How to distinguish poisoning from toxicosis of pregnant women. Poisoning or pregnancy. Clinically significant hormonal changes

26.06.2020

Pregnancy includes a period when a woman wants to carry a normal, healthy baby. At the same time, it is necessary to protect the body during the gestation period from various types of diseases so that medications, the body's reactions do not negatively affect the fetus. Sometimes during pregnancy there is a change in taste, an irresistible desire to eat exotic, unusual appears, at the same time the likelihood of intoxication increases.

Poisoning often prevents a critical situation from arising. But for a woman in a position, this is too serious a condition, because a systematic intoxication is formed. Along the way, dehydration occurs due to constant vomiting and diarrhea. These indications harm the fetus or end in premature failure of gestation. Based on this, it is necessary to accurately distinguish toxicosis from poisoning. But the disease begins not only during the period of bearing a child. Toxicosis turns out to be the beginning of some serious ailments.

Toxicosis is a frequently observed situation in women who are in an interesting position, it is preceded by a feeling of nausea and vomiting. It begins during the period of intoxication with toxic and other poisonous substances that appeared during the development of the fetus.

Toxicosis can occur at any time. The first trimester of childbearing is underway. The symptoms of the disease are determined by the position and feeling of the expectant mother. Pregnant women who are healthy in all respects, toxicosis are imperceptible. If the presence of a renal, hepatic or other ailment is noted, the malaise becomes more complicated.

Signs of the development of toxicosis:

Hormonal disruption of the body - during the carrying of a child, the structure of hormones changes in a woman, hence the state of health, vomiting, nausea, aggravated odors. But this situation passes by 15 weeks.
Placenta formation - the stage of its formation is accompanied by intoxication and ends at the end of the first trimester.
Persistent infectious diseases are the basis of the onset of toxicosis.
Various stressful situations are conducive to the onset of toxicosis at the third stage.
Multiple pregnancy is a factor of late toxicosis.

The emergence of acute poisoning

Intoxication can be accidental, suicidal, domestic, industrial, food, medicinal. Acute, chronic intoxication often begins. Acute intoxication appears due to chemical or medicinal drugs. It also differs in the focus of infection: through the oral cavity - with food, medicines; through the nose - gas, paint compounds; through the skin or mucous membranes. There are cases of poisoning with the wrong method of intramuscular and intravenous injections.

The most common sign of intoxication is food malfunction. It appears with the use of unusable, expired food products and as a result, symptoms arise: acute diarrhea and flatulence, pain and heartburn in the stomach and intestines, nausea and single attacks of vomit, migraine, loss of strength, temperature.

Food intoxication factors

Bacilli and microbes enter the stomach together with unsuitable food. These foods include:

Fungi that cause serious diseases.
Canned fish, insufficient quality content.
Vegetables and fruits containing excess pesticides or other pesticides.
Expired meat.
Dairy products, use after the specified period causes the growth of staphylococcus.

Symptoms of intoxication in pregnant women

Poisoning from pregnancy is distinguished by the following indicators. At this time, women in an interesting position experience a breakdown, vomiting, a feeling of nausea, diarrhea. The temperature rises to 39 degrees, but chills are felt. Such symptoms are felt together or separately. Mild poisoning usually ends in a couple of days, and there is no point in going to the hospital.

Distinctive characteristics of poisoning and toxicosis

The defining manifestation in this case is the unexpected occurrence of food poisoning. In women during pregnancy, after a certain period of time, signs of vomiting begin, dizzy, nauseous, and abdominal pains are observed. The intermediate period, constituting the intake of a toxic ingredient before the formation of the causes of poisoning, takes from one to five hours. It is important to note the dissimilarity with poisoning, the disease does not arise unexpectedly under any circumstances and gradually turns into a pronounced form of toxicosis. Vomiting and nausea almost always occur in women in the morning, the usual temperature does not increase, bowel movements are normal, you want to eat.

It is possible to distinguish toxicosis during pregnancy from poisoning by the absence of diarrhea and chills. The signs appear constantly and in the same way, there is no deterioration or improvement. The indicator is the growth of lymphoid areas. The skin acquires an earthy-grayish color, and when intoxicated, the skin becomes pale. Migraine, a problem with bowel movement occurs in the last period of gestation. But this is the body's normal response to preparations for labor. In this position, you should not self-medicate. The doctor will determine the diagnosis, prescribe special treatment.

The effect of poisoning on the pregnancy process

Intoxication, even in a simple category, reduces the flow of beneficial foods for fetal growth. Negatively affects intrauterine development. Metabolic disorders in food poisoning interferes with the supply of food to the placenta. Gastrointestinal cramps, vomiting, diarrhea can provoke a miscarriage.

Signs of toxicosis

Reye's syndrome is an acute liver failure, the disease creates abdominal cramps. It is worth rejecting the assumption of food intoxication if there are tumors of parts of the face, shortness of breath, sudden surges in pressure, runny nose, sneezing, sore throat, convulsions, exacerbation of the liver, cough. The disease manifests itself as ARVI.

The causative agent of infection is a virus in the body. Due to the complication of the disease, a coma develops.

It is possible to distinguish signs of acute adrenal insufficiency - Waterhouse-Friederiksen syndrome - with an increase in temperature, loss of strength, nausea, vomiting and, in addition, depression, pallor, convulsions, respiratory failure, if there is no motor function, in the absence of a light reaction. Coma also occurs.

Disease with acute renal failure - signs of the disease are similar to intoxication, in addition, there is blood in the urine, swelling, hematomas on the skin, pressure surges, nosebleeds, palpitations, yellowness.

When a staphylococcal bacillus enters the body, there is pallor, dehydration, an increase in lymphoid areas, lack of reaction, shortness of breath. Leads to the development of oxygen starvation, lack of calcium, the formation of dystrophy.

In the event of food intoxication, a woman must follow the recommendations:

Drink a lot of liquid often and in small amounts, while artificially inducing vomiting is not worth it. It is better to use the drug Regidron, which can restore and increase the lost balance during the period of dehydration. This drug is approved for pregnant women.

Say goodbye to junk food: fatty, heavy, spicy, spicy. You should not eat foods containing dyes, formaldehyde, sweets. For a certain period, stick to a diet, preferring dietary meat, fruit and vegetable fruits.
After the cessation of vomiting, take medications that absorb toxic substances in the stomach. This includes: Smecta, activated carbon, Enterosgel, but it is worth consulting your doctor so that he prescribes the correct treatment.

