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Dropsy during pregnancy: causes, proper treatment. Dropsy of pregnancy leads to dangerous complications if left untreated

The number of changes that the female body undergoes during the nine months of pregnancy is only inferior to the changes that occur over the same period of time with the fetus turning from a fertilized egg into a child. Moreover, the colossal load that a woman experiences, both on the physical plane and on the psycho-emotional plane, seriously affects her well-being, and if the body was not prepared for pregnancy, various diseases that are in chronic or sluggish forms can worsen, causing a lot of inconvenience.

At the same time, even if a woman becomes pregnant completely healthy, in the second half of pregnancy, she may experience exacerbations characteristic of this period. The most typical exacerbation is swelling, otherwise called dropsy of pregnant women. The lower extremities are most susceptible to edema, however, in the absence of timely therapy, the swelling spreads upward, covering the hips, rising to the arms and face. Against the background of swelling, blood pressure rises, and protein in the urine may appear - proteinuria. A progressive combination of the three listed symptoms indicates the transition of dropsy to.

The causes of dropsy in pregnancy and nephropathy are identical, and the development of nephropathy in pregnant women quite often occurs against the background of untreated dropsy. Young mothers and women after the age of thirty-five are more prone to dropsy, especially during the first pregnancy. There is a dependence of the appearance of edema on weather variables and other climatic and geographical conditions. In addition, the causes may be diseases of the heart and kidneys, as well as the presence of infection in the body. The risk group includes women with, as well as.

Symptoms of dropsy are the presence of puffiness, and the pathology has several stages. At the initial stage, swelling is not observed externally and is determined by a specialist - if a woman gains weight more than 800 grams per week, and when pressed, a slowly disappearing white trace remains on the body. In the next stage, the swelling is on the legs and reaches the thighs. Further swelling goes to the sacrum and abdomen, followed by coverage of the arms and face. And already at the third stage, we can talk about preeclampsia or nephropathy of pregnancy.

There is an opinion among some pregnant women and even gynecologists that dropsy is a common and not dangerous phenomenon of the second or third trimester of pregnancy, and women remain uninformed about the dangers of dropsy during pregnancy. However, neglecting such alarming symptoms is extremely imprudent and even dangerous, both for the female body and for the health and life of the baby. The consequences of dropsy in pregnant women are expressed in the transformation of pathology into nephrosis of pregnant women of the second and third degree, that is, pre-exlampsia and exlampsia, accompanied by the threat of abortion, damage to the kidneys, cardiovascular system, and even vision. In addition, to the complications of dropsy, and as a result of nephropathy is, and complications during childbirth, which can injure the child and become.

In fact, only a few of the complications of pregnancy and childbirth are not associated with dropsy and nephropathy ().

For therapeutic and prophylactic purposes, the doctor recommends that a woman adhere to a special diet for dropsy of pregnant women, corresponding to the seventh table according to the Pevzner classification. Nutrition involves the restriction or complete exclusion of table salt, a diet enriched with vitamins and reduced energy value, as a result of the restriction of fats and proteins. Intended dishes should be cooked with steam or boiling, in some cases baked dishes are allowed. Spicy, fatty, fried and smoked foods are strictly prohibited.

In addition, the treatment of dropsy of pregnant women involves constant monitoring of diuresis (the amount of urine excreted over a certain period of time), and if it is insufficient, it is possible to prescribe diuretics, mainly of plant origin, that do not harm the fetus. It is appropriate to use sedatives, drugs that normalize blood pressure, improve metabolic processes and blood circulation.

A separate column considers dropsy of the fetus in a pregnant woman. With all the danger of dropsy of pregnant women, dropsy of the fetus becomes an incomparable nightmare for a pregnant woman. In most cases, the pathology does not portend a favorable outcome for the child, and ends either with intrauterine fetal death or the death of the child almost immediately after birth.

The most common cause of fetal dropsy is hemolytic disease - in other words, "incompatibility" in the blood or in the Rh factor, which leads to the maternal immune system not accepting the fetal red blood cells. In addition, infectious diseases, chromosomal abnormalities, and fetal developmental defects can be the cause. Dropsy manifests itself by filling the cavities of the fetus with liquid, which leads to deformation of the body and not viability. Distinguish common dropsy of the fetus, in which the body of the fetus is completely deformed, has a small head against the background of an enlarged pasty body. There is no chance of survival, delivery is carried out using a caesarean section. With dropsy of the chest and abdominal cavity, dropsy of the head, the prognosis is also not favorable, even if the child survives, there are developmental delays and other pathologies.

