Late toxicosis, unlike toxicosis that accompanies pregnant women in the first months, is a rather serious complication and is called preeclampsia. Therefore, many expectant mothers are simply perplexed when they are diagnosed with late toxicosis. And it does not seem sick, and there is no vomiting, but the doctor is worried ... What is the matter and how serious is late toxicosis for the unborn child and mother - we will tell in today's publication.
How to recognize late toxicosis?
The fact is that it is very difficult to recognize this pathology, since the main symptoms of late toxicosis usually pass unnoticed for the expectant mother. That is why it is very important to regularly visit the doctor and take all the necessary tests on time.
So, the symptoms of late toxicosis are:
Why does late toxicosis occur?
In fact, the reasons for the development of this pathology can be many. Moreover, women who have recently given birth and are expecting a child again, those who have previously had an abortion, women under 19 and after 36 years get into the risk zone. Also, late toxicosis is most common in those women who have suffered from chronic kidney disease, heart disease and nervous system disorders before pregnancy. Note that women who work in environmentally harmful work are also susceptible to this disease.
How is late toxicosis manifested and how dangerous?
As a rule, late toxicosis begins with the fact that the woman's body does not cope with the excretion of fluid. There are swelling, problems with urination, kidneys may be disturbed. The most dangerous is that the accumulated fluid, getting into the tissue, causes hyperhydration - the body and internal organs are filled with fluid, which leads to slower functioning of the placenta, lack of oxygen for the fetus, swelling of the future baby’s brain, etc.
How to protect yourself from late toxicosis?
Unfortunately, it is not so easy to protect yourself from late toxicosis, as it is impossible to predict how a “pregnant” organism will behave and what anomalies can be revealed. However, it is quite possible to ease the period of pregnancy by following the recommendations of the doctors. So, what do experts recommend for the prophylactic purposes of late toxicosis?
- First of all - follow a diet and eat healthy and wholesome food. Do not get involved in smoked meats, sweet and salty foods.
In conclusion, we note that a disease such as late toxicosis is very insidious, as it appears, literally from nowhere and even before the birth itself, which, of course, may adversely affect the very process of childbirth. That is why we strongly recommend that you carefully listen to your well-being, and at the slightest deviation, do not postpone the visit to the doctor. As the saying goes: better to be afraid than to be afraid.
We sincerely wish you all diseases to avoid you, and the pregnancy was easy!
Signs and degree of danger
The disease is insidious in that it may not be felt for some time. The first suspicions may arise from a doctor when reading a urine test and after an external examination of patients.
Late toxicosis begins with an increase in blood pressure, the appearance of strong edema and protein in the urine, a sharp increase in weight.
Gestosis is fraught with great danger because it causes serious disturbances in the body. Disorders of water-salt metabolism do not allow the fluid accumulated in the body to be completely eliminated. As a result, the integrity of the placenta is disturbed, and the fetus loses oxygen and other useful substances necessary for development. Exchange products are poorly derived from amniotic fluid, which is dangerous for the nervous system of the unborn baby. Such a state threatens not only health, but also life. In a number of cases, a delivery of a previously expected period is indicated.
The main symptoms of late toxicosis are:
- severe swelling of the arms, legs and face,
- the presence of protein in the urine
- blood pressure in excess of 130/80,
- noise and tinnitus, dizziness, fainting,
- weight gain of more than 500 g per week,
- severe nausea, vomiting, the appearance of "flies" before his eyes.
The presence of one of the listed signs does not necessarily indicate the development of toxicosis, but requires increased attention to the future mother.
The main changes in preeclampsia are associated with disorders of the circulatory system. This causes oxygen starvation and fluid retention in the tissues.
Kidneys are very vulnerable. With their normal functioning, there should be no protein in the urine, but the disruption of the blood supply to the vessels leads to a malfunction of the organs, and as a result, the appearance of protein in unacceptable amounts. Late toxicosis affects the work of the nervous system. In severe cases, swelling of the brain may develop.
There are several forms of the pathological condition: dropsy, nephropathy, preeclampsia, eclampsia. All of them are different stages of the disease.
Belongs to the most common pathologies that occur in late gestation. Especially often develops in multiple pregnancies. The first signs are swelling of the feet and legs, aggravated in the morning. Gradually, swelling spreads to the arms, the area of the sacrum and lower back, face. A woman may notice that it is difficult for her to remove the ring from her finger or wear previously loose shoes.
Another common sign of dropsy is a decrease in the total amount of urine released per day. There is a sharp increase in weight, sometimes there is a feeling of heaviness in the body, shortness of breath, tachycardia. But in general, the general condition remains normal, abnormalities in the liver and kidneys are absent. After childbirth, dropsy symptoms go away without treatment.
In the early stages of the disease, it is possible to deal with the symptoms of dropsy at home. It is necessary to do this, even with a general satisfactory state of health, since the lack of treatment can lead to the transition of late toxicosis to the next stage of development.
