Gestosis (late toxicosis) in pregnant women: signs, degrees, consequences, treatment

Any woman who has given birth is familiar with some of the features of the course of pregnancy and the main stages of monitoring it: regular visits to a medical facility, testing, ultrasound examinations, weighing. Some people are surprised by the need to control weight. Like, why should medical workers care about the future figure of a pregnant woman? Any diagnostic procedure has a meaning and is conditioned by something.

How many kilograms should a woman's weight increase during pregnancy? Many will answer the question correctly - about 10 kg. What if it’s 20–25? Such an increase “speaks” of hidden (and not only) edema. And swelling is gestosis. For women, this disease is more commonly known as late toxicosis.

Edema is one of the diagnostic signs of gestosis, but the pathology is not limited to them. Gestosis passes more easily in healthy women. In this case it is called “pure”. This type of disease occurs in 30% of pregnant women. If it develops against the background of existing diseases (hypertension, diabetes, gastrointestinal ailments, kidney diseases), then in this case they speak of “combined” gestosis. It is clear that the latter form is more difficult.

The first signs of possible gestosis

This pathology concerns only pregnant women - after childbirth, gestosis goes away. However, gestosis is classified as dangerous disease. Its cunning lies in its complications. A quarter of female deaths during pregnancy are due to gestosis. The fetus dies 3-4 times more often than during an uncomplicated pregnancy.

The main cause of gestosis is a dysregulation of blood vessels, resulting in their spasm. Microvessels are mainly affected.

As for the pathogenesis of gestosis: many scientists see its connection with immune factors. Fetal antigens influence maternal antibody production. In turn, antibodies cause the formation of excess immune complexes, which have Negative influence on the pregnant woman's body.

How does gestosis manifest?

The disease is often called OPG-preeclampsia. OPG – the first letters of the terms: edema, proteinuria, . These are the main signs of pathology. The entire complex is not always noted. Mild gestosis can occur with one or two of the listed symptoms.

OPG complex of symptoms

Swelling is more common in pregnant women. A woman drinks a lot of fluid, which cannot completely leave the body and lingers in the interstitial space. Only the lower extremities may swell, but in more severe forms, the entire body may swell. Swelling is not always noticeable. Sometimes we are talking about a hidden form. It is detected by weighing. A weight gain of more than 0.5 kg per week indicates an emerging problem. Monitoring of fluid intake and amount of urine excreted is prescribed. If, during normal drinking conditions, less than 0.8 liters of urine is excreted, preeclampsia can be suspected.

Hypertension develops against the background of fluid retention. Blood pressure is monitored at every doctor's visit. Pressure during gestosis exceeds the norm by 15–20%. What pressure is considered normal? Usually it is 120/80. However, if a woman had symptoms at the beginning of pregnancy, then even the generally accepted norm for her may already be a signal for further examination.

Proteinuria refers to the excretion of protein in the urine. This sign indicates a violation of renal activity. Therefore, it is important not to skip a diagnostic procedure such as a urine test. After 20 weeks of pregnancy, urine is examined weekly.

If a woman has two of the three signs of this disease, then treatment at home is ineffective - it is better to hospitalize the patient.

Other symptoms include headache, vomiting, nausea, heaviness in the head. In the most difficult cases - changes in consciousness and convulsions.

The manifestation of pathology in pregnant women is more likely:

• Expecting their first child;
• Having genital tract infections: chlamydia, mycoplasmosis, ureaplasmosis;
• Suffering from chronic diseases: hypertension, diabetes, kidney disease, excess weight and others;
• Expecting twins.

Classification of gestosis

One of the classifications of pathology is divided into types:

1. Early gestosis;
2. Late gestosis.

The disease becomes more severe at the end of pregnancy.

Depending on the signs and form, the disease can be divided into the following degrees of severity:

1st degree

Dropsy of pregnancy is classified as gestosis of the 1st degree. This stage is characterized only by edema of varying severity. Usually they are less pronounced in the morning, and in the evening the condition worsens.

2nd degree

With grade 2 gestosis, all three symptoms of OPG are observed. In diagnosing hypertension, the most important indicators are diastolic pressure. The fact is that it is directly related to placental blood flow: the higher the diastolic pressure, the smaller child receives oxygen. It is noteworthy that it is not so much the increase in pressure that is dangerous as its abrupt changes. This stage is especially difficult for pregnant women with concomitant diseases.

Complications develop:

• Placental abruption;
• Bleeding;
• Premature birth.

The main danger is that with complicated gestosis, the fetus is at risk of death.

Nephropathy is diagnosed simply by urine analysis. If things go wrong, it is important to monitor the condition of the fundus. Changes may indicate.

Stage 3, preeclampsia

As the condition worsens, stage 3 of gestosis develops. Pain and heaviness in the head indicate the onset of preeclampsia. Possible blurred vision, vomiting, and pain in the liver area. Memory deterioration, apathy, insomnia, irritability and other signs of changes in blood circulation in the brain are possible. Edema has a damaging effect on the liver, as evidenced by pain on the right side. There are even hemorrhages in this organ. “Floaters” and “veils” before the eyes may indicate problems with the retina.

Main signs of preeclampsia:

1. The amount of urine decreases to 0.4 liters or less;
2. Blood pressure – 160/110 or more;
3. Protein in urine;
4. Blood clotting disorder;
5. Changes in liver function;
6. Nausea, vomiting;
7. Symptoms of brain and visual disorders.

Eclampsia

An even more severe degree of gestosis is eclampsia. In addition to all the above symptoms, convulsions are added. Typically, attacks are caused by external stimuli: loud sound, bright light, stress, pain. The attack does not last long - about 2 minutes. The danger of this condition is cerebral edema and death. Despite the similarities between gestational seizures and epileptic seizures, they have a number of differences. In epilepsy, urine tests are normal, there is no hypertension, and a characteristic epileptic aura is noted before a seizure.

HELLP syndrome

One of the dangerous forms is called HELLP syndrome. Its signs include bloody vomiting, jaundice, severe coma, and liver failure. Usually observed in women who have given birth frequently. May occur even after childbirth(unlike other forms of gestosis). About 80% of women and the same number of unborn children die from this type of pathology.

The most rare forms of gestosis include:

• Eczema;
• Dermatoses;
• Bronchial asthma;
• Pregnancy itch.

Some researchers suggest that all these forms are exacerbations of pre-existing diseases in women.

