During pregnancy, what week is severe toxicosis. When toxicosis begins. Non-drug treatments for toxicosis

10.05.2019

Many women suffer from toxicosis during pregnancy. Often it is his manifestations - weakness, bouts of vomiting, nausea - that should alert and make you think: "Am I not pregnant?"

Signs of toxicosis

Needless to say, the sensations during toxicosis cannot be called pleasant. A pregnant woman loses her appetite, she has increased salivation, constant drowsiness, fatigue and lethargy. Dizziness often occurs, taste preferences change, and some smells are disgusting. In addition, heartburn, nausea and vomiting are observed.

Fortunately, some of the fair sex are carrying a pregnancy without even suspecting that there is such a condition as toxicosis. Those who are destined to experience some or all of the above manifestations on themselves are said to be susceptible to toxicosis.

Types of toxicosis

Doctors divide toxicosis into early and late. Early toxicosis usually appears in the fourth to fifth week of pregnancy or a little later and completely disappears by the sixteenth week. But it also happens that a woman already feels bad with, and some - even earlier. Late toxicosis manifests itself in the 2nd and 3rd trimester of pregnancy.

The reasons for the development of toxicosis

Despite the new advances in medicine, the specific cause of the development of toxicosis is still unknown. A woman who turns to a gynecologist for an explanation is usually told that toxicosis is caused by hormonal changes, the individual qualities of the body. Certain chronic diseases, stress and many other external factors can also contribute to this condition.

Change in hormonal levels

Doctors believe that one of the reasons for the onset of toxicosis is the change in hormonal levels during pregnancy. Once in the uterus, the fertilized cell attaches to its wall. The fertilized egg grows, its waste products are thrown into the blood of the expectant mother. As a result, chorionic glycoprotein and gonadotropin appear in the blood of a pregnant woman.

In addition, there is an increase in the level of the hormones estrogen and progesterone. The maximum amount of hCG level is observed by the tenth week. By the presence of this particular hormone in the urine and blood, doctors establish the fact of pregnancy. Of course, the body begins to respond to a sharp increase in hormones, adapting to the changes.

But when a particular woman begins to have toxicosis, and whether it will be at all, no specialist will answer, since all organisms are different, and the course of pregnancy in each of the women occurs according to an individual scenario.

Emotional condition

The second and very important cause of toxicosis is the emotional state of a pregnant woman. She is often nervous if the pregnancy is not planned. Or there was a bad experience of previous pregnancies, and the woman is afraid for the fate of the child, as well as for her own fate and health.

And even with the successful course of a long-awaited pregnancy, a woman tends to worry about the health of the unborn baby. Having heard enough "horror stories", she worries about his development.

The pregnant woman's body reacts to the feeling of fear, anxiety and increased excitability by releasing "stress hormones". Therefore, when pregnancy occurs, a woman should calm down herself or, with the help of others, tune in to a successful pregnancy outcome and normal childbirth. As a rule, in this case, the state of health improves.

Hereditary factors

According to gynecologists, heredity has some effect. Often it determines in which week toxicosis may or may not begin. So, if the mother, when carrying her daughter, did not experience the unpleasant symptoms of toxicosis, then the daughter's pregnancy may also pass without him. But sometimes the hereditary factor malfunctions, and the daughter's pregnancy proceeds in a completely different way from the mother.

The relationship of toxicosis with diseases and lifestyle

And yet, most doctors are sure that toxicosis occurs more often in women who have problems in the gastrointestinal tract, as well as in pregnant women who lead an inappropriate lifestyle. Poor quality nutrition plays an important role in the onset of toxicosis.

Danger of toxicosis

Sometimes a woman feels the onset of pregnancy earlier than ultrasound or tests show - in the second or third week after conception. It is generally accepted that toxicosis in the early stages is not as dangerous as late. It starts suddenly and just as suddenly goes away by itself.

Late toxicosis, or gestosis, is very difficult. The woman has a constant urge to vomit. Heightened sense of smell, mood swings further increase the irritation of the pregnant woman.

Health problems are also observed: limbs swell, blood pressure "jumps", the amount of protein in the urine increases. The vivid manifestation of these symptoms makes the course of pregnancy painful.

To alleviate the condition of a woman, treatment is necessary, which consists in adjusting the lifestyle and nutrition of the pregnant woman. The higher the level of intoxication of the body, the more difficult the severity of gestosis and its treatment. Therefore, you do not need to try to cope with toxicosis on your own at a later date. It is imperative to consult a gynecologist.

Methods for the prevention of toxicosis

What toxicosis during pregnancy How normal is this phenomenon and should I see a doctor?

Toxicosis- This is a kind of reaction of the body to the emergence of a new life. It can begin a couple of days after conception or show up in a month or two, or even later. Doctors still cannot say for sure whether it indicates toxicosis during pregnancy the fact that not all is well in the body, or is a normal state. Morning nausea occurs in about 70% of women, and vomiting occurs in almost every second woman. These are the most memorable, but not the only signs: lethargy, drowsiness or, conversely, insomnia, swelling, loss of appetite and weight, apathy - in the same row. With something you need to come to terms, and something - you will have to treat. The main thing is to be able to distinguish safe from alarming symptoms and to start therapy in a timely manner.

Causes of toxicosis

There is a lot of speculation as to why some women develop toxicosis during pregnancy while others do not. But as long as none of them is given preference, there will always be those who, relying on their own experience, will be able to refute any of the theories. So, it is believed that toxicosis transmitted genetically: if a woman collided with him, then her heiress will face a similar fate. In reality, it often happens otherwise - the daughter does not go through her mother's experience. Another version says: "For the baby to develop in a safe environment, nausea and vomiting cleanse the pregnant woman's body of accumulated toxins and harmful elements." But why this does not happen to every woman is unclear.