In case of the most severe poisoning, a hasty hospitalization is necessary. In a medical institution, the doctor will provide medical assistance, stop poisoning, and help support pregnancy. The body's toxic resistance to food poisoning or pregnancy requires medical intervention before an accurate diagnosis and drug treatment can be established.

To improve self-awareness in case of toxicosis, women who are carrying a child need rest and tranquility. You should also drink decoctions, tea with lemon, mint.

Almost 2/3 of pregnant women encounter toxicosis of varying severity. He is able to significantly worsen the well-being of a woman and even cause her to be hospitalized. Fortunately, in most cases, toxicosis of pregnant women does not lead to disability, although this condition imposes certain restrictions on the regimen and nutrition.

What is considered toxicosis during pregnancy

Pregnancy without toxicosis is an absolute norm. But in the modern world this is rare, and the absence of any uncomfortable symptoms in the first days after a delay in menstruation is often perceived by a woman as an alarming sign. So what is toxicosis?

This term denotes a group of pathological conditions that arise only during pregnancy, lead to a deterioration in the woman's well-being and are manifested by extragenital symptoms. They may appear even before a missed period is recorded and a positive pregnancy test is obtained. So many women consider this condition to be the very first and quite reliable sign of a successful conception.

In fact, toxicosis refers to the dubious signs of pregnancy. After all, its symptoms are nonspecific, sometimes it is difficult to distinguish them from the signs of various somatic diseases. In addition, some complaints that appear in a pregnant woman may be of a psychogenic nature, that is, they do not have a physiological connection with the development of an embryo in the uterus. And sometimes a condition mimicking toxicosis occurs outside of pregnancy. This is possible if a woman is very much looking forward to her coming and has a tendency to somatize her emotions due to individual psychological characteristics.

The term "toxicosis" was introduced into everyday life at the beginning of the last century. Moreover, initially they were designated pathological extagenital conditions that occur at any gestational age. Currently, toxicosis is diagnosed only in the 1st trimester. And at a later date, they use the term "gestosis". And this is already a much more serious and potentially life-threatening condition for the fetus and the woman. But even now it is sometimes called late toxicosis, which is not a completely correct term.

Main clinical forms

According to the modern classification, toxicosis includes:

Vomiting of pregnant women is the most common form, accounting for up to 85% of cases. It is she who is most often called.
Salivation.
Dermatoses or "pruritus of pregnant women".
Chorea of pregnant women.
Bronchospasm and bronchial asthma.
Hepatosis, acute yellow atrophy of the liver.
Osteomalacia.

In terms of severity, toxicosis can have 3 degrees of severity: mild, moderate, severe. This is decisive when deciding on hospitalization of a pregnant woman, even if she does not show signs of the threat of termination and deviations in the development of pregnancy.

Why does he appear

For quite a long time, the development of toxicosis was associated with the poisoning of the woman's body with metabolic products (toxins) formed during the development of the embryo. Currently, this theory is recognized as untenable, since it does not explain the disappearance of the main symptoms as pregnancy progresses. Subsequently, many other assumptions were expressed, and some of them were reflected in the modern understanding of the pathogenesis of pregnancy toxicosis. The study of this condition is still under way, because the mechanisms of the development of key symptoms have not yet been finally established.

Today it is believed that the main causes of toxicosis during pregnancy lie in the developing hormonal imbalance in the woman's body and in the change in the functional state of her central nervous system (especially the diencephalic region and parasympathetic part). Subsequently, secondary dysmetabolic disorders occur. This aggravates the condition and can contribute to the formation of not functional, but structural changes in some internal organs with the appearance of new symptoms. With a severe course of toxicosis, dystrophic changes develop.

For example, vomiting leads to dehydration and electrolyte imbalances. This can already secondarily provoke disruption of the digestive tract, seizures, disruption of the functioning of the central nervous system and heart. Fasting concomitant with toxicosis or low absorption of essential nutrients contribute to hypoproteinemia and the accumulation of ketone bodies. With an unfavorable development of events, this can cause severe progressive hyperlipemia with subsequent fatty liver infiltration.

In some cases, signs of toxicosis can be explained by the allergization of the pregnant woman's body with trophoblast proteins.

Clinically significant hormonal changes

Pathogenetically important dyshormonal disorders of early pregnancy:

Relative estrogen deficiency. By itself, this does not lead to toxicosis, but in combination with other disorders it becomes clinically significant and contributes to the development of autonomic reactions.
The increasing concentration of progesterone in the blood. This hormone is produced by the corpus luteum of the ovary, which remains in place and continues to function after embryo implantation. Its main task is to prolong pregnancy, prevent spontaneous abortions and ensure adequate growth of uterine tissues. But the effects of progesterone are not limited to the reproductive system. It acts on smooth muscle fibers in the walls of the digestive tract to relax them. This can lead to an imbalance in the work of the stomach and various parts of the intestine, which becomes the cause of the appearance of unpleasant symptoms in toxicosis.
The progressively increasing production of chorionic gonadotropin in the first weeks of pregnancy. There is evidence that the peak values of this substance often act as a provoking factor for the development of vomiting. This can explain the predominance of complaints of nausea in the morning, when the concentration of hCG is usually highest.
Decreased secretion of glucocorticosteroids by the adrenal cortex. This leads to a decrease in the reaction of blood vessels to vasoconstrictor substances, contributes to the accumulation of fluid in the intercellular spaces.

Currently, dyshormonal changes are considered key in the pathogenesis of toxicosis.

What affects the likelihood of developing toxicosis

Toxicosis does not develop in all pregnant women. Even for the same woman, the period of bearing the first and subsequent children may differ. And if she has already experienced toxicosis earlier, during the second pregnancy, his symptoms may not bother. And it is impossible to predict its appearance.

There is also an opinion that there is a relationship between the likelihood of toxicosis and the sex of the conceived child. But it has no scientific evidence. In the earliest stages of pregnancy, when toxicosis usually appears, all embryos develop in the same way. They do not yet have differentiation of the reproductive system, this will occur only from the 8th week of gestation. Therefore, the sex of the child cannot affect the development of early toxicosis.