With different frequencies, pregnant women may suffer from other types of gestosis:

1. Osteomalacia. Otherwise – softening of the bones. A pronounced form is rare. More often it manifests itself in tooth decay, bone pain, changes in gait, and neuralgia. The reason for this condition lies in the lack of microelements - especially calcium - and vitamins.
2. Ptyalism (salivation). It is often accompanied by vomiting. With excessive saliva production, the body becomes dehydrated, speech is impaired, and the skin and mucous membranes are irritated.
3. Hepatosis. Accompanied by jaundice. It is necessary to differentiate with hepatitis. Therefore, a thorough diagnosis is carried out, and the woman is temporarily isolated from others.
4. Liver atrophy. If such a complication occurs when early gestosis and cannot be treated, it is recommended to terminate the pregnancy.
5. HELLP syndrome is considered to be a truly rare form. Still, for most women, pregnancy ends happily - with the birth of a healthy baby.

Complications of gestosis

Mild gestosis can be almost invisible. Why get examined, let alone be hospitalized, if you feel good and nothing hurts! But I would like to emphasize that The main danger of the disease is its consequences, such as:

• Pulmonary edema;
• Hemorrhage;
• Pathology of the cardiovascular system;
• Placental abruption;
• Kidney diseases;
• Delay in child development;
• HELLP syndrome;
• Early birth;
• Liver diseases;
• Fetal hypoxia;
• Brain swelling;
• Problems with the retina of the eye;
• Stroke;
• Death of a child;
• Death of a pregnant woman.

Important! The development of dangerous stages of gestosis and their consequences can be prevented by timely diagnosis and correctly prescribed treatment.

Diagnostics

Every woman undergoes regular medical examination during pregnancy; if alarming symptoms appear, such examination is carried out unscheduled, and diagnostic procedures are added.

TO necessary research relate:

1. Weighing. In the second part of pregnancy, weight gain should not exceed 350 g per week. If a woman has gained half a kilogram or more, then additional examinations need to be carried out.
2. The need to control fluid intake. For pregnant women, the rule “2 liters or more of water per day” is not suitable. And when pronounced edema appears, its amount should not be more than 1 liter. It is also necessary to control the volume of urine excreted.
3. Carrying out a blood test. The number of platelets and red blood cells is determined. Particularly important is the indicator of platelet content and coagulation. In addition to the general one, a biochemical analysis is carried out.
4. Blood pressure control, and on each arm. May indicate the presence of gestosis a big difference in indicators on the left and right hand.
5. Analysis of urine. It is necessary to monitor the presence of protein in the urine.
6. Ultrasound of the fetus with. With the help of this study, the degree of fetal development and malnutrition is revealed.
7. Dentist examination.
8. Fundus examination. If the vessels of the fundus are changed, this may indicate problems with the vessels of the brain.

A woman should not ignore medical examinations. This is especially true for mature mothers (after 35 years) and those who are giving birth to their first child. Also, pregnant women with chronic and infectious diseases should be attentive to their health.

Successful diagnosis is the key to a properly structured treatment strategy.

Important! Not a single symptom should escape the attention of a pregnant woman. She must immediately report her suspicions to her doctor.

How to treat gestosis?

Let's say right away that Preeclampsia cannot be completely cured. It goes away with pregnancy. However, it is possible to prevent its development into more severe forms.

Main areas of treatment:

• It is necessary to create a protective treatment regime. A woman should avoid strong emotional stress, be calm and balanced. Bright light, noise, heavy physical activity that does not correspond to her condition are harmful. If gestosis is mild, then remedies such as motherwort and valerian are prescribed, and in more severe forms, they resort to individual selection of sedatives taking into account pregnancy.
• To restore the function of the pregnant woman’s body, as well as to prevent fetal hypoxia, appropriate medications. These are medications that have a sedative, hypotensive, antispasmodic, and diuretic effect. Such drugs should improve placental blood flow, preventing fetal hypoxia. In case of exacerbation of existing chronic diseases appropriate treatment is prescribed to relieve symptoms.
• The birth canal must be prepared so that delivery during gestosis can be carried out in a timely and careful manner. The timing of delivery is determined by the condition of the pregnant woman. For example, a severe form of gestosis requires delivery no later than three days after the condition worsens. If eclampsia develops, delivery should be immediate. The safest for the baby’s health is childbirth at 38 weeks of pregnancy and later, since by this time all the vital systems of the fetus have time to form. Give birth naturally or use a caesarean section? The choice depends on the condition of the fetus and the birth canal of the pregnant woman. At severe gestosis When urgent delivery is necessary, a caesarean section is performed. If childbirth occurs naturally, anesthesia is recommended. And not so much for pain relief, but to improve placental and renal circulation, as well as a slight decrease in pressure. In the case of mild gestosis, treatment is prescribed, and childbirth occurs on time naturally.

For moderate and mild forms of gestosis, women are recommended to be hospitalized in a hospital. Severe gestosis may require resuscitation. The main research procedures carried out in the hospital:

1. Conducting a general urine test, as well as a Zimnitsky test.
2. Study of the condition of the unborn child (Doppler, ultrasound, cardiotocography).
3. Coagulogram and other blood tests.

Infusion therapy is used as treatment, the task of which is to remove tissue fluid, as well as replenish its deficiency in the vessels. For hypertension it is carried out individual selection medications.

Treatment lasts from several hours to several weeks. It all depends on the severity of the condition. The more dangerous it is, the less time a woman has. Delivery is the main outcome of any treatment. Therefore, in the most severe cases, an immediate caesarean section is performed.

Principles of hexose prevention

The main task of the patient and medical workers consists of timely detection of the disease and the beginning early treatment. Therefore, it is difficult to avoid gestosis without active prevention.

Avoid obesity. During pregnancy, women sometimes gain a lot of weight. Why is this happening? There are many reasons. Firstly, hormonal changes can cause an increase in appetite. Secondly, a woman begins to allow herself to eat everything, citing the fact that her figure is already deteriorating, it won’t get any worse. Thirdly, some women are sure that you need to eat for two. If she eats as before, the baby will not get many nutrients. Unfortunately, the effect of such eating behavior is sad - obesity and gestosis.

The diet for gestosis is very simple. The fetus needs protein (the cells of the unborn child’s body will be built from it), which means that a pregnant woman’s diet should include dairy products, lean meat, eggs, and fish. An increased protein content in food is also necessary because it migrates from the body.

You need vitamins, minerals, fiber. And they are most abundant in vegetables and fruits. Fiber is especially important: with a minimum of calories, it perfectly satisfies hunger. This diet is also favorable for the gastrointestinal tract - there will be no constipation or complications such as those that often bother pregnant women. It’s good to forget about the existence of flour and sweet foods. Except excess weight, they will give nothing to either mother or child.

The maximum weight gain during the entire pregnancy should be no more than 12 kg. Women with initial underweight may gain a little more. Conversely, plump mothers are allowed to gain a maximum of 10 kg.