Occurs as a complication of dropsy. In addition to pronounced edema of the whole body, a significant increase in blood pressure, dizziness, great thirst, insomnia, a feeling of heaviness, pain in the sacrum and lower back are noted. Often there are violations in the liver, which leads to an increase in its size, painful sensations in the right hypochondrium, jaundice. The risk of developing nephropathy is increased when a pregnant woman has other diseases, such as diabetes, hypertension, and nephritis.
Nephropathy belongs to severe lesions that lead to the development of fetal hypoxia and delayed its development, premature or complicated childbirth, and bleeding.
Pathology is associated with dropsy and nephropathy of pregnant women. At this stage of late toxicosis, a significant increase in the amount of protein in the urine is noted. It can reach 0.5-1 g / l per day and above. The woman noted severe swelling throughout the body, pain in the temples and right hypochondrium, nausea and vomiting.
Patients complain of visual impairment, an unstable psychological state - from euphoria and arousal to lethargy and apathy. Pathological changes are also noticeable in the blood test: the destruction of red blood cells and a decrease in the number of platelets occurs.
The condition of a woman is dangerous both for herself and for the unborn child, who does not receive the necessary nutrients due to the disruption of blood supply through the vessels of the placenta. As a result, the risk of fetal death or the development of diseases such as epilepsy or cerebral palsy increases.
Accompanied by fainting, convulsions, and a coma. Eclampsia develops rapidly, in some cases, after convulsive seizures, hemorrhage into the brain can occur, followed by irreversible coma. Convulsions, despite their short duration, are also very dangerous, as they can lead to sudden death.
Convulsive seizures of eclampsia begin with a slight trembling of the facial muscles. Then there is a sharp deterioration with the spread of seizures to the upper and lower limbs and trunk. The duration of the seizure is about a minute, they can be repeated so often that the woman does not have time to regain consciousness.
The most severe and dangerous form of the disease is a coma, which can occur abruptly, often without prior seizures.
When a woman regains consciousness, she complains of severe headaches, general weakness and fatigue. In most cases (70%) eclampsia develops during pregnancy, but its manifestation is possible during childbirth (30% of cases) and in the postpartum period (about 2% of cases).
In addition to dropsy, all forms of preeclampsia require treatment in a hospital in the pathology department. In case of renal failure, premature detachment of the placenta, acute hypoxia of the fetus, cesarean section is indicated.
Knowing the danger of late toxicosis, you must regularly visit an obstetrician-gynecologist throughout the gestation period. Every pregnant woman should regularly take a number of general activities:
- measurement of blood pressure, especially important indicators after exercise,
- delivery of the general analysis of urine to identify the protein, as well as analyzes on Nechiporenko and Zemnitsky,
- general and biochemical blood tests,
- control the amount of fluid you drink
- weekly weight gain measurement
- visiting an oculist to measure the fundus and visual acuity,
- Consultation nephrologist and neurologist,
- Ultrasound of the kidneys and adrenal glands,
With minor edema of the extremities and the overall satisfactory condition are limited to compliance with the general recommendations of the doctor on lifestyle and nutritional adjustments.
Diagnosis of nephropathy, especially its severe forms is not difficult, but in some cases it must be distinguished from diabetic and uremic coma.
In mild nephropathy, drug therapy is prescribed, which includes:
- sedatives (motherwort, valerian);
- antispasmodic drugs (papaverine, no-shpa),
- means for normalization of arterial pressure (Eufillin, Dibazol, Clofelin),
- drugs to reduce the risk of blood clots, normalizing blood circulation,
- diuretics to improve urination and eliminate edema.
The duration of treatment in the hospital department is from 10 to 14 days. Full normalization of the state is a fairly long process, it usually completes only after the birth of a child. The woman's blood pressure stabilizes, urine analysis returns to normal, and edema disappears.
With symptoms of pre-eclampsia, the pregnant woman is hospitalized in the intensive care unit for antihypertensive and anticonvulsant treatment. The main task is to stabilize the state and stop seizures. Only then can the question of delivery be raised. It can be produced both naturally and with a cesarean section, if there are additional indications for this.
In the absence of immediate treatment, the consequences of a severe course of late toxicosis can be:
- pulmonary edema,
- acute heart failure
- stroke or paralysis,
- mental disorders
- liver necrosis
- swelling of the brain and coma,
- fetal death and death for the mother.
Anticonvulsant therapy involves the intravenous administration of magnesium sulfate (magnesia). But the only way to save a woman from the severe symptoms of late toxicosis is to induce childbirth.
In milder forms of preeclampsia they are carried out at 36-37 weeks of pregnancy. In severe forms of eclampsia, immediate delivery is necessary immediately after the removal of seizures, regardless of the gestational age. If there are no additional indications (placental abruption), labor in a natural way is more preferable in this situation.
Power and day regimen
It is impossible to completely eliminate the risk of developing late toxicosis, but following the rules of good nutrition and a healthy lifestyle will allow women in the risk group to avoid severe forms of the disease.