The vegetative theory is based on an increase in the sensitivity of the peripheral nervous system to external stimuli. But again, the question remains open why this does not apply to all the fair sex. There is evidence that late pregnancies, whether they are the first, second or third, are more often accompanied by toxicosis of pregnant women... This is confirmed by statistics. But this statement is ready to refute many women who felt great, carrying a baby after 35, and young pregnant women who suffered for 9 months in their incomplete 20 years.

A glass of water on an empty stomach can relieve morning sickness. The liquid will wash away toxins and bile accumulated overnight, and will improve peristalsis.

There are more real versions: some women are faced with manifestations toxicosis of pregnant women not only during pregnancy, something similar happens to them during menstruation. This proves that there is a connection between such phenomena and, most likely, the matter is in hormonal changes. Chronic diseases of the digestive (gastritis, colitis, cholelithiasis), nervous (neurosis, depression) systems and liver can also provoke discomfort. And the immune system does not stand aside: all ailments I trimester can be explained by the reaction of the mother's body to foreign cells of the fetus (after all, the embryo also contains father's genes). Later, the body gets used to new inhabitants and ceases to fight them. Around the same time, the formation of the placenta is completed, which filters the child's metabolic products, therefore, their effect on the mother weakens.

Do not worry if in the first trimester, nausea and vomiting overtake a couple of times a day, they will not be able to disrupt the course of pregnancy. But if discomfort completely paralyzes the life of a pregnant woman, measures must be taken.

A psychological theory is also popular: if the expectant mother is not happy with the pregnancy and worries about the future fate of the child, her cerebral cortex gives alarming signals, and the body tries to "defend itself" from an uninvited invasion.

From all that has been said, one conclusion can be drawn: toxicosis cannot be predicted and it is not worth preparing for it. And only when obvious symptoms appear, one should proceed to practical actions.

Toxicosis during pregnancy: stages

Toxicosis of pregnant women always developing in I trimester, that is, up to 12-16 weeks of pregnancy. According to the severity, it is divided into mild, medium and severe.

At the first degree, the pregnant woman experiences a headache, increased salivation, deterioration in general well-being and mood. Nausea and vomiting can roll unexpectedly up to 5 times a day and are accompanied by loss of appetite. At the same time, the weight often remains the same. It's believed that mild toxicosis worries about 7 out of 10. This condition is considered a variant of the norm, so doctors advise to endure it or correct it by changing the way of life and nutrition.

If gagging occurs more often, and an increase in heart rate and a decrease in blood pressure are added to severe headaches, weakness and depression, then toxicosis of pregnant women goes into the second stage - the middle one - and requires the intervention of a specialist.

Heavy option toxicosis during pregnancy is quite rare and is accompanied by a sharp weight loss, vomiting more than 15 times a day, decreased urination and constipation. The body is threatened with dehydration, which will help to cope with intravenous infusions in the hospital, so the expectant mother is hospitalized.

Taking folic acid alone or as part of mineral complexes will not only have a beneficial effect on the formation of the child's organs and prevent malformations, but also help to cope with the toxicosis of pregnant women, stopping nausea and dizziness.

Gestosis during pregnancy

Gestosis was formerly called toxicosis the second half of pregnancy, considering the phenomenon of the same order. Now the opinion of experts has changed: at the heart of gestosis lies a vasospasm, provoking adverse changes in the organisms of the mother and baby. One of them, oxygen starvation, causes arterial hypertension, and renal dysfunction leads to fluid retention. Gestosis can overtake in third trimester, but it happens even earlier - after the 20th week. For some time it develops almost asymptomatically, and then falls on the body in full force.

To prevent this from happening, you must be attentive to all deviations from the norm. Any oddities should be alerted, for example, a small but not disappearing swelling in one leg, or a protein in the urine found after the next analysis and not detected during the screening test. If you block preeclampsia at the very beginning, there will be no problems. A neglected form is more difficult to cope with. In especially severe cases, when failures cannot be corrected, the expectant mother is placed in a hospital.

Gynecologist's help

Whatever the degree toxicosis- minor or severe - the gynecologist leading the pregnancy should be aware of the malaise. If changes in the perception of smells, tastes, nausea and vomiting overtake only a couple of times a day, more often in the morning, and the general condition remains satisfactory, the doctor will not prescribe medication. The first warning signs may be increasing weakness, headache, dizziness and weight loss. Having learned that the discomfort is growing, the doctor should be alert. Vomiting is dangerous because the body loses a lot of fluid and along with it useful substances - electrolytes (iron, potassium, calcium, magnesium, sodium, phosphorus, chlorine), without which the normal development of the child is impossible. To check if a deficiency has formed, clinical and biochemical blood tests are prescribed. If the indicators do not correspond to the norm, you should start fighting toxicosis... First, they use light herbal preparations that are safe for mom and baby, then more effective medicines.

Toxicosis treatment

If you appear in "ordinary" life, you simply refuse to eat, drink water, and the stomach is restored. The status of the expectant mother does not allow starving, therefore, whether you like it or not, you still have to eat, even if, after swallowing a little food, after 5-10 minutes you have to part with it.

Connoisseurs of the issue argue that easy and medium toxicosis can be tamed on your own. To begin with, exclude from the diet foods with a pungent smell and taste - smoked, fried, peppered, spicy foods. Try to limit yourself to food familiar to our strip - low-fat cereals in water or lactose-free milk, boiled vegetables, soups, dairy products. Even if the diet seems unbalanced in terms of the set of minerals and trace elements, it is not worth changing the diet. Metamorphoses are capable of starting toxicosis... Let's say a pregnant woman has given up fish because its smell causes headaches and nausea during this period. It can be assumed that as a result of this, the body of a pregnant woman does not have enough phosphorus, which the baby needs, and the reserves of the substance must be replenished.