Proper drinking regime is very important. Despite the threat of edema, you should not limit yourself too much in water. It is recommended to consume 1 to 1.5 liters of fluid per day, this also includes fruits, soups and other foods. But you cannot retain this water with salt. No matter how much a pregnant woman would like to eat a pickled cucumber or a piece of herring, there is no need to do this. To remove excess fluid, as well as improve renal blood circulation, it is useful to drink a decoction of bearberry, rose hips, cranberry juice, kidney tea (in consultation with your doctor!). For the same purposes, the doctor may prescribe special medications: cystone, canephron, etc.

And one more, and perhaps the most important principle prevention – active lifestyle. Pregnancy is not a disease. Therefore, a pregnant woman, like any other woman, should walk, swim, do yoga for pregnant women, Pilates, and not forget about special gymnastics. The main thing is not to overdo it. It is necessary to listen to your condition and stop exercising at the slightest suspicion of its deterioration. For your peace of mind, it is better to consult a doctor once again. Physical activity should not harm a woman and her unborn child. The doctor may recommend special exercises to help get rid of certain manifestations of the pathology.

Undiagnosed and untreated gestosis is dangerous. Only an attentive attitude towards oneself will allow a woman to give birth healthy child and maintain your own health.

Video: gestosis in the cycle “Pregnancy week by week”

Preeclampsia in pregnant women is a condition of malfunction of some vital organs, which manifests itself mainly late in the 2nd-3rd trimester. What to do when it appears, causes, symptoms and preventive measures will be discussed in the article.

What is gestosis

Gestosis during pregnancy corresponds to a number of manifestations, knowing which, you can initially diagnose the disorder:

• The presence of subtle and noticeable swelling in the arms, legs, and face
• Increased levels of protein compounds in the urine, called proteinuria
• Increase in blood pressure (hypertension)

The development of gestosis negatively affects the functioning of the heart, blood vessels, thyroid gland, and central nervous system. As a result, the composition of the blood even changes. The usual timing of the disease is 18-27 weeks, which is a late period.

Pregnancy with gestosis occurs in almost 30% of women. Sometimes it leads to the death of a newborn or expectant mother Therefore, the disease must be taken seriously.

In order to detect gestosis in time, you need to monitor it characteristic manifestations appearing sequentially during the first half of gestation. During this period, the expectant mother constantly experiences nausea, vomiting, and increased salivation. It is important to understand the extent of these symptoms, as the signs “ normal toxicosis"are the norm for a pregnant woman.

In the later stages, manifestations are supplemented by nephropathy (renal damage), dropsy, preeclampsia and eclampsia. The last two points are severe forms of toxicosis. The presence of such internal disorders is reflected externally - the skin suffers, and in addition, deviations appear due to the nervous system.

Combined gestosis call the situation of manifestation of signs of hypertension, deviations in endocrine system, dysfunction of bile excretion and urine excretion. After childbirth, gestosis completely disappears.

Causes of gestosis

The disease has not yet been fully studied, the exact causes, where in the early and later Preeclampsia is taken during pregnancy and has not been detected. However, there are a number of hypotheses that help to understand it and how unpleasant sensations and fatal consequences can be avoided.

The first hypothesis is called Cortico-visceral. She claims that due to the incomplete relationship between the cortex and subcortical tissues in the brain, a pregnant woman develops a neurosis that affects some reflex functions. Many practical studies confirm this point of view, since the appearance of gestosis often correlates with severe nervous strain.

The second point of view is called immunological. Judging by it, the strong hormonal shocks experienced by a woman during pregnancy lead to the emergence of an immunological conflict between the organisms of the fetus and mother. Because of this, the blood vessels are partially subject to spasms, which leads to an increase in blood pressure above normal and reduces the ability to nourish the body’s cells with blood.

A third look examines gestosis with genetic point of view. Based on this, the complication more often appears in expectant mothers who have a mother who suffered from preeclampsia. This disorder leads to a lack of vitamin B and other microelements, which results in increased blood clot formation.

As a result, vascular microholes are formed, through which plasma protein compounds enter the blood. The endothelium, the inner lining of the vascular wall, becomes permeable, causing fluid to leak into the tissue structures. This leads to thickening of the blood, which increases clotting due to excessive thrombus formation.

The plasma that has penetrated into the vessels stagnates in them, forming edema, increasing blood pressure, and so on. At the initial stages of the development of gestosis, these symptoms are invisible, but over time, after the second trimester or earlier, they begin to appear.

The vascular walls of the kidneys also suffer from the formation of the microholes described above. Through them, the urine is saturated with protein, which can be detected by conducting an appropriate analysis. Moreover, one of the first signs is a slight decrease in the frequency of trips to the toilet by a pregnant woman.

With gestosis, disturbances in brain function increase, since due to a blood clot and minor hemorrhages, growth and deficiency of nerve tissue is observed.

First signs

Preeclampsia on early development it is hardly noticeable, its symptoms are very similar to ordinary ailments, which is not uncommon during pregnancy. It is possible to track the pathology by periodically checking the pressure (it increases slightly). Other signs include headaches in women, a state of weakness, and the urge to vomit.

Early gestosis in pregnant women has the following symptoms:

• A urine test reveals elevated protein levels. An increase in the indicator in the future means the progress of the disease.
• Increase in blood pressure above 140 to 90
• The first manifestations of edema

Symptoms of gestosis during pregnancy

At a later stage, the disease affects a significant part of the internal organs, as a result the picture of symptoms becomes clearer and more varied. Preeclampsia affects the kidneys, liver, cardiovascular and central nervous systems. Hypoxia often occurs, due to which the fetus does not develop fully under conditions of oxygen deficiency.

With gestosis (toxicosis), the first thing that occurs is vomiting, which occurs several times a day. Due to periodic nausea, there is no appetite, but there is a tendency to eat spicy and salty foods. Body weight does not change, temperature is normal. The existence of these symptoms is typical for the first months of pregnancy, after which they disappear.

However, sometimes vomiting occurs again, becoming continuous (15-20 times). After this, the patient becomes very weak, blood pressure drops below normal, and the veins become thread-like. Urine analysis shows high levels of acetone and protein. An increase in temperature and severe arrhythmia are often observed.

Photo. Symptoms of gestosis in pregnant women

In pregnant women at a late stage, in the 2nd and 3rd trimester, the development of gestosis is gradual. The disease begins with dropsy, progressing first to preeclampsia and then to eclampsia. Dropsy has symptoms of swelling due to the accumulation of fluid in the body. Edema can be hidden or visible. They are localized in the ankle area, moving upward. The face, lower abdomen, arms, and legs are susceptible to swelling. Body weight is growing at an accelerated pace.