Predisposing factors include:

... In this case, the hormonal "surge" in a pregnant woman is usually higher than during conception with one embryo.
Tendency to neurosis-like and somatoform reactions, migraines. Indeed, in these cases, even before pregnancy, there is a change in the interaction between the brain, the autonomic part of the nervous system and target organs.
Infectious diseases and surgical interventions transferred shortly before conception, especially on the reproductive organs.
The presence of chronic diseases of internal organs. The onset and prolongation of pregnancy can become a factor that disrupts the existing balance and leads to decompensation of the existing pathology. This is especially true for diseases of the digestive tract.
Hereditary predisposition.
Age. Pregnant women over 35-40 years old are more likely to develop toxicosis. This is due to a decrease in their general compensatory capabilities of the body, a decrease in the functional activity of the endocrine and reproductive systems, the accumulation of chronic and not always diagnosed pathology of internal organs.

It is important to understand that the presence of predisposing conditions only increases the likelihood of developing toxicosis. And their absence does not guarantee good health in the first months of pregnancy. Absolutely healthy and quite emotionally balanced women often face toxicosis. This is no exception to the rule and only speaks of the development of their reaction to the changes occurring during pregnancy.

When does toxicosis begin

How long after conception does toxicosis occur?

The timing of the development of this condition is quite individual, but in any case, it appears only after implantation of the ovum into the functional layer of the endometrium of the uterus. And this process occurs no earlier than 5 days after the fusion of the egg and sperm, most often on the 9th day after ovulation.

But for a number of women, for various reasons, the implantation time is shifted and can be either 7-8 or 11-14 days. At the same time, a long time interval between fertilization and the introduction of the ovum is fraught with non-preservation of pregnancy, the woman's body simply does not have time to adequately respond and prevent the onset of menstruation.

What explains this period?

Fertilization of the egg most often occurs in the lumen of the fallopian tube. Therefore, for proper implantation, the formed ovum must reach the endometrium. He also needs to go through certain successive stages of development and transform in the process of active cell division into a blastocyst. Therefore, even if fertilization occurs in the uterine cavity, implantation is still possible only after a strictly defined number of days.

Only after the introduction and fixation of the ovum in the endometrium, the woman's body receives a signal about the onset of pregnancy and begins to produce hormones for its prolongation. And a pronounced increase in the level of progesterone and a progressive increase in the synthesis of hCG are just capable of provoking the onset of toxicosis. But this usually does not happen immediately after implantation, and only after reaching a certain concentration of hormones and a secondary change in the functional state of the nervous system. In addition, each pregnant woman has her own sensitivity to the processes taking place in her body.

So what week does toxicosis begin?

Most women begin to experience its symptoms within about 1.5 weeks after missed periods. Most often, they are preceded by other signs of an increase in progesterone levels: breast engorgement, increased nipple sensitivity, and others. But in some pregnant women, they appear almost simultaneously with nausea, already a week and a half before the expected date of menstruation.

The onset after pregnancy can also proceed with toxicosis. In this case, it is necessary to take into account the later implantation of the ovum in connection with the technical features and timing of the procedure for transferring embryos into the uterine cavity. Therefore, symptoms of toxicosis usually occur after confirmation of the fact of pregnancy using a laboratory test for hCG and ultrasound.

It is important to understand that toxicosis is not excluded when. After all, the place of implantation does not affect the functioning of the corpus luteum, the synthesis of hormones is supported by signals emanating from the developing ovum. Therefore, it is impossible to assume an ectopic pregnancy only by the severity of toxicosis, other symptoms indicate this pathology.

Main manifestations

The most common form of toxicosis is nausea and vomiting of pregnant women. They are usually combined with increased salivation, increased sensitivity to odors (both food and household), the appearance of taste preferences, and a change in appetite.

Nausea is an uncomfortable symptom, but it is not at all dangerous for a woman's health and for the development of an embryo. It can be almost constant, disturb in surges in response to external taste and aromatic stimuli, or appear mainly in the first hours after waking up in the morning. But evening toxicosis is also possible, which is not a gross pathology. The deterioration of the condition at the end of the day is explained by the fatigue of the pregnant woman with depletion of the functional reserves of the nervous system.

Vomiting most often accompanies nausea and develops at its peak. In the first half of pregnancy, morning urges usually occur on an empty stomach. But vomiting can also appear after eating. Its frequency and abundance depend on the severity of toxicosis and the presence of concomitant chronic diseases of the gastrointestinal tract. The diet of a pregnant woman is also of some importance. Plentiful, irritating, fatty foods usually aggravate the situation and more often provoke vomiting.

In addition, gastric emptying may not be spontaneous. Wanting to alleviate the condition, reduce the severity of nausea and feelings of heaviness and fullness in the abdomen, some pregnant women deliberately induce vomiting. This is fraught with the appearance of traumatic linear tears of the mucous membrane of the esophagus at the place of its transition to the stomach, which causes some discomfort and may even cause the appearance of separate streaks of fresh blood in the vomit.

Early toxicosis can also be accompanied by heartburn - a burning sensation behind the breastbone with a sour taste in the mouth, and sometimes with a sensation of irritation in the throat. The appearance of this symptom is explained by the relaxation of the cardiac sphincter between the esophagus and the stomach with the throwing of acidic contents into the upper sections and even into the oral cavity. The likelihood of heartburn increases with the deliberate provocation of vomiting. But in general, heartburn usually appears at more pronounced periods of gestation.

Changes in the general condition, the nature and severity of metabolic changes in toxicosis in the first half of pregnancy depend on the severity of its course. With repeated, debilitating vomiting, other symptoms appear and increase. They are associated with dehydration, electrolyte disturbances, protein deficiency, and impaired functioning of internal organs. Severe toxicosis is actually multiple organ failure.

