How to survive long-term toxicosis? Treatment. Toxicosis of pregnant women

13.06.2019

- pathological conditions associated with pregnancy, complicating its course and terminating after the end of gestation. By the time of occurrence, early and late toxicosis of pregnant women is distinguished. Early toxicosis of pregnant women is accompanied by hypersalivation (salivation), nausea, vomiting. Diagnosis of early toxicosis is based on complaints from a pregnant woman; the severity is established on the basis of a study of the biochemical parameters of blood, urine. Treatment of early toxicosis of pregnant women includes the appointment of a protective regimen, diet, antiemetic and sedatives, infusion therapy, physiotherapy.

General information

The concept of "toxicosis of pregnant women" includes an extensive group of gestational complications associated with the development of the ovum and disappearing after termination of pregnancy or childbirth. The development of toxicosis in pregnant women is associated with a violation of the adaptive processes of the woman's body to pregnancy. Toxicosis of pregnant women is expressed by various disorders of neurohumoral regulation: disorders of the functioning of the autonomic and central nervous systems, endocrine and cardiovascular systems, metabolic processes and the immune response.

Causes

The emergence of early toxicosis in pregnant women is etiologically and pathogenetically due to the development of the ovum in the uterus. There are many theoretical grounds for this condition: toxic, neuroreflex, hormonal, psychogenic, immunological hypotheses are distinguished that explain the development of early toxicosis in pregnant women. According to the toxic theory, the onset of pathological symptoms of toxicosis is caused by the poisoning of the maternal body with toxic products produced by the ovum or formed when metabolic processes are disturbed.

According to supporters of the neuroreflex theory, the development of early toxicosis in pregnant women is associated with irritation of the endometrial receptors by the growing fetus, which, in turn, is accompanied by an increase in the excitability of the subcortical structures, where the vomiting and olfactory centers are located, as well as zones that regulate the activity of digestion, blood circulation, respiration, secretion etc. In response to this irritation, a whole cascade of various autonomic reactions of the body arises - nausea, vomiting, tachycardia, salivation, pallor of the skin due to vasospasm, etc. By the end of the first trimester, the body of the pregnant woman adapts to such irritations, as a result of which the manifestations of early toxicosis disappear.

The hormonal theory explains the occurrence of toxicosis in pregnant women by increased production of chorionic gonadotropin, which promotes the proliferation and strengthening of chorionic villi, the development of the corpus luteum of pregnancy in the ovaries. After 12-13 weeks of gestation, the concentration of hCG in the peripheral blood begins to decrease.

From the point of view of the psychogenic theory, the development of early toxicosis of pregnant women is more susceptible to emotional, impressionable women, in whom the ratio of the processes of inhibition and arousal is disturbed. In these women, toxicosis can develop against the background of experiences associated with pregnancy. The immunological theory is based on the views that the ovum for a pregnant woman is an organism that is alien in antigenic composition, in response to which the woman produces antibodies, which cause toxicosis. All these theories are legitimate to a certain extent and complement each other.

In addition, it is known that the most severe early toxicosis of pregnant women occurs in women with aggravated somatic status (nephritis, hypertension, gastritis, peptic ulcer disease, colitis, obesity), overwork, neuropsychic trauma, inappropriate nutrition, bad habits. Toxicosis often develops in pregnant women who have had abortions in the past, chronic inflammation of the genitals (endometritis, cervicitis, adnexitis). In these women, even before pregnancy, there is a violation of adaptation, which is aggravated with the onset of gestation. Women with pronounced antiperistalsis of the esophagus, impaired swallowing reflex, increased activity of the vomiting center are also prone to the development of early toxicosis in pregnant women.

Classification

Tetania with toxicosis of pregnant women develops against the background of calcium metabolism disorders. Tetany is manifested by muscle cramps and often occurs against the background of hypoparathyroidism. Patients with early toxicosis need increased control of the gynecologist during pregnancy, as they subsequently often develop gestosis.

Diagnostics

The diagnosis of early toxicosis of pregnant women is established taking into account complaints, objective data, and the results of additional studies. An examination on a chair and an ultrasound scan allows you to make sure that the ovum is in the uterus, determine the gestational age, and trace the development of the fetus.