Preeclampsia can lead to kidney nephropathy, the symptoms in this case are the same:

• Presence of edema
• Increased protein in urine

Some of the symptoms may be absent. Dropsy with nephropathy often complement each other, increasing symptoms. The whole situation threatens to insufficient oxygen supply to the fetus.

Eclampsia

This is the name of the most severe phase of gestosis. At this time, painful cramps and an acute reaction to bright light and loud sound are likely for 1-5 minutes. Further, the pregnant woman may lose consciousness, even to the point of coma. It is clear that this does not bode well. In extreme cases, the placenta detaches, internal bleeding and premature birth develop. During this period, the fetus is in a state of oxygen deficiency and is in serious danger.

The condition of eclampsia is preceded by preeclampsia when the above symptoms of gestosis are complemented by heaviness in the back of the head, painful sensations in the abdomen, blurred vision, an increase in blood pressure above 150/105, a decrease in the amount of urine excreted, abnormalities in the functioning of the liver.

Preeclampsia during pregnancy is a dangerous condition, the first symptoms of which are few and in general the pregnant woman feels well. Increased swelling and increased pressure in the later stages should be alarming. If these signs appear, you should definitely visit a gynecologist.

Diagnostics

Diagnosis begins with a survey. If the doctor suspects gestosis, the diagnosis is refuted or confirmed:

1. Coagulogram - testing blood for clotting
2. Biochemical and general analysis of blood and urine
3. Tracking changes in weight and volume of urine excreted taking into account fluid intake
4. Checking the condition of the fundus
5. Measuring blood pressure in dynamics

To clarify the well-being of the embryo during pregnancy, ultrasound examination and Dopplerography are prescribed. It is possible to involve third-party doctors, including:

• Nephrologist
• Oculist
• Neurologist

Treatment of gestosis

Regardless of whether gestosis occurs in early or late pregnancy, the best option treatment is hospitalization. Only in this case there are high chances of preserving the functionality of the mother’s body and successful childbirth. Treatment at home is allowed only in the first stage of dropsy. Nephropathy and preeclampsia require mandatory hospitalization of the pregnant woman. Emergency termination of pregnancy is performed when the patient's life is in danger.

Treatment consists of determining the condition of the vessel walls, improving blood supply and circulation by reducing its viscosity, and normalizing water-salt metabolism. You should also monitor your blood pressure and respond with medication to its fluctuations in any direction. The result of treatment is consolidated by the general normalization of metabolic processes.

The duration of treatment depends on the depth of gestosis. For mild forms, 12-15 days of inpatient therapy are sufficient. At medium degree the hospital stay will be longer. Late gestosis of severe form requires daily treatment until the baby is born.

Early birth

Premature birth is indicated in the following situations:

• When the condition fails to improve despite therapy
• If in the case of resuscitation procedures after two hours there is no expected effect
• Violations noted intrauterine formation fetus
• Increased likelihood of severe consequences

After pregnancy equator late gestosis needs constant monitoring. Independent birth is allowed only when the woman in labor is in normal condition, when there is no doubt that she has enough strength for this. Otherwise, a caesarean section is resorted to to avoid the risk.

Consequences

If pregnant women are not treated, gestosis can lead to dysfunction of the kidneys and heart muscle. In addition, the lungs swell and internal hemorrhages occur.

The main danger to the fetus is placental abruption, due to which it does not receive enough nutrients and oxygen. Even with successful resolution of pregnancy, this results in delayed development.

Prevention

If a woman in labor has diseases of internal organs, in the second trimester and later, it is important for her to adhere to the following preventive measures:

• Get enough rest and sleep
• Eat a balanced diet
• Get minimal physical activity
• Take a walk every day
• Limit salt and liquid intake

If there are factors favoring the disease, you should register with gynecology already at early and follow all instructions from the gynecologist. In order not to miss the moment of worsening the situation, you will have to periodically undergo tests. Prescription of drugs occurs individually only for concomitant diseases.

The causes of gestosis, a dangerous complication of pregnancy, have been studied for a long time. But it was not possible to fully clarify the situation. Some experts believe that gestosis is caused by hormonal processes that affect the function of internal organs. Others consider the cause of gestosis to be immunological incompatibility between the fetus and the pregnant woman. Let's take a closer look at what causes can lead to gestosis, what consequences it has for the pregnant woman and the fetus, and what treatment tactics for gestosis are used in modern conditions.

What is gestosis?

The second name for gestosis is late toxicosis. This condition occurs quite often in pregnant women; gestosis is complicated in up to 16% of all pregnancies. The time of its development is the second half of the period from the 27th week of pregnancy. The toxicosis that appears usually progresses until the very end of pregnancy, causing negative impact over the entire woman's body. Preeclampsia is manifested by dropsy, nephropathy, preeclampsia and can develop into a life-threatening condition - eclampsia.

IN last decades There has been a tendency towards an increase in cases of gestosis. This is probably due to the fact that everything more women give birth to children in quite mature age– after 35 years. And at this stage of life, most people, unfortunately, already have chronic illnesses that complicate pregnancy.

How does gestosis develop?

It is believed that the basis for the development of gestosis in pregnant women is many various factors. Scientists have already proposed several theories of its origin. One of the main versions is cortico-visceral. That is, it can be assumed that gestosis is a manifestation of pregnancy neurosis, in which the relationship between the cortex and subcortical formations in the brain is disrupted. This is manifested by reflex reactions of blood vessels and problems with blood circulation.

In the mechanism of development of late toxicosis, disturbances in the hormonal regulation of the vital functions of the body also play a significant role. In addition, with gestosis they often talk about immunological incompatibility between the pregnant woman and her child. Some scientists even believe that the likelihood of developing gestosis is associated with hereditary factors. At the same time, many experts are unanimous in their opinion: the development of gestosis is caused by a combination of certain negative factors. This means, according to scientists, there is simply no single mechanism for its appearance.

IN scientific research Preeclampsia attaches great importance to the phenomenon of generalized vasospasm. It causes serious problems with blood circulation, which makes it difficult for many internal organs to function normally. A symptom indicating such a spasm is high blood pressure. Besides, great attention is given to damage to the endothelium, which lines the vessels from the inside. The affected endothelium produces insufficient substances that regulate the activity of the coagulation system and vascular tone. In addition, the sensitivity of the vascular walls to these substances changes.
Several substances affect the tone of blood vessels. Under the influence of negative factors, the ratio of components that narrow and dilate blood vessels shifts in favor of the former. This imbalance causes spasm. In this pathological situation, the fluidity of the blood changes, it becomes more viscous, and its coagulation inside the vessels is activated. As a result, blood circulation deteriorates, the pregnant woman’s tissues do not receive enough oxygen, and blood clots form.

