Symptoms and discomforts of pregnancy are those presentations and conditions that result from pregnancy but do not significantly interfere with activities of daily living or pose any significant threat to the health of the mother or baby, in contrast to pregnancy complications. Still, there is often no clear separation between symptoms versus discomforts versus complications, and in some cases the same basic feature can manifest as either a discomfort or a complication depending on the severity. For example, mild nausea may merely be a discomfort (morning sickness), but if severe and with vomiting causing water-electrolyte imbalance it can be classified as a pregnancy complication (hyperemesis gravidarum).
Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. Childbirth typically occurs around 40 weeks from the last menstrual period (LMP). This is just over nine months, where each month averages 31 days. When measured from fertilization it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following fertilization, after which, the term fetus is used until birth. Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.
Activities of daily living is a term used in healthcare to refer to people's daily self care activities. The concept of ADLs was originally proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, OH and has been added to and refined by a variety of researchers since that time. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status, particularly in regard to people post injury, with disabilities and the elderly. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.
Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Despite the name, nausea or vomiting can occur at any time during the day. Typically these symptoms occur between the 4th and 16th week of pregnancy. About 10% of women still have symptoms after the 20th week of pregnancy. A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.
Morning sickness occurs in about seventy percent of all pregnant women, and typically improves after the first trimester.[1] Although described as "morning sickness", women can experience this nausea during the afternoon, evening, and throughout the entire day. Unfortunately there is no strong evidence showing one treatment that works for all women. Ginger may help some women but the results change from study to study.[2]
Bleeding
It is common to have bleeding in early pregnancy, this is associated with implantation bleeding and can be mistaken for a regular period. However implantation bleeding is usually much lighter and in many cases sanitary napkins aren't necessary. Although excessive bleeding in the first trimester can also be associated with miscarriage.
Back pain
Back pain is common in pregnancy, can be very debilitating and can worsen in later pregnancy.[3][4] Estimates of prevalence ranging from 35% to 61% have been reported, with half or more beginning from the fifth month.[4] Back pain is believed to be caused by changing posture and can be worse in the evening.[4] Low to moderate quality evidence indicates that there is benefit from exercising in water, massage therapy, and back care classes.[3] There is a small amount of evidence to suggest that acupuncture, craniosacral therapy, osteomanipulative therapy or a multi-modal intervention (manual therapy, exercise and education) may also be of benefit.[3] Back care classes for pregnancy include a variety of exercises and guidance. General exercise that is not tailored to strengthen the back may not prevent or reduce back pain, but more research is needed to be sure.[5][6] Maternity support belts have not been shown to reduce low back pain in pregnancy.[7] They may have some adverse effects, including pain and skin irritation for the mother, and potential effects on the fetus.[7]
Pelvic girdle pain is complex and multi-factorial and likely to be represented by a series of sub-groups with different underlying pain drivers from peripheral or central nervous system,[8] altered laxity/stiffness of muscles,[9] laxity to injury of tendinous/ligamentous structures[10] to 'mal-adaptive' body mechanics.[8] Musculo-skeletal mechanics involved in gait and weightbearing activities can be mild to grossly impaired. PGP can begin peri or postpartum. Land or water based exercise may help prevent and treat lower back and pelvic pain but research on this subject is low quality.[11] There is pain, instability or dysfunction in the symphysis pubis and/or sacroiliac joints. Moderate-quality evidence from a systematic review suggest that exercise or acupuncture reduced pelvic pain or lumbo-pelvic pain more than usual care.[12][needs update]What Helps Alleviate SPD - Case Study
Pelvic girdle pain is a pregnancy discomfort that causes pain, instability and limitation of mobility and functioning in any of the three pelvic joints. PGP has a long history of recognition, mentioned by Hippocrates and later described in medical literature by Snelling.
The affection appears to consist of relaxation of the pelvic articulations, becoming apparent suddenly after parturition or gradually during pregnancy and permitting a degree of mobility of the pelvic bones which effectively hinders locomotion and gives rise to the most peculiar and alarming sensations.
Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency. Different animal species may use different gaits due to differences in anatomy that prevent use of certain gaits, or simply due to evolved innate preferences as a result of habitat differences. While various gaits are given specific names, the complexity of biological systems and interacting with the environment make these distinctions 'fuzzy' at best. Gaits are typically classified according to footfall patterns, but recent studies often prefer definitions based on mechanics. The term typically does not refer to limb-based propulsion through fluid mediums such as water or air, but rather to propulsion across a solid substrate by generating reactive forces against it.
Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain's widely used definition defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage"; however, due to it being a complex, subjective phenomenon, defining pain has been a challenge. In medical diagnosis, pain is regarded as a symptom of an underlying condition.
Occurs in between an estimated 21% to 62% of cases, possibly due to edema.[13]
Edema, also spelled oedema or œdema, is an abnormal accumulation of fluid in the interstitium, located beneath the skin and in the cavities of the body, which can cause severe pain. Clinically, edema manifests as swelling. The amount of interstitial fluid is determined by the balance of fluid homeostasis and the increased secretion of fluid into the interstitium. The word is from Greek οἴδημα oídēma meaning "swelling". The condition is also known as dropsy.
Leg cramps
Leg cramps (involuntary spasms in calf muscles) can affect between 30% to 50% of women during pregnancy, especially during the last three months of pregnancy.[14] Leg cramps can be extremely painful and whilst they usually last only a few seconds, they can last for minutes.[15] It is not clear whether some oral drug treatments (such as magnesium, calcium, vitamin B or vitamin C) are effective in treating leg cramps during pregnancy, nor whether these treatments are safe for the mother or her baby.[16] There is no evidence to assess the effectiveness and safety of other non-drug treatments such as heat therapy, massage or stretching the muscles (or dorsiflexion of the foot).[16]Leg Cramps During Pregnancy Case Study
Constipation
Constipation is believed to be caused by decreased bowel mobility secondary to elevated progesterone (normal in pregnancy), which can lead to greater absorption of water, but it can also be caused or worsened by iron supplementation.[4] It causes the "smooth muscle" along the walls of the intestines to relax. Thus, making sure that the future mother will absorb as much nutrients from her diet as possible in order to nourish the fetus and herself. As a side effect the feces can get extremely dehydrated and hard to pass.[17] Constipation can decrease as pregnancy progresses, with a rate as high as 39% at 14 weeks of gestation reducing to 20% at 36 weeks in one study at a time when iron supplementation was common.[4]
Dietary modification with more fiber or fiber supplementation. Also, increased PO fluids, stool softeners, bulking agents and eating fruit and fiber enriched foods often help. There is not enough evidence to say how best to treat constipation in pregnancy.[18] Stimulant laxatives may help but also cause diarrhoea and abdominal pain. Fibre supplementation may also help.[18]
Occasional, irregular, painless contractions that occur several times per day are normal and are known as Braxton Hicks contractions. Can be aggravated by dehydration which will respond to increased fluid intake. Regular contractions (every 10–15 min) are a sign of preterm labor and should be assessed by cervical exam.
Dehydration
Caused by expanded intravascular space and increased third spacing of fluids. Complications include uterine contractions, which may occur because dehydration causes body release of ADH, which is similar to oxytocin in structure. Oxytocin itself can cause uterine contractions and thus ADH can cross-react with oxytocin receptors and cause contractions.
Edema
Compression of the inferior vena cava (IVC) and pelvic veins by the uterus leads to increased hydrostatic pressure in lower extremities. Treatment includes raising legs above the heart, advising patient to sleep on her side to prevent the uterus from impinging on the inferior vena cava, reflexology, water emersion[19] & compression stockings.
Regurgitation and heartburn
Regurgitation and heartburn in pregnancy are caused by relaxation of the lower esophageal sphincter (LES) and increased transit time in the stomach (normal in pregnancy), as well as by increased intra-abdominal pressure, caused by the enlarging uterus.