In the second half of pregnancy, the expectant mother should minimize or completely abandon the use of smoked products, dishes with lots of spices and seasonings, sweets. It’s better to steam or bake in the oven.
With a tendency to edema, it is necessary to limit salt intake (no more than 3-4 g per day). Salt-free diet helps eliminate fluids and reduce swelling.
In the second half of pregnancy are useful:
- low-fat boiled meat and fish,
- cottage cheese and dairy products,
- liver, low fat cheeses,
- vegetables (carrots, cabbage, beets), fruits (apples, apricots, lemons), nuts,
- porridge (except manna),
- cowberry or cranberry fruit drinks, decoctions of dried fruits.
With a tendency to swelling and excessive weight gain, daily calorie intake should not exceed 3000. Careful observance of the rules of good nutrition will help not to exceed the weight gain rate per week - 350 grams. It is also necessary to monitor the amount of fluid consumed. It should be no more than 1-1.5 liters per day, including soups, compotes, teas.
An important condition for the prevention of the development of late toxicosis is compliance with the daily regimen. It is necessary to sleep at least 7-9 hours a day, of which 1 hour is daytime sleep. Leisurely walks in the fresh air are very useful.
The pathological condition can adversely affect the activity of the fetus. Therefore, the future mother is important to monitor the number of movements of the child throughout the day. From 25 weeks tremors should be well felt. If the child's activity is reduced, you must notify the doctor.
In order to calculate the number of fetal movements, it is necessary to put a hand to the stomach for half an hour. This should be done twice a day (morning and evening), being in a horizontal position in bed.
Other preventive measures
The risk of developing late toxicosis can be reduced with the attentive attitude of a woman to her health. A prerequisite for every pregnant woman is timely registration in the antenatal clinic. The future mother needs to take all the tests on time and observe the dates of visits to the doctor. During pregnancy, it is important to carefully monitor your weight, lead a healthy lifestyle.
Especially carefully follow the instructions of the doctor must be pregnant at risk. These are women with kidney and liver diseases, endocrine pathologies, pregnant twins, older than 35 years, and who have had sexually transmitted infections. Any signs of poor health should be notified to the doctor, who will prescribe the necessary tests and appropriate treatment.
What is the risk of late toxicosis?
The danger of late toxicosis in the gradual latent development: internal edema, protein in the urine, increased blood pressure often do not cause any discomfort in a pregnant woman and go unnoticed.
The doctor can identify this condition, so regular visits to him are so important. Gestosis disrupts metabolic processes and affects the state of the placenta: the child develops a lack of oxygen and nutrition.
In late toxicosis, salt metabolism disorders occur, sodium and water accumulate in the body, and the walls of blood vessels become more permeable. This leads to the filling of tissues and organs with fluid and internal edema.
Blood circulation is disturbed, tissues receive insufficient oxygen and nutrients. Brain, liver, kidney, uterus and placenta are affected. Hyperhydration leads to dystrophic changes, hemorrhages, violations of the functions of organs.
Causes of late toxicosis
Clinical studies aimed at studying the causes of preeclampsia did not reveal what is of paramount importance in its development.
To date, there are several assumptions:
- Proponents of corticovisceral theory believe that toxicosis during pregnancy in late periods is a peculiar neurosis, which is expressed in violation of the physiological cortical-subcortical connections. As a result, the work of the vascular system changes, the blood supply deteriorates.
- Endocrine theory claims that changes in the activity of the glands leads to dysregulation of the cardiovascular system, impairment of blood circulation and metabolism in the organs. This happens because hormones affect vascular tone, blood clotting and fluidity.
- Adherents of the immunological theory say that in preeclampsia an inadequate reaction of the maternal organism to the antigens of the child occurs. This leads to changes in the tone and permeability of blood vessels, and then to disorders in organs and tissues.
- Genetic theory is based on the assumption that the incidence of late toxicosis is higher in pregnant women whose mothers also suffered from this complication. Perhaps there are "genes for preeclampsia."
- Плацентарная теория утверждает, что основная причина гестоза – отсутствие характерных для нормально протекающей беременности изменений в сосудистой сети матки, питающей плаценту. Поэтому образуются вещества, которые нарушают работу сердечно-сосудистой системы матери.
Most researchers agree that it is impossible to isolate one cause of late toxicosis. Violation of the function of internal organs occurs due to the combined effects of various factors.
Signs of pathology
Symptoms of toxicosis in late pregnancy depend on the form of the pathology. According to this criterion, typical and atypical manifestations are distinguished. The first group includes:
- Dropsy. Its only symptom is swelling appearing on the arms, legs, abdomen, and face. This form is the first stage of late toxicosis of pregnant women. The woman’s well-being does not deteriorate, only with pronounced edema a feeling of heaviness, fatigue, excessive thirst. There are no changes in blood pressure, it is either normal or slightly below it. Almost a quarter of pregnant women with dropsy later develop nephropathy. Read more about dropsy during pregnancy →
- Nephropathy. This form is manifested by a combination of edema, hypertension and proteinuria (the appearance of protein in the urine). The main symptom is arterial hypertension, in some cases reaching 200/150 mm Hg. Art. and more. Gynecologists determine the degree of nephropathy on a special scale Savelyeva, she assesses a combination of various indicators during the examination.