In pregnant women with signs of toxicosis, a clinical blood test, biochemical parameters (total protein and fractions, fibrinogen, liver enzymes, electrolytes, CBS), and general urine analysis are performed. Shown is the measurement of daily urine output, pulse control, ECG and blood pressure, counting the frequency of vomiting.

Treatment of early toxicosis of pregnant women

A mild form of toxicosis in pregnant women does not require hospitalization; with moderate and excessive vomiting, treatment in a hospital is necessary. In mild cases, a pregnant woman is recommended to observe psychological and physical rest, taking sedatives (valerian, motherwort), vitamins, antiemetics (cerucal). The nutrition of a pregnant woman with toxicosis should be fractional, easily digestible, in small portions. With increased salivation, rinsing the mouth with herbal solutions with tanning properties (infusions of chamomile, mint, sage) is useful.

With moderate toxicosis of pregnant women, infusion therapy is carried out in the hospital - parenteral administration of saline solutions, glucose, protein preparations, hepatoprotectors, vitamins. In order to stop vomiting, according to indications, antipsychotic drugs (chlorpromazine, droperidol) are prescribed. A good effect is observed from carrying out physiotherapeutic procedures (electrosleep, endonasal electrophoresis, galvanization, herbal medicine, aromatherapy), acupuncture.

Treatment of severe toxicosis of pregnant women is carried out in intensive care units under the control of laboratory and hemodynamic parameters. Therapy includes the infusion of solutions in a volume of up to 3 liters, the introduction of antipsychotics, hepatoprotectors, antiemetics, and nutritional enemas. The severe degree of toxicosis in pregnant women is a danger to the woman and the fetus. If the treatment is untimely or ineffective, coma may occur) and obstetric pathology (cystic drift, hepatosis).

The prevention of toxicosis is facilitated by the responsible preparation of a woman for pregnancy, including timely treatment of chronic pathology, maintaining a healthy lifestyle, refusing to abortion, etc.

Toxicosis is a common and most frequent complication of pregnancy. WHO statistics show that in the first trimester of pregnancy, toxicosis affects up to 90% of all pregnant women. At a later date, toxicosis is less common: it affects about 40% of expectant mothers. Even the medicine of the XXI century is not able to correct these indicators.

Early and late toxicosis

Toxicosis, which begins simultaneously with the onset of pregnancy and lasts up to 12-16 weeks, is called early. Usually this condition is fairly easy and does not cause further complications. But early toxicosis can be severe. This happens in 1-2% of cases.

Late toxicosis, on the other hand, is not mild. This is always a serious complication of pregnancy, which is dangerous for mom and baby. For example, with late toxicosis in 30% of cases, childbirth occurs prematurely. If you do not take measures, then in 25% of cases, late toxicosis is the cause of maternal death during childbirth or shortly after.

Toxicosis during pregnancy occurs only during the period of bearing a child, it does not occur in any other life situations. Childbirth means the cessation of any toxicosis.

Why arises

It is still not known exactly for what reasons toxicosis of pregnant women occurs. There are a lot of theories, some are understandable only by professional doctors, here are some of the most common theories:

Neuroreflex. The receptors in the endometrium (the inner lining of the uterus) are irritated during fetal attachment and development. A signal about this goes to a certain part of the brain where the nerve centers are located that are responsible for reactions and reflexes: vomiting, olfactory, digestive and the like. The back reaction of the brain is toxicosis.
Toxic. The fetus produces substances that are foreign to the mother's body. Self-poisoning occurs.
Hormonal. With the onset of pregnancy, a woman's level of human chorionic gonadotropin (hCG) rises sharply. Toxicosis is an aggressive reaction of the body to an increase in the amount of this hormone in the blood.
Immunological theory. The fetal egg is half composed of cells that "came" from the child's father. They are alien to the mother's body. The immune system responds to this invasion with toxicosis.

Video from Tutta Larsen:

Timing when toxicosis begins

Toxicosis in the early stages can occur at any time for a period of four obstetric weeks (). Most often, women notice the first manifestations of toxicosis at 7-8 weeks of pregnancy.