Main criteria for severity

There are 3 degrees of severity of vomiting in pregnant women:

Lightweight. Vomiting occurs 2-4 times a day, while the discharge is not abundant and without pathological impurities. The pregnant woman has no weight loss, no abnormalities in the biochemical and general blood count. Her general condition is assessed as satisfactory.
Moderately heavy. The frequency of vomiting is 10 or more times a day. A pregnant woman loses weight, she has obvious vegetative disorders and signs of dehydration (dry skin, decreased urine output with acetonuria, severe asthenia, tachycardia and a tendency to lower blood pressure). But there are still no critical changes in the general and biochemical blood test, the existing hypochloremia and mild anemia are amenable to correction. The temperature is usually subfebrile. With inadequate treatment, the condition progresses, disorders of carbohydrate and fat metabolism develop.
Heavy. Indomitable vomiting (more than 20 times a day) is one of the many polymorphic symptoms caused by multiple organ failure. Body temperature can be subfebrile or febrile. There is a progressive decrease in body weight with signs of dystrophy of internal organs and tissues. The functioning of the kidneys is impaired, persistent oliguria, proteinuria, acetonemia and acetonuria develop. Liver damage causes jaundice due to bilirubinemia. The balance of minerals is grossly disturbed, there are obvious violations of all types of metabolism. With an increase in symptoms, the level of consciousness is disturbed, subsequently a coma develops.

Fortunately, indomitable vomiting of pregnant women with progressive deterioration is now rarely diagnosed. After all, such a severe form of toxicosis develops by a gradual aggravation of symptoms, so that there is a possibility of timely correction of the arising disorders.

When to worry

Most pregnant women experience a mild form of toxicosis, manifested by nausea and morning vomiting. This condition does not pose any threat and does not even require special treatment. Nevertheless, it is possible to develop symptoms that require an early visit to a doctor.

These include:

vomiting more than 10 times a day;
severe weakness and asthenia, significantly disrupting the daily functioning of a pregnant woman;
violation of the depth of consciousness (in the form of stunning and even stupor), the main symptom of this state is motor and mental retardation with a violation of the level of contact with the outside world;
weight loss;
dryness and decreased skin turgor;
the appearance of the smell of acetone in the exhaled air;
a clear decrease in the amount of urine excreted per day;
the appearance of yellowness of the sclera, visible mucous membranes and skin;
the sudden disappearance of complaints, which may be a sign of a progressive drop in hCG levels due to.

Strengthening existing symptoms, the appearance of new disorders - all this also requires consultation with a doctor.

What is included in the survey

Examination of pregnant women with complaints of symptoms of toxicosis is aimed at assessing their somatic state and excluding diseases that may lead to the appearance of similar complaints.

Diagnostics includes laboratory and instrumental studies:

a complete blood count to detect anemia and signs of inflammation;
biochemical blood test with a mandatory assessment of the functional state of the kidneys and liver, indicators of total protein and protein fractions, the ratio of key ions;
urine analysis, determination of daily urine output and daily loss of protein in the urine;
Ultrasound of the organs of the hepatobiliary system, pancreas and kidneys, which allows not only to identify existing chronic diseases, but also hepatosis associated with pregnancy;
consultation with a neurologist (with suspicion of neuroinfection, with the development of impaired consciousness);
according to indications - smears and, if necessary, a serological study to exclude foodborne toxicoinfections.

Pregnant women with toxicosis must be sure to regularly monitor the level of blood pressure. After all, nausea and weakness can be caused by its significant fluctuations, both upward and downward.

Pregnant women with a sudden disappearance or a sharp weakening of the main symptoms require special attention. They are shown an unscheduled ultrasound scan to confirm the viability of the embryo. The fact is that with a frozen pregnancy, toxicosis often quickly decreases due to the cessation of the synthesis of supporting hormones.

How to deal with toxicosis during pregnancy

Treatment of mild toxicosis is usually not carried out. Only with the development of neurosis-like reactions and a decrease in working capacity can a woman be offered therapy in a day or round-the-clock hospital. Moderate forms of toxicosis are the basis for deciding on the appropriateness of hospitalization. And severely expressed options require the prompt placement of a pregnant woman in a hospital or even in an intensive care unit.

It is important to understand that all prescribed drugs are not able to completely eliminate the main symptoms, since it is impossible to get rid of toxicosis while maintaining its only cause (pregnancy). The drugs used help to stop potentially life-threatening complications, alleviate some of the manifestations and thereby alleviate the woman's condition. Moreover, each prescribed remedy for toxicosis has its own point of application and certain indications. Therefore, only a doctor should select the optimal therapeutic regimen.

Possible directions of therapeutic action for toxicosis:

Elimination of existing dehydration, the choice of technique depends on the severity of dehydration and the patient's condition. Drinking is practiced using special saline solutions, infusion therapy based on rheopolyglucin, Ringer-Lock and others.
Correction of electrolyte disturbances and metabolic acidosis. With severe vomiting of pregnant women, the administration of a glucose-insulin-potassium mixture, sodium bicarbonate is often required. The selection of solutions for replenishing electrolyte deficiency is based on a dynamic assessment of their level in blood plasma.
Replenishment of apparent nutritional deficiencies. In severe cases, special nutritional mixtures are prescribed, plasma, albumin, serotransfusin can be administered intravenously.
Reduction of endogenous intoxication due to multiple organ failure. Intravenous administration of hemodesis is shown, sometimes extracorporeal blood purification procedures are performed.
Maintaining the function of the hepatobiliary system. In case of mild and moderate course with a hepatoprotective purpose and to improve the work of the biliary system, Hofitol, Essentiale are often prescribed. For severe disorders, treatment regimens for non-infectious hepatitis are used.
Fight kidney failure.
Fight vomiting. For this, Cerucal is most often used. Pyridoxine (vitamin B6) preparations, for example, Navidoxine, also have antiemetic effects. For the relief of severe vomiting attacks, injections of antipsychotics and antihistamines can be used.
Stabilization of the neurovegetative background, regulation of the activity of the central nervous system. With indomitable vomiting in the first days of treatment, potent substances (tranquilizers, some antipsychotics, anesthetics) can be used to quickly reduce the excitability of the main structures of the brain. In the future, it is recommended to take herbal preparations, magnesium. The very fact of hospitalization often has a stabilizing effect, which allows a pregnant woman to create a protective regime. Psychotherapeutic and some physiotherapeutic techniques are actively used (electrosleep, color and light therapy, aromatherapy, acupuncture, massage of the neck-collar zone and hands, darsonvalization, etc.).

In a severe course of toxicosis with the development of life-threatening and not amenable to at least partial correction within 24 hours of conditions, the issue of terminating pregnancy for medical reasons is being resolved. This measure is also necessary for the development of acute yellow atrophy of the liver.

How to relieve toxicosis without medication

Drug therapy for toxicosis is still by no means an everyday measure. With mild (and sometimes with moderate) vomiting of pregnant women, non-drug measures are sufficient. These include diet, work and rest, a variety of folk remedies for toxicosis. Some women during this period resort to the help of homeopaths.

