It disrupts the functioning of a number of systems and organs in the body of a pregnant woman. This condition disappears a few days after the birth of the child. According to research by specialists, gestosis to one degree or another is typical for a third of pregnant women. The disease often manifests itself between the sixteenth and twentieth weeks of pregnancy, but the third trimester of pregnancy is most typical for the occurrence of gestosis. The reason for the manifestation of this pathology is characteristic changes in the body of the expectant mother, due to which substances are formed in the placenta that make microscopic holes in the vessels. It is through these holes that protein and fluid enter the tissue from the blood. It promotes education swelling . At the very beginning of the disease, edema cannot yet be seen, but when weighed, a significant increase in weight is already observed.
Similar microperiods also form in the vessels of the kidneys, through which protein enters the urine. A general urine test, which a pregnant woman should undergo regularly, facilitates diagnosis and makes it possible to begin treating gestosis immediately after the onset of the disease.
Types of gestosis
It is customary to distinguish several types of gestosis in pregnant women. Early gestosis , which occurs in the first half of pregnancy, is manifested by nausea, vomiting, often uncontrollable. The woman has heavy salivation.Late gestosis appears on later pregnancy (third trimester). This condition is characterized by symptoms nephropathy , dropsy , preeclampsia , eclampsia . Rare forms of gestosis are also diagnosed, which manifest themselves liver diseases , skin , nervous system etc. It is also customary to highlight “pure” gestosis , which occur in a healthy pregnant woman in the absence of underlying diseases. "Combined" gestosis manifest themselves as a result of a disease that preceded this pathology. It could be , endocrinopathy , .
Causes of gestosis
To date, there is no single exact opinion about the origin of gestosis. However, there are a number of theories that suggest a certain etiology of gestosis. Yes, according to cortico-visceral theory Pregnancy gestosis is presented as a specific pregnancy, which is characterized by a violation of the interaction between the cortex and subcortical structures. As a result, reflex changes appear in hemodynamics. This theory is confirmed by the fairly frequent manifestation of gestosis as a consequence of nervous stress.
According to immunological theory gestosis occurs due to changes in the mechanisms that are responsible for ensuring transplacental immunity in the body. By genetic theory , those women whose mothers had preeclampsia are predisposed to gestosis.
Another theory indicates the relationship between gestosis and deficiency in a woman’s body B vitamins And . It is in the third trimester of pregnancy that the body requires significantly more of the mentioned vitamins. If their intake into the body is insufficient, the concentration in the blood becomes higher. Homocysteine is a very toxic substance for the endothelium. Under the influence of this substance, pores appear in the vessels through which the plasma passes into the tissue. The consequence is swelling, increased pressure in blood vessels and a decrease.
According to placental theory in patients with gestosis, trophoblast migration is disrupted, resulting in spasm , decreased intervillous blood flow , . Further, due to hypoxia, the endothelium is affected, hemodynamic disturbances occur, hormonal background, metabolism .
Symptoms of gestosis
With gestosis, changes occur in many organs: the functioning of the kidneys and liver, placenta, and nervous system is disrupted. May occur hypoxia chronic, fetal growth restriction syndromeA .
With early gestosis (), pregnant women usually experience vomiting, which can occur many times a day. There is constant nausea, decreased energy levels, and a desire to eat spicy and salty foods. Constant vomiting does not greatly affect the weight of a pregnant woman: it does not decrease noticeably. The temperature remains normal. The remaining symptoms described are typical only for the first months of pregnancy; later they disappear on their own. In more rare cases, a woman’s vomiting does not stop later, and she becomes indomitable. In this condition, vomiting can occur up to twenty times a day, and this occurs at any time of the day. The patient loses weight sharply and develops a persistent aversion to food. The pulse becomes more frequent, blood pressure decreases. In this case, tests indicate the presence in the urine acetone And squirrel . In especially severe cases, body temperature may rise and and a state of delirium.
With late gestosis, the disease develops in stages. First there is dropsy , over time passing into nephropathy , later - in preeclampsia And eclampsia . When dropsy occurs in pregnant women, swelling occurs due to constant fluid retention in the body. During this period, both hidden and obvious swelling may appear. Due to lower urine output from the body, a pregnant woman’s body weight increases very quickly, and urination is more intense at night. Swelling, as a rule, initially appears in the ankle area, then it begins to spread upward. Sometimes a woman experiences simultaneous swelling of the face. At the end of the day, the legs and lower abdomen look more swollen.
With nephropathy, a woman already has three main symptoms of gestosis: severe swelling, the presence of protein in the urine, and periodically manifested high blood pressure. A combination of any two symptoms may occur. Nephropathy manifests itself against the background of dropsy. In this condition, a high level of diastolic pressure, which affects the decrease in placental blood flow. Accordingly, the fetus receives less oxygen. Later, nephropathy can develop into eclampsia, which is a very dangerous condition for a pregnant woman. With preeclampsia, microcirculation in the central nervous system is disrupted. In addition to the three main symptoms of gestosis, this condition may include a feeling of heaviness in the back of the head, stomach pain, headaches, vomiting, and nausea. A woman’s vision and memory may deteriorate and her sleep may be disrupted. Due to impaired blood flow in the occipital part of the cerebral cortex, there may be a “veil” before the eyes or the flickering of “sparks” may be observed. Signs of preeclampsia include high systolic Blood pressure (from 160 mm Hg) and diastolic blood pressure (from 110 mm Hg). Urine excretion is significantly reduced, the number of platelets in the blood decreases, blood clotting decreases, and liver function is disrupted.