Regurgitation and heartburn in pregnancy can be at least alleviated by eating multiple small meals a day, avoiding eating within three hours of going to bed, and sitting up straight when eating.[20]
If diet and lifestyle changes are not enough, antacids and alginates may be required to control indigestion, particularly if the symptoms are mild.[20] If these, in turn, are not enough, proton pump inhibitors may be used.[20]
Dilation of veins in legs caused by relaxation of smooth muscle and increased intravascular pressure due to fluid volume increase. Treatment involves elevation of the legs and pressure stockings to relieve swelling along with warm sitz baths to decrease pain. There is a small amount of evidence that rutosides (a herbal remedy) may relieve symptoms of varicose veins in late pregnancy but it is not yet known if rutosides are safe to take in pregnancy.[19] Risk factors include obesity, lengthy standing or sitting, constrictive clothing and constipation and bearing down with bowel movements
Hemorrhoids
Haemorrhoids (piles) are swollen veins at or inside the anal area, resulting from impaired venous return, straining associated with constipation, or increased intra-abdominal pressure in later pregnancy.[21] They are more common in pregnant than non-pregnant women.[21] It is reported by 16% of women at 6 months postpartum.[22] Most pregnant women in countries where the diet is not heavily fiber-based may develop hemorrhoids,[23] although they will usually be asymptomatic.[21] Hemorrhoids can cause bleeding, itching, soiling or pain, and they can become strangulated.[21] Symptoms may resolve spontaneously after pregnancy, although hemorrhoids are also common in the days after childbirth.[21] Conservative treatments for hemorrhoids in pregnancy include dietary modification, local treatments, bowel stimulants or depressants, or phlebotonics (to strengthen capillaries and improve microcirculation).[23] Treatment with oral hydroxyethylrutosides may help improve first and second degree hemorrhoids, but more information on safety in pregnancy is needed.[23] Other treatments and approaches have not been evaluated in pregnant women.[23]
Pica
Pica is a craving for nonedible items such as dirt or clay. It is caused by iron deficiency which is normal during pregnancy and can be overcome with iron in prenatal vitamins or, if severe, parenteral iron
Caused by rapid expansion of the uterus and stretching of ligaments such as the round ligament. This pain is typically treated with paracetamol (acetaminophen).
Increased urinary frequency
Caused by increased intravascular volume, elevated GFR (glomerular filtration rate), and compression of the bladder by the expanding uterus. It may appear rather suddenly by head engagement of the fetus into cephalic presentation. Patients are advised to continue fluid intake despite this. Urinalysis and culture should be ordered to rule out infection, which can also cause increased urinary frequency but typically is accompanied by dysuria (pain when urinating).
During pregnancy, many women experience a separation of their stomach muscles, known as diastasis recti. It affects the rectus abdominis muscle.
The rectus abdominis muscle is divided down the middle by the tendinous line called the linea alba.[24] It is kept in line by the transverse abdominal and oblique abdominal muscles. During pregnancy, the growth of the fetus exerts pressure on abdominal cavity muscles, in particular the rectus abdominis. In pregnancies that experience rapid fetus growth or women with particularly weak abdominal muscles, this pressure can sometimes causes the rectus abdominis muscle to separate along the linea alba, creating a split between the left and right sides of the rectus abdominis.[25]
About one-third of all pregnant women experience diastasis recti at some point in their pregnancy, however it is much more likely to occur during the second trimester or third trimester of pregnancy. However, separation also frequently occurs during labor and delivery, or with women carrying more than one baby.[26] Many cases of diastasis recti correct themselves after birth, but some do not. In cases where it persists, exercise may help improve the condition, and sometimes surgery is needed to correct the problem to prevent pain and future complications.[27][28]