Proceed with caution: Confirm or refute concerns with analysis. If the alarm was not in vain, make up for the lack of a trace element with the help of a pharmacy drug recommended by a doctor. The food intake should be changed: everything that was previously eaten at breakfast is best divided into 2-3 meals. Immediately after waking up, while still in bed, you can eat one cookie or a handful of nuts. In the morning, preference should be given to solid foods: bread, cheese, muesli. After a shower and a little gymnastics, after an hour and a half it is good to add a little porridge to the eaten, and when you get to work, drink tea with a sandwich. It is important not to allow the appearance of hunger, you felt it - immediately satisfy with a small portion of yogurt or cottage cheese.

Despite the increased urge to urinate, do not limit yourself to drinking fluid - it removes toxins, toxins, excess bile, everything that causes intoxication. IN I trimester you can drink without restrictions, and it is better to do it 20-30 minutes after eating. Excessive liquid stomach contents are easier to escape. Avoid constipation: plant foods, probiotics, and natural laxatives will help avoid the problem. Abrupt changes in body position are also undesirable: so that they do not provoke dizziness, nausea and vomiting, slowly get out of bed, slowly leave the table, do not delay going to the toilet until the last moment.

Nutrition for toxicosis

Get along with toxicosis not easy, but possible. To begin with, using the selection method, designate a list of products that will help suppress vomiting that suddenly comes up in the most inappropriate place, in transport, for example. Many people use mints and chewing gum. Pumpkin juice, tea with lemon, ginger, honey, rosehip broth and cranberry juice also relieve attacks well. Carry a small thermos (150-200 ml) with these drinks. Essential oils help a lot too. Lavender, lemon and peppermint oils are especially effective. Place a drop of each on a handkerchief and inhale the fragrance at the right moment.

Pregnant lifestyle

Try to slow down the rhythm of life for a while, go to bed earlier - a night's sleep should last at least 8-9 hours, rest during the day. Do not lie down immediately after a meal, food must have time to move into the intestines. Continue to play sports, go for a walk. Fresh air saturates the blood with oxygen, stimulates blood circulation, metabolism and the elimination of toxins from the body. Don't quit your job - business will distract you from the changes that are taking place. In general, try not to focus on toxicosis, he will stop anyway only when he himself so desires. And it certainly should not become the most vivid memory of those days when a child grew up and gained strength inside you.

Gymnastics for pregnant women

Slopes

Sit in lotus position (knees apart, feet touching each other) on a roller or rolled-up blanket. Hands behind the back shoulder-width apart. Take a deep breath, as you exhale, bend to the right 30-40 °, stretching your arms in the same direction. The shoulders and neck remain motionless. By performing 10 bends in each direction, you will help the stomach walls to straighten out.

Breath

Remaining in the lotus position, place your hands on your shoulders and as you inhale, take your elbows back, bending at the shoulder blades, hold your breath for 3 counts. Without changing the position, breathe out, then again - take a deep breath, bend even more. Again hold your breath for 3 seconds and exhale, returning to the starting position.

Stretching

Lying on your back with straight limbs, while inhaling, take your left leg to the side and stretch your heel forward. Throw your opposite hand behind your head. After completing 10 repetitions, you will relax the nervous system, which will start the self-regulation mechanism in case of toxicosis.

Deflections

Lying on your back with bent knees and arms extended along the body, while inhaling, arch your lower back, leaning on your head, shoulder blades and sacrum. As you exhale, lower yourself to the floor. Hands at this time "go" behind the head. Repeat 15 times. During this movement, the walls of the stomach move apart, blocking the urge to vomit.

Stretching

Roll over on your side, bend your lower leg at the knee, put your straight arm under your head. As you inhale, move your upper arm behind your head and your leg back, increasing the distance between your chest and pelvis. Do at least 10 repetitions. The exercise is best done during a nausea attack.

Toxicosis is a rather unpleasant violation of the normal functioning of the body, which mainly concerns the digestive system. So, with toxicosis in a pregnant woman, food habits change dramatically, there is an aversion to familiar foods, and food smells can cause nausea. Moreover, this condition is often accompanied by frequent, from 3 to 12 times a day, vomiting and a significant decrease in appetite.

According to various estimates, between 10% and 50% of women experience toxicosis during pregnancy. Moreover, in most cases, it occurs in the early stages of pregnancy and goes away by itself by about 12-13. However, situations are possible when toxicosis occurs already in the third trimester: in these cases, it is usually more severe, and doctors sometimes even recommend hospitalization of a pregnant woman for constant monitoring of her condition.

Causes of toxicosis

The causes of toxicosis are quite varied, and in each specific case, this problem can be caused by the action of various factors. So, experts believe that one of the most common reasons for its appearance can be hormonal changes in the body, causing such a reaction. Over time, they argue, the woman's body adapts to changes, so the toxicosis passes.

Another factor that can cause toxicosis is the presence of chronic diseases. They weaken the woman's body and during a period of increased stress, to which it can be attributed, it reacts with a general deterioration of the condition. Additionally, a hereditary factor can aggravate the situation, which, according to doctors, plays a role in the onset of toxicosis: for example, if a woman's mother suffered from this symptom during pregnancy, she herself during this period significantly increases the likelihood of its occurrence.

In addition, it should be taken into account that the likelihood of toxicosis increases with late pregnancies, which are usually considered pregnancies after 30 years. Finally, experts emphasize that mothers expecting several children at once also suffer from toxicosis more often than those who are carrying only one child.

Nevertheless, in all these cases, you should treat the onset of toxicosis as a temporary problem and try to find ways to alleviate your condition. So, doctors recommend in no case to give up food completely, but to take it in small portions and focus on foods that do not have a pronounced taste and smell. It is also useful to take vitamin complexes in order to protect yourself from the deficiency of nutrients needed by the unborn baby.