With eclampsia, the most severe stage of gestosis, seizures are observed, while all functions of systems and organs are disrupted. Convulsions, which are provoked by pain, bright light, sharp sounds, etc., last several minutes. After the attack, the woman loses consciousness. Also, after such seizures, deep seizures may develop. This may provoke placental abruption , fetal hypoxia And premature birth . This condition threatens the life of the fetus.
It is important to take into account that with gestosis, a woman can feel quite well for a certain period of time, complaining only of slight swelling and noticeable weight gain. However, edema is characteristic not only of the extremities, but also of the placenta, which leads to insufficient oxygen supply to the fetus. Therefore, the symptoms described are a reason to immediately visit a doctor.
Diagnosis of gestosis
The reason for assuming such a diagnosis is the presence of the described symptoms in a pregnant woman. The doctor conducts regular examinations and weighs the patient to exclude the presence of edema. Diagnosis of gestosis is carried out taking into account the results general analyzes urine and blood. Constant measurement of blood pressure allows you to determine the presence of problems in this area. Also, to make a correct diagnosis, it is determined daily diuresis
, for which it is necessary to find out the ratio of the liquid that was drunk and the one that is released. As a rule, the diagnosis of “preeclampsia” is made in the presence of three symptoms: swelling
, protein in urine
And high blood pressure
.
If a woman does not have visible swelling, but the weight is gaining too quickly, then the doctor may perform McClure-Aldrich test . To do this, a saline solution is injected under the skin and it is determined how long it will take for the papule to resolve. If this happens faster than thirty-five minutes, there is hidden swelling in the body.
Treatment of gestosis
If a specialist determines only minor swelling of the legs in a pregnant woman, then treatment can be carried out on an outpatient basis. If there is significant swelling and protein in the urine, hospitalization is necessary and hospital treatment. With severe gestosis, there is a threat to the life of the mother and fetus. Therefore, treatment is carried out in the intensive care unit or intensive care unit.
Before prescribing treatment, it is mandatory for women to be examined in the hospital, including blood and urine tests, examination of the condition of the fetus by Ultrasound , cardiotocography And dopplerometry .
In the treatment process, infusion therapy is used to restore required quantity fluid in the vascular bed and removal of fluid from body tissues. It is also important to replace lost protein. In the presence of high blood pressure, it is used sexually transmitted infections. To prevent the development of gestosis, it is extremely important for pregnant women to constantly monitor their own weight. To do this, you should not overeat, you should eat food that has a high protein content, and significantly limit sweets and starchy foods in the menu. It is very important to consume a sufficient amount of fiber, which is found in vegetables, bran, fruits, and herbs. Women who notice that they have gained significant weight should limit their intake of spicy, salty and liquid foods. So, you should drink no more than 1-1.5 liters per day. An important factor Prevention of gestosis is full sleep (at least eight hours a day), a positive emotional background.
Another method of preventing gestosis is considered to be active image life. Pregnant women are recommended to take daily walks, swimming, yoga, and perform specially designed exercises for a certain period.
Preeclampsia is a disease during pregnancy that occurs in later months. This complication, which can be called “late toxicosis”, is now renamed gestosis.
What causes various premature births?
Treatment traditional methods development
inside plan shot
With this disease, the vital functions of the whole body work in a weakened mode. Preeclampsia usually appears in the second half of pregnancy. With this complication, the functioning of the kidneys, brain, and blood vessels significantly deteriorates.
Don’t think that gestosis in the second half of pregnancy is a joke. It occurs in one third of women. The difference from ordinary toxicosis is the timing. Early toxicosis occurs in the first weeks of pregnancy. And late gestosis occurs after the 35th week of pregnancy and later. If this happens earlier, for example, from 21 weeks, this is an alarm, because the treatment will be long.
Reasons for pregnancy
What causes this problem?
Let's consider the causes of this pathology.
- Much depends on the placenta. During pregnancy, very small holes form in it, allowing blood plasma and fluid to enter the tissue. This leads to swelling and weight gain.
- Kidneys. Microholes also form in them, through which protein escapes along with urine. And the more protein goes away, the worse your condition. The doctor takes a urine test, thanks to which the correct diagnosis can be established.
- The relationships between the cortex formations of the brain are disrupted. This leads to violations of cardio-vascular system, as well as poor blood circulation. As a result, the pressure will jump, and you will feel nausea and headaches.
- Heredity. If anyone in your family has had gestosis, you may be at risk for this disease.
- The influence of hormones.
You may have several reasons together. Which people can be susceptible to gestosis during pregnancy?
- With pathologies of the cardiovascular system.
- With endocrine diseases.
- With kidney and liver diseases.
- Women susceptible to depression and stress.
- Smoking, drinking.
- Obese people.
