Assessment and Management of Gastrointestinal Disorders during Pregnancy

Abstract

Pregnant women undergo several changes and adaptations in many organ systems. Some adaptations are secondary to hormonal changes in pregnancy, while others occur to support the gravid woman and her developing fetus. Several of the changes in maternal physiology during pregnancy include, for example, increased maternal fat and total body water, decreased plasma protein concentrations, especially albumin, increased maternal blood volume, cardiac output, and blood flow to the kidneys and uteroplacental unit and decreased blood pressure.  Other physiologic changes include increased tidal volume, partially compensated respiratory alkalosis, delayed gastric emptying and gastrointestinal motility, and altered activity of hepatic drug metabolizing enzymes.Pregnancy is a special health state where these many physiological changes occur affecting more or less all anatomical systems, therefore many discomfort, disorders and pathological problems need an exceptional assessment and management. In Albania even though there are three levels of health care service: primary, secondary and tertiary, the care during pregnancy is done mostly by obstetrician and gynecologist and the majority of this discomforts and disorder are managed by them, however a multi disciplinary specialist care is often required.  This paper will focus on gastro intestinal changes and disorders during pregnancy and their management.As universal medical postulate says prevention is the best cure, these changes during pregnancy should involve in special care from patient education so their will understand these changes and adaption to a medical specialist where the final health care service where medical tests care and necessary intervention are done appropriately.In conclusion, understating these changes and their profound impact of suitable assessment and care in pregnancy is essential to optimize maternal and fetal health.

Keywords: Pregnancy, physiological changes, gastrointestinal, assessment, management