ABOUT TOXICOSIS DURING PREGNANCY

In obstetric practice, three conditions are distinguished: early toxicosis, pretoxicosis and late toxicosis of pregnant women.
Toxicosis is a pathological condition that has many causes and is manifested by disorders of the central nervous system (CNS), cardiovascular system and metabolism. There are many theories of the development of toxicosis: cortical-visceral, neurocapillary toxic, immunological, Selye's theory, etc. In general, toxicosis develops in connection with a disruption in the relationship between the central nervous system of women and the developing ovum. The central nervous system is not able to adequately respond to incoming impulses and control the work of the internal systems of the body. This leads to spastic changes in the circulatory system of CK hypoxia in the most important organs: the brain, kidneys, liver, endocrine glands, etc. As a result, almost all types of metabolism are disrupted: protein, salt, water, carbohydrate, fat. For the fetus, placental insufficiency threatens the development of hypoxia and malnutrition.

Early toxicosis

Early toxicosis (or geistosis) manifests itself in the form of vomiting of pregnant women, hypersalivation, dermatosis, jaundice and neuropathology. It lasts until the 2nd - 3rd month of pregnancy. In women, appetite decreases, up to a complete aversion to food, taste and olfactory sensations change, nausea and vomiting appear. Moreover, vomiting can be from 2 - 3 to 10 or more times a day. The tactics of the behavior of a pregnant woman depend on the form of toxicosis (mild, moderate or severe), because the last two forms require treatment in a hospital.

Treatment of mild forms of early toxicosis

For the treatment of mild forms of early toxicosis, phytotherapy, vitamins (Gendevit, askorutin, vitamins B6, E, C, glutamic and lipoic acids, methionine, Essentiale, etc.), drugs that improve blood rheology (trental, curantil, theonicol and etc.). We bring to your attention two herbal collections. First: rose hips - 1 tablespoon, motherwort herb - 1 teaspoon (1 tsp), hawthorn fruits - 1 tsp, calamus rhizome - 1 tsp, field horsetail - 1 tbsp, St. John's wort - 2 tsp Mix everything and pour 400 ml of boiling water, leave for 30 minutes. and drink 100 ml 3 times a day for 20 minutes. before meals. Second collection: rose hips - 1 tbsp, valerian root - 1 tsp, hawthorn fruits - 1 tsp, yarrow - 2 tsp, birch buds - 2 tsp, St. John's wort - 2 tsp Prepare and take in the same way as the first collection.

Late toxicosis

Late toxicosis is represented by the following clinical forms: dropsy of pregnancy, nephropathy or OPG-gestosis (edema, proteinuria, hypertension), preeclampsia and eclampsia. Often these forms of toxicosis are successive stages in the development of one pathological process. Late gestosis develops after 20 weeks of pregnancy. For dropsy of pregnant women, persistent edema without an increase in blood pressure (BP) is characteristic.
Neuropathy is usually preceded by a pre-toxicosis condition. It is manifested by a triad of symptoms: edema, increased blood pressure and the appearance of protein in the urine. Examination reveals pathological weight gain, BP asymmetry by more than 10 mm Hg, negative diuresis, a decrease in the relative density of urine, protein in urine, an increase in hematocrit, a decrease in the number of platelets, a decrease in the level of protein in the blood, etc. Pathological changes lead to the development of metabolic acidosis. If symptoms of irritation of the central nervous system (headache or a feeling of heaviness in the occiput, forehead, sleep disturbances, vision disturbances, nausea, cyanosis of the lips, etc.) are added to the symptoms of nephropathy, then we are talking about the transition to the next stage of the pathological process - preeclampsia. It is clear that the treatment of nephropathy is carried out only in a hospital and includes diet and drug therapy. The diet should be rich in protein, stone and magnesium and limit salt and fluid. Simultaneously with the treatment of OPG toxicosis, placental insufficiency is prevented. The issue of delivery by cesarean section is decided by an obstetrician-gynecologist in the process of treating neuropathy.

The manifestations that accompany the first three months of pregnancy are represented by nausea, vomiting, weakness, a pronounced decrease in pressure, etc. Toxicosis is a condition that occurs precisely in the first half of pregnancy.

The stories of women about toxicosis during pregnancy cause sympathy or a smile in some people. More often those who have not experienced these painful sensations on themselves make fun of them. Indeed, toxicosis can seriously complicate the life of an expectant mother and even affect the course of pregnancy. Let's talk about it.

Toxicosis of pregnant women is a complication of pregnancy, which manifests itself most often in the first trimester of pregnancy and is accompanied by dyspeptic disorders. The most common manifestation is vomiting of pregnant women, which usually does not bring relief.

Quite often, nausea and vomiting of pregnant women are considered normal signs of pregnancy, but only if they do not occur more than 2-3 times a day and disappear by the end of the first trimester (12-14 weeks).

Distinguish:

mild toxicosis;
moderate toxicosis;
severe toxicosis.

Toxicosis of the second half of pregnancy

Unlike toxicosis of the first months of pregnancy, which, of course, spoils the mood of many expectant mothers, but most often does not pose a danger to the body of a woman and her baby, toxicosis of the second half of pregnancy is a pronounced complication in which the normal functioning of vital organs can be disrupted ...

The first sign is the appearance of edema. As a rule, swelling of the hands, feet and ankles occurs first.

Conditions called preeclampsia and eclampsia become severe manifestations of preeclampsia.

Slight dizziness during pregnancy is quite common. They can be caused by a sudden change in body position or a drop in blood sugar.

If your cardiovascular system is healthy and you are not diabetic, you have nothing to worry about. Try to sit down and stand up smoothly.

