High Risk Pregnancy
Restless Leg Syndrome, involuntary twitching and tingling in the legs, can be a problem during pregnancy and a particular problem for Mamas on Bedrest. The increased weight as a result of pregnancy and the increased stress on the circulatory system are the major reasons that the symptoms occur. Restless Leg Syndrome is primarily relieved by changing positions and/or getting up and moving around-both options that are limited or non-existent for Mamas on Bedrest. Conditions such as pregnancy induced hypertension and pre-eclampsia often require that Mamas on Bedrest lay on their left sides to increase blood flow back to the heart from the lower extremities, relieving stress on the circulatory system. With this requirement, leg discomfort may be exacerbated with few options for relief. Restless Leg Syndrome can progress and become quite uncomfortable, limiting Mamas’ ability to rest. So how can Mamas on Bedrest manage this non-life-threatening but very annoying problem?
Massage. As previously stated in other posts, prenatal massage is an excellent way for mamas to relax tired, aching muscles during pregnancy. Because of the additional weight, mamas’ bodies shift to accommodate the weight and as a result, the musculoskeletal system shifts out of alignment creating stress on muscles, ligaments and tendons. Prenatal massage therapists are able to rub and soothe these tired, achy tissues and relieve tension, fatigue and pain.
Relaxation. Meditation, hypnosis and deep breathing can also help relieve the symptoms of restless leg syndrome. Calming the nervous system, relaxing the mind and relieving worry, stress and anxiety often relieve the tingling and twitching associated with restless leg syndrome.
Support your legs. Adequate support and positioning will go far to relieve leg pain and restless leg syndrome. A Must have for Mamas on Bedrest is a Body Pillow, and positioning that pillow to properly support and align Mama’s body is essential. View our video on pillow positioning for a better bed rest.
Stretch. As previously stated, movement is essential to helping relieve symptoms of restless leg syndrome, yet movement for Mamas on Bedrest is limited. There are several simple stretches that mamas can do while on bed rest and we provide them on our free video channel for easy access.
Water. One reason that leg cramps and other symptoms of restless leg syndrome occur is due to dehydration. Adequate water intake is a must for all pregnant women, but especially for pregnant women with restless leg syndrome. Adequate hydration ensures that circulation flows that muscles and soft tissues are well lubricated and that muscle wastes are properly flushed away. But staying hydrated can present an additional problem for Mamas on Bedrest in that the increased fluid intake will result in increased urination. Many mamas try to limit fluid intake which only increases leg cramps, symptoms of restless leg syndrome and can increase the risk of developing a urinary tract infection. Its a delicate balance, but mamas, be sure to drink plenty of water while on bed rest.
Vitamins and Minerals. Most pregnant women are prescribed prenatal vitamins, but many of these vitamins only provide the minimum amounts of vital nutrients necessary to sustain pregnancy and mama and baby may need more. There have recently been several studies and articles published documenting the functional amounts of vitamins and nutrients that are needed to ensure that mama is getting all that she needs to remain healthy, for healthy development of the fetus and to sustain the pregnancy. Mamas with restless leg syndrome may be low on potassium or calcium. While it is not advised that mamas take mega doses of vitamins, ensuring that there is adequate, functional levels of vitamins and minerals will help prevent some of the twitching and discomfort of restless leg syndrome. In addition to prenatal vitamins, mamas may want to add or increase bananas-a good source of potassium-and calcium fortified orange juice and green leafy vegetable (also good sources of calcium) to their diets.
Restless Leg Syndrome can be an annoyance, but it needn’t incapacitate Mamas on Bedrest. Implementing the few tips above can go along way to relief and a bed rest free from leg cramps, twitching and tingling.
Mamas on Bedrest & Beyond would like to thank Tammy Mahan for sharing the perils and pearls of Restless Leg Syndrome with us.
It’s Video Wednesday!