What experts say. Doctors sometimes face a special situation:patients complain of toxicosis literally immediately after unprotected intercourse. However, such statements do not indicate at all a high-speed reaction of the woman's body. There is a psychological side here, anxiety about a possible pregnancy. Hence the imaginary signs of toxicosis.

Late toxicosis detected in women for a period of 18 weeks or more.

Not a single pregnant woman is immune from the manifestations of toxicosis. Most often suffer from toxicosis:

young girls under the age of 18 and women after 35;
overweight women;
with diseases of the endocrine and cardiovascular systems;
with impaired liver function;
with chronic diseases of the digestive tract;
harmful conditions of professional activity;
toxicosis in previous pregnancies;
smoking;
multiple pregnancy.

In the latter case, early toxicosis occurs approximately 2.7 times more often than during pregnancy with one child. Late toxicosis occurs more often by about a third.

In addition, toxicosis often occurs with unwanted pregnancy, which the woman still decided to endure. Usually in this case there is no readiness for motherhood, hence the many unpleasant sensations.

Symptoms of early toxicosis

The Internet can sometimes tell you a dozen signs of toxicosis. Official medicine has a different opinion. There are only two main symptoms of early toxicosis in pregnant women (doctors call them the clinical picture). nausea and vomiting... There are several additional symptoms that are rare:

salivation;
dermatoses (rashes, itching);
asthma of pregnancy (unexplained asthma attacks that are difficult to treat);
jaundice of pregnancy;
tetany (convulsions due to calcium depletion of blood);
osteomalacia (softening of bones due to their lack of calcium).

As for some other manifestations - increased sense of smell, aversion to food, irritability, they are not clinical symptoms of toxicosis. You can observe these manifestations in yourself at any stage of pregnancy without any nausea and vomiting.

Doctors distinguish three degrees of severity of toxicosis. First: vomiting up to 5 times a day, weight loss of no more than three kilograms. Second: vomiting 5-10 times, weight loss 3-4 kg, blood pressure decreases. Third degree: vomiting 10-25 times, even if the pregnant woman has not eaten for a long time, weight loss is more than four kilograms, a rise in temperature and tachycardia (heart palpitations) are added to the low blood pressure.

Symptoms of late toxicosis

The group of complications during pregnancy that occur after the 18th obstetric week, doctors call gestosis, or late toxicosis. The danger of this condition is that at first you may not pay attention to it. Only slight swelling is noticeable (swelling can be everywhere: on the arms, legs, face). They are written off for long walks or uncomfortable shoes.

That is why doctors are especially careful to monitor the weight of pregnant women, often refer them to urinalysis and measure blood pressure. So they reveal the clinical signs of gestosis:

external and internal edema (after all, fluid accumulates not only under the skin, but also in the internal tissues of the body);
significant weight gain (also often indicates excess fluid in the tissues);
protein in the urine.

If late toxicosis is not treated, complications arise:

Various kidney diseases. They are collectively referred to as "nephropathy".
Preeclampsia. Sleep may be disturbed. Headaches are common. It may seem to you that now you will faint: you feel faint, it darkens before your eyes.
Eclampsia. This is the most dangerous condition. First, a convulsive seizure occurs, similar to an epileptic one. Muscles contract involuntarily, and nothing can be done about it. The seizures can end in a coma.

What experts say. The earlier gestosis occurs, the more dangerous the situation is. If you don't take action, too many complications may accumulate by the time of delivery..

When will it take place?

Early toxicosis rarely crosses the border of the first trimester of pregnancy and ends at 13-14 obstetric weeks. Sometimes the complication can last until the 16th week.

Gestosis (late toxicosis) proceeds individually for each woman. Sometimes it only goes away after childbirth.

Toxicosis treatment - medical methods

If early toxicosis causes you inconvenience, interferes with a normal life, be sure to consult a doctor. He will conduct an additional examination and determine the severity of toxicosis. With gestosis, it is impossible to do without medical help.

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Early toxicosis

A severe form of toxicosis can lead to complications:

weight loss;
palpitations (tachycardia);
a constant increase in body temperature;
weakness.