But if your blood pressure has increased and at the same time there are headaches, a feeling of heaviness in the back of the head, nausea, flies flicker in front of your eyes, then this is a reason to call a doctor at home!

This complication of the second half of pregnancy can cause fetal hypoxia and lead to premature birth.

The reasons for this condition are currently not clear enough. Often it is associated with changes occurring in the placenta and leading to disruption of the work of this organ.

A number of reasons cause a spasm of small vessels in the body of the expectant mother, as a result of which capillary permeability is impaired, as well as the normal release of proteins and fluid into the tissue (this is where the protein comes from in the urine).

For the timely detection of the onset of late gestosis in the antenatal clinic, continuous examinations of pregnant women are carried out.

It is currently impossible to completely cure gestosis. However, timely started treatment helps prevent the development of severe forms of this disease. Therefore, do not neglect regular visits to your doctor.

Causes of toxicosis in pregnant women

Theories that tried to explain the etiology of pregnancy toxicosis by intoxication of the body with some kind of poison (or poisons), formed as a result of metabolic disorders in connection with pregnancy or coming from the ovum, have not been confirmed. Theories that tried to explain the origin of the disease by the intake of products of incomplete breakdown of proteins into the body of a pregnant woman, violations of mineral metabolism and ionic balance between tissues and juices of the body of a pregnant woman, sensitization of the body of a pregnant woman to "foreign proteins" (allergy), violation of hormonal balance, etc. of all these assumptions is due to the fact that their authors took the consequence for the cause of the disease, and the observations on the basis of which they built their assumptions were carried out without taking into account those complex connections and interactions that take place in the body of a pregnant woman. Along with this, the role of the central nervous system of a pregnant woman was underestimated, and often completely ignored, for which there were indications in Russian literature for a long time. So, in 1878 V. Favorsky expressed the correct idea about the similarity of the clinical picture of pregnancy toxicosis with neuroses. Yu Chudovsky (1871), I.P. Lazarevich (1892), V.I.Zdravomyslov (1930), V.V.Stroganov (1940), etc. also pointed out the importance of the central nervous system in the development of toxicosis of pregnancy.

Some clarity in the concept of the origin and development of pregnancy toxicosis was introduced only very recently, when they approached the study of this issue from the standpoint of Pavlovian physiology.

In the normal state of the cerebral cortex, pathways and peripheral organ (or organ system), the reaction of the woman's body to the onset and developing pregnancy is physiological, adaptive. Pregnancy in such cases has a physiological course. In case of dysfunctions of at least one of the three named components (cerebral cortex, pathways, peripheral organ), the body's reactions to pregnancy can be perverted, become pathological - toxicosis develops.

There are a lot of reasons that cause dysfunction of the cortex, pathways or peripheral organ.

These include, among others:

various pathological processes that deplete the cells of the cerebral cortex - overwork, neuropsychic shock, a serious illness, etc.;
pathological processes that disrupt the pathway system - a violation of hormonal balance due to a dysfunction of at least one of the intrasecretory organs, especially the pituitary gland (according to K.M.Bykov, not only the path should be attributed to the pathways: cortex - autonomic nervous system - peripheral organ , but also neurohumoral);
pathological processes affecting the peripheral organ - functional insufficiency of the receptor apparatus of the peripheral organ due to its underdevelopment, inflammation or other reasons.

The number of these and other processes is very large, since it is necessary to take into account not only those of them that first arose during a real pregnancy, but also those that a given woman had in the past. All changes occurring in the body of a pregnant woman are under the influence of regulatory systems, primarily the central nervous system. In case of dysfunction of the latter, which is observed in the conditions listed above, the mechanisms of cortical-visceral regulation are perverted, and this can lead to the development of pregnancy toxicosis. However, the latter point of view requires further development.

Thus, the toxicosis of pregnancy can be considered as a manifestation of a special, perverted reaction of the body to pregnancy. This reaction begins as a result of the development of the ovum and its individual elements. The chorionic villi seem to be of decisive importance. For this, for example, there are cases of development of pregnancy toxicosis with cystic drift and chorionepithelioma.

With toxicosis of pregnancy, a variety of dysfunctions and morphological (structural) changes in various organs and systems are observed. Along with the multiplicity of lesions of organs and their systems, with most toxicosis, it is possible to detect a predominant, more noticeable lesion of any one of them. The reasons for this are not well understood. One can think that with toxicosis of pregnancy, those organs and systems are affected earlier and most of all, which, for various reasons, turn out to be functionally insufficient.

A more pronounced lesion of some organs or systems in comparison with others, for obvious reasons, entails a more distinct manifestation of those symptoms of toxicosis that come from the affected organ. This made it possible to identify individual clinical forms of the disease. Depending on which organ or system of which organs undergoes a primary lesion in each case of toxicosis, they speak of nephropathy, dermatopathy, hepatopathy, hematopathy, arthropathy, osteopathy, psychopathy, etc., taking into account at the same time that they all manifest themselves against the background common disease.

Establishing one or another form of pregnancy toxicosis, one cannot be based on any individual symptoms, no matter how clearly they are expressed, since the same symptom can be the result of different phenomena. So, for example, vomiting can be a symptom of excessive (severe) vomiting of pregnant women, acute liver dystrophy, eclampsism, etc., while its origin may be based on pyloric spasm, antiperistaltic movements of the stomach and intestines, irritation of the vomiting center caused by cerebral edema, and other reasons; headache may depend on both cerebral vasospasm and edema; hypotension is observed in the early form of toxicosis - severe vomiting, but it is also a symptom of late toxicosis - severe eclampsia; jaundice is observed with hepatopathy, and with acute liver dystrophy, and with severe vomiting, and with eclampsia, etc.

