Preeclampsia during pregnancy is a phenomenon that occurs in many women. It is characterized by disturbances in the activity of internal organs and body systems due to processes associated with the development of the fetus inside the mother. This pathology occurs due to the fact that the female body cannot adapt to the changes taking place, and occurs only during the period of bearing a child. After childbirth or termination of pregnancy, such pathologies disappear, but sometimes their consequences are the appearance of various diseases that remain for life.

What it is?

Pregnancy is a physiological process in a woman’s body, during which there should normally be no nausea, vomiting, or any other discomfort. However, gestosis during pregnancy is a common pathological phenomenon, occurring in 25% of expectant mothers. This threatening condition for a woman's health often becomes life-threatening. This pathology provokes disruption of the vital functions of organs and systems, but the cardiovascular system and kidneys suffer most from its manifestations.

If gestosis during pregnancy occurs in a healthy woman who has no history of any manifestations of dysfunction of internal organs (kidney diseases, liver diseases, metabolic disorders, endocrine system functioning, hypertension, cardiac pathologies, etc.), it is called pure gestosis. It can develop both at the beginning of pregnancy and in the second half of the term.

Such pathologies that arise against the background of chronic diseases in a pregnant woman are called “combined gestosis.” This disease can occur at any time during pregnancy, but most often it begins to appear from the 28th week.

What causes gestosis

The exact causes of gestosis during pregnancy are not fully understood. Today, there are about thirty different theories regarding the causes and mechanism of its occurrence. It is believed that women are predisposed to the appearance of gestosis, for example, with pathologies such as:

• defective endocrine regulation;
• cardiopathology;
• endocrine disruption;
• pathological processes in the kidneys, liver and biliary tract;
• immunological diseases;
• obesity.

The risk group for early or late gestosis during pregnancy includes women who regularly experience stress and overwork, as well as pregnant women under 18 and over 35 years of age. Poor or unbalanced nutrition and bad habits can lead to the appearance of undesirable symptoms. Preeclampsia is often inherited: if the mother had a similar pathology, then most likely the disease will manifest itself in her pregnant daughter.

Signs of gestosis during pregnancy

The main symptoms of gestosis in the initial stages are dizziness, nausea, vomiting, psycho-emotional imbalance, changes in taste and smell perception. Gestosis is often called “late toxicosis”. The most characteristic signs of this pathology are increased pressure and the appearance of protein in the urine. A pregnant woman can tolerate changes in blood pressure quite normally without noticing the changes occurring. But in most cases, gestosis is accompanied by headache, nausea and vomiting. Sometimes a pregnant woman begins to see worse. Protein present in the urine indicates a malfunction of the kidneys, so a woman may experience severe swelling of her face and limbs.

Many women suffering from various diseases have experienced all the symptoms of gestosis during pregnancy. All mothers who are pregnant for the second or subsequent time know what it is. The fact is that if such a phenomenon happened once, then during subsequent pregnancies its symptoms often intensify. However, there are often situations when, during the second pregnancy, gestosis occurs in a milder form or does not develop at all.

Doctors distinguish 3 degrees of this pathology:

• Preeclampsia of the first degree (hydropsis of pregnant women) - swelling of the extremities. A woman may feel a slight numbness in her fingers.
• Preeclampsia of the second degree (nephropathy) is swelling of the extremities, accompanied by an increase in blood pressure. Develops against the background of increased swelling.
• III degree gestosis (preeclampsia) - swelling of the limbs, abdomen, face and neck. The condition is aggravated by low blood pressure and protein in the urine.

In severe cases of gestosis (eclampsia), convulsive seizures and the threat of miscarriage or fetal death are possible. In most cases, pathology appears during the first pregnancy, after the 32-34th week. If gestosis appears earlier (after the 20th week), this indicates its severe form. In general, the earlier such a disease manifests itself, the more aggressive its course.

This pathology disrupts pregnancy, so it must be monitored and treated. In case of complex gestosis, doctors usually resort to inducing premature labor or caesarean section.

The first sign of gestosis: proteinuria

The main indicator indicating the occurrence of gestosis during pregnancy in the later stages or in the first half of pregnancy is the appearance of protein in the urine. This pathology never occurs without proteinuria, although the detection of only an increased protein content does not indicate the appearance of gestosis.

Normally, there should be no protein in the urine. Even a slight increase in its amount in the range from 0.03 to 0.7 g/l in combination with an increase in leukocytes indicates inflammation in the kidneys. The higher its content, the stronger the inflammatory process. An increase in protein to 0.8 g/l or higher may indicate the appearance of gestosis.

The second sign of gestosis: increased blood pressure

A sign of gestosis during late pregnancy is a combination of proteinuria with an increase in blood pressure to 140/90 or higher. In rare cases, this symptom goes unnoticed. However, usually a woman feels a headache, dizziness, nausea, and spots flashing before her eyes.

The appearance of a tandem of high blood pressure and protein in the urine is called preeclampsia. This phenomenon indicates the onset of gestosis and requires attention from doctors.