- Pre-eclampsia. Includes symptoms of nephropathy, as well as other manifestations: headache, dizziness, feeling of heaviness in the occipital and frontal parts, insomnia, apathy, lethargy, visual disturbances in the form of "midges", "veils" or blindness, tinnitus. There are violations of the gastrointestinal tract (vomiting, nausea, pain in the abdomen).
- Eclampsia. The most severe and rare form of late toxicosis of pregnant women. It is a convulsive seizure that develops on the background of preeclampsia when exposed to a strong stimulus: loud sound, bright light, pain. First, twitching of the facial muscles appears, then tonic convulsions develop, sometimes with respiratory arrest and biting of the tongue. After - clonic convulsions (involuntary flexion and extension of the extremities), respiratory arrest, cyanosis, froth from the mouth. The seizure ends with a deep breath, the restoration of breathing.
Thus, all typical forms of late toxicosis of pregnant women represent different stages of this complication. Atypical include nephropathy with hypertension and non-convulsive eclampsia.
The processes that occur in the female body during late toxicosis are investigated much better than the causes that cause them. Changes occur due to spasm of the entire vascular system, reduction of blood circulation, impaired blood clotting and fluidity.
The heart muscle becomes weaker. As a result, there is a decrease in the blood supply to the tissues, in which dystrophic processes develop, leading to death. The lack of blood supply is most strongly reflected in the work of the kidneys, liver and brain.
The placenta consists mainly of vessels that, when gestosis, change and cannot provide the exchange of oxygen and nutrients between a pregnant woman and her child. Fetal hypoxia and intrauterine growth retardation occur.
Toxicosis in late pregnancy can lead to heart failure, pulmonary edema, acute renal failure, coma and the appearance of HELLP syndrome (destruction of liver cells, thrombocytopenia, erythrocyte hemolysis).
For the fetus, this condition is dangerous for premature placental abruption, the development of placental insufficiency, which leads to acute and chronic oxygen starvation, intrauterine growth retardation, premature birth.
Prevention of late toxicosis
A reliable means of preventing the development of late toxicosis does not yet exist. But the strength of women to reduce the risk of pathology and serious consequences to a minimum.
Consider measures to monitor the state of the expectant mother and do not miss the moment to provide medical care.
In order not to miss the first symptoms of late toxicosis during pregnancy, from the middle of the period you should start keeping a self-control diary. It records the increase in weight, for greater clarity - in the form of a graph.
A normal increase in body weight of 350 grams per week is considered.
Thus, you can track the appearance of internal edema, with this complication of weight increases faster due to the accumulation of water in the tissues.
Thanks to keeping a diary, the problem can be detected at an early stage and quickly resolved with the help of food adjustment and medication without resorting to hospitalization.
Fetal activity monitoring
Another indicator that is useful to fix is the number of movements of the future child. For several days you need to listen to his movements and celebrate them.
Push should be well felt from the 25th week. Then, when the approximate amount will be known, the control can be carried out twice a week, in the morning and in the evening for half an hour.
Since the activity and the general condition of the fetus are completely dependent on the health of the mother, with the development of late toxicosis, the amount of perturbation changes. If the child began to move rarely or, on the contrary, is too active, it is imperative to inform the gynecologist about this.
Late toxicosis of pregnant women or preeclampsia is a very serious complication, the consequences of which can be life-threatening for the mother and the unborn child. But with the prevention and timely detection of this problem, the correction of the state passes quickly and successfully.
Therefore, starting from the 20th week, a pregnant woman should carefully consider her diet and daily regimen, as well as not miss visits to the doctor and testing.
Author: Olga Khanova, doctor,
specifically for Mama66.ru
When choosing a therapy, the form of deviations is taken into account, and on the basis of these data the required method is built. Water dropsy is treated in the women's clinic, in the day hospital. Other manifestations require therapy under the supervision of a doctor in the inpatient department specializing in pathologies or in the intensive care unit at the maternity hospital. In some difficult cases, a possible way to save life is only a cesarean section.
If suspicions originated, it makes sense to immediately register with the antenatal clinic. It is better to be observed only by one specialist, so that he is aware of all the nuances of the patient's health. It is necessary to inform the doctor about your chronic ailments, as well as to take preventive measures.
Late toxicosis is very tricky, as it can occur almost from scratch, and even in close proximity to childbirth, which can create a serious threat. In no case should not let the crisis take its course. So if you suspect a negative development of the situation, listen more carefully to your inner feelings and do not delay the visit to the attending specialist. Such a reinsurance will not be superfluous, and will help pass the pregnancy safely at all its stages.
What is late toxicosis, and who is at risk?