In this situation, the pregnant woman experiences a certain decrease in performance indicators of cardio-vascular system. First of all, this concerns the volume of circulating blood, stroke volume, as well as cardiac output. As the endothelium is damaged, the vessel walls become more permeable. Because of this, the liquid component of the blood leaves the vessels and enters adjacent tissues. This pathological process is aggravated by the lack of balance between the colloid-osmotic pressure of the plasma and the tissues surrounding the vessels. This phenomenon is caused by a drop in the concentration of proteins in the blood and the fact that sodium begins to be retained in the tissues.

One of the serious dangers of gestosis during pregnancy is improper functioning of the kidneys. Kidney problems can manifest in different ways. Many women have protein in their urine, and some develop severe kidney failure. Another manifestation of late toxicosis is impaired blood circulation in the liver, which causes hemorrhages to occur in its tissues and foci of necrosis to form. Naturally, the function of this organ suffers greatly.

In addition, with gestosis, disturbances occur in the structure and functioning of the pregnant woman’s brain. Microcirculation deteriorates in it, dystrophy increases in nerve cells, blood clots form, hemorrhages appear, and swelling develops against the background of increased intracranial pressure.

The placenta also twitches due to strong changes, which can have a bad effect on the condition of the fetus. He may experience chronic hypoxia or developmental delay. In this case, fetal-placental blood flow is disrupted.

Classification of gestosis

1. According to the time of occurrence of gestosis

Appeared during pregnancy;

Appearing during childbirth;

Appearing in the first 48 hours after birth.

2. By type of gestosis

Dropsy of pregnancy or edema of pregnancy;

Nephropathy (mild, moderate, severe);

Preeclampsia;

Eclampsia.

In foreign sources, dropsy, nephropathy and preeclampsia are combined into one concept - preeclampsia, which has 3 stages: early, moderate and severe. And eclampsia is a more severe manifestation of gestosis, which stands apart.

3. According to the degree of gestosis

I degree - mild (beginning).

II degree - average (developed).

III degree - severe (progressive).

Preeclampsia - the presence of neurological symptoms.

Eclamsia:

Convulsive;

Non-convulsive.

Assessment of the severity of gestosis in points

Edema in pregnant women

One of the first symptoms of gestosis to appear is dropsy in pregnancy. Since fluid retention occurs in the tissues, the pregnant woman develops severe edema. It is worth noting that swelling can not only be obvious. Hidden edema, a sign of which is pathological changes woman's weight. So, it may be observed too fast growth weight (more than 300 g in 7 days), or weight may increase differently every week.

As for obvious edema, according to the degree of prevalence they are classified as follows:

Edema of the 1st degree. In this case, only the legs swell.

Edema of the 2nd degree. In addition to the legs, the pregnant woman’s stomach also swells.

3rd degree. Swelling affects the legs, abdomen and face.

And finally, the 4th degree. Generalization of edema occurs. This phenomenon is called anasarca.

Since urine excretion is difficult during gestosis, too much fluid is retained in the body of a woman suffering from gestosis and extra pounds appear. Nighttime urination occurs more often than daytime urination. The first swelling occurs in the ankle area. Then the swelling rises upward. Some pregnant women experience simultaneous swelling of the face. In the morning, swelling is less pronounced, because during sleep the fluid spreads evenly throughout the woman’s body. By evening, the swelling goes down and becomes more noticeable in the lower half of the body (legs, lower abdomen).

Despite noticeable swelling, general health Most women practically do not suffer during this period. Dropsy is diagnosed after examination, weighing, and comparison of the volumes of fluid consumed and excreted by the body.

Nephropathy in pregnancy

Protein in the urine of pregnant women in the later stages indicates the development of nephropathy. Nephropathy with late toxicosis manifests itself as follows: the presence of protein in the urine of a pregnant woman, high blood pressure and swelling. In some cases, not all signs may be present, but only two of them. Most often, nephropathy appears after dropsy has developed. The woman’s blood pressure in this case reaches high values ​​(systolic more than 135 and diastolic more than 85), which is considered an important diagnostic criterion. But it is also worth taking into account the initial pressure of the pregnant woman. We can talk about arterial hypertension in a particular patient when the systolic pressure rises by at least 30 mmHg. Art., and diastolic - by at least 15. Moreover, the diastolic indicator has special meaning, since it is associated with the level of oxygen supply to the fetus and with placental blood flow.

Late toxicosis can lead to very serious consequences - untimely placental abruption, bleeding and even fetal death. These complications are associated not with the fact that the woman’s blood pressure is elevated, but with its strong changes. The appearance of protein in the urine is a typical manifestation of gestosis. A gradual increase in its level is an unfavorable sign, indicating that the disease is getting worse. In this case, the woman’s urine output is usually reduced. Its daily volume can drop to 400 ml, and sometimes it is even less. The prognosis for gestosis depends on the amount of urine - the less it is, the more severe the consequences can be. The prognosis is also related to the duration of nephropathy; if it lasts for a long time, the risk of an unfavorable pregnancy outcome increases.

The main danger of nephropathy is that it can develop into a life-threatening condition - eclampsia. Nephropathy also creates the ground for the development of other serious pathologies (premature abruption of a normally located placenta, premature birth, severe bleeding, fetal hypoxia and even its death).

Nephropathy is usually diagnosed without difficulty, since it is talked about characteristic features. One of the important criteria when examining pregnant women with nephropathy is the condition of the fundus, the vessels of which reflect the characteristics of blood circulation in the brain.

It is also important to note that the condition of the body during gestosis is aggravated by other diseases that the woman suffered from even before pregnancy occurred.

Preeclampsia in pregnancy

As gestosis progresses, preeclampsia develops. In this condition, problems arise with microcirculation in the central nervous system. At this stage of the development of the disease, new symptoms are added: blurred vision, attacks of nausea, pain in the head, hypochondrium (right), and also in the epigastrium. These discomfort may vary in intensity, it all depends on the condition of the patient’s body.

Visual impairment is manifested by a decrease in visual acuity, the appearance of “spots”, “stars” and even “veils” before the eyes. This suggests that blood circulation in the occipital regions of the cerebral cortex was disrupted, and the retina was damaged.

Epigastric symptoms are associated with the appearance of small hemorrhages in the stomach. Discomfort in the hypochondrium occurs when the Glissonian capsule is overstretched due to edema. There are also particularly severe cases when hemorrhages appear in the liver. Organ function may be seriously affected.