- Girls under 18 years old.
- Women over 35.
- Girls who often had abortions, or those who give birth too often.
- If you have already had this disease.
- If you are expecting twins.
- Poor environmental conditions.
- Women having their first pregnancy.
Symptoms of toxicosis may vary
Main signs of pathology
What are the signs of gestosis during pregnancy? There are 5 main manifestations.
- Protein in the urine or proteinuria. From the kidneys, through the vessels, the protein enters the urine. Due to blockage of some vessels, blood stops flowing through them and the vessels narrow. The result is high blood pressure. Narrow vessels provoke oxygen starvation of the entire body and organs. This especially affects the liver, kidneys, brain, and placenta. As a result, the fetus cannot develop normally and the mother’s body suffers.
- Swelling. How can you notice or distinguish gestosis during pregnancy from ordinary normal swelling? If you notice swelling in your legs or anywhere else, don't panic right away. The main difference between gestosis is rapid weight gain. More than half a kilogram in a week. Swelling may not be visible to the eye, so try to weigh yourself regularly. However, we advise you not to immediately sound the alarm, but to consult a doctor so that he can diagnose you and prescribe treatment. If you start drinking a diuretic yourself to get rid of edema, this can harm the fetus.
- Nephropathy. When the disease occurs, the kidneys are affected, swelling appears, and the urine contains protein. This is very dangerous; if you do not see a doctor, you can lose your child.
- Preeclampsia. With this type of disease, similar symptoms appear as with nephropathy - swelling, high blood pressure and protein in the urine. Damage to the cells of the nervous system is added, which is very dangerous. This occurs in 5-6% of women. In this case, you will feel severe headaches, nausea, and heaviness in the back of your head. Further symptoms: vomiting, lack of understanding of what is happening. May prevent blood from flowing to the brain. Therefore, always consult a doctor.
- The rarest case is eclampsia. Includes all of the above symptoms. Convulsions of the whole body are added, which can lead to cerebral hemorrhage and stroke. May lead to the death of a child.
Impact of the disease on the child
One of the consequences is premature birth
Preeclampsia, which occurs in the second half of pregnancy, affects the development of the fetus.
Let's consider the main consequences:
- premature birth;
- lack of oxygen supplied to the child;
- developmental delay.
- The very first thing to do is consult a doctor. If you notice symptoms of gestosis, go to the doctor immediately. You must understand the seriousness of the disease.
- You don't have to ever eat everything you want. Try to minimize your consumption of salty, fatty, fried foods.
- Try to move more.
- Follow your doctor's recommendations.
To identify gestosis during pregnancy, you need to know your symptoms. You will need to pass a general and biochemical urine test, because it is by the protein content that you can determine gestosis, and also pay attention to blood clotting.
Be sure to measure your weight to notice a significant weight gain, which will also indicate violations. Typically, a woman should gain weight up to 350-370 grams.
You need to constantly measure your blood pressure. As scientists note, with this disorder there will be different pressures on the two hands. And it will be increased. Blood pressure will help you see the condition of your blood vessels.
The main thing is to regularly donate blood, urine, and go to the antenatal clinic.
Methods of treatment and prevention
Treatment of gestosis during pregnancy consists of using droppers with medications that will help restore the necessary fluid in the body, as well as restore lost protein. If you just have swelling, then you can take medications prescribed by your doctor at home.
Only a doctor should prescribe treatment for you
Sedatives are prescribed. With the help of medications, the functioning of all important organs of a woman is restored.
And with other forms, you need to stay in a hospital, where, if necessary, you will be provided urgent help. Doctors will also ensure that the birth is carried out on time. Perhaps it will be premature birth. In order not to expose either the woman or the child to danger, it is carried out C-section.
But always remember, only a doctor can prescribe treatment for you, never self-medicate. How can prevention of gestosis help during pregnancy? You can try to prevent this disease by following a few rules.
- Don't eat too much. No need to eat fatty, too salty, fried foods. Don't think that the more you eat, the better it is for your baby, it's not true. This can lead to gestosis or obesity.
- Eat protein foods - this is extremely important. It is best if it is veal or chicken. Try to boil them. And also eat eggs, cottage cheese, various types of fish.
- Remember that salt during pregnancy is very dangerous. If you constantly want pickles, humble yourself so as not to harm either yourself or your child. This includes salted nuts and herring.
- Eat plenty of fruits instead of sweets. Try to give up sweets, especially baked goods. On the contrary, fruits will enrich your body with vitamins and strengthen your immune system.
- Fiber is very important for pregnant women. It can be bought in the store in dry form and added to kefir. It is found in the following products: carrots, beets, mushrooms, fruits, seaweed, bran.
- Walk, walk fresh air, it is very beneficial for your body. Ventilate the room as often as possible, but be careful not to let it get drafty.
With these tips, you can prevent complications.
Traditional methods of treatment
Recipes help with problems traditional medicine. Let's look at the most effective of them.
Before use traditional methods, consult
For the first recipe you will need:
- cranberry;
- semolina;
- sugar.
Cooking method.
- Take 70 grams of cranberries and wash them.
- Press through a strainer.
- Pour boiling water – 200 ml.
