Petits maux de la grossesse

Abstract

45% to 89% of pregnant women experience nausea and vomiting. The treatment is nutritional (well accepted food, 4 to 6 meals per day). Pyridoxine (750 mg/day) is more effective on vomiting than on nausea. Antiemetic drugs (metopimazine, metoclopramide) are more or less efficient; some authors recommend homeopathic drugs or acupuncture. Persistent vomiting after 14 amenorrhea weeks suggests a psychological or an organic cause. There is no effective treatment for ptyalism. Constipation is first treated with an appropriate diet (fruits and both fresh and cooked vegetables for each meal); lactulose, vaseline oil and mucilage (ispaghul) or macrogol can then be used. Pyrosis occurs in late pregnancy, mainly when lying on the back and during night time: alginates are first prescribed and if they are not efficient enough, ranitidine or omeprazole can be used. In case of persistent pyrosis, oesophagoscopy may help detecting oesophagitis or hiatal hernia. Night cramps are highly painful: basic treatment is magnesium supplements for 2 to 3 weeks. Quinine (150 to 300 mg per dosing) is a symptomatic treatment and is not contraindicated. There is no effective treatment for the pelvic girdle relaxation that spontaneously recovers post partum. Lumbosacral pain is treated by lumbar lordose reduction: antalgesic drugs are not efficient. Massages and hydrotherapy reduce such pain. The treatment of congestive rhinitis is based on antihistaminic drugs: local vasoconstrictive drugs are contraindicated. In hypertrophic gingivitis, tooth brushing should be replaced by hydrojet. Epulis is uncommon and rarely requires surgery, except in abundant bleeding. Striae albae are common and there is no really effective treatment; moisturizing milks and creams can be applied to reduce dry skin.