Late toxicosis or preeclampsia is a pathology that occurs in the second half of pregnancy and is accompanied by disturbances in the work of the nervous system, endocrine, cardiovascular, hematopoietic, and other systems. As a result of progressive gestosis, pregnancy can result in premature labor or fetal death in utero. Most often, toxicosis in late pregnancy is accompanied by edema, proteinuria and an increase in blood pressure.
Fortunately, preeclampsia is not so common, according to obstetric statistics, this pathology is detected in about 10% of pregnant women.
Important! Late toxicosis of pregnant women may be latent or its symptoms will be mild, and the expectant mother will simply not give them any importance. Pathology can be identified by regularly passing urine tests and measuring blood pressure indicators, and for this, a pregnant woman should regularly attend a antenatal clinic.
The risk group for the development of preeclampsia in the second half of pregnancy includes:
- women with kidney, thyroid disease,
- women with hypertension,
- pregnant women who have gained too many kg in a few months,
- age of women over 35,
- pregnant women who bear several fruits at once,
- Iron-deficiency anemia,
- mother and fetus rhesus conflict
- women who detect intrauterine growth retardation,
- pregnant women who smoke (including passively) or consume alcohol.
Gestosis is also susceptible to the development of pregnant women who have experienced late toxicosis earlier when they were carrying a previous pregnancy.
How is the second half toxicosis manifested and when does it start?
Women at risk are interested in the answer to the question, when does late toxicosis begin and how to recognize pathology? The timing of gestosis in each pregnant woman is purely individual, but in most cases this pathology develops after 30 weeks of pregnancy, when the fetus is rapidly growing in the uterus and the load on all organs and systems increases.
Forms of late toxicosis divided into typical and atypical. Typical forms include:
- nephropathy (1-3 degrees),
These forms of preeclampsia are considered as manifestations of pathology of varying severity. Atypical forms of late toxicosis are characterized by monosymptomatic nephropathy in pregnant women, nephropathy with two symptoms and eclampsia without convulsive seizures.
Dropsy of pregnant women is characterized by the appearance of edema, which is most often localized on the lower extremities in the ankles, hands, anterior abdominal wall and face. Dropsy is the initial stage of late toxicosis.
As a rule, few women pay attention to this symptom and go to the gynecologist unplanned only when the edema is accompanied by increased thirst, heaviness, fatigue, restriction of full limb movements.
At this stage, the symptoms of late toxicosis are practically not expressed, with the exception of edema, blood pressure indicators remain within the normal range. If you do not pay attention to this condition, then dropsy gradually turns into nephropathy.
Complications of preeclampsia in pregnant women
What is the risk of late toxicosis?
The progression of preeclampsia and the development of preeclampsia and eclampsia in most cases leads to the following complications:
- pulmonary edema in a pregnant woman,
- development of heart failure
- development of acute liver failure,
- detachment of the normally located placenta and massive bleeding,
- development of placental insufficiency - this complication leads to acute fetal hypoxia, intrauterine growth retardation, premature birth, hemolysis of erythrocytes, degeneration of liver cells, and a decrease in platelet count.
In the absence of timely medical care, the pregnant woman and the fetus may die.
How to treat late toxicosis pregnant?
Early and late toxicosis of pregnant women are the reason for the enhanced monitoring of the expectant mother, frequent visits to antenatal clinics, regular testing. This will help to identify whether toxicosis develops, and if so, take appropriate measures in time.
Treatment of preeclampsia depends largely on the form of the pathology and the severity of its course. Edema or dropsy can be treated at home by following all the doctor's recommendations.
The main principle of therapy in this case is the restriction in the diet of pregnant salt and the use of a sufficient amount of pure water. They exclude spices, spicy dishes, fat, flour, baking - all these products contribute to fluid retention and progression of edema.
Nephropathy, pre-eclampsia and eclampsia require hospitalization of the expectant mother to the department of pathology of pregnancy or to the intensive care unit of the maternity hospital.
Treatment of severe preeclampsia is in compliance with the following recommendations and prescriptions:
providing a pregnant with complete psychological and physical peace
- the light should be muffled, talk in a low voice,
droppers with glucose solution and vitamins of group B
to support the child,
drugs that improve the function of the placenta
(instructions for the drug describes in detail the properties and composition of the drug),
- nutrition of a pregnant woman should be light, but completely balanced in order to satisfy the daily need of the body for proteins, carbohydrates, fats, vitamins.
With the progression of preeclampsia and the development of eclampsia, the doctor makes a decision on the delivery of a woman by cesarean section and nursing the child in special conditions. Of course, they also take into account the duration of pregnancy, it is important that the baby is born viable.
Indications for cesarean section with late gestosis are the following states:
- severe nephropathy of pregnant women, which is not eliminated medicamentally and progresses,
- preeclampsia and eclampsia,
- comatose state of pregnant
- retinal detachment on the background of high blood pressure,
- hemorrhages in the eyes,
- anuria - the absence of urine for more than 8-12 hours, this symptom in most cases indicates the development of acute renal failure,
- hemorrhages in the brain or spinal cord,
- placental abruption, acute hypoxia.
