestion caused by stress

6 - Avoid aspirin and other NSAIDs, if you must take them, do so on full stomach

7- Antacids may relieve indigestion

3- Hemorrhoids and constipation 

Hemorrhoids are swollen veins at the end of the large intestine (anus). They often stick out from the anus. They can also be located on the inside of the lower intestine 

Hemorrhoids can result from constipation. Bowels slow down during pregnancy. When stool is hard, the extra straining to eliminate it can put pressure on veins in your rectal area, causing them to become inflamed and bulge.

 - Bleeding, itching, and pain are common hemorrhoid symptoms. 

Hemorrhoids are common during pregnancy because:

The enlarged uterus places extra pressure 

Constipation, a common problem during pregnancy, 

- causes less frequent and more strained bowel movements. The bowels commonly move more slowly during pregnancy. 

- And iron in prenatal vitamins also can cause constipation. 

To prevent or ease constipation and hemorrhoids:

• Eat a high-fiber diet (lots of whole fruits, vegetables, and whole grains). 

• Drink plenty of fluids, especially water. 

• Don't strain (push hard) during a bowel movement. 

• Increase the amount of exercise you get every day. 

To treat the itching or pain of hemorrhoids: 

• Keep the anus clean by wiping carefully. Gently wipe from the front to the back. 

Baby wipes or hemorrhoid pads are usually gentler than toilet paper. 

• Take warm soaks in a tub or a sits bath. Warm water can help shrink or soothe hemorrhoids. Add baking soda to the water to relieve itching. 

• Apply ice pack compresses. 

• Avoid sitting for long periods, especially on hard chairs. 

• An over-the-counter or prescription medicine to apply to hemorrhoids to relieve the itching. 

• A stool softener to prevent straining.

4- Braxton hicks contractions: 

These are mild, intermittent, usually painless, uterine contractions.

a) These are normal contractions: 

b) Get plenty of rest. 

c) Change position as often as possible. 

d) Practice breathing techniques when contractions are bothersome.

5- Palmar erythema: Is reddening of the palms and itching caused by hyperemia of superficial capillaries 

How to relief? 

- This is normal during pregnancy. 

- Calamine lotion to the rescue the itchiness. 

- Disappears naturally. 

Palmar erythema would naturally disappear once the body has adjusted to the increased estrogen.

6- Nasal stuffing and epistaxis

Stuffiness in nose and sometimes even the nosebleeds that accompany it, usually start around week 16 of pregnancy and usually stick with you (and sometimes get worse) to the very end. So keep a tissue handy. 

High levels of the pregnancy hormones estrogen and progesterone increase blood flow to all of your body's mucous membranes — including the nose, the mucous membranes swell and soften, leading to a stuffy nose.

The constant blowing and sneezing produces the occasional nosebleed. 

 How to prevent? 

Use the right blow technique. Use your thumb to close one nostril, and blow gently out the other side. Repeat with the other nostril until you can breathe again. Make sure you use a soft tissue to prevent chafing. 

Take OTC relief. Medications like antihistamines and most decongestant nasal sprays may be safe for short-term use.

Moisten the air. 

Get more vitamin C after asking your doctor, this may make capillaries stronger, which reduces the chance of nosebleeds during pregnancy. Or just drink more OJ and eat more vitamin C-rich fruits and veggies like kiwis, bell peppers and tomatoes. 

Lean forward. When get a nosebleed, lean slightly forward rather than back, and pinch the area right above your nostrils and below the bridge of your nose closed for five minutes. If the bleeding continues, repeat. If nosebleeds become frequent during pregnancy, consult your practitioner. 

References: 

1. https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/indigestion-and-heartburn/

2. https://www.nhs.uk/start4life/pregnancy/week-by-week/2nd-trimester/week-14/#anchor-tabs

3. https://www.healthline.com/health/pregnancy/nosebleeds-while-pregnant

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Karyotyping for Chromosomal Abnormalities

 Karyotyping for Chromosomal Abnormalities 

Each chromosome pair viewed in a karyotype appears to have its own distinct "bar code" of  bands. What changes do scientists look for in a karyotype when diagnosing diseases and  disorders? 

Karyotyping is process of pairing and ordering all the chromosomes of an organism, thus providing a genome wide snapshot of an individual's chromosomes. IT prepared using standardized staining procedures that reveal  characteristic structural features for each chromosome.  

Clinical cytogeneticists analyze human karyotypes to detect gross genetic changes—anomalies involving several  mega-bases or more of DNA. Karyotypes can reveal changes in chromosome number associated with aneuploid  conditions, such as trisomy 21 (Down syndrome). Careful analysis of karyotypes can also reveal more subtle  structural changes, such as chromosomal deletions, duplications, translocations, or inversions. In fact, as medical  genetics becomes increasingly integrated with clinical medicine, karyotypes are becoming a source of diagnostic  information for specific birth defects, genetic disorders, and even cancers. 

heterochromatic regions, which tend to be AT-rich DNA and relatively gene-poor, stain more darkly in  G-banding. In contrast, less condensed chromatin—which tends to be GC-rich and more transcriptionally  active—incorporates less Giemsa stain, and these regions appear as light bands in G-banding. Most importantly,  G-banding produces reproducible patterns for each chromosome, and these patterns are shared between the  individuals of a species. 

USING KARYO-GRAMS TO DETECT CHROMOSOMAL ABNORMALITIES  

Today, G-banded karyo-grams are routinely used to diagnose a wide range of chromosomal abnormalities in  individuals. Although the resolution of chromosomal changes detectable by karyotyping is typically a few  megabases, this can be sufficient to diagnose certain categories of abnormalities.  