- Place on the fire and cook for 7 minutes. We filter.
- Add 1 spoon of semolina and boil for 20 minutes.
- Add 3 tablespoons of sugar to the resulting broth and bring to a boil.
- Let cool and drink the mousse.
Helps against swelling of dried apricots.
Cooking method.
- Let's take it a small amount of dried apricots.
- Pour boiling water over it and let it brew overnight in a warm place.
- You need to drink half an hour before breakfast.
Very good method avoid swelling - legs up.
- Every day you need to lie on your back and raise your legs up.
- Lie like this for 15 minutes. Thanks to this, blood circulation improves and there will be no swelling of the legs.
What's next? You may think that the next pregnancy after gestosis will proceed the same way. But not necessarily!
Before getting pregnant again, try to rest, boost your immunity, take vitamins, eat more vegetables and fruits. Get tested.
And, most importantly, during pregnancy, from the first days, consult a doctor on every issue, try to monitor your weight, and regularly take blood and urine tests. Watch your diet, take vitamins, not too much liquid, less salt, fatty foods, and sweets. Take a walk, breathe fresh air. Take medications that lower blood pressure and cope with swelling.
Let's look at the reviews of people who suffered from gestosis.
Lena Marinkova:
Towards the end of my pregnancy I was diagnosed with gestosis. I was terrified because I had read all sorts of scary things on the Internet. My arms and legs were very swollen. The doctor prescribed me a diuretic, put on a bunch of IVs, and the doctor also told me to eat everything without salt. This of course was torture for me. Labor had to be started using stimulation. Everything went well, I gave birth to a normal, healthy baby. My daughter’s weight was 2,800, so they kept us in the hospital for a little while. I'm so glad everything turned out okay. So don't be afraid if they tell you gestosis.
Alisa Mironova:
At week 38, my blood pressure was very high, my legs were swelling, and tests showed protein. I was immediately put on safekeeping. Well it was a little easier. They gave me IVs there, gave me some kind of drug, and constantly measured my blood pressure. I gained a lot of weight, although I tried not to eat a lot of flour and limited salty foods. I gave birth on time, by cesarean section, so that there would be no complications, and that everything would be fine with me and the baby. The weight was wonderful - 3300, I couldn’t believe my luck.
Be healthy, always monitor your condition so that there are no complications. Best wishes! Also find out why and what the norm is.
What it is? Gestosis during pregnancy is pathological condition an organism in which the functions of vital organs are disrupted and which is extremely difficult to control if it has entered an advanced stage.
The disease occurs mainly in the third trimester and has another name - late toxicosis. However, it differs from the classic ailment in the form of nausea and vomiting in that it entails dysfunction of the cardiovascular and endocrine systems, damage to the central nervous system as a result of spasm of blood vessels.
The prevalence reaches 30%; the situation is further complicated by the fact that gestosis in the first half of pregnancy is very difficult to detect in the initial stages of development. For example, late toxicosis, which began at 20 weeks, is detected only by 27–28 weeks.
What is the danger of gestosis?
Until now, despite the development of medicine, gestosis remains one of the main causes of maternal and infant mortality in the prenatal and postpartum period. It does not kill instantly, but contributes to the rapid decline of the body over several days.
The patient may lose vision, the ability to move independently, and one by one important organs stop functioning: liver, kidneys, heart, brain. The more serious the stage of gestosis, the less chance doctors have to save the patient and (or) her child.
Only close attention to the deterioration of your health and timely examination will help identify late toxicosis in early stages its development and avoid mortal risk.
Causes of gestosis
Scientists have not yet reliably determined what exactly causes the development of late toxicosis. There are only some assumptions about this:
- Pathological changes in the central nervous system. The relationship between the cerebral cortex and subcortical structures is disrupted, which leads to pathology. The trigger mechanism is psychological stress to which a woman could be exposed while carrying a child.
- Immune disorders, in particular, failures in the recognition of maternal tissue and fetal tissue. This process involves special T cells, which are regulators of the immune response.
- Crashes in endocrine system. Pregnancy involves dramatic changes in hormonal status, which can result in disruptions in the functioning of a woman’s entire body.
- Lack of folic acid. This provokes an increase in the level of non-proteinogenic amino acids, which are extremely toxic to the body.
Preeclampsia, a complication of pregnancy, involves spasm of all blood vessels - this is what causes the failure of vital organs.
Symptoms of gestosis during pregnancy by stage
There are several classifications of late toxicosis, but doctors in Russia identify 4 main stages in the development of the disease, each of which is characterized by certain clinical manifestations.
Dropsy
Not characterized enough good hatching fluids from the body resulting in swelling. This stage is divided into 4 stages, which are characterized by the ascending direction of localization of edema:
- The feet swell, and there is slight swelling of the legs.
- The legs swell completely, the lower third of the abdomen swells.
- The swelling rises higher and affects the face, in addition to the legs and body.
- Edema affects the entire body and is observed in internal organs.
Characteristic signs of edema
- When you press your finger on the surface of the skin, a dent remains. The longer it takes to disappear, the more severe the swelling becomes.
- There is tingling and numbness in the swollen limb.