The uncontrolled course of such a phenomenon can lead to serious consequences for the nervous system and can provoke loss of consciousness, seizures (eclampsia) and cerebral hemorrhage (stroke). This danger occurs at pressure levels of 160/110 mm Hg. Art.

Third sign: swelling

Edema itself is not considered an indicator of developing pathology. However, in combination with the previous indicators, they are a clear symptom.

The presence of swelling can be easily determined by yourself if you press your finger on the inside of the shin and hold for a few seconds. If even a small hole remains after pressing, it means that swelling is present. The appearance of swelling can be determined if the usual shoes suddenly begin to press or the rings are difficult to remove from the fingers.

Often, hidden edema occurs in the body of the expectant mother, which can only be detected through weight control and special medical tests. If edema appears, you should not take diuretics or self-medicate. Any therapy should be entrusted to a doctor.

Swelling is the only visible sign of unwanted pathology. The appearance of protein and increased blood pressure in most cases is detected only in the hospital. Therefore, it is very important for every pregnant woman to register with the antenatal clinic as early as possible and undergo all prescribed examinations in a timely manner.

Danger

The consequences of gestosis during pregnancy can negatively affect the health of both mother and child. This disease often becomes the culprit of many serious pathologies. As a result of gestosis, disturbances in the functioning of the kidneys, lungs and heart occur, the nervous system and vision suffer.

Dysfunctions of blood microcirculation, spasms in blood vessels, and the occurrence of microthrombi can provoke swelling and hemorrhage in the brain, heart, kidney, liver or pulmonary failure. Constant bouts of vomiting lead to dehydration.

This disease causes premature placental abruption, and with manifestations of late gestosis during pregnancy, it provokes premature birth. Leads to asphyxia in the newborn and often leads to his death. In a sluggish course, it causes fetal hypoxia and contributes to intrauterine growth retardation.

The most severe form of this pathology is eclampsia. In this case, we are no longer talking about saving the child, but about preserving the life of the mother. The only treatment here is emergency delivery or termination of pregnancy.

Survey

If you suspect the appearance of gestosis during pregnancy, the doctor will prescribe an appropriate examination. First of all, the following are assigned:

Treatment of gestosis during pregnancy

Attacks of nausea and rare vomiting, the main manifestations of toxicosis, can simply be tolerated. Many pregnant women cope with these symptoms by drinking water with a few drops of lemon juice on an empty stomach in the morning.

For some people, drinks with mint or lemon balm, sour fruit drinks and juices help get rid of nausea. Very often, doctors in these cases recommend the consumption of fermented milk products and cheese. Many women save themselves from discomfort by rinsing their mouth with a decoction of chamomile or sage.

In severe conditions of the pregnant woman (development of renal failure or acute liver dystrophy), in the absence of treatment results, termination of pregnancy is recommended.

If gestosis manifests itself in the second half of pregnancy, accompanied by constant vomiting, consultation with a specialist is necessary. In this case, we must not forget about the drinking regime. Medicinal treatment, including homeopathic remedies, should be prescribed only by a doctor, and medications should be taken only under his supervision.

Treatment of grade I gestosis occurs on an outpatient basis. All other cases of treatment of gestosis in the third trimester of pregnancy are carried out in a hospital. Based on the severity of the disease, the patient may be prescribed bed or semi-bed rest. The pregnant woman is shown complete psycho-emotional rest. If necessary, the doctor may prescribe sedatives.

Despite the pronounced swelling, fluid intake should not be limited, and taking diuretics is also undesirable. Drug treatment is based on symptoms in order to normalize the functioning of the mother’s organs and systems, as well as to exclude hypoxia of the developing fetus. Registered:

• vitamins B, C, E;
• agents that stimulate uteroplacental blood flow;
• drugs that reduce the permeability of vascular walls;
• drugs that help lower blood pressure and other drugs.

The duration of treatment is determined individually and depends on the course of the pathological process, the physical condition of the expectant mother and fetus. The main condition for effective recovery is timeliness and professionalism.

Prevention

It is necessary to take care of preventing the occurrence of manifestations of gestosis even at the stage of pregnancy planning. To do this, you need to undergo an examination and receive appropriate consultation from specialists. If necessary, undergo appropriate treatment.

The main prevention of gestosis during pregnancy is:

• long sleep and proper rest;
• avoiding excessive physical activity;
• positive psycho-emotional attitude.

In terms of preventing gestosis, special exercise therapy exercises, massage, swimming pool exercises, yoga and long walks in the fresh air have a good effect on the body of pregnant women in terms of preventing gestosis. During this period, you should not make sudden movements.

It is necessary to organize a complete and balanced daily menu. Food must be consumed often, but in small portions. It is very important to maintain temperature balance: food should not be too hot or cold. You should adhere to proper nutrition and exclude fatty, spicy and fried foods, confectionery, chocolate, cocoa and coffee.

It is advisable to consume cereals containing fiber (buckwheat, oatmeal) daily. We must not forget that a lot of fiber is contained in beets, carrots, seaweed and fresh herbs.