Is it possible to avoid late toxicosis during pregnancy?
The best prevention of the development of gestosis in pregnant women is parental planning and a comprehensive examination of a woman before conception. Analyzes, ultrasound, consultation of an endocrinologist and a gynecologist will identify problems and undergo a course of treatment if necessary - this significantly reduces the risk of complications during the period of childbearing, because many chronic pathologies create prerequisites for the development of toxicosis.
If the pregnancy is unplanned, and the woman does not know if she is healthy, then the first thing she needs is to register with the antenatal clinic as soon as possible. If the survey reveals chronic diseases or disorders in the internal organs, the gynecologist will take measures at the very early stage of gestation to prevent complications of pregnancy, including early and late toxicosis.
Special attention is paid to the collection of anamnesis, so a woman should be ready to answer such questions:
- were they before the pregnancy, how did they proceed, at what period was the baby born and with what body weight,
- are there any patients with arterial hypertension or diabetes mellitus
- whether the woman suffers from chronic diseases.
Be sure to appoint a pregnant woman to undergo examination by an ophthalmologist (oculist). During the study, the doctor with the help of a special device checks the condition of the fundus. Changes in the fundus of the eye are the first sign of the development of toxicosis of pregnant women or a great inclination of the future mother to this pathology, even if the patient is not disturbed by anything.
In the video in this article, the specialist tells how to reduce the likelihood of developing toxicosis during pregnancy and what consequences for the fetus can be borne by the progression of this complication and the negligent attitude of the expectant mother to her health. Women at risk cannot be delayed in registering for pregnancy and should be done before 11 weeks, and even better earlier. If you ignore these recommendations, the price may be too high, both for the mother and for the child.
How is late toxicosis manifested during pregnancy?
The most typical is the triad of symptoms: edema, the appearance of protein in the urine and an increase in blood pressure. However, their severity is different. Perhaps a combination of two symptoms of the three classic.
Edemas are manifested by an excess gain in body weight after 20 weeks of gestation. In normal pregnancy, weight gain is 350–400 g per week and 10–12 kg for the entire pregnancy. When preeclampsia weight gain is more than 400-500 g per week, fluid retention is accompanied by a decrease in the amount of urine.
Arterial hypertension - increase in blood pressure up to 135/85 mm Hg. Art. and higher.
The appearance of protein in the urine is the most constant and reliable sign of preeclampsia. During normal pregnancy, protein in the urine is not determined. The amount of protein depends on the degree of kidney damage and the severity of preeclampsia.
The appearance of other clinical symptoms, as a rule, indicates the development of critical forms and complications of gestosis.
Are there gestosis stages?
Previously, doctors identified four stages of preeclampsia.
The first stage — edema of pregnant women — was manifested only by the appearance of edema, the second stage was called nephropathy — at this stage, kidney damage of the pregnant woman appeared, protein appeared in the urine, edema in the pregnant woman increased, blood pressure increased, and the amount of urine decreased.
The third stage - pre-eclampsia is a critical, but reversible state preceding the most severe, fourth, the stage of preeclampsia - eclampsia.
The main clinical manifestation of this serious complication of pregnancy is the addition of symptoms of brain damage.The characteristic and alarming symptoms of preeclampsia are headache, dizziness, blurred vision (flickering in the eyes, mist in the eyes, temporary loss of vision, etc.), tinnitus, nasal congestion and difficulty breathing, drowsiness, pain in the upper abdomen, nausea and vomiting. A woman is worried about a feeling of heaviness in the back of her head or headaches, nausea, vomiting, blurred vision, inadequate perception of what is happening, that is, changes in the mental sphere.
Preeclampsia is a very dangerous condition of increased convulsive readiness of the body, when any irritant (loud sound, bright light, pain, vaginal examination) can provoke a convulsive fit (eclampsia) with all possible adverse consequences for the mother and fetus.
Now the first three stages of preeclampsia are increasingly united by one concept - preeclampsia.
What happens in the body of a woman with gestosis?
Changes in the body of a woman with preeclampsia, are studied much better than their cause. Their basis is a spasm of all blood vessels, a decrease in circulating blood volume, a change in blood clotting and fluidity, impaired microcirculation. In addition, with gestosis, there is a weakening of the heart. All this leads to a significant reduction in the blood supply to the tissues until their death.
Most sensitive to a lack of blood supply to the kidney, liver and brain. The placenta does not cope with the work, and the so-called placental insufficiency develops. In fact, it consists in the deterioration of blood circulation in the mother-placenta-fetus system, in the violation of the provision of oxygen and nutrients exchange between the mother and the baby, which causes the oxygen starvation of the fetus and intrauterine growth retardation.
The most dangerous condition
Eclampsia is the most dangerous manifestation of severe preeclampsia. It occurs against the background of pre-eclampsia and is characterized by the disruption of almost all systems and organs. The main symptom of pre-eclampsia is the appearance of seizures.
