Grp 5 - Project Plan

8/3/2019 Grp 5 - Project Plan

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DE LA SALLE HEALTH SCIENCES INSTITUTE

COLLEGE OF MEICINE

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

STUDENT AUDIO VISUAL PROJECT:

Common Complaints of Pregnant Women

SESSION PLAN

Presented to:

Dr. Soledad Chu-Crisostomo

Presented by: Group 5

Maravilla, Rachelle

Mendoza, Christian Julius

Mendoza, Rigel

Nazareno, Christine

Pacifico, Priscilla

Ridao, Hanna

Vergara, Renn Miguel

Villarin, Lilia



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SESSION PLAN

A. PROJECT TOPIC:

Common Complaints of Pregnant Women

B. PARTICIPANTS:

The video is intended for all women who are within the reproductive age range (15 –

44 years old) and most especially to gravid patients, particularly to those who are

primigravida patients in the De La Salle University Medical Center – Obstetrics and

Gynecology Out Patient Department.

C. TIME AND TIME ALLOTMENT:

The educational video will be 8 minutes long and will be played on March 6, 2012

(Tuesday), from 10:00 am to 12:00 noon and on March 10, 2012 (Saturday) for the

Annual Buntis Day Celebration at the DLSU Medical Center Out Patient Department.

D. VENUE:

2nd

year - Section B classroom, College of Medicine Building, De La Salle Health

Sciences Institute and De La Salle University Medical Center Out Patient Department.

E. SESSION OBJECTIVES :

1. To participate and contribute toward achieving the Goal 5 of the Millenium

Development Goals – to improve maternal health by achieving universal access to

reproductive health by information dissemination and education and by providing

possible first aid measures to relieve the common complains in pregnancy. This

will be executed by:

a. Enumerating the different complaints/ symptoms of women during

pregnancy and explaining the mechanism behind each symptom;

b. Identifying which among the said complaints is the most common and the

least common through conducting a survey around the De La Salle

University Medical Center - Obstetrics and Gynecology OutpatientDepartment

2. To create a systematic effective plan of relaying the information and knowledge

regarding the common complains in pregnancy among the pregnant patients of

the DLSUMC OB-GYNE OPD. This will be executed by:



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a. Creating a multimedia presentation that can explain the mechanism

behind each symptom in ways that a non-medical individual can fully

comprehend;

b. Creating a multimedia presentation which could help in the dissemination

of factual information to pregnant mothers who lack education on proper

management of the different symptoms experienced during the course of pregnancy

F. CONTENT:

I. INTRODUCTION

Perhaps one of God's greatest gifts to women is their capacity to bring new life

into the world. While many women are left feeling wonderfully blessed with the

knowledge that a baby is growing in their wombs, this doesn't alter the reality

of the many physical changes and drawbacks happening to their bodies. In this

video, the group will be presenting some of the most common complaintswomen have over pregnancy, its accompanying misconceptions and the proper

ways to best handle these said problems.

II. COMMON COMPLAINTS/HEALTH CONCERNS OF PREGNANT WOMEN

1. NAUSEA WITH OR WITHOUT VOMITING

i. Definition

Nausea pertains to the sensation of being about to vomit, while

vomiting is the expelling of undigested food through the mouth. It

is colloquially termed as the morning sickness, even though it is

actually worse in the morning, it is still misleading because the

symptoms not only happen in the morning, but may also last for

the whole day.

ii. Pathophysiology

There is still no well-established cause for nausea and

vomiting in pregnancy, however, studies suggest that a

combination of factors such as genetic, endocrine,

gastrointestinal, psychosocial and evolutionary

adaptations contribute to these symptoms. Human Chorionic Gonadotropin and Estrogen—that are

active during pregnancy are involved. Several studies have

shown that an increase in the said hormones is closely

associated with nausea and vomiting of pregnancy.



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iii. Management

Nausea and vomiting in pregnancy are usually self-limited.

May reduce the discomfort through changes in diet and

lifestyle.

o Small frequent meals are highly recommended.

o Although pregnant women are encouraged to eat

whatever it is that appeals to them, fatty foods and

foods with strong odors should be avoided.

o Ginger supplements have also been reported to be

beneficial; however, large quantities should not be

used as treatment.

o Vitamin supplements should be taken especially

vitamin B-complex.

For pharmacological therapies, doxylamine-pyridoxine

combination has been proven to be safe and effective in

the treatment of nausea and vomiting.