Herbal infusions based on mint, chamomile, lemon balm, valerian, sage, rose hips, oregano, ginger are widely used. Some of them have a mild sedative effect, others help to reduce the severity of the gag reflex. But do not forget that herbal medicine is potentially allergenic. In addition, plants that can affect blood clotting should be avoided without consulting a doctor.

Helps against toxicosis during pregnancy and aromatherapy, despite the woman's increased sensitivity to odors. To reduce the severity of nausea, you can inhale a small amount of essential oils of peppermint, lemon, anise, ginger oil. They are usually used not in a pure (concentrated) form, but in a mixture with a neutral base oil. For such inhalations, you can use aroma lamps, aromaculons, or simply apply a few fragrant drops on a handkerchief.

How to eat

Nutrition for toxicosis is a very important aspect. Food should be taken fractionally, which will avoid overeating and prolonged "hungry" intervals. Many women manage to cope with morning sickness with a light snack right after waking up, right in bed. Such a meal will increase the level of glucose in the blood, because the natural morning subhypoglycemia for a pregnant woman can become a factor provoking vomiting.

During the day, crackers, a slice of lemon, a teaspoon of honey, a small amount of sunflower seeds, and cranberry juice can be used to reduce the symptoms of toxicosis. The composition of such a snack is selected individually, empirically.

Food during the period of toxicosis should be easily digestible, appetizing-looking, freshly prepared, with a minimum of artificial flavors and preservatives. At the same time, it must ensure the supply of essential nutrients and have an adequate calorie content. It is advisable to give up frying and deep-frying, the use of fatty sauces, smoked meats and factory-made sausages. Preference should be given to baked, boiled and stewed dishes, as well as fresh vegetables and fruits. Marinades and pickles can be used in a limited way, if you have the appropriate taste preferences.

It is recommended to include in the menu foods high in digestible protein, vitamin B6, polyunsaturated fatty acids. But freshly baked bread, yeast dough and flour of the highest grade, legumes should be discarded - they can increase gas formation in the intestines, which will negatively affect the well-being of a pregnant woman.

When to expect relief from the condition

How long does toxicosis last in pregnant women and for how long during gestation to wait for the disappearance of its symptoms? This question is one of the most frequent at an obstetrician-gynecologist's appointment. After all, nausea and other symptoms are very uncomfortable and can even disrupt the social life of a pregnant woman.

Toxicosis is typical for the first trimester of pregnancy, in most cases it begins to fade at 12-14 weeks of gestation. But sometimes his symptoms persist for some time (up to about 20 weeks), which is quite acceptable. Therefore, to denote this condition, it is more correct to use the term "toxicosis of the first half of pregnancy".

The disappearance of symptoms is explained by physiological changes that occur from the 12th week of gestation. It is about the formation of the placenta. It not only forms a semi-permeable selective barrier between the blood of the mother and the fetus, but also performs an endocrine function. At the beginning of the first trimester, she begins to actively synthesize hCG and other hormones, which were previously produced by the corpus luteum in the ovary. And at 14-16 weeks, this function completely passes to the placenta. At the same time, the concentration of hCG in a woman's blood gradually decreases, which explains the improvement in her well-being.

Therefore, at the beginning of the second trimester, toxicosis usually passes. Of course, this happens gradually, with a gradual depletion of symptoms and an improvement in the general well-being and activity of the pregnant woman.

Morning toxicosis is a fairly common occurrence in early gestation. And in many cases, this does not require the use of any drugs. As the pregnancy progresses, its symptoms disappear, which usually allows the woman to fully enjoy the period of bearing the child.

Pregnancy is very good news for almost every woman. Nevertheless, with its onset, rather strange things begin to happen to many of them. Pregnant young ladies begin to look with disgust at those products that they used to love very much. They can be irritated by any smell, even a rather pleasant one, and being in a stuffy room can bring them to fainting. A similar incident is called When it ends and why this state begins, not every expectant mother knows. Let's figure it out.

Toxicosis - what is it?

If you are stable and not only, you feel general weakness and do not adequately respond to familiar smells, then most likely you are pregnant. Of course, to confirm this condition, it is worth visiting a doctor or buying a special test, but these signs are quite true. The main signs of toxicosis look like this:

drowsiness;
nausea and vomiting;
increased salivation;
increased irritability;
depressed state;
persistent weight loss;
heightened sense of smell.

Also, itchy skin and various dermatoses can sometimes appear. The most severe forms lead to osteomalacia, bronchial asthma of pregnancy, tetany and acute yellow hepatic atrophy.

Almost every woman experiencing such a condition is very interested in the question of whether toxicosis can end on its own or it needs to be treated. Before talking about the methods of exposure and treatment, it is worthwhile to dwell in more detail on the causes and timing of toxicosis.

When it feels like this

Many women, when planning a pregnancy, begin to be interested in all the intricacies of this condition in advance. First of all, they, of course, are interested in what month the toxicosis ends, but it is more important to be prepared for the onset of feeling unwell.

The deterioration of well-being in pregnant women is early and late. Early toxicosis most often manifests itself at 4-6 weeks of pregnancy, and in special cases, even in the first week of conception. However, doctors do not associate such an overly early toxicosis with the physiological state of a woman. Most often, the reasons are psychological: the girl is too worried about unprotected intercourse, her blood pressure jumps, as a result, nervous nausea appears.

Real toxicosis most often manifests itself precisely in the later stages of women can experience this condition again. In recent months, doctors often refer to this condition not as toxicosis, but as gestosis of pregnant women.

It is a mistake to think that if a girl is pregnant, she will definitely feel sick sooner or later. This statement is fundamentally wrong. The absence of toxicosis is the same physiological norm as its presence. There is a significant percentage of women who do not experience any negative feelings at all. Unfortunately, the percentage of lucky women is quite small, so let's talk about when the toxicosis of the first and last trimesters begins and when it ends.

How much to suffer?

In principle, it is rather difficult to determine the exact dates. Everything is very individual here. Some ladies can observe in themselves only slight nausea and dizziness, others are forced to ask for placement in a hospital. The same picture is with the timing. The onset of discomfort usually occurs in the fifth week and ends by the 12-13th.