A growing body needs a large amount of proteins and vitamins, so you should regularly eat dishes made from lean meat, fish, cottage cheese, and eggs. Fresh fruits, juices and vegetables must be present in the daily diet. Vitamin infusions from rose hips, decoctions of dried fruits and fruit drinks from berries will provide the body with the necessary vitamins and minerals.

If gestosis occurs, it is necessary to increase the consumption of liquids and protein foods, since water helps normalize blood flow, and proteins are excreted in the urine. You need to drink at least 2-2.5 liters of liquid per day (this includes drinks, soups, broths, juicy fruits).

You should watch your weight. After the 28th week, weight gain should not be more than 500 grams. Normally, a woman should not gain more than 12 kg during her entire pregnancy.

Before starting treatment for gestosis, you should decide on the stage, degree and clinical picture in a particular case and in a particular woman. To do this, it is worth recalling the main characteristics of this disease.

Treatment of early gestosis

The main manifestations of early gestosis: nausea, vomiting in the morning, excessive salivation (salivation), insomnia - can be treated without medication. Some women are able to overcome the initial signs, and a glass of water with lemon on an empty stomach helps them cope with the symptoms. If vomiting is periodic, and nausea is a constant concern, then you can try brewing tea with lemon balm, mint or lemon. For breakfast, it is better to eat fermented milk products: cottage cheese, kefir or cheese. You can also use fruit and berry juices, fruit drinks, compotes, or try rinsing your mouth with infusions of sage and chamomile. If there is excessive salivation, rinsing with yarrow and oak bark 10-15 minutes before meals will help.

If vomiting is constant and uncontrollable, then be sure to consult your doctor, as this condition can threaten both your health and the health of the child.

In the early stages of toxicosis, drinking water should not be neglected. Due to excessive vomiting, dehydration of the body will increase, therefore it is necessary to consume fluid in sufficient volume.

If renal failure or liver dystrophy occurs in the first half of pregnancy and if treatment is ineffective within 24 hours, termination of pregnancy is indicated. The method of terminating pregnancy in such early stages (usually 6-12 weeks) is induced abortion.

Late form therapy

Preeclampsia itself in the later stages occurs quite rarely, according to statistics, about 8% of all pregnancies.

During the treatment of late gestosis, strict bed rest, prolonged sleep, and the absence of irritants and worries are prescribed. Treatment with sedatives is recommended: motherwort, valerian, sedatives. In addition, it is necessary to follow the correct diet: food should be easily digestible, rich in vitamins, balanced with proteins and carbohydrates. Eating fruits, vegetables, a sufficient amount of fruit drinks and juices. Sometimes it is recommended to eat food directly in bed and chilled.

Contrary to many advice on the Internet, you should not neglect drinking water during severe swelling, since, on the contrary, you need to replenish the volume of the bloodstream.

Hospital treatment

Ultrasound is one of the ways to diagnose problems

For late gestosis, the main type of treatment is inpatient. All medications prescribed at the hospital stage are aimed at reducing fetal hypoxia and normalizing the functions of the internal systems of the pregnant woman’s body.

During treatment, diuretics are not prescribed under any circumstances, as they reduce the volume of total circulating blood in the body, thereby exacerbating existing abnormalities and disrupting placental circulation.

The exception is heart failure and pulmonary edema, although diuretics are sometimes used for these conditions (but only under the condition that the patient's condition is stable).

While the patient is in the hospital, she is closely monitored, which includes:

• bed rest;
• monitoring blood pressure 4-5 times a day;
• body weight check (once every 4 days);
• monitoring the liquid consumed and excreted throughout the day;
• control of protein in urine (the daily portion of urine is checked once every 5 days, the daily amount is checked every 2-3 days, depending on the patient’s condition);
• general urine test every 4-5 days;
• complete blood count platelets, hematocrit once every 7-10 days;
• examination by an ophthalmologist;
• urine test according to Nechiporenko once;
• ECG once;
• monitoring the vital functions of the fetus every day;

The doctor can prescribe a number of medications, but self-medication in such a situation is unacceptable

Drugs for the treatment of gestosis in later stages:

• Antispasmodics (drotaverine, papaverine)
• Sedatives (valerian orally 1 tablet 2-3 times a day)
• Antihypertensive drugs (methyldopa; metoprolol only from the second trimester of pregnancy, amlodipine only from the 2nd trimester of pregnancy)
• Antiarrhythmics (Verapamil)
• Hormone therapy (estrogens from 5 to 10 weeks of pregnancy; gestagens from 7 to 8 weeks of pregnancy)
• Glucocorticosteroids (prescribed under the supervision of 17-corticosteroids in the urine until 25-36 weeks of pregnancy)
• Antiplatelet agent (for 3-4 weeks)
• Ascorutin (first 3 months of pregnancy; 16-18, 24-26 and 30-32 weeks of pregnancy)
• Iron supplements

It is important to follow all instructions

From physical procedures:

• Central electroanalgesia - exposure to high-frequency pulsed current on the cerebral cortex and subcortex, average procedure duration up to 30 minutes
• Electrosleep - a procedure lasting on average from 30 minutes to 2 hours is prescribed, its essence is to introduce the patient into the therapeutic sleep phase under the influence of a pulsed current
• Endonasal galvanization - electrophoresis using turundas through the nasal sinuses, improves blood circulation in the brain
• Non-invasive hemomagnetic therapy – designed to enhance the impact and effectiveness of drug therapy

The main goal of inpatient treatment for this type of pathology is to replenish the lack of fluid in the bloodstream. Additionally, individual doses of antihypertensive drugs are selected and the loss of protein in the body is compensated.