However, with timely diagnosis of a pathology that is only taking its development, in clinics equipped with appropriate equipment and highly qualified personnel, a complex intrauterine procedure is carried out - hemotransfusion - blood transfusion to an unborn baby in the womb. Today, this operation, which requires high professionalism from the staff and technicality from the equipment, saves the lives of many babies, giving them the right to life, and their mothers the right to happiness, proving to the whole world that miracles do happen!

Dropsy during pregnancy - one of the forms of preeclampsia, occurs in women at any time, manifested by edema. The condition requires the appointment of therapy, otherwise there is a transition to the next form of gestosis, which is more difficult. Treatment is carried out on an outpatient basis, hospitalization is less often required.

The essence of pathology

Dropsy of pregnant women is the initial stage of gestosis - this is a condition that occurs as a result of a decrease in the adaptive properties of a woman's body. The pathological process consists in the retention of a large amount of fluid in the body, its accumulation in soft tissues. This causes the formation of edema, deterioration in the general well-being of a pregnant woman, disruption of the heart.

Due to thickening of the blood, fetal nutrition is disturbed - its hypoxia develops, the process of intrauterine development slows down.

The main mechanism for the development of dropsy is a change in the water-salt balance. Pathology is diagnosed at any stage of pregnancy, but more often at 5-6 months. In 25% of women, dropsy passes into the next form of gestosis - nephropathy.

Causes of dropsy

A change in the water-salt balance occurs under the influence of complex processes occurring in the body of a pregnant woman, primarily a violation of the hormonal background. Dropsy develops against the background of an extragenital pathology already present in a woman:

  • hypertonic disease;
  • diabetes;
  • chronic pyelonephritis or glomerulonephritis;
  • heart failure;
  • chronic lung diseases.

The risk of developing dropsy in overweight women, difficult working conditions, low social level increases. A burdened history is important - if a woman also suffered from edema in previous pregnancies. Dropsy develops more often in pregnant women under 18 years of age and over 35 years of age.

stages

Dropsy during pregnancy develops gradually, so several of its stages are distinguished.

The classification is based on the prevalence of edema.

  • Stage 0. There are no visible edema, but a decrease in the amount of urine excreted and too rapid weight gain make it possible to suspect pathology.
  • Stage 1. Swelling of the feet and lower third of the lower leg appears.
  • Stage 2. Puffiness is found on the legs and arms.
  • Stage 3. The accumulation of fluid occurs in all soft tissues - legs, arms, anterior abdominal wall, as well as in body cavities. This condition is called anasarca.

Depending on the stage of dropsy, therapeutic tactics and the risk to the fetus are determined.

Symptoms

Edema is the main symptom of dropsy. In the initial stages, they appear by the end of the day. When the form is running, the puffiness does not disappear at all.


A typical sign that allows you to identify hidden and obvious edema is a pathologically rapid weight gain.

With a normal pregnancy, a woman adds no more than 400 grams per week. If the increase reaches 1.5-2 kg, this is a clear sign of dropsy.

Due to improper distribution of fluid, the pregnant woman constantly feels thirsty, which makes her drink even more water - a vicious circle is formed. As the fluid escapes into the tissues, the frequency of urination decreases. It also reduces the amount of urine produced.

The skin of women with dropsy is pale, has a glossy sheen - this is due to its stretching due to the accumulation of fluid. When listening to the heart, an increase in heart rate is detected. The blood pressure rises.

Diagnostics

It is possible to identify dropsy of pregnant women on the basis of complaints of a woman, characteristic symptoms. The diagnosis is confirmed by regular measurement of body weight, determination of the ratio of drunk and excreted fluid per day. Some laboratory studies and tests are used:

  1. A complete blood count shows an increase in hemoglobin levels;
  2. Biochemical analysis reveals an increase in the amount of electrolytes, dysproteinemia;
  3. The Aldrich test is used - 0.2 ml of sodium chloride solution is injected intradermally, normally the bubble resolves within an hour, and with dropsy it leaves in 15 minutes;
  4. At stage 4 pathology, fluid is detected in the abdominal cavity using ultrasound.