There are many dangers here. With weight loss, the kidneys may sink. Developing, the baby will begin to "take" calcium from the mother's body. Then her teeth begin to literally crumble, her gums bleed, and fragility of bones increases. Oxygen deficiency is found in the maternal blood. This means that the baby will practically begin to suffocate. Doctors call this condition fetal hypoxia, it prevents the child from developing normally.

And how to go to work and do household chores if you don't have the strength to get out of bed in the morning? In this situation, the doctor sends the patient to the hospital. There, they will organize intravenous nutrition, establish water-salt metabolism, provide peace and constant observation. Certain medications may be prescribed. These are usually vitamins. Or drugs that relax the uterus (so that there is no threat of miscarriage). All these methods quickly restore the health of mom and baby.

There is another method of treating toxicosis. It is called immunocytotherapy. For this, lymphatic fluid is taken from the child's father and injected into the mother under the skin of the forearm. In this case, the woman's body quickly copes with toxicosis. After all, half of the baby's cells contain cells of the father's organism that are “alien” to the mother. It is important that the father of the child does not suffer from any infectious diseases, otherwise immunocytotherapy is impossible.

There are also various homeopathic remedies. Since these medicines are of herbal origin, they have almost no contraindications. Only a doctor can prescribe homeopathic treatment for severe toxicosis.

Very rarely, no medical measures help stop or at least alleviate early toxicosis. The condition of the expectant mother can become dangerous for her life. Then doctors will make a difficult decision to terminate the pregnancy. Fortunately, nowadays such situations hardly arise.

In our time, they are trying to fight with early toxicosis by means of alternative medicine. If the doctor does not forbid, then acupuncture, herbal medicine or hypnosis can be used to treat early toxicosis. If early toxicosis causes psychoemotional complications rather, a course of electrosleep or consultation with a psychologist will help.

Gestosis

If late toxicosis manifests itself in a pregnant woman only in the form of dropsy, she can be treated at home. The doctor's instructions will be as follows:

restriction of fluid in food to 1-1.5 liters per day;
reduce salt and sugar intake;
take herbal sedatives, as well as drugs that increase blood formation.

Attention! With gestosis, diuretics should not be taken!

If the expectant mother has a noticeable increase in pressure, she will be sent to a hospital.

Preexlampsia and eclampsia are indications for urgent labor. If the pregnant woman cannot give birth by herself or there is no time for this, doctors will prescribe an emergency caesarean section. In late pregnancy, the baby will be saved.

Can toxicosis be avoided?

Medical statistics show that absolutely healthy women almost never suffer from pregnancy toxicosis. If you are planning to conceive, carefully examine "the day before" and, if necessary, carry out treatment:

eliminate excess weight, if possible;
heal sore teeth and gums;
sanitize if you have chronic infections;
set the daily routine (so that there is no overwork).

When pregnancy comes, take up a special sport (gymnastics, yoga, swimming) and be sure to take a walk every day.

These measures will help either to completely avoid toxicosis of pregnant women, or to survive it easily.

In no case should you be afraid of early toxicosis. This is unpleasant, but you can survive.

In the morning it is advisable to have breakfast before getting out of bed. If there is no one to prepare and bring breakfast, take care of yourself. Put a bottle of mineral water, fruit drink, compote (whatever you like) by the bed and put your favorite fruits, vegetables, nuts. The main thing is that the food cannot go bad overnight. After breakfast lie down or sit, think about good things, and only then get up. Afraid to fall asleep again? Set a timer or set an alarm.
Essential oils are wonderful. A drop of oil on your pillow can help fight nausea in the morning. Carry ginger oil with you and inhale its scent if it gets sick. Attention: oils must be natural, substitutes will not help! On the Internet, it is often advised to drop the oil directly onto the skin of the hand and hold it near the nose. In fact, it's best not to do that. A good essential oil will easily irritate your skin. And it's better not to use the bad ones at all!
If you don't like the concentrated scent of ginger oil, try ginger-infused foods such as cookies.
If you are sick and nauseous in transport, it is useful to carry mineral water, an apple, a piece of cheese or some other delicacy with you. We'll have to do a couple of experiments to find “your” product. And if it's really bad, but getting out of the subway / bus car and other transport is impossible, you will have to stock up on thick plastic bags and wet wipes. Threw up in front of everyone? Just say: "I am pregnant!" and don't be shy about anything. The most important thing right now is your wellness and health.
If you drink often, but very little, vomiting can be avoided.
From folk remedies for toxicosis, a special collection helps. You need to mix in 2 tsp. dry mint, yarrow herb and calendula flowers, add 1 tsp. valerian root. Insist half an hour in 400 ml of boiling water, then strain. The collection is taken in 2-3 tbsp. l. every two hours throughout the day. The course is 25 days, then you need a break for half a month.
Activated charcoal helps with nausea. But first, you need to consult a doctor about taking it.
The salivation will disappear if you rinse your mouth with sage, mint or chamomile infusion.