For example, aneuploidy, which is often caused by the absence or addition of a chromosome, is simple to detect  by karyotype analysis. Cytogeneticists can also frequently detect much more subtle deletions or insertions as  deviations from normal banding patterns. Likewise, translocations are often readily apparent on karyotypes.

Reference  

• Caspersson, T., Zech, L., & Johansson, J. Differential banding of alkylating fluorochromes in  human chromosomes. Experimental Cell Research 60, 315–319 (1970) doi:10.1016/0014- 4827(70)90523-9 

• Speicher, M. R., Ballard, S. G., & Ward, D. C. Karyotyping human chromosomes by combinatorial multi-fluor FISH. Nature Genetics 12, 368–375 (1996) 

(https://www.nature.com/scitable/content/Karyotyping-human-chromosomes-by combinatorial-multi-fluor-14585/)

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Minor discomforts During Pregnancy

 Minor discomforts During Pregnancy

During pregnancy, a women's body changes in many ways. These changes can sometimes be uncomfortable but most of the time they are normal. Most women will experience some discomforts during first, second, and third trimester during pregnancy. Symptoms of discomfort during pregnancy vary from woman to another. The main cause of those discomforts are hormonal changes during pregnancy.  

• Minor discomforts during first trimester: 

Pregnant woman in her 1st trimester may experience symptoms such as:

Morning sickness (nausea and vomiting) – frequent urination – breast tenderness – fatigue – headache – dizziness – vaginal discharge (leuKorrhea).

1. Morning sickness (nausea and vomiting):

They are common discomfort of the first trimester, causes are unknown, and research suggests that the unusual increasing in the level of estrogen and progesterone, deficiency of vitamin b6 may be a contributing factor. Nausea affects about 80% of women during pregnancy, and about 50% experience both nausea and vomiting. Severe vomiting is called hyperemesis gravidarum.

How to deal with Nausea and vomiting? 

• Get out of bed slowly

• Avoid sudden movement

• Always look for changing the air of the room and others.

• Eat small, frequent meals.

• Eating dry crackers, cheeses, lemonade, and increasing food containing vitamin b6 such as meat, banana, and fish.

2. Frequent urination: 

Increased voiding frequently because of hormonal changes during 1st trimester 

Management:

Report any burning sensation to your doctor.

Do some exercises to strengthen the perineal muscles (Kegel exercise)

3. Breast tenderness and enlargement: 

Causes are increased amount of estrogen and progesterone influences glandular tissue and lobular alveolar growth of the breast, this make it become tender and enlarged.

How to manage? :

▪ wear supportive maternity bra with pads at night

▪ wash with warm water, keep dry and avoid soap on nipples

▪    Change sleeps position

▪ Caffeine should be avoided 

4. Fatigue:

Although experience with fatigue tends to vary, most women will feel more tired than usual during their pregnancy. Fatigue during pregnancy is most common during the first trimester. It tends to go away during the second trimester, but will usually return in the third trimester. Some cases, fatigue is due to anemia (low blood iron)

How to cope with it? 

▪ Rest when you feel tired

▪ Eat a Balanced Diet, get enough iron, protein, and calories

▪ Adjust Schedule, you may have to temporarily adjust your schedule to be less busy.

5. Dizziness:

May be caused by:

• Quickly moving from a sitting position to a standing position 

• Low blood pressure due to the uterus compressing major arteries

• Low blood sugar

• Low iron (anemia)

• Dehydration 

How to deal with dizziness? 

• Avoid standing for long periods. If you must stand, make sure that you keep your feet moving to help increase circulation.

• Stand up slowly and hold on to the walls and other stable structures for support and balance.

• Get up slowly from either sitting or lying down. 

• Eat regularly. Avoid long periods between meals; it is better to snack throughout the day.

• Avoid hot baths or showers.

• Avoid lying on back once you reach the middle of your second trimester.

• Wear loose, comfortable clothing to avoid restricting circulation.

6. Headache: 

Headaches during pregnancy can be a result of hormonal changes, tension, and congestion, constipation, lack of sleep, dehydration, low blood pressure, low blood sugar, and even caffeine withdrawal.

How to treat headache? 

• Posture plays an important role. Try to stand up and sit up straight.

• Get plenty of rest and practice relaxation exercises 

• Exercise (daily 30-minute walk)

• Eat frequent and well-balanced meals

• Avoid foods that set off headaches, such as chocolate, caffeine, dairy, meats with preservatives.

• keep hydration by drinking at least 8 cups of water a day (dehydration can be a trigger)

• Applying a compress to your head or neck when having a headache

• Eating more frequent meals to avoid low blood sugar 

• Massage your head (or have someone to do it for you)

• If you are sensitive to light and/or sound, try blocking these out or minimizing (sunglasses, earphones to block noise)

• Take a dose of acetaminophen (if your doctor approves)

7. Increased vaginal discharge(leukorrhea)

Leukorrhea is a leak of thin or thick whitish viscous vaginal secretions (physiological change)

Causes: increase mucus production by vaginal glands and vaginal mucosal hyperplasia, usually there is no odor irritation, itching or discomfort unless hygiene is poor

How to deal with vaginal discharge? 

• Cleanliness by daily bathing

• Wear perinatal pads

• Perform hygienic practice such as wiping front to back

• Avoid nylon underpants that retain heat and moisture in the genital area

• Apply and use absorbent cotton underpants

• Report to health care providers if accompanied by pruritus, foul odor. 

References: 

1. https://www.medicinenet.com/common_causes_of_pregnancy_discomforts/article.htm

2. https://nurseslabs.com/discomforts-pregnancy/

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