The exact causes of toxicosis in pregnant women have not yet been established. It is customary to give the greatest role in their appearance to disorders of the interaction of the nervous system and the work of internal organs.

The causes of toxicosis are not fully understood by modern medicine. So, the influence of the systems of the reflex apparatus is assumed (increased activity of the nervous system during pregnancy), along with this, a change in the hormonal background of a woman is not excluded. There is a lot of discussion about the effect of increased allergic mood, altered immune reactivity of the body, as well as a malfunction of the cortical-visceral nervous system during pregnancy (excessive activation of certain areas of the cerebral cortex). However, one should not forget about such symptoms of early toxicosis as a disorder of the function of the gastrointestinal tract (nausea, vomiting, heaviness in the stomach), which is also associated with impaired communication between the nervous and digestive systems of the body. In this situation, a close connection of the reflex apparatus of the gastrointestinal tract (receptors of the esophagus, stomach and intestines) with the vegetative centers of the corresponding region of the cerebral cortex is triggered. It is because of the disturbance in the perception of the cerebral cortex that the impulses coming from the receptors of the gastrointestinal tract can be perverted (disorders associated with the receptor apparatus of the uterus itself or the pathways transmitting impulses can also be involved in the appearance of toxicosis). In turn, direct violations of the area of the cerebral cortex, which is responsible for the analysis of impulses from the organs of the reproductive system and the digestive system (diencephalic region), cause some of the most characteristic symptoms of pregnancy: loss of appetite, nausea, excessive salivation, taste perversion (craving for unusual products , predominant consumption of sweet or, conversely, salty, etc.), vomiting. Together with changes in the nervous system in the body of a pregnant woman, the endocrine system undergoes pronounced restructuring. This, in turn, leads to changes in metabolic processes in the body. It should be noted that the first pregnancy, as a rule, proceeds with a more pronounced toxicosis, which is associated with a new situation for the body, in which it is necessary to develop new adaptive mechanisms. In turn, subsequent pregnancies are in most cases easier in relation to the symptoms of toxicosis in the early stages of pregnancy. The intensity of the manifestation of symptoms of early toxicosis largely depends on the genetic material that is introduced into the woman's body, that is, if pregnancy is from different men, then toxicosis can be expressed in varying degrees of intensity. The first pregnancy can proceed with less, and the second pregnancy - with more pronounced symptoms of early toxicosis, or vice versa.

It is also important that toxicoses in the early stages of pregnancy are more pronounced in multiple pregnancies and in pathologically occurring pregnancies, for example, in the case of cystic drift. At the same time, pregnancy with early toxicosis can proceed differently: with symptoms of vomiting of pregnant women and salivation or in the form of dermatosis of pregnant women - one of the most common forms, more rare forms - with convulsive contractions of certain muscle groups, softening of the bone structure, with symptoms of acute yellow atrophy of the liver , with a bronchial-asthmatic component.

Symptoms and signs of toxicosis during pregnancy

With all the variety of symptoms and multiplicity of forms, all known forms of pregnancy toxicosis are united by a commonality of features, which include:

the undoubted connection of the disease with the presence of developing elements of chorionic villi in the body of a pregnant woman;
changes in blood pressure (hypotension, hypertension);
lowering all excretory functions;
instability of body temperature (from an increase of tenths of a degree to a pronounced febrile state);
a rare recurrence of toxicosis in subsequent pregnancies, apparently due to the development of regulatory and compensatory adaptations (in comparison with other forms of toxicosis, repeated excessive vomiting is more often observed, which may have a conditioned reflex origin).

Pathological anatomy

Pathological changes in the parenchymal organs, found in severe forms of pregnancy toxicosis, have a pronounced degenerative character. With all forms of toxicosis, they have a lot in common.
The most characteristic changes in severe toxicosis of pregnancy are: necrosis of cells of parenchymal organs, especially of the liver and kidneys, with an insular location of areas of necrotic tissue; an abundance of blood clots in the vessels of the affected organs, especially in the hepatic veins; a multiplicity of foci of hemorrhage in the interstitial tissue of the liver, kidneys, heart, brain and other organs with damage to the walls of the vessels feeding them; swelling of the brain and hemorrhages in it (from pinpoint to extensive).

In the initial forms of the disease, they are poorly expressed and relatively easy to treat. Thanks to this, it becomes possible not only to preserve the pregnancy, but also to restore the functions of the affected organs. In advanced cases, the pathological process may be irreversible and cause persistent organ dysfunctions.

The most common manifestation of toxicosis in early pregnancy is vomiting, which occurs in 50-60% of cases. It should be noted that vomiting is preceded by bouts of nausea, which are most pronounced in the morning, as well as after travel in transport or certain odors. Such obsessive attacks of nausea and lead to vomiting. It is noted that, as a rule, vomiting does not happen every day and does not affect the general well-being of the pregnant woman. Therefore, toxicosis does not include recurrent bouts of vomiting, but only excessive severity of nausea and frequent bouts of vomiting. Disturbing daily and frequent bouts of vomiting lead to physical and psycho-emotional exhaustion of the woman and therefore require corrective treatment. Toxicosis in pregnant women is vomiting that occurs not only in the morning, but repeated several times a day and even after eating. In connection with the possible severity of vomiting, it is customary to distinguish 3 degrees of severity of toxicosis in early pregnancy.

