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2. Normal Discomforts of Pregnancy
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h. Hemorrhoids
1) Definition: Swelling of veins in and around the anus.

2) Physiological basis

(a) The enlarging uterus creates circulatory congestion.   (b) Constipation is a contributing factor.   (c) Increased progesterone relaxes the walls of the veins. 3) Management (a) Avoid constipation and straining with bowel movements.   (b) Practice kegel exercises.   (c) We advise sitz baths.   (d) Adequate rest, and exercise as permitted by the OB care provider, will help also.   (e) Ice the area.   (f) The expectant mother should rest in bed with her hips and lower extremities elevated.   (g) Analgesic ointments may be prescribed by the OB care provider. 4) Indicators to refer to your OB care provider. (a) Severe, persistent symptoms should be reported.  
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(b) Bleeding, swelling, and severe pain are all reasons to contact your OB care provider.
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