See more methods of dealing with early toxicosis:

Nutrition for toxicosis

Another important point in pregnancy is nutrition. If it is organized correctly, toxicosis may be mild or not appear at all.

No fatty, smoked food, give up canned food. Better to steam or bake.
Multi-colored soda contains harmful dyes that can easily make you sick.
You should eat vegetables and fruits every day. Plant foods should take up about a third of the daily diet.
Dairy products are a must. If you don't just like milk, drink kefir and other fermented milk drinks. For those who do not like cottage cheese, cheese can be advised. However, it is better that dairy products are not greasy.
If you are attracted to sweets, buy marmalade, marshmallow or marshmallow. Cakes, caramels and chocolates should remain in a past life for a while.
Vitamin B6 is especially useful for toxicosis. Eggs, fish, legumes, and avocados are rich in this vitamin.
Do you like honey? This is also a good remedy for toxicosis. Remember that this product cannot be added to hot drinks - from this it loses its beneficial properties.
Instead of tea, it is better to drink a special vitamin infusion. Put a tablespoon of rose hips and a couple of apple slices in boiling water, let it brew.
If you do not have high acidity, lemon water will help (squeeze the juice of half a lemon, bring water to the volume of a glass).
Pumpkin juice or broth will help relieve nausea.
Eat small meals often. If possible, eat reclining.

Why is there no toxicosis?

One should not think that there is no pregnancy without toxicosis. If you are in good health, and conception was planned, pregnancy toxicosis may not occur at all or be very mild.

There is a situation that you definitely need to pay attention to. If the toxicosis began, and then abruptly, suddenly stopped, this may mean a frozen pregnancy. Then - urgently to the doctor. Especially if such a symptom appeared before the eighth obstetric week of pregnancy.

Be considerate of yourself. Choose in time the techniques that will help to cope with toxicosis. Be sure to visit your doctor regularly so as not to miss late toxicosis. And then the pregnancy will really be easy.

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What to do with nausea in early pregnancy

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Toxicosis of pregnant women is a concept that unites a group of gestational complications associated with the development of the ovum and disappearing after childbirth or termination of pregnancy. Doctors associate the development of toxicosis in pregnant women with a violation of the adaptive processes in a woman's body to pregnancy. Toxicosis is expressed by impaired functioning of various systems and organs.

In medicine, early toxicosis, late toxicosis (gestosis) and rare forms of the complications under consideration are distinguished.

Table of contents:

Early toxicosis of pregnant women

This concept means gestational complications that develop in the first trimester (up to 12-13 weeks). It is early toxicosis that is most often diagnosed in pregnant women, but, as a rule, all uncomfortable / unpleasant sensations with such a complication disappear without a trace and do not pose a threat to the fetus or the woman herself.

Reasons for the development of early toxicosis

In the course of studies of the complication in question, it was concluded that several factors can become the reasons for its development:

All these factors can be in every pregnant woman, and which one will play a major role does not matter. Doctors noted that early toxicosis in women with aggravated somatic status is severe, that is, they have a history of nephritis and / of the duodenum. With almost 100% certainty, doctors predict the appearance of early toxicosis in pregnant women who have undergone abortions, have a history of chronic diseases of the female reproductive system (,).