The length of hospital stay depends on the severity of gestosis and the presence of its complications. The average length of hospital stay ranges from 1 to 2 weeks.

Preeclampsia in obstetrics is considered one of the most difficult problems threatening the mother and fetus. This concept refers to a complex of disorders in the body of a pregnant woman, affecting the cardiovascular system, liver and kidneys. Preeclampsia is most often observed during late pregnancy - it is diagnosed in 30% of women.

There are many things that can be said about what gestosis is in pregnant women. These are conditions that develop simultaneously and are manifested by deterioration in the functioning of several vital organs and systems:

• nervous;
• cardiovascular;
• liver;
• kidneys

There is also a violation of the metabolic process system. Severe toxicosis during pregnancy is fatal in 40% of women. This is not an independent disease, but a consequence of a decrease in the adaptive capabilities of the female body, leading to the inability to fully provide for the vital needs of the fetus.

What is the danger of the condition

The greatest danger of late gestosis during pregnancy is HELLP syndrome. The causes of death in this condition are:

• liver bleeding;
• placental abruption;
• pulmonary edema;
• acute renal dysfunction.

The main danger of HELLP syndrome is severe thrombocytopenia and intravascular coagulation disorders, which develop due to a mismatch between fetal and maternal proteins. These conditions lead to massive bleeding, which is extremely difficult to stop.

Another dangerous complication of pregnancy is eclampsia. This is the extreme stage of gestosis, characterized by the development of hypertensive crisis, convulsive syndrome, against the background of which placental abruption may occur. This condition causes the death of mother and child in 80% of cases. The only way to save life with this complication of gestosis is an emergency caesarean section, even with severe prematurity.

Impaired blood flow in the liver during the development of toxicosis leads to the formation of acute fatty hepatosis - the degeneration of liver cells into fat cells. The complication is rare, but almost always ends in death.

Toxicosis is dangerous not only due to lethal complications, but also to conditions that negatively affect the subsequent health of the mother and child:

• loss of vision;
• pneumonia;
• thrombosis in various organs;
• heart failure;
• dehydration;
• oxygen starvation of the fetus;
• defective intrauterine development.

Knowing what gestosis is during pregnancy and why it is dangerous allows you to timely diagnose complications and avoid maternal and child mortality.

Causes of occurrence in later stages

The main reason for the development of this condition is the fertilized egg - that is, the very fact of pregnancy. Therefore, the disease occurs only in pregnant women and almost always disappears after childbirth. Why in some women the fetus increases the risk of developing preeclampsia, medicine cannot say. There are several theories explaining the occurrence of the pathological condition:

• allergic;
• renal;
• placental;
• hormonal;
• immunological.

The main mechanism for the formation of pathology is a sudden spasm of blood vessels throughout the body. This leads to disruption of the blood supply to all tissues and organs, which is manifested by a violation of their functions. Increasing blood viscosity is also of certain importance.

There are a number of conditions that contribute to the development of toxicosis. They are called risk factors:

• age – under 19 or over 35 years old;
• burdened heredity;
• features of the profession;
• presence of harmful production factors;
• bad ecology;
• bad habits of the mother during pregnancy;
• insufficient or irrational nutrition;
• unwanted pregnancy;
• liver diseases;
• presence of gynecological pathology;
• persistent increase in blood pressure;
• gestosis in previous pregnancies.

Since there are many reasons for the development of pathology, a woman needs to undergo an examination of the whole body, especially if this is a repeat pregnancy. Extragenital pathology (diseases not related to the reproductive organs) leads to the development of mixed forms that are more severe. If a woman has frequent cases of swelling, headaches, or discomfort in the heart, she needs to be under the supervision of a doctor throughout her pregnancy.

Symptoms in the 3rd trimester

Preeclampsia is accompanied by the development of multiple organ failure, so it is not difficult to determine its symptoms in the later stages. Pathology is manifested by the development of one or more symptoms. The earliest sign is swelling. Edema affects the limbs, the anterior abdominal wall or the entire body.

Another common symptom is a persistent increase in blood pressure. It is associated with impaired microcirculation. This condition manifests itself as fatigue, headaches, and spots before the eyes.

The most severe sign of gestosis in late pregnancy is HELLP syndrome. It is usually detected at 35 weeks. Symptoms increase very quickly:

• severe malaise;
• headache;
• vomit;
• pain in the liver area;
• jaundice;
• Urine tests show high levels of protein.

The outcome is a convulsive attack that turns into a coma.

There are several rare forms of gestosis that have an atypical clinical picture.

Atypical forms are difficult to diagnose, which increases the risk of complications.

