Symptom Remedies
Pre-Eclampsia: A frequent reason Mamas are prescribed bed rest
August 25th, 2010Pre-Eclampsia-Definition and Background
Pre-Eclampsia is a medical condition that only affects women during pregnancy and post partum. It is characterized by 
high blood pressure and protein in the urine, subsequently creating a toxic physical environment for both mother and baby. It is frequently the reason a pregnant woman is prescribed bed rest. While it can occur anytime during pregnancy, it typically occurs after 20 weeks of pregnancy, in the late second or third trimester. Pre-Eclampsia occurs in 5-8% of all pregnancies globally and is the cause of some 76,000 maternal deaths and 500,000 infants annually.
Pre-Eclampsia can rapidly become a serious or even fatal medical condition. Women should know the signs and symptoms of pre-eclampsia and report any signs or symptoms they have to their health care provider immediately.
Major Signs and Symptoms of Pre-Eclampsia
None – The problem with Pre-Eclampsia, much like other hypertensive disorders, is that it often has no symptoms.
Hypertension is known as “the silent killer” and pre-eclampsia is no different. Bed rest has been shown to reduce blood pressure and frequently reduces the signs, symptoms and complications that may arise as a result of pre-eclampsia. Even though bed rest is inconvenient at best and quite uncomfortable and physically challenging at its worst, if your health care provider prescribes bed rest for pre-eclampsia, Please follow his or her directions, even if you feel fine.
Hypertension – Hypertension or high blood pressure is defined as two blood pressure readings over 140/90 at two different times at least six hours apart. However, pregnant women with normally low blood pressure, such as 110/65, may be diagnosed with pre-eclampsia prenatally or in the post partum period when their blood pressure rises to 135/80 and/or they develop signs and symptoms of pre-eclampsia.
In 1990 the National Institutes of Health, National High Blood Pressure Education Program: Working Group Report on High Blood Pressure in Pregnancy issued the following research guidelines:
In the past it has been recommended that an increase of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure be used as a diagnostic criterion, even when absolute values are below 140/90 mm Hg. This definition has not been included in our criteria because the only available evidence shows that women in this group are not likely to suffer increased adverse outcomes. Nonetheless, it is the collective clinical opinion of this panel that women who have a rise of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure warrant close observation, especially if proteinuria and hyperuricemia (uric acid [UA] greater than or equal to 6 mg/dL) are also present.
For this reason, it is extremely important that women know what their baseline blood pressure readings are and at each prenatal visit they ask their providers what their blood pressure is. In this way, both health care provider and patient can be on the look out for blood pressure abnormalities and address them as soon as possible.
Swelling (Edema) – Swelling can be an insidious symptom of pre-eclampsia because so many women experience swelling of their hands and/or feet or even their faces when they are pregnant. However, when the swelling is significant enough to change your facial features, you should notify your health care provider immediately, advising them that you believe the swelling has become excessive. You may need to show them a photo of you prior to pregnancy, your driver’s license for example, to prove your point. In any event, if swelling concerns you, make sure it becomes a concern of your health care providers and that it is addressed.
Proteinuria – Proteinuria occurs when proteins, usually filtered by the kidneys and retained in the blood stream, leak into the urine because the small blood vessels in the kidneys have become damaged allowing the proteins to pass through. (This is usually due to your elevated blood pressure. Remember, pre-eclampsia creates a toxic physical environment to both mother and baby!)
Other Common Signs and Symptoms of Pre-Eclampsia
Sudden Weight Gain – Since weight gain is a hallmark of pregnancy, it’s often hard to discern between regular pregnancy weight gain and weight gain associated with Pre-Eclampsia. The rule of thumb is that if you start gaining more than 2 lbs per week or more than 6 lbs in a month, you should consult with your health care provider as this could be an indication of pre-eclampsia.
Headache – Severe, migraine-like headaches which are often one sided and dull and throbbing could be a warning that your blood pressure is dangerously high. Contact your health care provider immediately for evaluation.
Nausea or Vomiting – While nausea and/or vomiting is common in the first trimester, it usually abates during the second and third trimesters. If you have sudden onset of nausea and/or vomiting in the second or third trimester, contact your health care provider immediately for evaluation.
Changes in Vision – If you experience any sudden blurred vision, double vision, flashing spots, or sudden light sensitivity, this is another warning that your blood pressure may be dangerously high. Contact your health care provider immediately for evaluation.
Racing pulse, mental confusion, heightened anxiety, trouble catching your breath – While all of these symptoms can occur in pregnant women, when they suddenly occur from out of the blue and especially if they occur together, this is cause for concern. Contact your health care provider immediately.
Stomach or Right Shoulder Pain – I want to be a bit more specific here. The pain you may be experiencing here is right upper quadrant abdominal pain, specifically, liver pain. The pain may be “radiating” or “referred” to the right shoulder, but its origin is in the liver. This pain requires immediate attention as it is an indication that the liver is under stress and you may be suffering from HELLP (Hemolysis-bursting of red blood cells, Elevated Liver enzymes levels, and Low Platelet count) as serious obstetrical complication. It is imperative that you be evaluated immediately if you have symptoms of HELLP to avoid more serious complications or even death.