2. BACKPAINS

i. Definition

Backache — with soreness, stiffness, and pain — is one of the

most common pregnancy symptoms. And, unfortunately,

backache often starts early on in your pregnancy and persists (or

worsens) until you give birth (when Pregnancy Backache is

replaced by Postpartum Back Pain).

ii. Pathophysiology

Increased hormone levels released during pregnancy

softens the ligaments and loosens the joints to prepare the

mother for parturition. These two occurrences then lessen

the support to the mother's back.

A woman's center of gravity will gradually move forward

as she approaches term due to the expansion and growth

of the uterus and the baby, respectively. This will then

cause her posture to change.

During pregnancy, the baby will become an additional

weight that the mother's back must support.

If a woman has poor posture, stands excessively or bends

over, she is more prone to trigger/increase the intensity of

her back pains.

http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/landing.aspx

http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/postpartum-bachache.aspx

http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/postpartum-bachache.aspx

http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/landing.aspx



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iii. Management

Exercise can reduce the strain of the growing fetus as it

prevents the muscles that support a pregnant woman's

back from weakening.

Massage Good Posture

Heat from a warm bath or a hot compress can lessen the

discomfort brought about by back pains.

3. ROUND LIGAMENT PAIN

i. Definition

It is a sharp, shooting pain in the abdomen which is more on the

right side than left and is a common complaint in pregnancy often

starting in the second trimester.

ii. Pathophysiology

The round ligaments hold the uterus in suspension within

the abdomen. As the uterus grows in size and weight, the

ligaments become very long and thin – stressing and

tensing like rubber bands.

The ligaments pull and tug on nearby nerve fibers and

sensitive structures, causing pain.

Ligament spasm, an involuntary contraction or cramp,

usually triggers the sharp pain. These spasms are foundmore frequently on the right side than the left because of

the normal tendency of the uterus to turn to the right.

May also be brought on by exercise

iii. Management

Consult doctor if it is indeed a round ligament pain

Activity modification – avoid sudden movements, shifting

positions slowly may provide relief. Brace abdomen when

coughing/sneezing since coughing and sneezing can trigger

round ligament paint

Rest

Analgesia



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4. VARICOSITIES AT LOWER EXTREMITIES AND VULVA

i. Definition

Varicose veins are abnormally enlarged superficial veins usually

seen in the thigh and leg. In the majority of cases, these large

superficial veins are of a cosmetic nuisance. These veins connectwith the deep veins of the leg and play a minor role in the transfer

of blood to the heart.

ii. Pathophysiology

Linked to increase pressure in the veins, due to the gain of

weight and volume that promotes stasis of blood, thereby

increasing pressure in the veins of the extremities

Valves in the veins which prevent the back flow of blood

back into the legs. When these valves become

damaged/defective, the blood flows backwards and causesswelling and engorgement of the veins.

Further, the female sex hormones are thought to weaken

the walls of the veins and make them lax—thus causing

them to engorge with blood.

Female retains a lot of weight and fluid during pregnancy.

In addition, the baby in utero may also compress some

parts of the pelvis (lower abdomen) and lead to an

engorgement of the veins in the lower extremities,

including the veins in vulva/vagina.

Interplay of various risk factors: prolonged standing,

increase in sex hormone estrogen and excess weight &

pressure carried by the extremities

iii. Management

Elevation of the legs

Avoid standing for prolonged periods

Wear elastic support stockings

Walk or exercise daily as this stimulates the muscles which

can push the blood away from the leg

Weight management

Avoid tight clothing that can compress the waist or groin



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5. HEMORRHOIDS

i. Definition

Hemorrhoids are painful, swollen veins in the lower portion of the

rectum or anus. This may cause great discomfort and pain to the

pregnant patient and may even bleed.ii. Pathophysiology

Growing fetus puts pressure on the pelvic veins and

inferior vena cava, causing stasis of blood in the veins of

the lower half of the body, increasing the pressure in the

veins below the uterus and causing them to dilate.

Aggravated by constipation which is also commonly

experienced by pregnant women due to increased

progesterone levels, causing a decrease in bowel motility,

and compression of the uterus to the intestinal structures. Straining due to hard bowel movement causes

development of hemorrhoids.

iii. Management

Pain and swelling are usually relieved by topically applied

anesthetics, warm soaks, and stool-softening agents.

The patient should consult her doctor and ask for a safe

and effective anesthetic or medicated suppository to

alleviate the pain.

The patient may also soak her bottom in a water tub for 10to 15 minutes few times each day, or position it over a

basin full of warm water.