When the toxicosis of the first trimester ends, pregnant women enter a rather pleasant period in terms of well-being. This is such a natural respite that allows you to replenish your strength and feel the joy of future motherhood. But in three months everything can change. Toxicosis in the last stages most often proceeds much more severely, and its consequences are more dangerous for both the mother and the child.

In addition to all the previously mentioned symptoms, edema, high blood pressure and excruciating heartburn are also added. This state can continue until the very birth, therefore, when toxicosis ends this time, the young mother feels happy twice: the baby is already with her and all these terrible conditions are behind.

The reasons

Why and why toxicosis manifests itself is still not known for certain. It is logical to assume that this condition is generated by hormonal changes in the body of the expectant mother, which is simply necessary for the correct development of the fetus. Of course, when the toxicosis ends, this is a great relief, but, probably, if the reasons for its appearance were precisely known, the unpleasant sensations could have been avoided altogether.

Today it has been reliably established that toxicosis most often affects young ladies with diseases of the gastrointestinal tract, thyroid gland or liver. Also, smokers will most likely have to suffer, as well as those who work a lot and often experience nervous strain. There are several more factors that contribute to the manifestation of toxicosis:

the presence of chronic diseases of any kind;
hereditary predisposition;
psychological components;
very early pregnancy.

The overwhelming majority of doctors consider toxicosis to be a normal condition and advise simply to endure this period.

Of course, if you just got a little more irritable or want to sleep all the time, there is nothing dangerous about it. But what if you are tormented by uncontrolled, debilitating vomiting, or you are rapidly losing weight at a time when you should be gaining it?

The consequences of toxicosis

So, we have found out when it starts in pregnant women and when toxicosis ends. Now let's talk about why you shouldn't endure and wait, but you must definitely tell the doctor about your feelings.

Severe toxicosis can result in liver or kidney damage. Since, due to frequent vomiting, electrolyte-water metabolism is disturbed in the body of the expectant mother, toxic pregnant women are often observed.For the same reason, the woman's body does not receive the required amount of vitamins and minerals, which is why osteoporosis is likely to develop, convulsions are often observed. Due to the fragility of bones, fractures are more frequent, even with low loads. Lack of calcium and other minerals also leads to the breakdown and loss of hair and teeth.

Toxicosis with twins

Multiple pregnancies most often give the expectant mother much more problems and discomfort. This is due to the fact that a woman carrying twins, and even more triplets, has an even higher concentration of hormones in the blood. Therefore, when toxicosis ends (and this usually happens at 16 weeks), the expectant mother will have a double (or triple) relief. However, there are also such exceptions when a woman carrying more than one fetus does not experience any unpleasant sensations at all.

All doctors treat toxicosis differently. Basically, treatment methods are divided into four groups:

medicinal;
homeopathic;
aromatherapy;
immunocytotherapy.

The first option is most popular in severe cases. It should be understood that all medications, except, perhaps, vitamin complexes and "No-shpy", are toxic and dangerous. But sometimes you can't do without them. In especially severe cases, the pregnant woman is certainly placed in a hospital and all activities are carried out under the strict supervision of the attending physician. In this article, I would like to get away from the specific names of the drugs used for treatment, because they can only be prescribed by a doctor. In 99% of cases, drug treatment is quite successful, completely or partially removing the symptoms of toxicosis.

The second treatment option is homeopathy. This method is the most harmless for both the mother and the child, because the drugs are selected individually, taking into account all the features. With this treatment, side effects or accidental overdose are practically excluded.

Aromatherapy. Peppermint oil is widely used to treat toxicosis. It is enough for several nights in a row to place a handkerchief with a couple of drops of this oil near the bed - and the painful morning bouts of vomiting will become weaker. It also helps well. If you feel a sharp discomfort, put a drop of ginger oil on your palm, rub and inhale slowly and deeply several times. The faintness will recede.

The most progressive treatment for toxicosis is immunocytotherapy. This is a procedure when purified lymphocytes of her husband (sexual partner) are injected under the skin on the forearm. The effect occurs most often within a day. Such treatment is carried out only in a hospital setting after a thorough examination of the partner for various infections: HIV, syphilis, hepatitis C and B. It should be noted that the method is quite dangerous, despite the research carried out, there is still a risk of infecting the mother and / or the child with one of these diseases.

In addition to these methods, some doctors also use acupuncture, hypnosis, and other non-traditional methods.

How to relieve symptoms at home

As you already understood, you should not wait for toxicosis to end, you can and should fight with it. First of all, you can try to help yourself on your own:

walk more often and ventilate the premises;
before getting out of bed in the morning, eat some nuts, a crouton of gray bread or small cookies;
eat reclining or lie down for a short time and immediately after eating;
exclude fried, salty, fatty and instant foods from the menu;
eat more foods containing vitamin B6 - fish, legumes, eggs, avocados, chicken;
if you feel sick, chew more (cumin seeds, gum, mint leaves), it has been proven that chewing movements reduce vomiting;
eat every 2 hours, but little by little, snack on a slice of lemon, nuts, dried fruits, etc.;
food should be cool or slightly warmed;
train yourself to drink a glass of warm alkaline mineral water without gas every morning;
drink often, but little by little, fruit drinks, chamomile tea, rosehip infusion, apple juice, with honey and lemon, green tea are suitable;
you can use infusions of peppermint, chamomile, sage, calendula, valerian and yarrow, these herbs help well with abundant saliva.

Toxicosis of pregnant women Is a pathological condition that occurs only during pregnancy, complicates its course and, as a rule, disappears with its interruption or on its own during treatment.

Causes of the onset of toxicosis

To date cause of toxicosis insufficiently studied. There are no exact data on the origin of this pathological condition. The International Association of Obstetricians and Gynecologists identified the most likely causes of toxicosis:

Hormonal changes... From the first days after conception, great changes occur in a woman's body associated with a change in the amount of hormones secreted. Against this background, the well-being of a pregnant woman may worsen;
The presence of chronic diseases... It is noted that toxicosis occurs more often in women with weakened immunity and diseases of various organs (especially for diseases of the digestive, respiratory and endocrine systems). Therefore, women planning a pregnancy are advised to undergo a full medical examination in advance;
Psycho-emotional state of a woman... , lack of sleep, large mental stress contribute to the development of toxicosis and aggravate the severity of their manifestation;
:, the use of drugs;
Woman's age... It is noted that early pregnancy (mother's age up to 20 years) and late (over 35 years old) often occur with various forms of toxicosis;
Heredity... Genetic predisposition plays a significant role here: if a woman's mother, aunt or grandmother suffered from toxicosis, then the probability of developing gestosis in this woman is also high.