Mild - the mildest vomiting. The changes present in the body of a pregnant woman consist in minor changes in the nervous system (such as fatigue, increased irritability, nervousness, alternating with apathy). Against this background, a decrease in the activity of nervous processes in the cerebral cortex was noted, and a more pronounced increase in the excitability of the subcortical centers, disruption of the autonomic nervous system (responsible for involuntary types of body activity - sweating, salivation, reflex reaction of the eyes, sense of smell), significant metabolic and functional disorders other organs and systems do not occur. As a result, the symptomatology of a mild course of toxicosis implies the presence of vomiting 2 to 4 times a day, mainly after a meal. Against this background, there should be no strong fears, since part of the food entering the body is still absorbed and active weight loss does not arise. Usually the general condition suffers, the body temperature remains normal, the heartbeat slightly increases (up to 90 beats / min), the blood pressure remains normal. Frequently disturbed by frequent mood swings, increased drowsiness, loss of energy, poor performance. The amount of urine excreted remains the same, although it is somewhat more frequent. In the overwhelming majority of cases, bouts of vomiting continue on average during the first 2-3 months of pregnancy, are quite easy to treat, and in many cases pass spontaneously.

Observance of rest helps to reduce salivation, for which they resort to means that regulate the work of the nervous system, such as: valerian, motherwort, novopassit, psychotherapy, hypnosis. Severe dehydration requires infusion therapy: Ringer-Locke's solution, 5% glucose solution with insulin. In order to prevent skin damage, the facial skin is lubricated with zinc paste or petroleum jelly. Early toxicosis of pregnant women can manifest themselves in the form of rare forms. These include the following manifestations.

Dermatoses of pregnant women.
Tetania pregnant- Toxicosis is manifested by muscle cramps of the upper extremities, less often - of the lower extremities, facial muscles. The main reason for the occurrence of such a course of toxicosis is a violation or complete cessation of the function of the parathyroid glands and a violation of calcium metabolism. The severe course of toxicosis with repeated exacerbations is the reason for the operation to terminate the pregnancy. Treatment for milder forms is calcium, dihydrotachysterol and vitamin D.
Osteomalacia of pregnant women- bone disease, bone softening. This is a form of toxicosis, in which women are warned against further gestation. In the case of pregnancy, all the processes described above are aggravated, which is fraught with serious complications. It is important to note that the course of osteomalacia in most cases is erased. The main symptoms that bother a woman are pain in the legs, pelvic bones, muscles. Along with this, there is weakness, increased fatigue, tingling and numbness in various parts of the body, as a result of which there is a change in gait, which is associated with an increase in tendon reflexes and soreness of the pubic joint. X-ray and ultrasound examinations help in the diagnosis of this kind of toxicosis course. Thanks to these methods, the discrepancy of the bones of the pubic joint is detected, however, unlike true osteomalacia, there are no structural changes in the bones. Treatment is carried out by taking vitamin D fish oil, progesterone and ultraviolet radiation of the body.
Acute yellow liver atrophy it can also become a manifestation of toxicosis in the first half of pregnancy, while it is extremely rare and can be the result of excessive vomiting of pregnant women or occur independently of it. Such disorders in the body are the result of protein and fatty degeneration of liver cells. With this manifestation of toxicosis, the size of the liver decreases, icteric staining of the skin and sclera appears. Along with this, severe nervous disorders can be observed: depression, impaired consciousness, delirium. Later, the general condition worsens and a coma sets in, after - the death of the pregnant woman. The duration of the process in this case takes on average 2-3 weeks. When the first symptoms of a similar course of toxicosis occur, it is advisable to terminate the pregnancy. But sometimes even such measures may not give a positive result with adequate treatment.
Bronchial asthma of pregnant women also seems to be an extremely rare form of early toxicosis. The alleged reason for the occurrence of such a course of toxicosis is the increased activity of the parathyroid glands with impaired calcium metabolism. As a treatment for toxicosis of this form, calcium preparations, vitamin D and sedatives are used. In case of suspicion of bronchial asthma that arose even before pregnancy, you should be examined and treated even before the intended pregnancy. Exacerbation of bronchial asthma during pregnancy indicates the need for long-term preservation of pregnancy, prevention of premature birth and individual therapy.

With the onset of pregnancy, a woman's body undergoes a complex and diverse restructuring. The balance between the organs and systems of the body, disturbed with the onset of pregnancy, is quickly restored, and they come to a state that best meets the interests of the body of both a pregnant woman and a developing fetus.

Toxicosis is a syndrome in which swelling begins in a pregnant woman, arthial pressure and the amount of protein in the urine increase. Women with kidney disease and previous high blood pressure are more susceptible to this complication. Diabetes also increases your risk. Toxicosis is the main cause of premature birth and pregnancy complications. If left untreated, it can lead to seizures, a condition called eclampsia. No one knows exactly what causes eclampsia, although there are many theories. In one study, electrodes were placed on nerves adjacent to blood vessels in four different types of women: pregnant women with high blood pressure, non-pregnant women with high blood pressure, pregnant women with normal blood pressure, and non-pregnant women with normal blood pressure. Women with preeclampsia were found to have high activity of sympathetic nerves, which led to narrowing of their blood vessels and a subsequent increase in blood pressure.

It is well known that the sympathetic nervous system is involved in the response to aggression and associated stresses. One of the researchers who participated in the study suggested that the reason for the rise in blood pressure in women with preeclampsia is that they had a "defect in the central system that deals with conflicts", which can increase the levels of certain hormones and contribute to the rise in blood pressure.

Other studies of pregnant women with toxicosis have shown that these women feel less attractive, less loved, more helpless than women without toxicosis. Maybe they are overly sensitive to the opinions of others, trying to focus on what others expect of them. For such women, pregnancy becomes another crisis and adds stress to their and even more stressful life. Although they perceive pregnancy as a crisis, they are not ready to cope with the emotions that are associated with it. But their body responds by raising their blood pressure. They often have conflicts with employers: blood pressure rises when trying to discuss maternity leave. They try to prepare everything for childbirth in advance. Compared to women who do not suffer from eclampsia, the feelings of these women are expressed physically through an automatic - unconscious - reaction of the nervous system: their neck and face turn red, they speak quickly, their blood pressure rises, their head dizzy, and their heart rate rises. One study shows that women who gain weight rapidly rupture their membranes too early (one of the leading causes of premature birth); women who have toxicosis suffer from increased anxiety, social isolation, hypochondria. If a woman does not want her child to go to an intensive care unit, she will gradually begin to see her body as the best place to intensively care for her child, and among other things, the cheapest.