The patient is also suggested to modify her diet and take a

high fiber diet and many glasses of water daily to avoid

straining and constipation.

To prevent worsening the hemorrhoids, the patient is

advised to avoid standing and sitting for long continuous

periods of time and to lie down on her left side a few

times a day to relieve the pressure from her rectal veins. She is also expected to avoid lifting heavy objects or doing

heavy work.

Kegel exercises is also suggested which can ease

pregnancy symptoms including hemorrhoids.

She may also use petroleum jelly on the area of the

hemorrhoids to ease bowel movements. Finally, a good



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hygiene must be kept by the patient at all times to avoid

any incidence of infections.

6. HEARTBURN

i. Definition

It is a burning substernal sensation, usually reported as a result of excess gastroesophageal reflux of acid. It is common in late

pregnancy.

ii. Pathophysiology

Since pregnancy causes the upward displacement and

compression of the stomach by the uterus, the tendency

of the acidic contents of the said organ is to move to the

most dependent site, the lower esophagus.

Progesterone, a hormone produced in pregnancy in large

amounts, brings about the relaxation of the esophagealsphincter. This event also caters to the introduction of acid

to the lower esophagus, causing the pain to be felt under

the sternum.

iii. Management

Advised to take smaller, yet more frequent meals.

Refrain from lying flat or bending over so as not to

encourage the movement of acids to the esophagus,

instead they should keep their head and part of their

upper torso slightly elevated (especially when resting). Relief can also be provided by antacids such as Aluminum

Hydroxide, Magnesium Trisilicate, or Magnesium

Hydroxide. These medications may be given alone or in

combination. Omeprazole is considered safe for pregnancy

as well. However, Cimetidine or Ranitidine can only be

given to pregnant patients in cases of persistent and

severe symptoms of heartburn. Misoprostol is

contraindicated for it stimulates labor.

7. FATIGUE

i. Definition

Fatigue is the lost of energy and motivation that goes with a

concomitant need to rest. Though weakness and fatigue are

usually used at the same time, they slightly mean different things.

Weakness is the lack of physical strength, requiring the affected

individual to exert extra effort to move various parts of the body



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whereas fatigue is a feeling of tiredness or exhaustion due to lack

of energy or strength.

ii. Pathophysiology

During pregnancy, a pregnant woman's body has to work

twice as hard due to the accelerating fetal growth this

includes increase in hormone production, increase in

metabolism as well as increase in blood flow leading to

easy fatigability.

The increase in blood flow is needed for the growing fetus

to get the nutrients it needs. -The increase of levels of

progesterone also plays a role in fatigue in pregnancy.

Nausea and vomiting can make a pregnant woman tired.

Anemia is usually associated with fatigue during the early

stages of pregnancy.

iii. Management

Take frequent rest breaks during the day

Scale back on nonessential activities and responsibilities

Eat a balanced diet

Drink plenty of water

Sleep early

8. HEADACHE

i. Definition

Common early in pregnancy, it is characterized by a squeezing

pain or an ache on the sides of the head or the back of the neck.

But the pain can appear in other areas as well. It may cause snap

throbbing pain or a dull ache.

ii. Pathophysiology

May result from sinusitis or ocular strain caused by

refractive errors

During midpregnancy, most headaches decrease in

severity or disappear.

They may be a consequence of hypertensive disorderslater in pregnancy

Pregnant women can also experience headaches due to

stress, fatigue, caffeine withdrawal, lack of sleep,

dehydration and low blood sugar.

iii. Management

Eat well-balanced meals



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Apply cold or heat packs to your head

For sinus headache, apply a warm compress around your

eyes and nose

For tension headache, apply a cold compress or ice pack at

the base of your neck

Maintain your blood sugar by eating smaller, morefrequent meals.

Massaging your shoulders and neck is an effective way to

relieve pain

Rest in a dark room and practice deep breathing

Warm shower or bath

Avoid eating

o Chocolate

o Alcohol

o Yogurt

o Aged cheese

o Peanuts

o Breads with fresh yeast

o Preserved meats

o Sour cream

9. LEUKORRHEA

i. Definition

Leukorrhea is an increased vaginal discharge that is (often) not

pathologic but instead is caused by the increased mucus

formation by the cervical glands in response to high levels of

estrogen in the body.

ii. Pathophysiology

Should it happen that the discharge is irritating and is

accompanied by an itching and burning sensation, certain

pathologic causes must already be considered, such as

Trichomonas vaginalis, Candida albicans and Gardnerella

vaginalis. The specific cause can be identified via examination of a

fresh smear under the microscope.