Symptoms of early toxicosis of pregnant women

The most characteristic signs of early toxicosis, which appear at 5-6 weeks of gestation, are considered to be a sudden change in taste and smell, drowsiness, lethargy and loss of appetite. The doctor can objectively determine weight loss, a decrease in blood pressure, an increase in azotemia in the blood, the appearance of acetone in the urine and electrolyte disturbances. ... Depending on how severe the vomiting is, doctors distinguish several degrees of early toxicosis:

Note: a severe degree of early toxicosis leads to hemorrhages in the conjunctiva, increased heart rate up to 120 beats per minute, and hypotension, the general condition of the pregnant woman worsens. In this case, the gynecologist will insist on hospitalization of the pregnant woman.

Diagnosis of early toxicosis of pregnant women

The considered type of gestational complication of pregnant women is revealed by analyzing the woman's complaints, based on objective data and the results of additional examinations. The gynecologist examines the woman on the chair and conducts, which helps to make sure that there is an ovum in the uterus, determine the gestational age and make sure that the fetus is developing normally.

If a pregnant woman presents complaints characteristic of early toxicosis, then she must be carried out, and.

Treatment of early toxicosis of pregnant women

A mild degree of early toxicosis of pregnant women does not require hospitalization, but some methods of improving a woman's well-being must still be applied. Usually, everything is limited to the intake (or infusion of motherwort), vitamins and antiemetics (cerucal). If the type of gestational complication under consideration is accompanied by profuse salivation, then the doctor may recommend rinsing the mouth with infusions of chamomile, and (these plants have tanning properties). To reduce the intensity of nausea and vomiting, it is necessary to correct the nutrition of the pregnant woman - it should be fractional, the food should be easily digestible, and the food should be taken in small portions.

Note: any medications and infusions of sedative herbs are prescribed to a pregnant woman only by a gynecologist. An independent choice of treatment for early toxicosis is fraught with pregnancy complications.

With a moderate degree of early toxicosis, the treatment of a pregnant woman is carried out in stationary conditions, where she is prescribed infusion therapy - intravenous administration of Disol / Acesol / Trisol (saline solutions), glucose, hepatoprotectors, vitamins and protein preparations. To stop vomiting attacks, a woman is shown the use of antipsychotic drugs, an excellent effect is also observed when carrying out physiotherapy - for example, electrophoresis, electrical sleep, acupuncture.

A severe degree of early toxicosis in pregnant women is a critical condition, therefore, such patients are treated in intensive care units under constant monitoring of hemodynamic and laboratory parameters. Treatment is reduced to the infusion of solutions in a volume of at least three liters, the introduction of antipsychotics, hepatoprotectors, antiemetics.

Note: a severe degree of early toxicosis can end in coma and the death of a woman, therefore, most often in this case, doctors carry out an artificial termination of pregnancy for medical reasons. Spontaneous termination of pregnancy often occurs.

Early toxicosis, in most cases, is considered normal if it is mild to moderate in severity. Most often, the unpleasant symptoms of the phenomenon in question disappear after 12-13 weeks of pregnancy, and if this does not happen, then the gynecologist will conduct a full examination of the patient in order to exclude hepatitis, pancreatitis, hepatosis and cystic drift.

Late toxicosis of pregnant women (gestosis)

Late toxicosis, or preeclampsia, of pregnant women is called a complication of pregnancy in the third trimester, which is characterized by the development of profound disorders in vital organs and systems. Late toxicosis begins to develop after 18-20 weeks of pregnancy, but it is diagnosed only at 26-28 weeks of pregnancy.

Causes of late toxicosis

Modern gynecology has several theories about the reasons for the development of this type of gestational complication of pregnancy, therefore, this condition is often called the "disease of theories". Let's highlight the most popular opinions:

Hormonal disorders... There is a violation of the regulation of vital functions, which leads to an immunological conflict between the fetus and the mother.
Corticovisceral theory... During pregnancy, disruptions in the relationship between the cortex and the subcortical structures of the brain can occur, and this provokes reflex changes in the vessels and the circulatory system.
Generalized vasospasm... This leads to a violation of the blood supply to organs and tissues, increases blood pressure, decreases the total volume of blood that circulates in the vascular bed.
Damage to the inner lining of blood vessels... This disorder leads to oxygen starvation of the cells of the brain, kidneys and liver.