- Severe swelling causes a feeling of fatigue in a pregnant woman.
These are the most early symptoms gestosis during pregnancy - if doctors prescribe the necessary therapy to a woman, then late toxicosis will not develop further.
Nephropathy
If, when swelling appears, no therapeutic measures was not accepted, then the disease progresses and enters the stage of nephropathy. In addition to fluid retention, hypertension appears in the body, and urine tests indicate an increase in protein.
All these symptoms will be noticeable to the doctor if the patient visits the antenatal clinic at least once every 2 weeks and regularly tests necessary tests. Nephropathy has several degrees, which have certain symptoms:
- I degree - the pressure does not exceed 150/90, and the distance from the upper to the lower limit should be normal. A urine test reveals protein of no more than 1 g/l. There is swelling of the lower extremities.
- II degree – pressure does not exceed 170/100, protein in the urine increases and begins to reach 3 g/l. Edema spreads not only to the lower extremities, but also to the lower third of the abdominal wall.
- III degree – pressure above 170/110, protein in urine exceeds 3 g/l, edema spreads throughout the body, edema is detected internal organs.
Nephropathy, especially its severe degree, cannot go unnoticed, and the pregnant woman will be forced to go to the hospital due to the deterioration of her condition.
Preeclampsia
In some cases, stage III nephropathy, despite treatment, develops into preeclampsia. The main difference between this condition and nephropathy is that the pregnant woman has a circulatory disorder in the brain.
There is a real threat to the life of the mother and fetus, which requires immediate hospitalization. Among the signs severe gestosis During pregnancy, the following can be distinguished:
- Confusion
- Headache
- Loss of vision and/or hearing
- Feeling of heaviness in the back of the head
- Manifestations of sclerosis
- Hemorrhages in the walls of vital organs
- Vomit
If a woman in this condition is left without medical care, she will die. Preeclampsia involves placing the patient in an intensive care unit, since her well-being must be monitored around the clock.
Eclampsia
It is considered the most severe degree of gestosis of pregnancy, in which even emergency and highly qualified care does not guarantee that the woman will survive. Some doctors are inclined to consider preeclampsia initial stage eclampsia.
Eclampsia involves worsening the manifestations of nephropathy and a rather weak response of the body to the measures taken to save the patient’s life.
Characteristic signs of eclampsia
- Loss of consciousness
- Tonic convulsions
- Clonus
- Severe weakness
- Strong headache
- Extensive swelling of internal organs (most often the brain)
- Blood pressure above 170/110
Eclampsia does not occur suddenly, so if you respond promptly to worsening health and test results, you can successfully prevent this condition.
Treatment of gestosis by stages - drugs, regimens
For each stage of gestosis in the third trimester of pregnancy, the doctor selects appropriate therapy. For diagnosis, the results of urine and blood tests, blood pressure indicators, body weight indicators (over several weeks), and fundus examinations are used.
Treatment of stage I of gestosis (edema)
The main reason for the appearance of edema is the delay in the removal of fluid from the body. Traditionally, Russian obstetricians and gynecologists practice strict control over fluid intake and significant limitation of its volume.
- The results of such a “diet” are not always noticeable: the pregnant woman is constantly thirsty, and existing swelling goes away too slowly. However, no new ones are formed.
Gradually, our doctors began to adopt the experience of Western specialists: a pregnant woman is allowed to drink as much as she wants, but with one condition - all the liquid consumed must have a pronounced diuretic effect. This could be cranberry juice or brewed lingonberry leaves. This method of treating gestosis is much easier to tolerate, and it gets rid of edema much faster.
Except natural remedies Your doctor may prescribe diuretics:
- Canephron is available in the form of drops, as well as in the form of dragees. Dilates renal vessels, prevents excess fluid absorption. Reduces protein excretion in urine.
- Cyston - increases blood supply to the epithelial tissue of the urinary system, has an antibacterial and diuretic effect. Available in tablet form.
- Phytolysin – promotes relaxation of smooth muscles, has an anti-inflammatory and diuretic effect. It is produced in the form of a special paste from which a suspension must be made.
In case of severe edema, hospitalization and treatment in a hospital setting are indicated for a pregnant woman.
Treatment of stage II gestosis (nephropathy)
Nephropathy involves a combination of edema and increased blood pressure. Consequently, therapy that helps normalize blood pressure is added to the treatment of fluid retention in the body.
Since the pressure surge can occur repeatedly and within short term, the pregnant woman should be admitted to the hospital to monitor her blood pressure around the clock, as well as monitor her kidney function. To stabilize the condition, the following will be prescribed:
- Complete peace. Physical effort provokes a rise in blood pressure, so the woman needs to remain in bed for several days.
- Taking sedatives. They help lower blood pressure, but during pregnancy some of them can have an abortifacient effect, so you should not choose a sedative yourself.
- A diet whose goal is to reduce salt and fluid intake, as well as normalize the ratio of proteins, fats and carbohydrates in the diet.
- Taking antispasmodics. Since late toxicosis is based on vasospasm, it is important to prevent it. IN otherwise the symptoms of placental gestosis will worsen. During pregnancy, drugs such as No-shpa and papaverine are allowed.