After a convulsive seizure, the woman is in a comatose state for some time, her consciousness returns gradually, she does not remember anything that happened. Convulsive seizures may be repeated at short intervals. During an attack, due to a sharp rise in blood pressure, a rupture of the cerebral vessel may occur, which causes a stroke - intracranial hemorrhage. There is also a high risk of premature placental abruption, which can cause fetal death.
Photo source: Shutterstock
Every year, in Russia alone (which is not at all the “world champion” in fertility), about a million pregnant women come to women's clinics on appointed days and, waiting for their turn (in this plan n.
In recent years, obstetricians are increasingly attracted to urinary tract infections, which are often detected for the first time during pregnancy. This is primarily due to the frequency of occurrence of this pathology (among sab.
Premature detachment of the placenta - too early, before the birth of the fetus, separation of the placenta from the uterine wall. This serious complication requires urgent medical attention.
The beginning of late toxicosis
Gestosis usually appears from week 28 and continues until the onset of labor. About 20% of pregnant women suffer from late toxicosis. To understand whether you are among them or not, you should know what symptoms accompany this condition.
- Edema is the main symptom of late toxicosis. The woman constantly feels a feeling of thirst, but at the same time the amount of fluid consumed is much more allocated. This is a mild form of preeclampsia, which requires a certain diet and lifestyle changes.
- Increased pressure is a dangerous symptom that accompanies late toxicosis of pregnant women. In order to diagnose a regular increase in blood pressure in time, it is necessary to measure it daily in the morning and evening, fixing the indicators. With the results you need to acquaint the gynecologist at each planned visit.
The onset of preeclampsia is characterized by these two signs. But if the necessary measures are not taken in time, the state will worsen, representing a risk for the future baby.
The development of late toxicosis
The next stage of preeclampsia in the absence of qualified treatment is nephropathy. It is characterized by strong edema, an increase in pressure and an increase in protein concentration in the urine. It should be borne in mind that toxicosis in late pregnancy can develop without all the symptoms. For example, swelling may be quite small. Thus, the surest way to determine the onset of preeclampsia in time is to regularly measure pressure. According to doctors, already at the mark of 135/85, late toxicosis can be suspected and additional tests should be prescribed. That is why daily measurement of pressure and fixation of results is a necessary measure for the timely diagnosis of preeclampsia.
The last, most dangerous stage of late toxicosis is preeclampsia, as well as eclampsia. In the first case, there is a sharp increase in pressure, impaired water-salt balance, problems in the functioning of the cardiovascular system and liver, migraines, deterioration of vision.
If preeclampsia is suspected, hospitalization should be provided as soon as possible to avoid eclampsia, which is the most dangerous stage. It causes prolonged and frequent seizures, reaching to the loss of consciousness. It is important to bear in mind that it can end in death for both the mother and the unborn child.
Danger of complications
Gestosis at any stage can cause many problems in the functioning of the body. First of all, this is a significant weakening of the heart muscle. This leads to a decrease in the blood supply to the tissues and their further death. Poor blood circulation is most reflected in organs such as the liver, kidneys, and brain.
Placental vessels, which begin to carry less nutrients and oxygen from mother to baby, also suffer. Because of this, there is a risk of oxygen starvation and the development of various pathologies.
Other hazards that may be caused by late toxicosis:
- pulmonary edema,
- destruction of liver cells,
- heart failure.
Thus, if toxicosis in early pregnancy brings only discomfort, then in the third trimester it can be the cause of extremely serious diseases.
Unfortunately, there are no measures that completely prevent the appearance of preeclampsia. But you can reduce the risk of its development and minimize the risk of pathologies, observing certain requirements.
- Balanced diet. By the third trimester (if this is not done before!), You should definitely exclude from your diet smoked and canned food, spicy, salted, as well as chocolate. Eating fried foods should be kept to a minimum, it is much better to use the oven or steam cook. You also need to control the volume of fluid that is drunk and withdrawn. In this case, soups, tea, compotes, as well as vegetables and fruits with high water content should be taken into account.
- Compliance with the regime. This is a very important part of preventive measures. It is necessary that the night's sleep was not shorter than 8 hours, also try to arrange an hour's rest during the day. It is important to be as much as possible in the fresh air, it is useful to take walks at a leisurely pace. Try to reduce the emotional load plan.
- Weight control. To do this, you need to carry out weighing at least 1 time per week and record the results. Keeping such a report will allow detecting the onset of late toxicosis at the very beginning, which increases the chances of its successful treatment. Normally, the weight should increase by 350-400 g per week. If the process is faster, it is necessary to undergo additional tests and eliminate the development of edema of internal tissues.
- Monitoring fetal activity. This is a fairly informative indicator that will allow to detect the presence of problems at the initial stage. Normally, fetal movements begin to be felt from 25-26 weeks. After the average number of movements will be recorded, you can begin daily monitoring. They should be counted in the morning and evening every day, recording the results. Since the activity of the child depends on the state of the mother, the appearance of late toxicosis will lead to a change in the number of shocks.