Early gestosis usually develops in women who are pregnant for the first time. They occur more easily than in multiparous women.

Forms of pathology

Preeclampsia is classified based on the number of symptoms and severity. Monosymptomatic gestosis is distinguished when a woman has one of the signs - swelling, increased blood pressure or protein excretion in the urine. With polysymptomatic toxicosis, a combination of two or three signs at the same time is possible. The severity of gestosis does not depend on the number of symptoms.

Mild and severe gestosis

Classic toxicosis is called the Zangenmeister triad - a woman simultaneously experiences edema, hypertension and protein in the urine. To assess the risk of developing eclampsia, the stage of gestosis is determined.

Table. Stages of pregnancy toxicosis according to characteristic manifestations.

With regard to blood pressure, one cannot rely on specific numbers when determining the degree of severity. If a woman’s blood pressure was initially low, then signs of gestosis may appear at a blood pressure level of 130-140/90 mmHg.

Impaired kidney function is the latest symptom of toxicosis. Its appearance poses a great danger in prognostic terms. To determine hidden edema, the patient is regularly weighed. During a normal pregnancy, a woman gains no more than 400 grams per week. In severe cases, accompanied by impaired renal function, weight gain reaches 2 kg in 7 days.

How to treat gestosis during pregnancy

Treatment of gestosis during pregnancy in the 3rd trimester is carried out pathogenetically and symptomatically. Etiotropic therapy is an emergency delivery, it is used only in very severe cases. To treat gestosis during pregnancy, an integrated approach is used and it is carried out in a hospital setting.

Therapy is aimed at eliminating hypertension, edema, and restoring kidney function. It is also necessary to treat the disease that provoked the development of toxicosis. When talking about how to treat gestosis during pregnancy, doctors point out the importance of creating absolutely calm conditions for the woman. This is achieved by prescribing strict bed rest and sedatives.

Treatment tactics are aimed at preserving pregnancy as much as possible. Indications for urgent termination of pregnancy are:

• development of eclampsia;
• severe complications of gestosis;
• other obstetric pathology;
• lack of effect from treatment;
• rapid progression of symptoms.

Drug therapy involves the use of drugs that affect the main symptoms and mechanisms of toxicosis.

1. Sedatives. They influence the central nervous system, eliminating excessive excitability and anxiety, and normalize sleep. Relanium, Sibazon, Seduxen are prescribed orally or intramuscularly.
   
   
2. Antihistamines. Act as an amplifier of sedatives and improve sleep. Use Fenkarol, Suprastin orally or intramuscularly.
   
   
3. Antispasmodics. They help reduce the tone of the uterus, dilate blood vessels, reducing pressure. No-shpa or Papaverine is used intramuscularly.
   
   
4. Antihypertensive drugs. Normalize blood pressure levels. Pregnant women are allowed to take Dibazol and Dopegit; the dosage is selected in accordance with blood pressure.
   
   
5. Magnesium sulfate. A complex action drug that has the ability to reduce blood pressure, calm the central nervous system, and eliminate seizures. The drug is prescribed intramuscularly, in severe cases – intravenously.
   
   
6. Means for improving microcirculation. Trental, a sodium chloride solution, is prescribed intravenously. The drugs thin the blood and improve its fluidity.
   
   
7. For severe gestosis, infusion therapy is necessary. It consists of intravenous administration of solutions - Reopoliglyukin, Hemodez, glucose solution.
   
   
8. Hepatoprotectors. The drugs improve liver function, preventing the development of HELLP syndrome. Essentiale or Solcoseryl are prescribed as intravenous infusions.
   
   

The duration of treatment is determined by its effectiveness. The optimal period is considered to be 7-10 days. Long-term use of drugs is not recommended due to the negative effect on the fetus.

How to treat gestosis after childbirth

A woman who has suffered pregnancy toxicosis is transferred for observation to an antenatal clinic after childbirth. In 98% of women, gestosis goes away on its own after childbirth, so no special treatment is required. How long gestosis lasts after childbirth and when it goes away in the remaining 2% of patients depends on the severity of their condition.

A woman is advised to abstain from pregnancy for the next 3-5 years. How to treat gestosis after childbirth depends on how it proceeded during pregnancy. If swelling persists, diuretics are prescribed. If protein continues to be excreted in the urine within two months, you should consult a nephrologist and urologist.

Prevention of gestosis during pregnancy

Prevention of the development of early gestosis in pregnant women involves the following measures:

• timely detection of extragenital pathology;
• elimination of chronic foci of infection;
• regular examination of women at risk during pregnancy;
• elimination of emotional and physical stress;
• ensuring adequate sleep;
• proper nutrition;
• prevention of constipation;
• sufficient physical activity;
• daily walks in the fresh air;
• taking magnesium and folic acid.

Conclusion

In order for the expectant mother and child to be healthy, it is enough to follow all measures to prevent gestosis, especially if the woman has a predisposition to it. When the first signs of late toxicosis appear, the woman should be hospitalized in a hospital, where specialists will monitor her around the clock.