Due to changes in cerebral circulation, a pregnant woman may be bothered by other unpleasant phenomena: memory loss, sleep problems (insomnia or excessive sleepiness), apathy, fatigue, irritability.

Also, in the case of preeclampsia, the functioning of the coagulation system worsens, the level of platelets in the blood drops, and blood pressure reaches dangerous levels. Systolic pressure exceeds 160 mm, and diastolic pressure exceeds 110. The daily amount of urine becomes very small (less than 400 mm), and the protein concentration in it increases (from 5 g).

Eclampsia in pregnant women

With advanced gestosis, an extremely dangerous condition called eclampsia develops. Main sign onset of eclampsia - convulsive attacks. Seizures are usually associated with exposure to any external factor(fright, flash of light, knocking, loud scream, pain). The seizure lasts no more than two minutes and includes four alternating moments.

At the first stage of the attack, the facial muscles and eyelids begin to twitch slightly. The eyes stop, their gaze becomes fixed. Dilated pupils begin to deviate and disappear behind the upper eyelids. Therefore, only the whites of the eyes are visible. The mouth curves, the corners of the lips droop. The spasms spread lower and involve the arms.
Fingers curl into fists. This initial stage lasts no more than half a minute.

Then the second period begins. In this case, all muscles (including respiratory ones) are covered by tonic convulsions. The pregnant woman's head throws back, her hands continue to twitch. All muscles tense, the spine bends, the torso stretches. The patient becomes pale and clenches her teeth tightly. Breathing stops and turns blue skin. This most dangerous moment of an eclampsia attack, as a rule, lasts no more than 20 seconds. In this case, the pregnant woman may die as a result of cerebral hemorrhage.

The next stage of the attack is the appearance of clonic convulsions. They move along the body from top to bottom, following each other without interruption. There is no breathing, and the pulse is not recorded. Then the frequency of seizures decreases, they become less intense and gradually subside. At this time, you can hear the pregnant woman's deep sigh, which is accompanied by snoring. After which breathing becomes deep and rare. The duration of this phase is up to one and a half minutes, and in some cases even longer.

At the last (fourth) stage, the attack resolves. The resolution of the seizure is indicated by constriction of the pupils and pinkening of the face. In this case, bloody foam may appear at the mouth.

After the attack ends, the patient does not come to her senses immediately. And when consciousness returns to her, she cannot remember what happened during the attack. Her main complaints are a feeling of exhaustion and pain in the head. In particularly severe cases, the woman does not have time to recover when another seizure begins. Attacks can follow one after another several times. If after an attack the patient falls into a deep coma, the prognosis worsens significantly. Coma is evidence of probable hemorrhages and cerebral edema.

Sometimes eclampsia occurs without convulsions. In this case, the patient’s vision becomes dark and intense headaches occur. The patient's blood pressure rises and she falls into a coma. The risk of hemorrhage in nonconvulsive eclampsia is very high. The possibility of the patient's death cannot be ruled out.

Eclampsia should be distinguished from manifestations of epilepsy. Urine tests for epilepsy are within normal limits, blood pressure does not rise. There is an epileptic aura and an epileptic cry. In addition, anamnesis data indicate epilepsy.

To accurately establish the fact of gestosis, one consultation with a doctor, of course, will not be enough. A pregnant woman should regularly visit her gynecologist and be under dynamic supervision. During the examination, the doctor measures the woman's weight, assesses her pulse and blood pressure. Pressure exceeding 135/85 should be alarming, since this is one of the characteristic symptoms of gestosis. The pregnant woman is also examined for edema and found out whether the volume of urine excreted per day has decreased.

A urine test, as well as a blood test (general, biochemical), will help confirm/exclude gestosis. In addition, if general toxicosis is suspected, ultrasound, Doppler and cardiotocography are indicated.

If test results indicate possible gestosis, a number of additional studies are performed. The pregnant woman is prescribed an examination by other specialists (therapist, neurologist, ophthalmologist, nephrologist). It is also necessary to perform a hemostasiogram and do urine tests (for protein, according to Nechiporenko, Zimnitsky).

Complications of gestosis

Late toxicosis of pregnant women is dangerous due to the following complications:

Retinal detachment and hemorrhage in the fundus;

Heart failure, stroke, heart attack;

Brain swelling;

Pulmonary edema;

Impaired liver function, hepatic coma;

Development of renal failure;

Placental abruption;

Fetal hypoxia;

Intrauterine fetal death.

In the most severe cases, HELLP syndrome develops. The abbreviation in its name is formed as follows: H - hemolysis, EL - increase in liver enzymes, LP - drop in platelets.

Treatment of gestosis

If suspicions of gestosis are confirmed, the patient must create favorable conditions (medical and protective regime), support the function of important organs and provide qualified medical care for delivery.

If gestosis has not progressed far (1st degree), outpatient observation of the patient is possible. In other cases, pregnant women are recommended to undergo inpatient treatment in the prenatal department of the maternity hospital. In case of severe nephropathy, as well as when gestosis has reached preeclampsia or eclampsia, it is advisable to place the woman in a multidisciplinary medical institution or a specialized maternity hospital, which has an intensive care unit and a department for premature babies.

Treatment of mild gestosis

If gestosis is manifested by severe swelling and mild nephropathy, it is advisable to prescribe the following treatment:

Diuretic herbal mixture;

Vitamins A and E as antioxidants;

Drugs that improve the rheological properties of blood, they prevent dystrophic changes in the placenta, improving placental blood flow - chimes, trental;

Antispasmodic drugs (no-spa, papaverine);

For arterial hypertension, antihypertensive drugs are prescribed - aminophylline, dibazol;

Herbal sedatives, for example, tincture of motherwort or valerian.

Treatment of moderate and severe gestosis

When nephropathy is severe, preeclampsia or eclampsia develops, the woman is transferred to intensive care and a resuscitator is involved. To improve the patient's condition with metabolic disorders, a course of infusion therapy is carried out (administration of rheopolyglucin, Trisol and fresh frozen plasma). In case of advanced gestosis, it is necessary to use anticoagulants (heparin intravenously). And diuretics, for example, furosemide, will help a short time normalize water-salt metabolism in the patient’s body and remove excess water.

In addition, women suffering from gestosis, regardless of the severity of symptoms, are advised to take selective sympathomimetics (ginipral). They reduce risk premature birth and are a means of preventing fetal hypoxia.

Treatment of gestosis with folk remedies

With mild gestosis, simple folk remedies will help improve the condition. Thus, it is recommended to take lingonberry and cranberry fruit drinks, rose hips, and kidney tea. Soothing herbal remedies (for example, motherwort) can be used for preventive purposes, starting from the 14th week. But it should be remembered that with severe gestosis traditional methods are unlikely to be effective.

