The PGM Method - Pregnancy and Postpartum Considerations: Difference between revisions

(added content and references to page_still to add image and youtube video under thyroid hormone)
(added content and references to gestational diabetes)
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** Morning sickness and vomiting
** Morning sickness and vomiting


'''''It is very important that the healthcare provider should monitor any thyroid problems and thyroid levels!'''''<ref name=":0" />  
'''''It is very important that the healthcare provider should monitor any thyroid problems and thyroid levels!'''''<ref name=":0" />
 
=== Gestational Diabetes ===
 
* Monitored with glucose intolerance test
* Requires medical management
* Can be affected by exercise and education (diet and lifestyle)
* Risk factors linked to diet and lifestyle factors<ref>Ming WK, Ding W, Zhang CJ, Zhong L, Long Y, Li Z, Sun C, Wu Y, Chen H, Chen H, Wang Z. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233372/ The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis]. BMC pregnancy and childbirth. 2018 Dec;18(1):1-9</ref>
* Increased risk of:
** Hypertension
** Future diabetes for mother and child
** Caesarean section
** Preeclampsia
*** Serious medical condition – life threatening<ref>De Kat AC, Hirst J, Woodward M, Kennedy S, Peters SA. Prediction models for preeclampsia: a systematic review. Pregnancy hypertension. 2019 Apr 1;16:48-66</ref>
*** [https://preeclampsia.org/ Preeclampsia.org] (Preeclampsia Foundation)
*** Monitor blood pressure and protein in urine
*** If blood pressure > 140/90 mmHg and excessive protein in urine
*** Symptoms such as:
**** Headaches
**** Vision changes
**** Nausea
**** Vomiting
**** Rib pain in right side
**** Low urine output
**** Sudden weight gain
**** Swelling, oedema
**** Shortness of breath
**** Impaired liver function


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Revision as of 17:32, 10 June 2021

Original Editor - Deborah Riczo

Top Contributors - Wanda van Niekerk, Kim Jackson, Vidya Acharya and Tarina van der Stockt  

Hormonal Changes[edit | edit source]

Relaxin[edit | edit source]

  • Increases during pregnancy so that the body has the ability to stretch
  • Often seen as the culprit for problems during pregnancy
  • Research indicates that there is no link between pelvic girdle pain and relaxin serum levels during pregnancy[1]
  • Relaxin relaxes the uterus and myometrium, as well as cervix
  • Also allows for the pubic symphysis area widening during the first trimester
  • During first 12 weeks of pregnancy – hormone increases 10 times and then starts to taper off
  • Women in early stages of pregnancy already having back pain due to surge of relaxin in the system to prepare for childbirth – decreases to about 50 % of peak value by 20th week[2]

Estrogen[edit | edit source]

  • Levels increase during pregnancy
  • Responsible for water and sodium retention
  • Relaxing effect on muscles and ligaments
  • Increases vascularity in the respiratory membrane and signs of this include:
    • frequent nosebleeds, nasal stuffiness (congestion), voice changes

Progesterone[edit | edit source]

  • Increases body temperature
  • Hyperventilation
  • Decrease in gastric mobility
  • Decrease in smooth muscle tone

Thyroid Hormone[edit | edit source]

  • Increases basal metabolic rate (BMT) by 25% during pregnancy [3]
  • Thyroid disorders second most common endocrine disorder in pregnancy and postpartum (diabetes is the most common)[4]
  • Subclinical hypothyroidism (increased need for thyroxin during pregnancy)
  • Symptoms of hypothyroid:
    • Difficulty concentrating/ brain fog
    • Excessive weight gain
    • Cold
    • Extreme fatigue
    • Muscle cramping
    • Constipation
  • Symptoms of hyperthyroid:
    • Nervousness/anxiety
    • Weight loss/low weight gain
    • Hot
    • Fatigue, difficulty sleeping
    • Tremor
    • Increased and/or irregular heart rate
    • Morning sickness and vomiting

It is very important that the healthcare provider should monitor any thyroid problems and thyroid levels![4]

Gestational Diabetes[edit | edit source]

  • Monitored with glucose intolerance test
  • Requires medical management
  • Can be affected by exercise and education (diet and lifestyle)
  • Risk factors linked to diet and lifestyle factors[5]
  • Increased risk of:
    • Hypertension
    • Future diabetes for mother and child
    • Caesarean section
    • Preeclampsia
      • Serious medical condition – life threatening[6]
      • Preeclampsia.org (Preeclampsia Foundation)
      • Monitor blood pressure and protein in urine
      • If blood pressure > 140/90 mmHg and excessive protein in urine
      • Symptoms such as:
        • Headaches
        • Vision changes
        • Nausea
        • Vomiting
        • Rib pain in right side
        • Low urine output
        • Sudden weight gain
        • Swelling, oedema
        • Shortness of breath
        • Impaired liver function

Sub Heading 2[edit | edit source]

Sub Heading 3[edit | edit source]

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ Clinton SC, Newell A, Downey PA, Ferreira K. Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the Section on Women's Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women's Health Physical Therapy. 2017 May 1;41(2):102-25.
  2. ↑ Kristiansson P, Svärdsudd K, von Schoultz B. Serum relaxin, symphyseal pain, and back pain during pregnancy. American journal of obstetrics and gynecology. 1996 Nov 1;175(5):1342- 7
  3. ↑ Ramprasad M, Bhattacharyya SS, Bhattacharyya A. Thyroid disorders in pregnancy. Indian journal of endocrinology and metabolism. 2012 Dec;16(Suppl 2):S167.
  4. ↑ 4.0 4.1 Alemu A, Terefe B, Abebe M, Biadgo B. Thyroid hormone dysfunction during pregnancy: A review. International Journal of Reproductive BioMedicine. 2016 Nov;14(11):677
  5. ↑ Ming WK, Ding W, Zhang CJ, Zhong L, Long Y, Li Z, Sun C, Wu Y, Chen H, Chen H, Wang Z. The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2018 Dec;18(1):1-9
  6. ↑ De Kat AC, Hirst J, Woodward M, Kennedy S, Peters SA. Prediction models for preeclampsia: a systematic review. Pregnancy hypertension. 2019 Apr 1;16:48-66
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