Body weight and diuresis should be monitored daily.

Dropsy treatment

Women with stage zero and stage I dropsy are treated on an outpatient basis. A strict drinking regime is prescribed - no more than a liter of liquid during the day. At the same time, salt intake is limited. A balanced diet is shown, daily you need to eat protein foods - meat, fish, dairy products. It is necessary to observe the regime of work and rest.

Treatment of dropsy at stages 3 and 4 is carried out in a hospital. The same therapeutic and protective regimen is applied - diet, restriction of fluid intake, rest. Additionally prescribed medications:

  • antispasmodics;
  • diuretics;
  • sedatives;
  • antihistamines.

Diuretics are prescribed with caution, since their use can have the opposite effect - due to increased release of the liquid part of the blood from the vessels.

Prevention

Preventive measures against dropsy must begin before pregnancy. First of all, the risk of developing pathology is determined. Then a balanced diet, vitamin and mineral complexes are prescribed. The required drinking regimen is determined in advance.


 It is important to determine the correct drinking regime

Working conditions are determined taking into account the risk group. Throughout pregnancy, it is necessary to control body weight and daily diuresis. If signs of swelling appear, appropriate treatment is carried out.

Dropsy of the fetus is the process of accumulation of fluid in the tissues and cavities of the child's body while he is in the mother's body. The condition is accompanied by a violation of the work of all organs, immediately after birth, the child requires intensive treatment.


Causes

Dropsy in the fetus develops under the influence of various factors:

  • genetic disorders;
  • heart defects formed in utero;
  • anomalies in the development of blood vessels;
  • congenital infections;
  • anomalies in the development of the urinary organs;
  • maternal preeclampsia.

There is an increased risk of dropsy in children if the pregnant woman is under 16 or over 40 years old. Often the pathology is present in multiple pregnancies. One form of dropsy is caused by an Rh conflict between the fetus and the mother.

Types and symptoms

Depending on the cause of origin, two forms of the disease are distinguished.

  1. Immune. due to Rh incompatibility. It is rare due to timely diagnosis. The prognosis is usually favorable.
  2. Non-immune. Caused by various anomalies and infections. The outcome is often fatal.

Symptoms are detected immediately after the birth of the child. The head of the newborn looks disproportionately large in relation to the body. The weakness of all muscle groups is characteristic - the child cannot keep the limbs bent, the stomach spreads like a frog.

A characteristic feature is the openness of the sutures between the bones of the skull. As a result, bulging of fontanelles is observed. There is marked inhibition of all reflexes. Examination reveals increased heart rate, low blood pressure, and irregular breathing.

Diagnostics

Thanks to the ultrasound method, the diagnosis can be made even during pregnancy. The echo signs of dropsy of the fetus are:

  • polyhydramnios;
  • an increase in the size of the head;
  • detection of fluid in cavities;
  • enlargement of the liver and spleen.

After the birth of the child, they are examined for infections, and narrow specialists are consulted to determine the cause of the pathology.

Treatment


 dropsy in children

Immediately after birth, the child undergoes intensive therapy, depending on the prevailing symptoms:

  • hardware breathing;
  • the introduction of cardiac drugs;
  • diuretics;
  • blood transfusion;
  • puncture of cavities to remove fluid.

Depending on the cause, antibiotics and hormones are prescribed. Sometimes surgery is required.

The prognosis for dropsy of pregnancy in most patients is favorable. Women carry the pregnancy to the required term, delivery occurs naturally.

The state of pregnancy brings a woman real happiness and joy in anticipation of a baby. However, there are clouds in the sun. Each period of pregnancy has its own characteristics and problems associated with this period. Even with the normal course of the first half of pregnancy, the second half can present an unpleasant surprise in the form of increased pressure, edema, and late toxicosis. Such a surprise is dropsy of pregnant women.

With this disease, toxicosis occurs, which occurs as a result of a violation of the exchange of salts and water in the body and the appearance of severe edema associated with impaired blood supply in the capillaries and precapillaries. Their cause is the accumulation of salts and water retention in the tissues of the body. At the same time, the indicators of protein in the urine and blood pressure are within the normal range. The sad thing is that this condition can begin 3 or 4 months before delivery and continue until the very end of pregnancy.