- Taking protein drugs. Nephropathy involves increased leaching of protein from the body, so the doctor’s task is to increase its levels.
Comprehensive timely treatment of gestosis during pregnancy at the stage of nephropathy, in most cases, gives a positive effect and stops further progression of late toxicosis.
Treatment of stages III and IV of gestosis (preeclampsia and eclampsia)
Both of these diseases involve serious dysfunction of the kidneys, liver, heart, brain, as well as large blood vessels of the placenta, so this stage of gestosis most often has consequences for the child.
If the pregnancy has reached the period at which the fetus can be born viable, then the mother undergoes an emergency caesarean section.
To stabilize the patient's condition, the following measures are taken:
- Intravenous drip administration of magnesium, rheopolyglucin, glucose and diuretics, which should relieve the woman of edema.
- Complete rest and strict bed rest. As a rule, with eclampsia the patient feels so weak that she is unable to get out of bed on her own.
- Administration of anticonvulsants if the patient experiences tonic seizures.
- Hourly monitoring of protein levels in urine. Since the woman is not able to take the test herself, a catheter is inserted into the urethra.
- Connection to the artificial lung ventilation system.
- Taking strong sedatives to normalize blood pressure and prevent new seizures.
Emergency delivery should be carried out only when convulsive contractions have been stopped and relative stabilization of blood pressure has been achieved.
Pregnancy after mild forms of gestosis should proceed under close medical supervision. Since the exact causes of late toxicosis are unknown, it is difficult to determine specific preventive measures that would protect the pregnant woman from developing this disease.
- Most the right way protect yourself from preeclampsia and eclampsia - timely treatment for early stages gestosis.
Usually, early gestosis is usually called toxicosis of pregnant women; these are its classic symptoms with nausea and vomiting, intolerance to strong odors, weakness and severe drowsiness. However, doctors consider toxicosis to be not as dangerous for the fetus as the development of so-called late gestosis.
Pregnancy gestosis or toxicosis are painful changes during pregnancy caused by hormonal fluctuations, various pathologies and diseases. According to the time when a problem may occur, it is allocated early gestosis during pregnancy and late.
Causes of gestosis in pregnant women
Although the manifestations of gestosis have been studied for a long time, until today it has not been possible to identify the exact causes of this pathology. Pregnant women with disorders of the nervous system and brain, problems with the heart and blood pressure often suffer from gestosis. Connections with kidney pathologies and the development of gestosis, with the presence of allergies, endocrine and metabolic failures, as well as the presence of bad habits before conception.
Very young expectant mothers or older mothers often suffer from gestosis - this is explained either by immaturity or age-related changes bodies, as well as those who are carrying twins, who have excess weight and blood pressure, or who in the female line also had gestosis in their family.
According to the severity of manifestations and the severity of the course, it is customary to distinguish three degrees in late gestosis.
1st degree gestosis during pregnancy
Usually mild gestosis during pregnancy is called dropsy of pregnancy. These are initial, relatively mild manifestations. At the same time, pronounced, quite serious edema forms throughout the body and leads to large increases in body weight. Swelling is visible on the limbs, on the body and even on the face; they intensify in the evening, progress and are difficult to correct. Against the background of dropsy, the phenomena of nephropathy may occur - damage to the kidneys when they cannot cope with their tasks.
Gestosis 2nd degree during pregnancy
It is the development of nephropathy (kidney damage) with the progression of edema and increased blood pressure, the manifestation of protein in the urine that is already classified as severe gestosis. Such changes indicate that the body cannot cope with the stress that pregnancy places on it and is malfunctioning. Gradually, as the process progresses, extremely severe manifestations of gestosis may occur - preeclampsia and eclampsia. These are serious damage to the nervous system against the background of all the changes that are occurring - swelling, pressure, loss of protein by the kidneys. These changes produce the most severe and life-threatening consequences of gestosis during pregnancy.
What are the dangers of gestosis in late pregnancy?
Gestosis develops exclusively in pregnant women - they are directly related to gestation. After childbirth, gestosis usually goes away, but often, in severe cases, the consequences of gestosis remain even after childbirth. However, gestosis is dangerous during pregnancy, especially in the third trimester. They can lead to eclampsia - severe seizures that are life-threatening. With them, the pressure goes off scale, the kidneys fail, and the whole body swells. This condition requires immediate resuscitation and the birth of a baby to save both lives.
Consequences of gestosis for the mother
But often, even after delivery, as a result of severe complications of pregnancy, serious consequences of gestosis arise for the mother after childbirth. This can include severe postpartum bleeding leading to anemia, as well as complications such as the development of strokes or brain damage due to seizures, irreversible kidney damage with the development of kidney failure, visual impairment, constant headaches due to high blood pressure and much more.
Consequences of gestosis for a child
Naturally, if the mother’s condition is serious developing baby will suffer with her. The development of gestosis during pregnancy is no less dangerous and has consequences for the child. Naturally, the most dangerous complication will be fetal death fetus as a result of hypoxia and nutritional deficiency. This occurs due to severe swelling of the placenta or its detachment, bleeding and premature birth.