Method of delivery for gestosis

The method of delivery depends on the woman’s well-being and the condition of the fetus. If ultrasound and CTG confirm that the child is not suffering, a natural birth is quite possible. But in some cases, doctors decide to undergo surgery. Caesarean section is performed when gestosis is severe, treatment is ineffective, and the fetus develops hypoxia.

Therapeutic measures for late toxicosis are carried out during pregnancy, during childbirth, as well as during the recovery period after them. Preeclampsia after childbirth usually goes away on its own, but sometimes it is necessary to continue drug treatment.

Indications for delivery with gestosis

1. Mild gestosis with no effect of treatment within 12 days.

2. Moderate gestosis with no effect from treatment for 5-7 days.

3. Severe gestosis in the absence of effect from treatment within 1-2 days.

4. Preeclampsia after intensive therapy for 2-4 hours.

5. Eclampsia.

6. The appearance of complications from severe gestosis.

7. Progressive placental insufficiency accompanied by intrauterine growth retardation or hypoxia.

Prevention of gestosis

The risk group for the occurrence of gestosis includes women with the following pathologies:

Arterial hypertension and hypertension;

Diseases of the kidneys and genitourinary system;

Infectious diseases;

Diseases of the endocrine system;

Presence of chronic diseases;

Violation of fat metabolism.

This should be taken into account in order to carry out the necessary preventive measures (from the beginning of the 2nd trimester). To do this, you must, first of all, take care of your diet and proper rest.

If necessary, drug prophylaxis is prescribed. Its goal is to improve the functioning of the nervous system, kidneys, blood coagulation system, support the liver, and normalize metabolism. The duration of the medication course is usually from three weeks to a month.

Diet for gestosis

Thoughtful balanced diet can alleviate the condition of a woman with gestosis. A special diet is recommended for pregnant women suffering from dropsy. The basis of nutrition should be boiled foods with a small amount salt. Limiting salt is a very important component of such a diet. It is also necessary to avoid fried and spicy foods. The diet should be varied - you need to eat both animal and plant products. Fruits, vegetables and yogurts will be very useful.

Try not to overeat and limit the amount of liquid to one and a half liters per day; you cannot greatly limit the amount of water - this can lead to dehydration. The volume of fluid released per day should exceed the volume drunk.

Regimen for gestosis

Stressful regimen is one of the factors that worsens the course of gestosis. You need to find time to relax and try to avoid stress. Night sleep must last at least 8 hours. You can get some sleep during the day. But too calm a daily routine during gestosis is undesirable. Pregnant women will benefit from walking on fresh air, as well as special fitness and exercises for pregnant women; with the permission of a doctor, you can visit the pool during pregnancy. Spa treatment with pregnancy management is useful.

(late toxicosis of pregnancy, PTH) – pathological conditions the second half of pregnancy, characterized by a triad of main symptoms: edema (latent and visible), proteinuria (the presence of protein in the urine), hypertension (persistent increase in blood pressure). Accompanied by disorders of the functions of vital systems: cardiovascular, nervous, endocrine, hemostasis. According to the severity of the disorders, pretoxicosis, hydrops of pregnancy, nephropathy of pregnancy, preeclampsia and eclampsia are distinguished. May cause maternal and child mortality.

Late toxicosis of pregnant women is divided into pure and combined gestosis. Pure gestosis develops during pregnancy in women who do not suffer from concomitant diseases, and combined gestosis develops in women with a history of various diseases. An unfavorable course of gestosis is observed in pregnant women suffering from hypertension, renal pathology (pyelonephritis, glomerulonephritis), diseases of the biliary tract and liver (dyskenesia, previous hepatitis), endocrine glands (adrenal glands, thyroid, pancreas), lipid metabolism disorders.

Causes of gestosis

Complications of gestosis

The development of complications of gestosis is always associated with the death of the pregnant woman and the fetus. The course of gestosis can be complicated by the development of renal and heart failure, pulmonary edema, hemorrhages in the liver, adrenal glands, kidneys, intestines, spleen, and pancreas.

Characteristic complications of gestosis are premature detachment of a normally located placenta, placental insufficiency leading to developmental delay, hypoxia and fetal malnutrition. In severe cases of gestosis, HELLP syndrome may develop, the name of which is an abbreviation of the symptoms: H - hemolysis, EL - increased levels of liver enzymes, LP - decreased platelet levels.

Treatment of gestosis

The basic principles of treatment of emerging gestosis are: hospitalization and compliance with medical and protective measures, elimination of disturbances in the functioning of vital organs and systems, careful and quick delivery. Outpatient treatment of gestosis is allowed only for stage I dropsy. Pregnant women with severe gestosis (nephropathy, preeclampsia, eclampsia) are hospitalized in hospitals with an intensive care unit and a department for premature babies. In especially severe cases of gestosis, early termination of pregnancy is indicated.

Therapeutic measures for gestosis are aimed at the prevention and treatment of complicated pregnancy and intrauterine fetal disorders (hypoxia, malnutrition and developmental delay) by normalizing:

• activity of the central nervous system;
• circulation, coagulability, blood viscosity;
• metabolic processes;
• condition of the vascular wall;
• blood pressure indicators;
• water-salt metabolism.

The duration of treatment for gestosis depends on the severity of its manifestations. With a mild degree of nephropathy, hospitalization is carried out for at least 2 weeks, with a moderate degree - for 2-4 weeks, taking into account the condition of the fetus and the pregnant woman, followed by discharge for observation in antenatal clinic. Severe forms of gestosis (nephropathy, preeclampsia and eclampsia) are treated in a hospital under the supervision of resuscitators until delivery.

Early delivery for gestosis is indicated for persistent nephropathy of moderate severity, if the effect of treatment is absent within 7-10 days; severe forms of gestosis in cases of failure of intensive therapy measures for 2-3 hours; nephropathy, accompanied by delayed development and growth of the fetus during treatment; eclampsia and its complications.

Independent childbirth during gestosis in pregnant women is allowed if the condition of the mother in labor is satisfactory, the therapy is effective, and there are no intrauterine disorders of fetal development according to the results of cardiac monitoring and ultrasound examinations. Negative dynamics in the condition of a pregnant woman with gestosis (increased blood pressure, the presence of brain symptoms, increased fetal hypoxia) serves as an indication for surgical delivery.