Striae gravidarum (pregnancy-related stretch marks) occur in 50% to 90% of women,[29] and are caused both by the skin stretching and by the effects of hormonal changes on fibers in the skin.[30] They are more common in younger women, women of color, women having larger babies and women who are overweight or obese, and they sometimes run in families.[30] Stretch marks generally begin as red or purple stripes (striae rubra), fading to pale or flesh-color (striae alba) after pregnancy that will generally be permanent.[29][30][31] They appear most commonly on the abdomen, breasts, buttocks, thighs, and arms, and may cause itching and discomfort.[29][30] Although several kinds of multi-component creams are marketed and used, along with vitamin E cream, cocoa butter, almond oil and olive oil, none have been shown to prevent or reduce stretch marks in pregnancy.[29][30] The safety for use in pregnancy of one herbal ingredient used in some products, Centella asiatica, has been questioned.[30] Some treatments used to reduce scarring, such as topical tretinoin lasers,[31] are sometimes used on stretch marks, but evidence on them is limited.[30] Topical tretinoin has been shown to cause malformations in animals, without adequate human studies on safety in human pregnancies.[32]
Generalized itching
It is a quite common complaint in pregnancy to have generalized itching which is not due to any systemic disease or any skin lesion.[33] The itching is very frustrating and it may disturb sleep which leads to exhaustion and impaired quality of life. But till now, there is no clear satisfying treatment for this symptom. So more researches are needed to define a possible, effective, and safe management.[33]
Endometriosis is a condition in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside of it. Most often this is on the ovaries, Fallopian tubes, and tissue around the uterus and ovaries; however, in rare cases it may also occur in other parts of the body. The main symptoms are pelvic pain and infertility. Nearly half of those affected have chronic pelvic pain, while in 70% pain occurs during menstruation. Pain during sexual intercourse is also common. Infertility occurs in up to half of women affected. Less common symptoms include urinary or bowel symptoms. About 25% of women have no symptoms. Endometriosis can have both social and psychological effects.
Back pain is pain felt in the back. The back is divided into middle back pain (thoracic), lower back pain (lumbar) or coccydynia based on the segment affected. Neck pain (cervical), which is considered an independent entity, can involve similar processes. The lumbar area is the most common area for pain, as it supports most of the weight in the upper body. Episodes of back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation. Discomfort can radiate into the arms and hands as well as the legs or feet, and may include numbness, or weakness in the legs and arms.
Constipation refers to bowel movements that are infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.
Hemorrhoids, also called piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term "hemorrhoid" is often used to refer to the disease. The signs and symptoms of hemorrhoids depend on the type present. Internal hemorrhoids often result in painless, bright red rectal bleeding when defecating. External hemorrhoids often result in pain and swelling in the area of the anus. If bleeding occurs it is usually darker. Symptoms frequently get better after a few days. A skin tag may remain after the healing of an external hemorrhoid.
Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis.
Kegel exercise, also known as pelvic-floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed multiple times each day, for several minutes at a time, for one to three months, to begin to have an effect.
Dysmenorrhea, also known as painful periods, or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the pelvis or lower abdomen. Other symptoms may include back pain, diarrhea, or nausea.
Arnold Henry Kegel was an American gynecologist who invented the Kegel perineometer and Kegel exercises as non-surgical treatment of genital relaxation. Today pelvic floor exercises are widely held as first-line treatment for urinary stress incontinence and any type of female incontinence and female genital prolapse, with evidence supporting its use from systematic reviews of randomized trials in the Cochrane Library amongst others. Kegel first published his ideas in 1948. He was Assistant Professor of Gynecology at the Keck School of Medicine of USC.
Postherpetic neuralgia (PHN) is neuropathic pain which occurs due to damage to a peripheral nerve caused by the reactivation of the varicella zoster virus. Typically, the nerve pain (neuralgia) is confined to an area of skin innervated by a single sensory nerve, which is known as a dermatome. PHN is defined as dermatomal nerve pain that persists for more than 90 days after an outbreak of herpes zoster affecting the same dermatome. Several types of pain may occur with PHN including continuous burning pain, episodes of severe shooting or electric-like pain, and a heightened sensitivity to gentle touch which would not otherwise cause pain or to painful stimuli (hyperalgesia). Abnormal sensations and itching may also occur.