Symptoms of gestosis (late toxicosis)

The very first manifestation of the considered type of gestational complication is dropsy, which is characterized by fluid retention in the body and the appearance of persistent edema. At first, they can be hidden and they can be detected only after studying the graph of an increase in the body weight of a pregnant woman, but after the edema becomes obvious, pronounced, the doctor classifies the stages of dropsy:

1st stage - edema extends only to the lower extremities, and specifically - to cover the legs and feet;
Stage 2 - edema is present both on the lower limbs and on the anterior abdominal wall of the abdomen;
Stage 3 dropsy - edema is present on the lower and upper limbs, face and abdomen;
4 studia - edema becomes universal, generalized.

Note: with dropsy, the general well-being of a pregnant woman, as a rule, is not disturbed. But if the edema is pronounced, then the patient will complain of increased fatigue, thirst and a feeling of heaviness in the legs.

After a pregnant woman has developed, nephropathy may occur, which will be characterized by a combination of three symptoms - edema, hypertension and proteinuria (the appearance of protein in the urine). Even if only two of these symptoms are present, the doctor will diagnose pregnancy nephropathy. It is worth noting that in pregnant women in the third trimester it will not be stable, but wavy. To track these jumps, you need to compare the pressure indicators of the first months of pregnancy and the current period of bearing a child.

Note: the development of dangerous complications with gestosis (for example, premature placental abruption, bleeding or fetal death) is often provoked not by high blood pressure, but by its fluctuations.

Pregnancy prognosis for nephropathy is highly variable. The combined forms of late toxicosis significantly worsen the prognosis - for example, if a woman develops nephropathy against the background of a previously diagnosed nephritis. A long course of nephropathy can go to the next stage of development of late toxicosis - preeclampsia.

Preeclampsia characterized by circulatory disorders of the central nervous system. The symptoms of preeclampsia will be not only the manifestations of nephropathy, but also nausea and vomiting. There are memory impairments, lethargy, indifference to the outside world and close people, visual impairment, pain in the epigastric region.

There are a number of indicators that indicate the development of preeclampsia of late toxicosis in pregnant women:

blood pressure - 160/110 and above;
diuresis - less than 400 ml;
nausea and vomiting;
the amount of protein in the urine - 5 grams or more per day;
brain disorders;
visual impairment;
decrease in platelets in the blood;
disruption of the liver;
decrease in blood clotting indicators.

The development of a seizure in eclampsia can be triggered by any external stimulus - for example, sharp pain, bright light, stress, or loud sound. The duration of a seizure attack is 1-2 minutes, it begins with twitching of the muscles of the eyelids, face, and then spreads to the muscles of the upper / lower extremities and the whole body. A pregnant woman's eyes freeze at the time of a convulsive seizure, the pupils roll up, the corners of the mouth drop, and the fingers clench into fists.

After 30 seconds from the onset of an attack of eclampsic seizures, the woman begins tonic convulsions - the body of the pregnant woman tenses and stretches, the spine bends, the head is thrown back, the jaws are tightly compressed, the skin acquires a bluish tint. Since during an attack, the respiratory organs are involved, a violation of this activity and loss of consciousness occurs.

Note: just at the moment of loss of consciousness in a pregnant woman who is in a convulsive seizure against the background of eclampsia, a cerebral hemorrhage and rapid death may occur.

10-20 seconds after tonic seizures, clonic seizures begin to develop - the woman literally fights in convulsions, continuously moving her arms and legs, as if jumping up and down in bed. Such convulsions last a maximum of one and a half minutes, and then there is a hoarse breath, with the release of foam from the mouth.

Important:after the end of the convulsive seizure, the pregnant woman remembers nothing about it, feels severe weakness and headache. Any irritant, including drug injections, can trigger the onset of a new attack.

Non-convulsive eclampsia is considered a very dangerous condition - a coma develops suddenly against the background of high blood pressure. This type of eclampsia is characterized by extensive cerebral hemorrhage and the death of a woman.