This week, I am taking a look at the HealthTap App. As you will recall from the last blog entry, HealthTap is a health information website that provides health information, tips and breaking health information. The site boasts some 40,000 physician experts from all 50 states and 128 specialties. HealthTap has just rolled out its new App and now consumers can have the convenience of health information at their fingertips.
The App is more than just an encyclopedia of health information. It is a way for consumers to store and track their own health information. This morning, I downloaded the app onto my iPad. The App then guided me through the registration process and enabled me to input personal information and preferences. I was able to “follow” doctors whose work I highly respect and often cite in my blogs and other educational information. I can contact my own gynecologist (who is a participating physician), ask questions of other physicians and get feedback on lab information, tests and other health inquiries.
I have to say that I barely scratched the surface of the HealthTap App. I am sure that it has many more functions that I have yet to discover. But I found it really easy to use, easy to read and easy to input and save my information. I think that this app may be a handy way for Mamas on Bedrest to chart their bed rest progress. In particular, when I think of mamas with cervical insufficiency, each time you go to the OB, you can chart your cervical measurements and keep track. If you have pregnancy induced hypertension or pre-eclampsia, you can track your blood pressures and/or urine proteins (if your OB has you doing urine dip sticks). And this tool is useful after your pregnancy as well; helping you to chart breastfeeding, weight loss, exercise, sleep, and other health indices.
Give it a shot. It’s free and fun (The Geek in Me was quite giddy playing with this!!).
Magnesium Sulfate has long been used in obstetrics to prevent seizures associated with pre-eclampsia, eclampsia, pregnancy induced hypertension and preterm labor. On May 30, 2013, the United States Food and Drug Administration issued a drug safety alert stating that clinicians should not prescribe Magnesium Sulfate for seizure prevention during pregnancy for more than 5-7 days because of the risk of low calcium and bone abnormalities in the fetus.
Magnesium Sulfate has been used for decades ”off label ” (not for its originally FDA approved indication) for the prevention of preterm labor and the prevention of seizures caused by markedly increased blood pressure as seen in pre-eclampsia and eclampsia. It was first prescribed in Germany in 1906 to prevent seizures associated with eclampsia and was injected into the intrathecal cavity (at the base of the spine). In 1926 it was prescribed intra-muscularly and in 1933, the IV form of “Mag Sulfate” became available.
As recently as February 2013, researchers published a study touting the benefits of Magnesium Sulfate and saying that there were no appreciable side effects. Upon close scrutiny of the article, one clearly sees that this particular study only addressed potential side effects to the mother. This study, like many others, completely ignored the potential harm to the developing fetus, assuming that if magnesium sulfate is in fact safe for mamas it is safe for babies. This simply isn’t the case.
In response to 18 adverse drug reports submitted to the Safety Information and Adverse Event Reporting system, the FDA conducted its own research to see why some mothers had problems and some did not. Babies born to these 18 women all had osteopenia (low bone mass density) and were at greater risk of sustaining fractures. The average amount of time the mamas received Magnesium sulfate was over a 10 weeks. The FDA found that the maximum time that a mamas should take Magnesium Sulfate is a mere 5-7 days and then the FDA recommends stopping the medication. The prolonged administration of Magnesium Sulfate led to the side effects, which seem to resolve once Magnesium Sulfate is stopped.
This MedScape News Report has a couple of really good take home messages. First and foremost, clinicians must closely monitor Magnesium Sulfate administration and ensure that mamas understand that the drug is being used off label, has the potential to affect their unborn babies’ bones and that they have the right to say “no”. Second, we health care researchers have to be careful when reading studies lest we draw false conclusions and inform the public that there is no harm when there is or there is harm when there is not.
MedScape News: http://www.medscape.com/viewarticle/805009
Jeffrey Michael Smith, Richard F Lowe, Judith Fullerton, Sheena M Currie, Laura Harris and Erica Felker-Kantor
An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC Pregnancy Childbirth, May 2013