Charley horse is a popular colloquial term in Canada and the United States for painful involuntary spasms or cramps in the leg muscles, typically lasting anywhere from a few seconds to about a day. It is less likely to refer to a bruise on an arm or leg and a bruising of the quadriceps muscle of the anterior or lateral thigh, or contusion of the femur, that commonly results in a haematoma and sometimes several weeks of pain and disability. In this latter sense, such an injury is known as dead leg. Dead leg and charlie horse are two different kinds of injury: a dead leg involves someone or something hitting a leg, causing it to go numb. A charlie horse involves the muscles contracting without warning, and can last from a few minutes or a few days. It often occurs in contact sports, such as football when an athlete suffers a knee to the lateral quadriceps causing a haematoma or temporary paresis and antalgic gait as a result of pain.
Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments.
Endometritis is inflammation of the inner lining of the uterus (endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also part of spectrum of diseases that make up pelvic inflammatory disease.
Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. Venous ulcers develop mostly along the medial distal leg, and can be painful with negative effects on quality of life.
Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to insufficient strength of the closure of the bladder.
Uterine prolapse is when the uterus descends towards or through the opening of the vagina. Symptoms may include vaginal fullness, pain with sex, trouble urinating, urinary incontinence, and constipation. Often it gets worse over time. Low back pain and vaginal bleeding may also occur.
Postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth. Some have added the requirement that there also be signs or symptoms of low blood volume for the condition to exist. Signs and symptoms may initially include: an increased heart rate, feeling faint upon standing, and an increased breath rate. As more blood is lost, the woman may feel cold, her blood pressure may drop, and she may become restless or unconscious. The condition can occur up to six weeks following delivery.
A perineal tear is a laceration of the skin and other soft tissue structures which, in women, separate the vagina from the anus. Perineal tears mainly occur in women as a result of vaginal childbirth, which strains the perineum. It the most common form of obstetric injury. Tears vary widely in severity. The majority are superficial and may require no treatment, but severe tears can cause significant bleeding, long-term pain or dysfunction. A perineal tear is distinct from an episiotomy, in which the perineum is intentionally incised to facilitate delivery. Episiotomy, a very rapid birth, or large fetal size can lead to more severe tears which may require surgical intervention.
Pain management during childbirth is the treatment or prevention of pain that a woman may experience during labor and delivery. The amount of pain a woman feels during labor depends partly on the size and position of her baby, the size of her pelvis, her emotions, the strength of the contractions, and her outlook. Tension increases pain during labor. Virtually all women worry about how they will cope with the pain of labor and delivery. Childbirth is different for each woman and predicting the amount of pain experienced during birth and delivery can not be certain.
The postpartum physiological changes are those expected changes that occur to the woman's body after childbirth, in the postpartum period. These changes mark the beginning of the return of pre-pregnancy physiology and of breastfeeding. Most of the time these postnatal changes are normal and can be managed with medication and comfort measures, but in a few situations complications may develop. Postpartum physiological changes may be different for women delivering by cesarean section. Other postpartum changes, may indicate developing complications such as, postpartum bleeding, engorged breasts, postpartum infections.
↑ Matthews, A; Haas, DM; O'Mathúna, DP; Dowswell, T (8 September 2015). "Interventions for nausea and vomiting in early pregnancy". The Cochrane Database of Systematic Reviews. 9 (9): CD007575. doi:10.1002/14651858.CD007575.pub4. PMID26348534.
1 2 3 Liddle, Sarah D.; Pennick, Victoria (2015-09-30). "Interventions for preventing and treating low-back and pelvic pain during pregnancy". The Cochrane Database of Systematic Reviews (9): CD001139. doi:10.1002/14651858.CD001139.pub4. ISSN1469-493X. PMID26422811.
↑ Eggen, MH; Stuge, B; Mowinckel, P; Jensen, KS; Hagen, KB (June 2012). "Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial". Physical Therapy. 92 (6): 781–90. doi:10.2522/ptj.20110119. PMID22282770.