Diagnostic measures

The gynecologist, when diagnosing the type of gestational complication under consideration, takes into account the woman's complaints, pays attention to her appearance (it is just possible to detect swelling) and is guided by the results of examinations. To determine the degree of late toxicosis, a pregnant woman is sent for blood and urine tests, and an ophthalmologist examines her.

If there are suspicions of the development of gestosis (late toxicosis), then ultrasound and Doppler ultrasound are necessarily carried out - this will help to assess the condition of the fetus and placental blood flow.

Treatment of late toxicosis (gestosis)

Treatment of gestosis in the conditions of outpatient management of a pregnant woman is allowed only with its mild course; in all other cases, a woman is hospitalized in such institutions where there is an intensive care unit and everything necessary for urgent delivery.

The goal of treating gestosis is to normalize the work of the central nervous system, stabilize metabolic processes, and normalize blood pressure indicators. The duration of therapy for late toxicosis depends only on the intensity of its manifestation.

Note: spontaneous childbirth with severe toxicosis of pregnant women is allowed only if the condition of the woman in labor is satisfactory, the therapy is effective, and there are no violations of intrauterine development of the fetus. Even a slight negative trend serves as an indication for operative delivery.

Rare toxicosis of pregnant women

If we talk about rare forms of toxicosis of pregnant women, then it is worth highlighting several of the most pronounced.

Dermatoses of pregnant women

They arise against the background of hormonal disorders, "malfunctions" of metabolic processes and an imbalance between the cortex and subcortical structures of the brain. Such toxicosis appears almost immediately after conception, and disappears after childbirth.

Dermatoses of pregnant women are manifested by erythema, and herpetic eruptions. They do not pose any danger to the life of the mother and the fetus, but treatment is necessary, as this will alleviate the woman's condition.

As part of measures aimed at getting rid of the considered form of a rare gestational complication, a diet with limited protein and fat is prescribed. Of the drugs, those that are able to normalize metabolism will be effective.

Jaundice of pregnancy

Most often it occurs in the third trimester of pregnancy, but early toxicosis, which is difficult, can also accompany. When pregnant women appear, the doctor must necessarily examine the woman in order to differentiate the condition in question from pathological damage to the liver and / or biliary tract.

Treatment for jaundice in pregnant women consists in prescribing a balanced diet and using certain medications, for example, cholestyramine or nerabol. It is allowed to use antihistamines and phenobarbital in the treatment of jaundice of pregnant women, and if the clinical manifestations of the considered form of gestational complications are increasing, and even accompanied by a severe course of early or late toxicosis, then the woman will be shown abortion.

Acute fatty hepatosis of pregnant women

An extremely dangerous condition that develops at 33-40 weeks of pregnancy. It always begins acutely, in almost all cases ends with the death of the fetus or the woman herself.

Treatment of acute fatty hepatosis of pregnant women implies the immediate termination of pregnancy, detoxification therapy and the introduction of protein / lipotropic agents.

Chorea of \u200b\u200bpregnant women

This form is associated with a violation of calcium metabolism, which occurs due to the hypofunction of the parathyroid glands. Chorea of \u200b\u200bpregnant women is manifested by convulsive twitching of the muscles of the upper / lower extremities. Most often, this form of a rare toxicosis occurs in women with a history of rheumatism.

Treatment of chorea in pregnant women is carried out in a hospital, the woman is prescribed sedative drugs and drugs that can normalize calcium metabolism (vitamins D, E and calcium gluconate).

Osteomalacia

This is an extremely rare form of toxicosis in pregnant women, due to its development by decalcification of bones and their softening. Most often, the pelvic bones and spine are affected, this process is accompanied by severe pain and deformation of the affected bones.

Treatment of osteomalacia in pregnant women consists in carrying out therapy aimed at normalizing phosphorus-calcium metabolism.

Toxicosis of pregnant women is a disorder in the body that is associated with the onset of conception. Doctors aim not only to alleviate the condition of a woman, but also to preserve the normal intrauterine development of the fetus. Regardless of what type of toxicosis develops in a pregnant woman and to what degree of severity it proceeds, the woman should be under the supervision of a gynecologist, and in most cases, in hospital treatment.

Tsygankova Yana Alexandrovna, medical columnist, therapist of the highest qualification category