Trichomonas vaginalis

o Vaginal discharge: foamy

Vaginal epithelium: with small punctuate,

reddened areas (aka strawberry cervix)

Candidiasis or Moniliasis

o Vaginal discharge: cheesy white; tends to adhere to

vaginal mucosa; accompanied by severe itching,

burning sensation



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Vaginal epithelium: redness and chafing of the skin

of the vulva and perineum

Gardnerella vaginalis

o At least three of the following criteria must be

satisfied for one to make a diagnosis of Gardnerellainfection.

iii. Management

Consult a doctor and request for lab exams to identify

which treatment should be given

Observe proper hygiene

10. CONSTIPATION

i.

DefinitionHaving bowel movements fewer than three times a week is

considered as constipation. It is usually characterized by hard, dry,

and difficult to eliminate stools which are typically small in size.

Some people with this condition find it hard to have a bowel

movement, often experiencing straining, bloating, and a constant

feeling of a full bowel.

ii. Pathophysiology

The pressure of your growing uterus on your rectum

The pregnancy hormone progesterone, which slows the

transit of food/increase transit duration through your

digestive tract

Interplay of risk factors: worry, anxiety, minimal physical

exercise, and a low-fiber diet

iii. Management

Eat a healthy diet. Include high-fibre foods such as

wholegrain cereals, wholemeal bread and fresh fruit and

vegetables every day.

Drink plenty of fluids.

Exercise



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11. PICA

i. Definition:

The unusual craving for bizarre foods and materials that

are barely edible (e.g. laundry starch, clay, dirt)

Ingestion of starch: amylophagia

Ingestion of clay: geophagia

12. PTYALISM

i. Definition:

Copious salivation, apparently due to the stimulation of

salivary glands by the ingestion of starch

G. TEACHING AND LEARNING ACTIVITIES*

H. RESOURCES*

*Refer to table below:

G. TEACHING AND LEARNING ACTIVITIES H. RESOURCES

(1) Video Presentation

Video presentations are always effective in

presenting ideas since it is not boring. The

audience will be able to have fun watching

and at the same time, absorb the message

being presented in the video. It is one of the

effective ways of making the audience sit

through the whole presentation without

falling asleep. Also, it is a good way of making

them remember the message by having a

catchy way of presenting it.

(2) Creative Props

Best way of making the audience envision

what is being talked about is through

simulation. And what makes a simulation or

• Pictures

• Camera

• Voice recorder

• Visual Aids

• Drawings

• Illustration Board



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demonstration more effective than creative

props. It is one of the ways of letting the

audience totally understand what is being

taught by directly seeing how the instructions

presented are done. There will also be less

need for explanation since they can directly

see what is being presented.

• Pictures

J. EVALUATION

The viewers will be given an evaluation sheet that will serve as a feedback onthe presentation of the group. Listed are various points of evaluation based on

the different aspects of the presentation. The viewer will be asked to shade a

smiley face if she feels that the group was able to accomplish that particular

parameter, otherwise, a sad face would indicate that the viewer felt that the

group missed out on that parameter. At the end of the evaluation, a space is

also provided for any sentiments of the viewers that are not covered by the

objective questions.



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K. REFERENCES

1. Arsenault, M., & Lane, C. A. (2002). The management of nausea and vomiting in

pregnancy. SOGC Clinical Practice Guidelines, (120), 7. Retrieved

from http://www.sogc.org/guidelines/public/120E-CPG-October2002.pdf

2. Jarvis, S., & Nelson-Piercy, C. (2011). Management of nausea and vomiting in pregnancy.

Retrieved from http://www.bmj.com/content/342/bmj.d3606

Please shade the corresponding smiley / sad face if the following conditions

were met in order to have an informative educational video regarding the

common complaints of pregnancy

Content is relevant and clearly explained

Presentation is done orderly and at a rate

that is understandable/comprehendable

Language used was appropriate and understandable/

comprehendable

Words and narration was clear and understood

Music/Sound effects were appropriate for theoverall presentation

Images/Video clips were clear and appropriate

for the overall presentation

Video is presented in a creative, lively manner that

enhanced learning and stimulated curiosity about the topic

Video was informative and was able to answer

questions and eliminate confusion regarding the topic

Overall rating for the video

Comments and suggestions:

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________



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3. Goodwin, T. M. (2002). Nausea and vomiting of pregnancy: An obstetric syndrome.