There are three forms of toxicosis:

Early (develop in the first trimester of pregnancy);
Late (occur in the second and third trimester, more often in the last two to three months);
Rare (most often begins in the first trimester, but can occur at any stage of pregnancy).

Early toxicosis: types, timing, treatment

Early toxicosis occur early in pregnancy and end by the end of the first trimester. Most often, symptoms begin at 5-6 weeks of pregnancy, less often at an earlier date (some women feel a deterioration in well-being almost immediately after conception, even before the onset of a delay in menstruation). Allocate two forms early gestosis:

Vomiting of pregnant women

Lightweight;
Moderate;
Excessive.

Drooling (salivation).

Vomiting of pregnant women- the most common form of early toxicosis. In the first weeks of pregnancy, many women experience nausea and vomiting, which occur in the morning, not every day and do not affect the condition of the pregnant woman in any way. Such vomiting does not belong to toxicosis and does not require treatment.

Information Gestosis includes vomiting, which is repeated several times during the day, accompanied by severe nausea, a sharp decrease or lack of appetite, a change in taste preferences and olfactory sensations.

According to the severity, there are:

Lightweight shape. Vomiting is repeated up to 5 times a day, more often after a meal, slightly worsens the woman's well-being, is easily treatable or resolves on its own by 10-12 weeks of pregnancy;
Moderate shape. Vomiting occurs up to 10 times a day, is not associated with food intake, is accompanied by a significant deterioration in the woman's condition, general weakness. With proper treatment, this form of toxicosis gradually stops. In the future, pregnancy develops normally.
Excessive shape. Vomiting occurs up to 20 times or more per day and contributes to the development of a serious condition of a woman. Fasting and dehydration lead to weight loss, wasting, fever and heart rate. Emergency treatment is required, in the absence of which a fatal outcome is possible.

Drooling (ptyalism) - this is increased salivation and the loss of more fluid (up to 1 liter or more per day). Ptialism can occur as an independent form of toxicosis or accompany vomiting of pregnant women. With severe salivation, a woman's well-being worsens, sleep is disturbed, weight loss and dehydration of the body are possible due to fluid loss. Due to the constant secretion of saliva, maceration of the skin and mucous membranes occurs.

Treatment ptyalism and mild vomiting are performed on an outpatient basis. In the absence of an effect, the woman must be hospitalized and further examination and treatment is carried out in a hospital setting. In case of moderate to excessive vomiting, hospitalization should be immediate.

Special treatment for early toxicosis consists of the following measures:

Providing complete physical and emotional peace;
Correct diet (intake of high-calorie food in fractional portions every 2-3 hours);
Taking sedatives (,);
Antiemetic therapy;
Vitamin therapy;
Hepatoprotectors;
Intravenous drip infusion of solutions to combat dehydration.

Important If the ongoing treatment does not give the desired effect and the condition of the pregnant woman worsens, then an emergency termination of pregnancy is indicated.

Late toxicosis: types, timing, treatment

Late toxicosis develops most often after 30 weeks of pregnancy. In rare cases, it manifests itself already in the second trimester and then proceeds more malignantly, it is less responsive to treatment. There are the following forms of gestosis:

Dropsy of pregnant women(fluid retention in the body and the appearance of persistent edema);
Nephropathy(clinically manifested by three symptoms: edema, high blood pressure);
Preeclampsia(transitional stage from nephropathy, characterized by dysfunction of the nervous system);
Eclampsia(the final stage of late gestosis with the onset of seizures and loss of consciousness).

Dropsy of pregnant women occurs with fluid retention in the tissues. Its main clinical manifestation is edema, which progresses with the development of the disease. Allocate three degrees of severity of dropsy:

First degree. Swelling appears on the legs, when pressure is applied to the tissue in the tibia, visible depressions remain;
Second degree. The edema spreads further to the trunk, but water does not stagnate in the abdominal cavity. Depressions remain when pressing on the abdomen;
Third degree. Swelling appears on the trunk and face. The general condition of the pregnant woman worsens: increased fatigue, shortness of breath, palpitations appear.

Treatment this stage of toxicosis includes:

Restriction of liquid (no more than 1 liter per day) and table salt when cooking;
Exclusion from the diet of all foods that can retain water in the body: smoked, fatty, spicy, salty;
(furosemide, hypothiazide, etc.).

In most cases, the treatment is effective and takes no more than 6-8 days for mild to moderate and 10-12 days for severe toxicosis.

Nephropathy most often develops against the background of unrecognized timely or improperly treated dropsy of pregnant women. This form of late toxicosis is characterized by triad of symptoms:

Swelling;
Hypertension (increased blood pressure);
Proteinuria (increased protein in the urine).

Nephropathy can be monosymptomatic (only one symptom is observed - hypertension or albuminuria) or polysymptomatic (two or three signs appear simultaneously).

Treatment nephropathy should be performed only in a hospital setting. Therapy consists of the following activities:

Complete bed rest, a state of physical and emotional rest;
Normalization of nutrition. A pregnant woman is prescribed a predominantly dairy-vegetable diet, a strict restriction of fluid intake, salt and fats. Fasting days (fruit or) are held once a week;
Normalization of sleep by taking sedatives;
Taking diuretics to reduce swelling
Consultation with a therapist and taking antihypertensive drugs to lower blood pressure.

In case of unsuccessful treatment, it is necessary to carry out early delivery, because further prolongation of pregnancy can threaten the health and life of a woman.

The final stages of the development of gestosis are preeclampsia and eclampsia. When preeclampsia headaches, blurred vision, drowsiness, increased fatigue appear. Some patients experience abdominal pain, nausea, vomiting,. These symptoms are associated with profound changes in cerebral circulation and increased intracranial pressure.

Treatment preeclampsia is the same as in nephropathy, but all injections, intravenous infusions should be carried out only under anesthesia (inhalation of nitrous oxide and oxygen) so as not to provoke an attack of eclampsia.