Any of the long-standing diseases can make themselves felt by exacerbation. Even something that has never bothered you before may well show its face now. Many ailments “come out” already in the first trimester. But in the second half of pregnancy, one of the most dangerous complications can develop - gestosis.

Preeclampsia in pregnant women is accompanied by dysfunction of vital organs, mostly the vascular system and blood flow.

Types of gestosis in pregnant women

Preeclampsia is also called late toxicosis of pregnancy. It is impossible to accurately determine what causes the development of gestosis and what the mechanism of this process is. Doctors say that a whole complex is always involved in the development of gestosis. But most often its appearance is provoked by chronic illnesses.

If gestosis develops against the background of the visible well-being of the pregnant woman and in the absence of any diseases, experts call it “pure gestosis.” This phenomenon occurs in 20-30% of pregnant women. In the case of the development of gestosis against the background of an existing disease (hypertension, kidney disease, liver disease, pathology of the endocrine system, lipid metabolism disorders), we are talking about “combined gestosis.”

Depending on the form in which gestosis manifests itself and the symptoms accompanying it, there are types of gestosis, which are, as it were, its stages or degrees of severity:

• Hydrops of pregnancy is the earliest stage at which the legs and hands appear, first hidden and only then obvious. However, swelling does not yet mean the appearance of gestosis. Only a specialist can judge this. Therefore, never draw premature conclusions and especially do not take any therapeutic actions.
• Nephropathy develops against the background of dropsy and is accompanied by impaired renal function. The first sign is increased. Nephropathy can quickly develop into the most severe form of gestosis - eclampsia, and therefore requires immediate treatment. Complications and consequences of nephropathy can be the most terrible.
• Preeclampsia is characterized by swelling, increased blood pressure, and protein in the urine. Disturbances in the blood supply to the central nervous system may occur, which causes a feeling of heaviness in the back of the head or nausea, vomiting, blurred vision, and possible mental disorders.
• Eclampsia is the most severe stage of gestosis. Convulsive attacks appear, the functions of organs and systems are disrupted, and a stroke may even occur. Eclampsia is also dangerous due to the risk of premature placenta, premature birth, hemorrhage, and fetal death.

Treatment methods for gestosis during pregnancy

Regardless of what form of gestosis develops in a woman, she must definitely tell the doctor about it and begin treatment, since gestosis in all its manifestations is very dangerous for the child and mother.

It is impossible to cure gestosis. But in most cases it is quite possible and very necessary to alleviate its course. Mild forms of gestosis can be treated at home, more severe ones - in a hospital setting, often in close proximity to the intensive care unit.

If the doctor suspects that you have developed gestosis, the first thing you will have to do is undergo many tests and undergo mandatory examinations to confirm the diagnosis and establish its form. The accumulation of fluid in a woman’s body is also monitored and the dynamics of body weight are monitored. Pregnant women with gestosis are prescribed a diet with limited fluid (800-1000 ml per day) and salt, enriched with proteins and. An examination by an ophthalmologist, consultation with a therapist, nephrologist and neurologist are required. An ultrasound examination, including Doppler testing of the fetus, is mandatory.

As a rule, a woman is prescribed drugs to calm the nervous system, for example, motherwort or valerian for mild symptoms and strong sedatives in case of eclampsia. If dysfunction of organs requires drug treatment, appropriate drugs are prescribed: diuretics, as well as drugs that lower blood pressure and improve blood flow in small vessels, including the placenta. At the same time, placental insufficiency is prevented (Actovegin, vitamins E, B6, B12, C).

In general, it all depends on the manifestations of gestosis and the condition of the pregnant woman. However, it is extremely important not to self-medicate, as this can lead to rapid development of complications and dire consequences. If therapeutic measures do not bring relief, or the condition of the mother or child worsens, premature birth is stimulated.

Preeclampsia can be characterized by both an asymptomatic course without any special complaints, or rapid development with a sharp deterioration in the condition. Therefore, delaying in case of suspected gestosis can be dangerous. And treatment can only be carried out under the supervision and prescription of professional doctors.

Especially for- Elena Kichak

From Guest

I was diagnosed with gestosis at 28 weeks, based on urine tests, and was immediately admitted to the hospital without further investigation. They did an ultrasound and a CTG, and everything in the world, I had to lie there for a long time. But she carried it to term and gave birth to a healthy baby.

Reading time: 9 minutes

Many pregnant women wonder why they need to be weighed at every appointment with a specialist in the antenatal clinic? Expectant mothers think that doctors are overprotective of them, considering weighing as an excessive interference in their personal life, because it makes no difference how much a woman weighs. But the doctors are absolutely right: weighing helps to identify in time a dangerous disease for pregnant women - gestosis during pregnancy.

What is gestosis

An ailment such as gestosis is considered a serious disorder of the mother’s body, and often leads to serious consequences: placental abruption, convulsions, seizures. Advanced gestosis and self-medication are fraught with delayed fetal development or death. The danger of the disease is that it does not make itself felt for a long time. The easiest way to detect it is by simple weighing: a woman’s significant excess weight is one of the signs of gestosis.

