American Medical Association Family Medical Guide - American Medical Association [284]
Leg Cramps
Some women get sharp pains or cramps in their legs during pregnancy (especially during the last 3 months), possibly from increased pressure of the uterus on the blood vessels that carry blood to the legs, or from a calcium deficiency. These cramps may be followed by dull aching that can last several hours.
To prevent muscle cramps, take in 1,500 milligrams of calcium every day (either in your diet or in supplements), and stretch your calf muscles before going to bed and first thing in the morning. To treat muscle cramps, massage the sore area, straighten and flex your ankle and toes upward, and try to get up and walk around slowly.
Swollen Ankles and Hands
During pregnancy, your shoes may feel tight and your rings may no longer fit your fingers because of swelling (edema) caused by the increased fluid that is retained during pregnancy. To relieve some of the swelling, avoid salty foods (and don’t add salt to food), elevate your legs while resting, and try not to stand for long periods. Because swelling can also be caused by a serious condition called preeclampsia (see page 526), see your doctor if the swelling is severe or if you have other symptoms of preeclampsia, such as headaches or blurred vision.
Dental Problems
The increased level of the hormone progesterone during pregnancy makes your gums swollen and spongy, which allows bacteria to grow more easily between your teeth and gums. Some women have noticeable swelling of the gums that disappears without treatment after delivery. Your teeth and gums may also be more susceptible to infection during pregnancy because your dentist may postpone some treatments and procedures (if they involve general anesthesia, for example) until after childbirth. Although dental X-rays are usually considered safe (a lead apron draped over the woman’s abdomen protects the fetus from radiation), routine X-rays are usually postponed until after pregnancy.
Brush and floss your teeth at least twice a day. And be sure to have regular dental cleanings and checkups during pregnancy to try to prevent tooth and gum problems.
Skin Changes
Your skin may change in a number of ways during pregnancy. Changes in hormone levels result in increased production of pigment-producing cells. Pigmentation may darken in already pigmented skin areas such as freckles, moles, and birthmarks. Your nipples and the areolas (the pigmented areas surrounding the nipples) may become darker. In some women, a line of darker skin may extend down the middle of the abdomen. Patches of dark skin (medically called chloasma or melasma) may appear on your face. These darkened skin patches usually fade over time after delivery. Because sunlight can intensify the pigment changes, stay out of the sun or use a sunscreen with a sun protection factor (SPF) of at least 15.
The skin of your abdomen may itch because the skin is stretched tight as the uterus enlarges. Apply a moisturizer to relieve dry, itchy skin. Red lines called stretch marks may appear on your breasts, abdomen, and thighs, especially if you gain weight rapidly or put on too much weight during your pregnancy. Because stretch marks can be permanent, try not to gain too much weight.
Hormone changes may cause excessive perspiration by widening blood vessels, which increases blood flow to the skin. Sweating may be more apparent at night because it can wake you up. To relieve heavy perspiration, wear loose-fitting clothes; drink plenty of liquids, especially water; and keep your bedroom cool at night.
Anemia
One of the most important components of blood is a protein called hemoglobin, which carries oxygen to tissues. If hemoglobin in your blood falls below an adequate level, you can develop a condition called iron deficiency anemia (see page 610). Another possible cause of anemia during pregnancy is inadequate intake of the B vitamin folic acid (see page 514),