Such diseases are prone to women who, even before pregnancy, were obese and had kidney problems and high blood pressure.

What are the manifestations of dropsy of pregnancy?

As mentioned above, the likelihood of dropsy is typical for overweight women. However, this process can be controlled. If a pregnant woman gains 500 or 700 grams of weight every week, and the average rate ranges from 260 or 300 grams in 7 days, then the risk of dropsy is very high. This is evidenced by the fact of tight shoes. This is when your favorite shoes suddenly start to squeeze you or the ring on your finger suddenly becomes small and can hardly be removed from your finger. All this is a wake-up call that the time has come for treatment. After all, if you do not immediately start treatment, then the edema can reach large sizes and rise from the foot and lower leg, where they initially appear further along the body. The next affected parts of the body may be the abdomen, lower back, arms and head, and this will already have a fourth degree of dropsy. The most characteristic thing is that with this disease, pressure, protein indicators in the blood and urine are normal, and the amount of urine excreted decreases, although the work of the liver and kidneys is not impaired.

How can this disease be distinguished from renal edema? First of all, the color of the skin. With dropsy, the skin has a glossy appearance, and with kidney diseases, a pale color will become characteristic of it. In addition, the kidneys function normally. There are also hidden edema. Then only a rapid weight gain and weak urination will show the presence of the disease.

Moreover, the state of health remains normal, sometimes shortness of breath, a feeling of thirst or fatigue and heaviness in the body disturb. Tachycardia is possible.

How to treat dropsy?

With early manifestations of dropsy, it can be treated at home. In this case, special diets are used, for which the amount of salt in food is reduced and the amount of fluid taken is reduced. The nutrition of such a pregnant woman should be complete and include dishes from low-calorie fish and meat, a full range of vegetables and fruits, as well as low-fat dairy products. Be sure to organize a fasting day with a mono-diet. It can be a milk or cottage cheese day, or maybe an apple day.

Of the medications, it is recommended to use ammonium chloride, sedatives and medications that have an antispasmodic effect, such as papaverine or no-shpu. It is also necessary to use medicines, the action of which is aimed at strengthening the walls of blood vessels. These will be rutin, ascorbic acid or calcium gluconate.

When taking ammonium chloride in the body, there is a loss of potassium, and in order to replenish it, you need to eat dried apricots and figs, as well as potatoes, which are a natural source of this chemical element.

In folk medicine, there are also recipes for this problem. If you drink a decoction of juniper or cornflower, taking 200 milligrams a day, then the symptoms of dropsy will quickly disappear. If this does not happen, then it is better to seek help from a medical institution and undergo treatment in a hospital under the supervision of a doctor.

Author of the publication: Alisa Egorova

Dropsy of pregnancy is considered one of the most common forms. This condition is accompanied by an increased accumulation of fluid in the body. Dropsy itself does not pose a danger to either the woman or the fetus. However, regular and adherence to certain treatment rules is simply necessary, since in some cases this condition can develop into nephropathy, and sometimes into eclampsia.

Dropsy of pregnant women: causes. In fact, doctors believe that the main cause of such a violation is problems with the nervous system. This, in turn, leads to problems with the circulatory system - the walls of blood vessels become more permeable, the balance of salts and fluids in the body is disturbed. A huge amount of salts, mainly chlorides, is retained in the tissues of the body, and, consequently, water begins to accumulate there. As a rule, fluid accumulates in the subcutaneous tissue.

Dropsy of pregnancy: symptoms. Edema is considered the most noticeable sign of dropsy in pregnant women. This condition in most cases accompanies the first pregnancy and appears in the last 3-4 months. Edema appears much less frequently in the last month of pregnancy or immediately before childbirth. As a rule, this condition is preceded by hidden puffiness, which is very easy to notice if you regularly weigh yourself. The fact is that with the accumulation of fluid in the body, a woman begins to gain a lot of weight.

First, the feet and legs swell. In later stages, the disease rises higher and covers the pelvic organs. The last stage in the development of dropsy is called "general edema". The fact is that in this state, absolutely the entire body swells, including the arms, shoulders and face.