Classification of toxicosis during pregnancy

Toxicosis of pregnancy by the time of their occurrence is usually divided into two groups: the first is characterized by a predominant disorder of food reflexes (nausea, salivation, vomiting) and less often - a disorder of the function of the vascular system (hypo- or hypertension), for the second - a predominant disorder of the function of the vascular system: hypo - or hypertension, increased permeability of the walls of blood vessels and their fragility, etc.

According to the classification adopted by most obstetricians, they are distinguished:

early toxicosis - vomiting of pregnant women, severe vomiting, ptyalism, dermatoses, etc.; they are found in the first 1-4 months of pregnancy;
late toxicosis - dropsy of pregnant women, nephropathy, eclampsism, eclampsia; they are usually observed in the last 2-3 months of pregnancy.

Special attention should be paid to rare forms of toxicosis, which include hepatopathy (toxic jaundice), acute liver dystrophy, tetany of pregnant women, chorea of pregnant women, osteomalacia, arthropathy, etc.

Early toxicoses are usually characterized by dehydration of the body, late ones, on the contrary, by excessive accumulation of fluid.

Treatment of toxicosis during pregnancy

The uncomplicated course of toxicosis can be treated at home. If the toxicosis reaches a moderate or severe degree, hospitalization is indicated for the woman.

Meals should be fractional - a pregnant woman should eat often and in small portions.

The use of psychotherapy, homeopathy, acupuncture is effective. It is advisable to do without serious medication for such short periods.

A diet for each specific woman can only be prescribed by her doctor, because despite the lack of medicines, both diet and the intake of different decoctions, and the intake of homeopathy are a treatment.

Caring for patients with toxicosis of pregnancy

Along with the special treatment measures listed above, proper patient care is also carried out to obtain sufficiently effective results.

It is necessary to timely place the patient with toxicosis in the maternity hospital, in the ward of pregnancy pathology. Here it is necessary to strictly observe all the rules of the therapeutic and protective regime aimed at normalizing the regulatory functions of the body. This is achieved by the correct alternation of sleep and wakefulness, regular food intake, the elimination of any irritants, in particular bright light and noise in the ward, by influencing the patient's psyche with the doctor's word (psychotherapy) and the benevolent, affectionate treatment of all staff, prolonged sleep and other methods.

There should always be clean air in the ward in which patients with pregnancy toxicosis lie. To do this, the room should be ventilated often and for a long time. Patients sleep well in a dark, well-ventilated, cool room. Therefore, in the wards where patients with pregnancy toxicosis (except for patients with eclampsia) lie, the window can remain ajar all the time even in winter, but with the indispensable condition of reliably wrapping patients in warm blankets and constant monitoring by the attendants.

Patients with late toxicosis of pregnancy, with the exception of patients with eclampsia and those in a preeclampsic state, need special skin care, as one of the main excretory organs. A daily warm shower with rubbing of the skin enhances the respiratory and excretory functions of the skin and plays an essential role in the complex of therapeutic measures.

Food (dairy and vegetable) should be given at strictly defined hours. It should be rich in sugar and vitamins (especially C and B!) And, if possible, contain no table salt (salt-free milk-vegetable diet). Fluid intake in any form should be limited to a minimum, especially with severe edema. With dropsy and nephropathy of pregnant women, fasting days are prescribed 1-2 times a week, that is, all food (and drink) is limited to 1 kg of fruit (apples, grapes, tangerines or oranges) or 0.5 kg of sweetened fresh cottage cheese.

With eclampsia and preeclampsia, a fasting diet is prescribed; if the patient is in a satisfactory condition, 1-2 glasses of warm sweet tea with milk are allowed.

Daily bowel movement, independent or with an enema, and from time to time the appointment of magnesium sulfate as a laxative is necessary in all cases of severe toxicosis, with the exception of unconscious patients with eclampsia.

During the entire stay in the hospital, patients with pregnancy toxicosis are thoroughly examined daily by a doctor (interview, examination of the function and condition of organs and systems, analyzes, weighing, determination of urine output, etc.), and if necessary, specialists are involved: therapist, ophthalmologist, neuropathologist, etc.

Prevention of toxicosis of pregnancy

Prevention consists, first of all, in observing all the rules - hygienic, dietary, etc., provided for pregnant women. Particular attention should be paid to a pregnant woman in the first and last 3 months of pregnancy, when signs of pregnancy toxicosis appear most often, in the first case - early, in the second - late.

It is impossible to be limited only to narrowly special (obstetric) observation; it is necessary to familiarize oneself with the state of the whole organism, using, where appropriate, the consultations of specialists. Identified diseases should be eliminated with careful care and treatment.

If the initial signs of toxicosis are detected, the pregnant woman is taken under special supervision, and if outpatient treatment does not lead to a cure in a short time, she is sent to the pregnancy pathology ward, where appropriate inpatient treatment is carried out until her health is fully restored. Indications for referring pregnant women to the hospital are: the presence of protein in the urine (over 1%). maximum blood pressure over 135 mm Hg, increasing edema, daily weight gain at the end of pregnancy over 75 g. The latter circumstance (pathological weight gain) is a very pathognomonic symptom of an impending serious complication of pregnancy; it should not escape the attention of the doctor supervising the pregnant woman.

Correct treatment of the early stages of the disease is the prevention of further progression of toxicosis, which in severe cases poses a great threat to the health and even the life of the pregnant woman and the fetus.