The development of late toxicosis during pregnancy is an alarming signal that requires urgent action. Your attentive attitude to your condition and timely visit to the doctor will help to avoid the unpleasant effects of preeclampsia.
The concept and definition of late toxicosis
Pregnancy is complicated by late toxicosis in about 13% of pregnant women. Most often it occurs after the 30th week. Symptoms of toxicosis are increasing gradually. Therefore, with timely registration, regular visits to the doctor and testing, you can significantly reduce the risk of pathology and prevent a threat to the life of the mother and the unborn child.
If late toxicosis occurs, the endocrine, cardiovascular and nervous systems are disturbed. Preventing death in severe cases is only possible through emergency caesarean section. The danger of this condition is manifested in acute heart failure, coma, pulmonary edema, premature detachment of the placenta, the occurrence of acute hypoxia in the fetus. Pathology proceeds in several stages, the most severe and dangerous of which are the last.
Late toxicosis during pregnancy is also known as gestosis. It completely passes in the period from several hours to several days after delivery. However, high blood pressure, caused not by preeclampsia, but by hypertension, cannot pass on its own and requires the adoption of separate therapeutic measures.
The risk category includes the following categories of women:
- Age less than 18 years and over 35 years.
- The presence of preeclampsia during previous pregnancies.
- The development of multiple pregnancy.
- Diseases in the form of heart defects, hypertension, chronic kidney disease, etc.
In most cases, the cause of late toxicosis remains unknown. In general, this is not decisive, since all efforts are directed at combating the grave consequences of pathology.
Symptoms of late toxicosis
The main symptom of preeclampsia are swelling. The fluid consumed by the woman in large quantities is not completely eliminated from the body, but remains in the space between the tissues. Edema usually occurs only in the lower extremities, but in severe form the whole body can swell. There is a so-called hidden form of edema, which can only be detected by weighing. This is evidenced by the addition of weight over 500 g during the week. There is a need to control the amount of fluid consumed and, accordingly, urine output. If, in compliance with the normal drinking regime, urine excretion is lower than 0.8 l, this may be the most likely manifestation of preeclampsia.
Together with fluid retention comes the development of hypertension. Therefore, the pressure must be constantly monitored. As a rule, the pressure during late toxicosis becomes above the norm by about 15-20%. Some women have hypotension in the initial period of pregnancy, when the level of pressure is lower than the standard. This factor must be taken into account during the examination.
A serious symptom is proteinuria, when protein is secreted along with urine. This symptom indicates impaired kidney function. In such a situation, urinalysis is of great importance, which should not be missed. After 20 weeks of pregnancy, this study is conducted weekly. If a woman has several symptoms of pathology, home treatment becomes ineffective, such patients are recommended to be hospitalized.
Other symptoms manifest as headaches, nausea and vomiting, heaviness in the head, and with severe form, convulsions and altered consciousness are observed.
The main types of preeclampsia
Symptoms and forms of the disease allow you to divide the preeclampsia into several degrees of severity:
- The first degree of gestosis in pregnant women is manifested in the form of dropsy. A woman becomes noticeable swelling, which decreases in the morning and increases again in the evening.
- The second degree is characterized by the presence of all the main symptoms. First of all, it is diastolic pressure, directly related to the blood flow of the placenta. With increasing pressure decreases the supply of oxygen to the fetus. The greatest danger is represented by pressure changes in the form of regular surges. This stage is complicated by the presence of comorbidities. The most severe are such complications as bleeding, fetal hypoxia, placental abruption, the onset of preterm labor. All of them create a real threat of fetal death.
- In the third degree of preeclampsia, preeclampsia develops, manifested by pain and heaviness in the head. At the same time, vomiting, pain in the liver can appear, visual disturbances are noted. Apathy comes, memory deteriorates. All this is accompanied by insomnia, irritability and other symptoms indicating an altered circulation of the brain. The liver can be traumatized by severe edema, up to hemorrhage.
The most severe form of late toxicosis is eclampsia. In addition to the symptoms already listed, seizures appear. Attacks can be triggered by external stimuli - pain, loud sounds, stress, bright light. They last about two minutes. The danger of this condition is swelling of the brain, bleeding into the brain, which can be fatal.
Complications and effects of late toxicosis
Most often, the development of late toxicosis occurs after the 20th week of pregnancy. It causes serious complications, which are the main causes of deaths.
As a rule, late toxicosis during pregnancy can cause the following complications:
- There are spasms of small arteries, detected by oculists during examination of the fundus.
- The permeability of the vascular walls increases, the outflow of blood in the veins worsens. As a result, there are obvious or hidden edema, protein appears in the urine.
- The liquid component of the blood goes into the surrounding tissue. Because of this, the blood thickens, increases its clotting.
- Lower lower and higher upper blood pressure.