Lower back pain - Low back pain is so common in pregnancy that it is difficult to distinguish between the typical low back pain of pregnancy and low back pain associated with pre-eclampsia. If you are unsure, certainly consult your health care provider. But consult with your health care provider immediately if the low back pain is present with right upper quadrant abdominal pain as this may be another sign of pre-eclampsia.
This is a cursory overview of Pre-Eclampsia and we will delve into the subject with more depth in coming blog posts. Just remember that pre-eclampsia can have serious medical consequences for both you and your baby including death, so if you are concerned about symptoms, consult with your health care provider and have an immediate evaluation.
This list of signs and symptoms is edited and reprinted from the list presented on The Pre-Eclampsia Foundation website. This website is a holds a wealth of information on pre-eclampsia; current research and resources for more information and to get more help and/or support.
Did you have pre-eclampsia during your pregnancy? Are you a Mama on Bedrest now for pre-eclampsia? Share your story in our comments section below.
Kegels: Essential Exercises for Mamas on Bed Rest
February 16th, 2010
Most women have heard of Kegels and at one time or another have been advised to perform Kegel exercises. But in my experience as a woman’s health professional, I find that many women have no idea what muscles are involved in Kegel exercises and as a result have no idea how to perform one properly. So I offer here a short review.
Kegels are essential exercises for all women, but especially for pregnant women on prescribed bed rest. Mamas on bed rest, with their prolonged inactivity and growing uteri are at increased risk of weakened pelvic floor muscles which will be further stretched and potentially weakened if they vaginally deliver their babies. The results can be urinary incontinence (involuntary loss of urine with coughing, laughing, sneezing), organ prolapse (bladder, uterine or rectal prolapse (bulging or protrusion of the bladder, uterus or rectum through their respective openings to the outside), or decreased sexual sensation due to the lax musculature. But I don’t want to get ahead of myself here. Let me start with the basics and work forward.
Dr. Arnold Kegel developed “Kegel” exercises to help women strengthen the pelvic floor muscles following pregnancy.
Dr. Kegel noted that women frequently became incontinent following pregnancy and found that if they could strengthen the pubococcygeus “PC” muscle (the muscle that is suspended along the pelvic floor like a hammock and holding all of the pelvic organs in place), they could often improve or reverse urinary incontinence as well as bladder, uterine or rectal prolapse. He started teaching his patients how to contract the PC muscle and Kegels were born
So how is a Kegel done? First, you have to be sure that you are working the proper muscles. If you are squeezing and releasing your buttocks, you are probably not working your pelvic floor muscles-at least not effectively. You can be sure you are working the pelvic floor muscles:
- By stopping the flow of urine while urinating. While this is a good way to get to know the pelvic floor muscles and what they feel like when contracted, do not stop the flow of urine ROUTINELY as a way to strengthen the pelvic floor muscles. This practice will actually weaken the muscles and cause or worsen urinary incontinence.
- You can look at your perineum and watch as you contract the muscles. If you are performing the exercises correctly, you will see the anus “wink” the perineum move up and down and the clitoris “nod” (thanks to Desiree Andrews of Prepforbirth.com for these great visuals!). This is a great way to see and learn which muscles are working. You can place a mirror on the floor and squat over it to see the muscles or hold a mirror between your legs. However, if you’re pregnant, it may be hard to hold the mirror between your legs and see and this is really hard of you are on bed rest. But for non-pregnant women, this is a good way to start learning how to Kegel.
- You can feel for muscle contractions by placing a finger or two into your vagina and then contracting the pelvic floor muscles around your fingers. Again, once you know which muscles to contract, you can effectively perform Kegels.
- There are devices that one can use to help stimulate the PC muscles. Physical therapists often use such devices when teaching clients how to do Kegels. Additionally, one can buy such devices and learn to Kegel using the devices.
Now once you get the basic muscle contractions down, you can then move on to some “advanced” Kegeling.
Squeeze, Hold, Release : This is just as it states. Squeeze your PC muscle, hold for a few seconds and release.
Elevators: This is an increasing contraction and likened to making floor stops while on an elevator. You begin by lightly contracting your pelvic PC muscle. After about 2-4 seconds, increase the contraction further pulling up the PC muscle. Hold for another 2-4 seconds and then tighten the contraction again. Hold for 2-4 seconds and then release. A variation is to gradually release the contractions holding for 2-4 seconds as the “elevator goes down.”
Quick Bursts: These are just what they say, quick contractions. You quickly contract the PC muscle, say 10 times. Rest for a brief moment and then repeat the series. This should be done several times over the course of about 5 minutes.
Some people recommend that women “Kegel” approximately 20o times a day-performing a variety of contractions. If you Kegel regularly, say 3-4 times a day performing 10 or more Kegels at a time, you will strengthen the PC muscle. But as the saying goes, the more you work a muscle, the stronger it becomes. So if you want to keep your PC muscle strong and have a strong pelvic floor, Kegel often, several times a day and in various situations so that you not only develop pelvic floor muscle strength, but also muscle control which can help prevent incontinence and enhance sexual pleasure.