American Journal of Obstetrics and Gynecology, 186(5), S184-S189. Retrieved

from http://www.sciencedirect.com/science/article/pii/S0002937802800163

4. Sherrie. (March 25, 2011). Back Pain During Pregnancy and What to Do About IT. In

herhealthworld Quality Women's Health Blog. Retrieved January 31, 2012,

fromhttp://www.herhealthworld.com/back-neck-pain/back-pain-during-pregnancy-and-what-to-do-about-it/.

5. BabyCentre Medical Advisory Board. (2009, June). Baby Centre. Retrieved January 31,

2012 from Baby Centre Web site: http://www.babycentre.co.uk/pregnancy/

antenatalhealth/physicalhealth/backache/

6. Round Ligament Pain. (March, 2007). American Pregnancy Association. Retrieved

January 31, 2012 fromhttp://www.americanpregnancy.org/pregnancyhealth/

roundligament.htm

7. Glass, J. (2010, May 13). Migraine Headaches and Pregnancy. WebMD. Retrieved

January 31, 2012 from http://www.webmd.com/migraines-headaches/migraine-

headaches-and-pregnancy.

8. Headaches during pregnancy. (October, 2011). BabyCenter, L.L.C. Retrieved January 31,

2012 from http://www.babycenter.com/0_headaches-during-pregnancy_2035.bc.

9. Fatigue during pregnancy. (February, 2011). BabyCenter, L.L.C. Retrieved January 31,

2012 from http://www.babycenter.com/0_fatigue-during-pregnancy_2911.bc.

10. Fatigue During Pregnancy-Topic Overview. (November 10, 2010). WebMD. Retrieved

January 31, 2012 from http://www.webmd.com/baby/tc/fatigue-during-pregnancy-

topic-overview.

11. Your Pregnant body. (June, 2009). March of Dimes Foundation. Retrieved January 31,

2012, from http://www.marchofdimes.com/pregnancy/yourbody_fatigue.html.

12. Fatigue During Pregnancy. (n.d.). More4Kids Inc. Retrieved January 31, 2012 from

http://pregnancy.more4kids.info/114/fatigue-during-pregnancy/. 13. Fatigue During Pregnancy. (n.d.). Women's Healthcare Topics. Retrieved January 31,

2012 from http://www.womenshealthcaretopics.com/preg_fatigue_during.htm.

14. Alday-Singson, A. (2008). Prenatal care of the healthy woman. In W. Sumpaico, I.

Ocampo-Andres, et al. (Eds.), Textbook of obstetrics (pp. 257-278). Quezon City:

Association of Writers of the Philippine Textbooks of Obstetrics and Gynecology, Inc.

15. Fauci, A., et. al. (2008). 4. Harrison’s Principles of Internal Medicine (17th ed.). United

States: The McGraw-Hill Companies, Inc.

16. Cunningham, F. G., et.al. (2010). Prenatal Care, and Medical and Surgical

Complications. Williams Obstetrics (23rd ed., p. 210-212, 1052). USA: The McGraw-Hill

Companies, Inc.17. Rodriguez, D. (2010, May 13). Myths and Facts About Heartburn - Digestive Health

Center - Everyday. Health Information, Resources, Tools & News Online -

EverydayHealth.com. Retrieved January 31, 2012, from

http://www.everydayhealth.com/digestive-health/myths-and-facts-about-

heartburn.aspx

http://www.webmd.com/migraines-headaches/migraine-headaches-and-pregnancy


http://www.babycenter.com/0_headaches-during-pregnancy_2035.bc

http://www.babycenter.com/0_fatigue-during-pregnancy_2911.bc

http://www.webmd.com/baby/tc/fatigue-during-pregnancy-topic-overview


http://www.marchofdimes.com/pregnancy/yourbody_fatigue.html

http://pregnancy.more4kids.info/114/fatigue-during-pregnancy/

http://www.womenshealthcaretopics.com/preg_fatigue_during.htm

http://www.womenshealthcaretopics.com/preg_fatigue_during.htm

http://pregnancy.more4kids.info/114/fatigue-during-pregnancy/

http://www.marchofdimes.com/pregnancy/yourbody_fatigue.html



http://www.babycenter.com/0_fatigue-during-pregnancy_2911.bc

http://www.babycenter.com/0_headaches-during-pregnancy_2035.bc





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Grp 5 - Project Plan