1 2 Ho, SS; Yu, WW; Lao, TT; Chow, DH; Chung, JW; Li, Y (June 2009). "Effectiveness of maternity support belts in reducing low back pain during pregnancy: a review". Journal of Clinical Nursing. 18 (11): 1523–32. doi:10.1111/j.1365-2702.2008.02749.x. PMID19490291.
1 2 O'Sullivan, Peter B.; Beales, Darren J. (May 2007). "Diagnosis and classification of pelvic girdle pain disorders—Part 1: A mechanism based approach within a biopsychosocial framework". Manual Therapy. 12 (2): 86–97. doi:10.1016/j.math.2007.02.001. PMID17449432.
↑ European guidelines for the diagnosis and treatment of pelvic girdle pain.Eur Spine J. 2008 Feb 8 Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B.
↑ Possible role of the long dorsal sacroiliac ligament in women with peripartum pelvic pain. Acta Obstetricia et Gynecologica Scandinavica Volume 81 Issue 5 Page 430-436, May 2002, Andry Vleeming, Haitze J. de Vries, Jan MA Mens, Jan-Paul van Wingerden
↑ Liddle, SD; Pennick, V (30 September 2015). "Interventions for preventing and treating low-back and pelvic pain during pregnancy". The Cochrane Database of Systematic Reviews. 9: CD001139. doi:10.1002/14651858.CD001139.pub4. PMID26422811.
↑ Mondelli M, Rossi S, Monti E, et al. (September 2007). "Long term follow-up of carpal tunnel syndrome during pregnancy: a cohort study and review of the literature". Electromyogr Clin Neurophysiol. 47 (6): 259–71. PMID17918501.
↑ Sohrabvand, F; Shariat, M; Haghollahi, F (October 2006). "Vitamin B supplementation for leg cramps during pregnancy". International Journal of Gynaecology and Obstetrics. 95 (1): 48–9. doi:10.1016/j.ijgo.2006.05.034. PMID16919630.
↑ Allen, RE; Kirby, KA (15 August 2012). "Nocturnal leg cramps". American Family Physician. 86 (4): 350–5. PMID22963024.
1 2 Zhou, K; West, HM; Zhang, J; Xu, L; Li, W (11 August 2015). "Interventions for leg cramps in pregnancy". The Cochrane Database of Systematic Reviews. 8 (8): CD010655. doi:10.1002/14651858.CD010655.pub2. PMID26262909.
1 2 Rungsiprakarn, P; Laopaiboon, M; Sangkomkamhang, US; Lumbiganon, P; Pratt, JJ (4 September 2015). "Interventions for treating constipation in pregnancy". The Cochrane Database of Systematic Reviews. 9 (9): CD011448. doi:10.1002/14651858.CD011448.pub2. PMID26342714.
1 2 Smyth, RM; Aflaifel, N; Bamigboye, AA (19 October 2015). "Interventions for varicose veins and leg oedema in pregnancy". The Cochrane Database of Systematic Reviews. 10 (10): CD001066. doi:10.1002/14651858.CD001066.pub3. PMID26477632.
↑ Borders, N. (2006). After the afterbirth: a critical review of postpartum health relative to method of delivery. Journal of Midwifery & Women’s health, 51(4), 242-248.
1 2 3 4 5 6 7 Tunzi, M; Gray, GR (15 January 2007). "Common skin conditions during pregnancy". American Family Physician. 75 (2): 211–18. PMID17263216.
1 2 Alexiades-Armenakas, MR; Bernstein, LJ; Friedman, PM; Geronemus, RG (August 2004). "The safety and efficacy of the 308-nm excimer laser for pigment correction of hypopigmented scars and striae alba". Archives of Dermatology. 140 (8): 955–60. doi:10.1001/archderm.140.8.955. PMID15313811.
1 2 Rungsiprakarn, P; Laopaiboon, M; Sangkomkamhang, US; Lumbiganon, P (19 February 2016). "Pharmacological interventions for generalised itching (not caused by systemic disease or skin lesions) in pregnancy". The Cochrane Database of Systematic Reviews. 2: CD011351. doi:10.1002/14651858.CD011351.pub2. PMID26891962.
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