Note: Second image courtesy of www.menstruation.com.au
Cold Remedies for Mamas on Bed Rest
December 11th, 2009I think I’m getting a cold. The other day I was teaching a fitness class, bent over and nearly fell on my face. My head got that “full” feeling and I thought, “Oh no, not now!” I have been feeling tired and have been burning the candle at both ends to get everything done for the holidays before my kids get out of school for winter break. I suppose I may have over done it a bit.
I hated being sick when I was pregnant and with each pregnancy I got at least one cold. Because of the stress of pregnancy on the immune system, pregnant women are at greater risk for contracting various cold and flu viruses. In this era of H1N1 it’s hard to know just what to do if you get sick. Many obstetricians allow pregnant mamas to take a few over the counter cold remedies; Tylenol, Sudafed and Benadryl are commonly regarded by obstetricians as safe to take. But if you are on bed rest, sometimes the recommendations are different-especially if you are taking medications for diabetes, high blood pressure or to halt preterm labor. Because of drug to drug interactions, if you are taking medications for any one of the aforementioned conditions or for some other reason, you need to be especially careful and consult with your obstetrician or midwife before taking ANY over the counter could products.
When viruses strike during pregnancy, it can be helpful to employ some of the “old timey” remedies that our mothers and grandmothers may have used to relieve the symptoms. Most of these remedies come from items in your pantry and are safe to use in pregnancy. But always check with your obstetrician or midwife to be sure.
Congestion
Vicks Vapor Rub (For chest): Apply a warm towel or hot water bottle over your chest after application to help relieve chest congestion and tightness.
Saline Nasal Washes: Saline nasal sprays are an excellent and safe way to clear congested (and runny) nasal 
passages. If you want to help clear the sinuses, use a Neti pot or other nasal irrigation system in combination with the saline. Saline solutions are easily made with 8 oz of warm water and 1/4 tsp of non-iodized salt.
Vaporizer/Humidifier: Many people recommend cool mist humidifiers, but I found that when I am sick I am typically cold and prefer a warm mist humidifier. I suppose that this is a personal preference but you may want to ask your doctor or pharmacist if you are undecided.
Sore Throat
Tea: Tea is far and away my favorite thing to relieve a sore throat. I like to make tea as hot as I can stand it and sip it. Of course when you are pregnant, you want to avoid caffeinated teas as the caffeine will cross the placenta and babies don’t clear caffeine as easily as we do. Non-herbal teas such as Green and Black teas contain caffeine. Depending on your situation, your OB or midwife may not want you to have caffeine so you may need to avoid these and other caffeinated teas. If you are unsure, ask before consuming these teas.
According to the American Pregnancy Association, many herbal teas and most commercial herb teas (Celestial seasonings teas for example) are safe during pregnancy. Many herbalists and midwives may disagree so if you have questions, definitely consult with an experienced herbalist. However, the American Pregnancy Association advises caution with the following herbs:
Dandelion-Insufficient, reliable information exists regarding safety in pregnancy
Chamomile-Insufficient, reliable information exists regarding safety in pregnancy
Nettles-Natural Medicines Database gives nettles a rating of Likely Unsafe , even though it is used in countless pregnancy teas and recommended by most midwives and herbalists.
Rosehips-Insufficient, reliable information exists regarding safety during pregnancy
Alfalfa-Possibly unsafe
Yellow Dock-Possibly unsafe
For more information, visit the American Pregnancy Association Website, www.americanpregnancy.org.
Saline Gargles
This ancient remedy is still very effective at relieving a sore throat. Place about one teaspoon of regular table salt in about 2 cups of warm water. Gargle as needed. The good thing about this is that you can do it as often as you like.
Cough
Honey-I recently learned from some pediatricians that a teaspoon of honey taken every few hours can alleviate
coughs. No one seemed too sure about the mechanism, but I would imagine that the honey coats the throat and may relieve the cough reflex. No proof here, just a thought on my part. When viruses strike during pregnancy, it can be helpful to employ some of the “old timey” remedies that our mothers and grandmothers may have used. Most of these remedies come from items in your pantry and are safe to use in pregnancy. But always check with your obstetrician or midwife to be sure.
Vick Vapor Rub-This is by far the most “out there” remedy that I had heard, but I tried it myself last year and it did allow me to sleep. You apply Vicks Vapor Rub to the soles of your feet and then put on thick socks and climb into bed. Now I don’t know why it’s effective; perhaps the socks help the Vicks to be absorbed into the soles of the feet and then the effects travel all over the body. I really can’t explain this and wouldn’t have believed it if I hadn’t tried it and had it work. While it may not be effective, it is something you can try that won’t harm you or your baby.
Now remember, these are a combination of “wives tales” and old time home remedies and while some may scoff at them, some are effective. Likewise, since home remedies can be effective and are essentially using products “off label”, you should check with your OB or midwife before using them. But in most cases, they are far less toxic than some of the over the counter and prescription remedies (and often far less potent) and may provide some much needed relief.