Dropsy of pregnancy: how dangerous is it? As already mentioned, dropsy of pregnant women in itself cannot harm either the mother's body or the body of the unborn child. First, fluid never accumulates in serous cavities. Secondly, the kidneys, heart and other organs function absolutely normally. Urine analysis does not reveal any abnormalities. The only thing that worries the expectant mother is the constant heaviness and limited movement, which is explained by a significant increase in body weight. Sometimes the symptoms go away on their own a few weeks before delivery. In any case, dropsy disappears immediately after the birth of the child.

On the other hand, cases are also known when dropsy passed into more serious conditions - for example, nephropathy or eclampsia. That is why women in this condition should be regularly examined by a doctor who leads them throughout their pregnancy. And although the treatment of dropsy is carried out, as a rule, at home, with persistent swelling, it is sometimes necessary to place a woman in a hospital.

Dropsy of pregnancy: treatment. The success of the treatment of dropsy mainly depends on the woman's compliance with the correct regimen, and the future mother with edema needs bed rest. It is desirable that there is always a pillow under your feet.

In addition, you need to pay attention to nutrition. Such women are advised to give up salt, as well as fried and too fatty foods. It is better to eat dairy products, cottage cheese, cheese, kefir, sour cream. In addition, it is recommended to consume fresh vegetables and fruits. It is also necessary to limit the amount of liquid you drink - no more than one liter per day.

As for drug treatment, it comes down to the appointment of vitamin preparations, as well as weak drugs with a diuretic effect, which help to remove excess water from the body. As a rule, subject to all the rules, the edema subsides, but may reappear if the expectant mother returns to her previous way of life.

In perfectly healthy women in the last months of pregnancy, minor edema of the lower extremities is relatively often observed. We can talk about dropsy of pregnant women only in those cases when a large amount of fluid accumulates in the tissues, especially in the subcutaneous tissue. In some women, the accumulation of fluid occurs in the deep-lying sections of the fiber, filling the spaces between individual organs or located inside the organs (hidden edema).
Edema usually begins in the ankle area and from there gradually spreads upward. In some women, at the same time as the ankles, the face begins to swell, which becomes puffy. In severe cases, the edema spreads to the mammary glands and to the abdomen, where a doughy pillow is formed, hanging over the bosom, on the hands, on the labia, etc.
If the patient walks, the legs and feet swell especially strongly; in the supine position, the patient edema appears in the region of the sacrum and on the back surfaces of the thighs and legs. In the morning, swelling is less noticeable than in the evening.
Even with severe edema, the health and general condition of pregnant women continues to be good: they do not complain, and clinical and laboratory studies do not reveal significant deviations from the norm. In particular, the kidney function is not changed - there are no pathological elements in the urine. There is oliguria (little urine) or polyuria (a lot of urine). Arterial pressure is not increased. The composition of the blood is normal.

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Flow the disease can be either very short-term - swelling quickly disappears from one bed rest, or long-term. Edema that has disappeared may reappear after a while, and edema that has persisted for months may disappear in a few hours before the onset of childbirth. As a rule, increased edema is accompanied by oliguria, their decrease is accompanied by polyuria.
Correct and timely treatment makes it possible in almost all cases to achieve a complete recovery, i.e., to prevent the transition of dropsy to the subsequent stages of toxicosis - to nephropathy and eclampsia, which often occur if edema began to appear early - at the VI-VII month of pregnancy.

For diagnosis, a test for the hydrophilicity of the tissue can be used.
A correct idea of ​​the accumulation of fluid in the body or its removal from it can only be obtained by comparing the daily amount of fluid drunk, urine excreted and the weight of the pregnant woman.

Treatment with severe disease should be carried out in a hospital. The patient must comply with bed rest; limit the amount of meat and fat in the diet, fluid intake (up to 1 liter per day) and chlorides, prescribe food rich in vitamins (vegetables and fruits). It is useful to replace drinking water with milk; to enhance sweating, a daily warm shower is recommended, followed by rubbing the entire body red hot.
Inside give as a laxative 25 g of magnesium sulfate.
After achieving stable results, the pregnant woman is discharged under the systematic supervision of the antenatal clinic.