Eclampsia manifests itself with a sharp appearance of seizures and complete loss of consciousness. The seizure proceeds in three stages:

First stage. Small contractions of the muscles of the face appear, which pass to the muscles of the upper extremities. This period lasts 20-30 seconds;
Second phase. There are severe cramps throughout the muscles, breathing is disturbed until it stops completely, the woman loses consciousness. The stage lasts no more than 25 seconds.
Stage three. The convulsions stop, the pregnant woman falls into a coma. Upon regaining consciousness, the patient does not remember anything, complains of severe fatigue, muscle pain. The duration of the third stage is up to 1.5 minutes.

Treatment activities with eclampsia, they should be urgent and take place with the obligatory presence of resuscitators. Therapy includes:

Relief of seizure seizures by inhalation of oxygen, nitrous oxide and ether;
Lowering blood pressure by intravenous administration of antihypertensive drugs (the woman should be under anesthesia at this time);
Sleeping pills (a pregnant woman is put into a state of medication sleep for 1-2 days).

Intensive care in the intensive care unit should be carried out for about 10 days. If in the course of treatment the seizures resume, the woman is prescribed an emergency delivery.

Rare forms of toxicosis: types, timing, treatment

Rare forms of toxicosis often begin in the first trimester, but can occur at any stage of pregnancy. This type of toxicosis includes:

Dermatoses (various skin diseases);
Jaundice of pregnancy (icteric staining of the skin and visible mucous membranes);
Yellow atrophy of the liver (acute liver disease with degeneration of liver cells);
(respiratory tract disease, manifested by shortness of breath, shortness of breath and periodic attacks of suffocation);
Tetania (convulsive seizures caused by impaired calcium metabolism in the body);
Osteomalacia (a disease characterized by softening and deformation of the bone system due to a violation of phosphorus-calcium metabolism in the body).

Dermatoses pregnant women include a group of skin diseases that occur only during pregnancy. Itching during pregnancy is most common and can spread throughout the body. The woman's general health worsens, irritability appears, and sleep is disturbed. Less commonly, there are eczema (an inflammatory skin disease that manifests itself as a profuse rash, itching and burning). Treatment is carried out in a hospital. A pregnant woman is recommended a sparing diet with the exception of spicy, smoked foods. To reduce itching and burning, vitamin therapy, calcium preparations are prescribed. Lotions with a solution of potassium permanganate are applied locally to the affected areas.

Jaundice pregnant women are rare. Its main clinical manifestations are liver damage, icteric staining of the skin, itching. When the diagnosis is made, the pregnant woman is urgently hospitalized and the pregnancy is terminated at any time.

Yellow dystrophy of the liver- an extremely dangerous form of rare toxicosis. It is very difficult and often fatal. There is liver damage, an increase in jaundice, a sharp appearance of seizures and a coma. Immediate termination of pregnancy is shown, which can help save a woman's life.

Bronchial asthma as a manifestation of toxicosis occurs in isolated cases. It responds well to treatment and the pregnancy can be maintained. The pregnant woman is prescribed vitamin therapy, sedatives and calcium preparations.

Tetania pregnant occurs when the parathyroid glands are disrupted, which leads to a significant disruption of calcium metabolism in the body. Clinically, the disease manifests itself in the form of muscle cramps in the upper and lower extremities, less often in the muscles of the face and trunk. For treatment, they take parathyroidin (a hormone produced by the parathyroid glands), calcium preparations. In most cases, treatment is successful and the pregnancy continues.

Osteomalacia occurs as a result of a violation in the body of the exchange of phosphorus and calcium. Clinically manifested by decalcification and softening of the bones (usually the spine and pelvis), which leads to severe pain and deformation of the skeleton. Treatment includes vitamins D and E, physiotherapy (ultraviolet radiation). In the absence of the effect of therapy, termination of pregnancy is indicated.

In the medical sense, toxicosis (another name is gestosis) is a group of pathological changes in a woman's body that arise in connection with the appearance and development of a fetus. Gestosis is characterized by various symptoms that complicate the course, and stop after the end of birth. The most common symptoms of toxicosis, in addition to nausea and vomiting, are morning sickness, dizziness, excessive accumulation of saliva, increased heart rate and pulse. Early toxicosis occurs in almost most women and lasts from the first weeks to the end of the first pregnancy. In the mechanism of the onset of gestosis, an important role is played by hormones produced by the placenta and affecting the metabolic processes in the fetus and the expectant mother. In this case, the nervous system and internal organs begin to respond to these changes with symptoms of toxicosis. There are several theories of the onset of toxicosis. The most popular and well-grounded of them is the neuro-reflex one. According to this theory, in the subcortical structures, where the majority of protective reflexes are formed, vital processes are activated during pregnancy. In the subcortex, for example, is the vomiting center, as well as the olfactory zones involved in the management of internal organs, in particular the stomach, heart, lungs, salivary glands. Hence the increased heart rate, profuse salivation, gastrointestinal manifestations. But whatever the mechanism of the onset of toxicosis, there is undoubtedly one thing: the body of a pregnant woman behaves in such a way as to endure and preserve the new life that has appeared inside. Having understood this, it will be easier to accept and cope with the manifestations of toxicosis. With symptoms of early toxicosis, which is mild, vomiting occurs no more than 3-5 times a day. These days, you need to supply the body with a sufficient amount of liquid in the form of soups, broths, fruit and vegetable juices, dairy drinks. If attacks of nausea and vomiting occur more than 15 times a day, we can talk about the occurrence of severe toxicosis of the first trimester. In this case, a doctor's consultation is necessary. It is better to eat fractionally and often throughout the entire time. It is better to observe 5-6 meals a day. Diversify your menu, include vegetables, fruits, dairy products, cottage cheese. After each meal, it is advisable to rinse your mouth with a refreshing liquid. Preliminary consult and get an appropriate consultation from the dentist. Toxicosis in the late stages, in the third trimester of pregnancy are more serious complications. They may be accompanied by an increase in blood pressure, the appearance of edema on the legs, and protein may be present in the urine. In such cases, constant visits and observation by the doctor leading the pregnancy are mandatory. Pregnant women need to monitor their weight gain. On average, it is 10-15 kg for all 9 months. Early toxicosis in a mild form may be accompanied by slight weight loss - up to 3-5 kg, but after their manifestations, the weight will begin to increase. In more severe forms, pregnant women can lose about 5-8 kg, so weight control should be carried out under the strict supervision of a doctor.