During the process of bearing a child, the mother's placenta begins to produce substances that damage the woman's blood vessels, as a result of which plasma protein begins to enter the muscle tissue, causing edema. Swelling is what causes excess weight. Due to the rapid and constant loss of fluid, it is more difficult for the body to pump blood through the vessels, and to normalize blood circulation, blood pressure increases.

High blood pressure, combined with edema that affects the limbs, face, placenta and brain, causes a sudden deterioration in the health of the pregnant woman. Swelling impairs the oxygen supply to the body of the mother and fetus, which leads to convulsions, and in some cases to heart failure, heart attacks, pulmonary edema, strokes, retinal detachment, and placenta.

Preeclampsia is observed in every fifth woman who has given birth. Most often, the disease appears by the 34-35th week of pregnancy, but sometimes earlier - already at the 20th week. Due to the fact that severe gestosis is dangerous for the mother and fetus, in many cases doctors recommend a cesarean section or induce premature birth. Manifestations of the disease disappear immediately after childbirth.

Types of gestosis in pregnant women

There are two forms of gestosis - in the early and late stages of pregnancy. Preeclampsia (toxicosis) at the 20th week is usually called early, and at the 28th week – late. According to statistics, if a pregnant woman shows signs of early toxicosis, she will suffer from manifestations of gestosis in the later stages.

Early

Nausea, vomiting and other symptoms of toxicosis are often found in a pregnant woman, so many no longer consider them a pathology. But this is not so: pregnancy is a normal state of the female body, and a pregnant woman should not experience any ailments. The manifestation of ailments in the early stages of pregnancy should be alarming; to clarify the situation and exclude the diagnosis of “preeclampsia,” it is better to consult a doctor.

There are three degrees:

• Mild – attacks of nausea and vomiting no more than 5 times a day.
• Average – no more than 10 times a day.
• Severe – about 20 times a day and more often.

Late

This form is dangerous due to complications. There are four stages of late gestosis. The first stage, also called dropsy during pregnancy, is characterized by the appearance of edema. The first signs of edema are expressed by numbness of the limbs and fingers. When the fingers become numb, they become unruly, it is impossible to put rings on them, and it is difficult to bend and unbend. In addition to gestosis, the culprit of edema is chronic kidney disease and heart disease. Another common cause of edema during pregnancy is progesterone, which is intensively produced by the pregnant woman’s body.

To confirm the diagnosis of gestosis, a Maclure-Aldrich test is prescribed: a small dose of saline is injected under the skin; based on the resorption of this substance, experts judge the presence of edema, which can be hidden or visible. If there are 3 liters of fluid or more in the body, swelling becomes visible. Swelling develops like this: first the feet swell, then the legs, thighs, stomach, and finally the head. If swelling occurs, you should urgently seek help.

The second stage, nephropathy, is a consequence of the first stage, dropsy. Due to the small amount of fluid in the vessels, a complication of the disease begins - an increase in pressure occurs. The consequences of such an increase in pressure during pregnancy are sudden bleeding, placental abruption, which sometimes lead to fetal death.

The third stage, preeclampsia, is fraught with an increase in blood pressure to 160 to 110. As a result, severe headaches, spots in the eyes, vomiting, nausea constantly appear, mental disorders, and memory loss are observed. Plasma protein begins to pass into the urine, so preeclampsia during pregnancy can be easily detected by a simple urine test.

The fourth stage, eclampsia, is more dangerous than the others. Sometimes eclampsia begins immediately after nephropathy, and develops unexpectedly for the woman. Eclampsia during pregnancy manifests itself as strong pulling or small cramps. Convulsions occur in attacks that last several minutes. The attack ends with a temporary loss of consciousness. Sometimes a pregnant woman unexpectedly, without any convulsions, falls into a coma.

Causes and symptoms of gestosis during pregnancy

Despite ongoing research and analysis, doctors have not yet been able to accurately determine the pathogenesis of gestosis. Researchers of pathologies in pregnant women disagree about the causes of late toxicosis. Several possible causes of the development of the disease are reliably known, which include:

• Pathology of the heart, blood vessels, brain.
• Diseases of internal organs - liver, kidneys, endocrine organs, bile ducts.
• Smoking, drug addiction, alcohol abuse - especially when carrying a child.
• Allergy.

The disease occurs more often in the following categories of women:

• Under 20 and over 35 years old.
• They suffer from kidney diseases.
• Overweight, high blood pressure.
• Pregnant with twins.
• Pregnant for the first time.
• With poor heredity (mother or grandmother suffered from late toxicosis during pregnancy).

Symptoms of early gestosis include:

• profuse drooling;
• bouts of vomiting;
• attacks of nausea;
• dizziness;

Symptoms of late gestosis include:

• Swelling causing weight gain. If you gain weight by more than 12 kg, you should pay attention to this fact. If swelling accompanies pregnancy, you should find out its cause. It is possible to reliably determine the disease based on the combination of all signs.
• High blood pressure. Due to a lack of fluid in the circulatory system, the pressure rises to 140 to 90 and higher. In some girls, high blood pressure is accompanied by headaches, attacks of dizziness and nausea. For others, it does not manifest itself at all. In combination with swelling, increased pressure indicates gestosis.
• Protein in urine. As the disease develops, protein begins to be released in the urine: the walls of blood vessels located in the kidneys begin to let blood components through. The more protein there is in the blood, the more serious the manifestations of gestosis will be. A routine urine test can detect protein.