The influence of gestosis in the mother on the development of the fetus is pronounced. Such children are weakened, they suffer from chronic hypoxia, are stunted in growth and development, and can often be ill for a long time after birth.
Considering the need to carry out childbirth earlier in the development of pathology, we can add here another answer - why gestosis is dangerous for the fetus. When a child is born much earlier than expected, he is completely unprepared for independent life and requires special care; he may have health problems and developmental delays.
Preeclampsia in pregnant women usually occurs in the second half of pregnancy. Due to physical changes in the body during this crucial period for a woman, the functioning of the most important organs and systems becomes abnormal. Edema is an alarming signal of the presence of gestosis. The peculiarity of the course of gestosis is that its presence often does not cause harm to the body in the first stages. Early detection of this problem is one of the tasks of an obstetrician-gynecologist who monitors a woman’s pregnancy in antenatal clinic. The diagnosis of “preeclampsia” is made based on speed dial weight.
Since swelling is quite common among pregnant women, many of them no longer pay attention to it, considering the presence of edema to be normal in their condition. However, indifference during pregnancy is unacceptable: the gradual accumulation of fluid in all tissues of the expectant mother’s body threatens the unborn child, since excess fluid ends up in the placenta. If protein is present in the urine analysis of a pregnant woman, this becomes evidence of impaired kidney function. This is how gestosis shows its second “face”. Abnormal functioning of organs cannot but have a negative impact on the circulatory system. So, the third signal indicating the presence of gestosis is increased blood pressure.
To prescribe treatment, for an experienced gynecologist, the presence of even one symptom is enough, because the further development of gestosis is impossible to predict. Of course, the disease may not progress beyond edema and high blood pressure in its development, but you should not count on this. In some cases, gestosis can provoke convulsive attacks and even completely disrupt the functioning of internal organs. Naturally, this is very dangerous both for the expectant mother and for the fetus developing in her womb. There are different pathological cases: bleeding, detachment of a healthy placenta, hypoxia, fetal death. That is why it is necessary to start fighting this disease as early as possible.
What is gestosis in pregnant women?
Preeclampsia today is understood as a phenomenon previously called late toxicosis. Developing in approximately 16% of the total number of all pregnancies, it took 2nd - 3rd place among the various causes of death of expectant mothers, thereby becoming the cause of illness and death in newborns. Risk factors for the development of gestosis are:
- the presence of gestosis during a previous pregnancy;
- pregnant woman’s age 20 – 35 years;
- first pregnancy or pregnancy from a new sexual partner;
- multiple pregnancy;
- hereditary predisposition;
- chronic infections, stress, intoxication;
- bad habits.
Preeclampsia in pregnant women
- Early gestosis, observed, as a rule, in the first trimester. It is also called early toxicosis, since it is accompanied by vomiting of varying complexity.
- Late gestosis, starting in the second half of pregnancy, occurs with edema and high blood pressure. Protein is observed in the blood test.
- A rare form of the disease. Can occur at any stage of pregnancy. In addition to the main symptoms, it is accompanied by dermatosis, asthma, jaundice, psychopathy and other diseases.
Preeclampsia manifests itself in four degrees of severity:
- Dropsy of pregnancy. Swelling, first appearing on the knees, gradually spreads to the thighs, abdomen, face and body. If your weight gain is more than 300 g per week, or your weight is constantly changing, you should think about the possible formation of edema.
- Nephropathy. Its nature is an increase in blood pressure, as well as the appearance of protein in the urine during swelling that precedes the development of these pathologies. Often a woman does not complain about anything. In severe cases, nephropathy can progress to the next degree.
- Preeclampsia. Its manifestations are similar to nephropathy, but complications include damage to the central nervous system. A pregnant woman may notice spots before her eyes, experience abdominal pain and headache. These symptoms pose a serious threat to a woman’s health, indicating the development of cerebral edema. If appropriate measures are not taken in time, the disease will quickly progress to the next stage.
- Eclampsia is characterized by the appearance of seizures and loss of consciousness. In this case, it is advisable to resort to emergency delivery for the benefit of the mother and her child.
Symptoms of gestosis
The symptoms of gestosis are quite varied. The first manifestations of late toxicosis can be observed at 28–29 weeks of pregnancy. This is mainly swelling of the limbs and face. This “dropsy” is considered the mildest manifestation of gestosis. In the absence of pronounced expression, a woman may not even pay attention to these changes. In order to determine the presence or absence of edema, it is necessary to carefully monitor your weight gain during pregnancy at all stages. An increase of 350–500 g per week is considered normal, no earlier than from the 28th week of pregnancy. When this range is exceeded, it may indicate fluid retention in the body, causing dropsy.
Nephropathy, affecting the parenchyma and glomerular apparatus of the kidneys, is a more severe manifestation of gestosis. Here, edema is already pronounced, blood pressure is elevated and protein is present in the urine, the amount of which determines the prognosis of the disease. The main symptom of progressive nephropathy is a small amount of urine excreted. On this very danger sign A pregnant woman should pay attention first. An approximate scheme for the development of gestosis here is as follows: edema - blood pressure - proteinuria (protein in the urine). Stages 3 and 4 of gestosis discussed above are the most dangerous. Therefore, having noticed even the most minimal manifestations of the disease, a pregnant woman should contact the gynecologist who is observing her as soon as possible and paint an accurate picture of what is happening.