Prevention of gestosis

Factors predisposing to the development of gestosis are: hereditary predisposition, chronic pathology of internal organs in a pregnant woman (kidneys, heart, liver, blood vessels), Rh conflict, multiple pregnancy, large fetus, pregnancy in a woman over 35 years old. Prevention of gestosis in women with risk factors should be carried out from the beginning of the second trimester of pregnancy.

In order to prevent the development of gestosis in pregnant women, it is recommended to organize a rational regimen of rest, nutrition, physical activity, and stay in the fresh air. Even with normal development Pregnancy requires restriction of fluid and salt intake, especially in the second half. An important component of the prevention of gestosis is pregnancy management throughout the entire period: early registration, regular visits, monitoring body weight, blood pressure, laboratory research urine, etc. Prescription of drug prophylaxis for gestosis depends on concomitant diseases and is carried out according to individual indications.

Gestosis, or late toxicosis,– one of the most severe complications of pregnancy, characterized by disruption of the functioning of many organs. This pathology is very dangerous: according to statistics, it is one of the top three diseases leading to maternal mortality. For this reason, the occurrence of gestosis should be taken seriously and all doctor’s recommendations should be carefully followed.

Classification and severity of gestosis

Today there is several classifications of gestosis:

1. In combination with other diseases;
2. By stages of severity(mutually replace each other);
3. By time of occurrence.

In combination with other diseases:

• Pure late gestosis(occurs against the background full health and the well-being of a woman, is not combined with other diseases);
• Combined gestosis: more severe form, because occurs against the background of other serious diseases ( arterial hypertension, endocrine pathologies, obesity and others).

By stages of severity:

• Dropsy of pregnancy: occurs when fluid is retained in the body, which is characterized by the occurrence of edema;
• NephropathyI. This gestosis in pregnant women is characterized by increased blood pressure, edema and the appearance of protein in the urine. It should be noted that these signs do not always appear simultaneously, and only one of them may exist (for example, arterial hypertension);
• PreeclampsiaI: characterized by increased intracranial pressure and changes in cerebral circulation, which is manifested by headaches, blurred vision, nausea, vomiting and other symptoms;
• Eclampsia: the final and extremely dangerous stage of gestosis, in the absence emergency assistance inevitably leads to the death of mother and child. The woman’s condition worsens significantly, to the point of loss of consciousness, and severe convulsions begin.

By time of occurrence:

• Early gestosis during pregnancy: occurs immediately after 20 weeks (usually at 22-24 weeks) and is more malignant, difficult to treat;
• Late gestosis: occurs after 30 weeks (usually at 35-36), proceeds quite favorably.

Symptoms

Preeclampsia during pregnancy has different symptoms depending on the stage of its course.

Dropsy of pregnancy

Signs of gestosis at this stage are manifested by edema of varying prevalence:

1. Mild gestosis: swelling of the legs appears (if you press on the front surface of the leg, pronounced pits remain - impressions);
2. Moderate degree: swelling progresses, spreading to the torso;
3. Severe degree: swelling covers a large surface of the body. The woman's general condition worsens, shortness of breath and tachycardia appear.

Nephropathy

Nephropathy in most cases occurs as a result of lack of timely treatment of hydrops in pregnancy. This stage of gestosis manifests itself triad of symptoms:

1. Increased blood pressure;
2. Worsening swelling;
3. The appearance of protein in the urine(proteinuria).

Preeclampsia in the second half of pregnancy in the stage of nephropathy can include all of the listed symptoms or manifest itself with only one sign.

Preeclampsia

With preeclampsia, it begins to increase intracranial pressure, which is manifested by severe headaches, flickering of spots before the eyes, and severe weakness. If left untreated, this stage quickly progresses to eclampsia.

Eclampsia

With the development of eclampsia, it begins seizure attack, after which the woman falls into a comatose state:

1. First stage(20-30 seconds). Convulsive contractions of the muscles of the face and upper limbs appear;
2. Second phase(25 seconds). Cramps affect all muscles, including the respiratory one. Respiratory arrest occurs, the woman loses consciousness;
3. Third stage(1-1.5 minutes). The woman falls into a comatose state, the convulsions stop. When the patient regains consciousness, she does not remember anything about the attack.

Treatment

information Preeclampsia of any severity is dangerous for the course of pregnancy and the condition of the woman herself, so it is important to identify it in a timely manner and begin treatment.

Treatment of hydrops in pregnant women

• Following a diet with a strict exclusion of salt, spicy and smoked foods;
• Limit fluid to 1.5 liters per day;
• , removing excess fluid from the body(furosemide and others);
• Drugs to improve placental function( , ascorbic acid).

Treatment for dropsy begins at outpatient setting If there is no effect within 10-14 days, the woman is hospitalized in the pregnancy pathology department.

Treatment of nephropathy

Treatment of nephropathy should be carried out only in a hospital setting:

• Bed rest with complete exclusion of psycho-emotional and physical stress;
• Following a diet with limited fluid and salt. Fasting days are recommended once a week;
• Diuretics;
• Mild sedatives ( , );
• Antihypertensive drugs to lower blood pressure;
• Consultation with a therapist, ophthalmologist, urologist.

If the condition of the woman or child worsens, or there is no effect from the treatment, early delivery is recommended, regardless of the stage of pregnancy.

Treatment of preeclampsia

Treatment of preeclampsia is carried out by analogy with nephropathy, but it should be borne in mind that causing pain to a woman can provoke an attack of eclampsia. For this reason, all manipulations, including injections, should be carried out only with anesthesia ( best option- nitrous oxide).

Treatment of eclampsia

Eclampsia is a very dangerous condition that can quickly lead to the death of the child and woman. Treatment should begin immediately and must be carried out together with resuscitators in the intensive care unit:

1. Introducing a woman into anesthesia;
2. Relief of seizures;
3. Administration of drugs to lower blood pressure;
4. Medication sleep for 1-2 days.

If there is no effect of treatment, emergency delivery is indicated at any stage of pregnancy.

Complications

important Preeclampsia – indeed dangerous pathology, in which sometimes doctors have to forget about the child and do everything to save at least the mother’s life. Preeclampsia in the second half of pregnancy is not a condition with which you should joke: severe forms (preeclampsia, eclampsia) can develop in a matter of hours and lead to extremely serious complications.

Possible complications of gestosis:

• Premature termination of pregnancy;
• Intrauterine growth retardation;
• Premature abruption of a normally located placenta;
• Kidney, heart, liver failure;
• Heart attack;
• Retinal detachment;
• Hemorrhage in internal organs, including the brain (stroke);
• Thrombosis of large vessels;
• Cerebral edema followed by coma;
• Fetal death;
• Death of a woman.

Never refuse hospitalization if your doctor strongly recommends it: remember that your life and the life of your child are most valuable!