Mechanism of development of gestosis
Since the causes of gestosis are quite diverse, scientists have developed several theories for the development of this pathology. According to one of them, the disease is caused by disharmony of the cerebral cortex and subcortical formations. This is manifested by reflex changes in the vascular system and impaired blood circulation. An important prerequisite for the development of gestosis is a violation of the hormonal regulation of functions important for human life organs and systems. An important role in the development of gestosis is played by the immunological incompatibility of maternal tissues with fetal tissues. Most scientists agree with the opinion about the role of hereditary predisposition in the occurrence of gestosis. But most researchers have a different opinion, from which it follows that there is no single mechanism for the development of gestosis. But the combined effect of various damaging factors on the development of this pathology is quite possible.
Considering all possible mechanisms for the development of gestosis, importance must also be given to the spasm of all blood vessels, leading to impaired circulation in tissues and organs with a disorder of their functions. High blood pressure just reflects vasospasm. Damage to the endothelium, the inner layer of blood vessels, also deserves special attention. This phenomenon causes a decrease in the endothelium of the synthesis of substances that affect vascular tone, as well as the blood coagulation system, with a simultaneous change in the sensitivity of the vascular wall to them.
Preeclampsia is accompanied by severe kidney disorders, which manifest themselves in different ways - from the appearance of protein in the urine to acute renal failure. With gestosis, the liver also ceases to perform its functions normally: circulatory disorders in the liver tissues occur, dead areas appear, and hemorrhages occur. The brain of a pregnant woman undergoes structural and functional changes for the worse:
- microcirculation is disrupted;
- blood clots appear in the vessels, accompanied by the development of dystrophic changes in nerve cells;
- pinpoint or small focal hemorrhages occur;
- edema is accompanied by increased intracranial pressure.
With gestosis in pregnant women, pronounced changes in the placenta are observed, which are the cause of the development of a chronic form of hypoxia and delayed fetal development. All these changes are accompanied by a decrease in fetal-placental blood flow.
Diagnosis of gestosis
If gestosis is suspected, in order to make an accurate diagnosis, the pregnant woman must undergo general and biochemical urine tests to determine the protein in her daily norm, as well as to check the number of platelets and the condition of the entire blood coagulation system. The detection of edema is facilitated by continuous monitoring of body weight, and the state of the vascular system and the level of blood pressure are judged by pressure, which must be measured on both arms. Of particular value to diagnostic study involves an examination of the fundus by an ophthalmologist, as well as an ultrasound of the fetus to detect hypoxia. Pregnancy requires every woman to regularly donate urine and blood, weigh herself and measure blood pressure. However, women who are at risk deserve close attention from doctors: primiparas, carrying multiple fetuses, over 35 years of age, carriers of sexually transmitted infections and those suffering from chronic diseases.
Treatment of gestosis
The essence of treatment for gestosis is to restore the normal state women's health. In the second half of pregnancy, in case of development of gestosis, the main rule of behavior is timely contact with a specialist without attempts at self-treatment. Correct treatment of gestosis can only be prescribed by a doctor, taking into account the fact that some medications, as a result of their use, can further aggravate the condition of the pregnant woman and the fetus she is carrying. An example is a situation where a pregnant woman, wanting to get rid of edema, on the advice of relatives, begins to take diuretic pills. However positive result she will not be able to achieve this, since the cause of edema here is pathological vascular permeability. This incorrect approach to treatment worsens the condition even more.
All doctor's instructions can be easily followed in home environment if gestosis is mild. However, severe forms require observation by hospital specialists, where they will promptly provide any medical care. Timely delivery is also an important stage in the treatment of gestosis. If the pregnant woman’s condition does not improve, fetal hypoxia is detected, and there is no effect of therapy, childbirth becomes the only way out in this situation. With mild forms of gestosis, the birth of a child naturally quite realistic, however, there is a risk of deterioration of the woman’s condition during pushing with an increase in the load on the mother’s body. In most cases, a caesarean section is performed, especially in cases of renal or liver failure, stroke, eclampsia and retinal detachment.
Carrying out preventive measures for gestosis is important point, since complete recovery from of this disease does not seem possible. The goal here is to prevent the condition from getting worse. The main thing is timely detection. Pregnant women should approach all tests and examinations in the office responsibly in order to monitor the progress of pregnancy.
While in " interesting position“, even if it proceeds normally, it is important to properly develop a diet and stick to it. So, fiber and proteins should predominate in food products, but it is advisable to reduce the consumption of fatty and floury foods. Pregnant women should stay in the fresh air as much as possible, but walking should not be tiring. A “gestational” pregnant woman will help not only herself, but also the baby growing inside her, since these measures help improve blood supply to tissues and reduce hypoxia.
From all of the above, it follows that not a single expectant mother is immune from the development of gestosis, but protection from its dangerous complications is quite possible. To do this, you just need to take good care of your health, listening to the slightest changes in it, and also feel full responsibility for both your own and the health of the unborn baby.