What is dangerous and how to treat gestosis - 1st and 2nd degree

A disease such as gestosis poses a danger to both the mother and the fetus. The disease causes a whole range of complications and diseases of many internal organs: liver, kidneys, lungs. Of particular danger is impaired blood circulation and increased blood pressure - this is fraught with the appearance of microthrombi in the vessels.

Blockage of blood vessels causes hemorrhage; due to swelling of the brain, interruptions in the activity of many internal organs - kidneys, liver, heart - are possible, and there is a danger of falling into a coma. Such a seemingly harmless symptom as an attack of vomiting is dangerous. Vomiting is a cause of dehydration. Lack of fluid leads to placental abruption. Also, lack of fluid causes fetal asphyxia.

According to statistics, mild and moderate degrees of the disease in every tenth case are considered the causes of premature birth. If the disease is severe, the probability of premature birth is already 20%. The last stage of the disease, eclampsia, is the cause of premature birth in every third case of gestosis. It is known that hypoxia occurs during eclampsia, as a result of which every third fetus dies. Many children whose mothers suffered from gestosis in the last stage grow up sick and weakened, and they often experience developmental delays.

Eclampsia is also dangerous for the mother. Therefore, sometimes doctors resort to urgent delivery - this is the only way to save the life of the child and mother. If a woman experiences mild to moderate edema, treatment takes place in the pathology department. If pregnancy is accompanied by severe swelling and symptoms of preeclampsia are observed, treatment is carried out in the intensive care unit.

To replenish fluid in the body, doctors prescribe infusion treatment - using droppers to eliminate some symptoms of gestosis. In addition, doctors take the following measures - removing fluid accumulated in the tissues. It is also urgent to replenish protein reserves in the body and take measures to reduce blood pressure.

If the patient’s condition cannot be improved within three days, the pregnancy must be terminated by artificial delivery - caesarean section. If the patient cannot be brought out of the state of preeclampsia within three hours, doctors also consider it necessary to perform a caesarean section.

How to prevent disease - prevention methods

A common cause of gestosis is hereditary predisposition and other unavoidable factors. Therefore, it is often impossible to prevent the disease, although there are effective preventive measures that can alleviate the course of the disease. These measures must be observed from the first months of pregnancy - at 38 weeks they are no longer useless, at such late stages you need to prepare for childbirth. What to do to reduce the manifestation of late gestosis?

• Monitor your own weight both before and during pregnancy. Monitor weight gain; if kilograms are rapidly gaining, immediately adjust your diet. The alarm should be sounded if weight gain during pregnancy is more than 0.5 kg per week. The permissible norm is no more than 0.3 kg per week. The maximum weight gain by the end of the 38th week of pregnancy is 12 kg.
• Limit your consumption of salty foods, fatty foods, flour, and water. Instead of fatty meat, eat its dietary varieties; instead of flour and sweets, eat more fruits and vegetables containing fiber.
• Even during pregnancy, try to make time for moderate yoga, Pilates, and swimming. Alternate exercises while standing and lying down to avoid putting pressure on the bladder and ureter.
• Take a walk in the fresh air.
• Do breathing exercises.
• Follow a daily routine; sleep should last at least 8 hours.
• As a preventive measure, use decoctions of rose hips, bearberry, and other tinctures that help reduce swelling.

Gestosis during pregnancy: reviews

Lena, 29 years old: At the 20th week of pregnancy, during an examination at the LCD, it was discovered that I had gained 10 kilograms. A week before giving birth, at the 40th week of pregnancy, I felt slightly dizzy, nauseous, and suddenly started having convulsions - it was preeclampsia. The doctors took measures, lowered the pressure, which jumped to 190 to 120. They put on IVs and took medications. Girls, late toxicosis is a dangerous disease, be sure to seek medical help.

Anna, 25 years old: I was diagnosed with gestosis unexpectedly - at the 38th week of pregnancy. After reading the forum, I was very scared that I would have to have an abortion. But my mother told me not to read the forums, but to start treatment. I was sent to the hospital. There they explained to me that there could be no abortion, but only a caesarean section as a last resort. If you have been diagnosed with mild gestosis, there is no need to worry, just listen to the doctors, and everything will be fine!

Ira, 32 years old: Around the 22nd week of pregnancy, I began to feel numbness in my toes. After 3 weeks, at an appointment at the residential complex, it was discovered that in addition to swelling, I had high blood pressure up to 140 over 100, and was urgently sent for treatment to a hospital. She spent two weeks in the hospital receiving treatment. My blood pressure returned to normal and I started to recover. Before the baby’s birthday, I monitored my weight, ate healthy, and drank water in moderation. The baby was born on his own, without a cesarean section, and completely healthy.

Video: gestosis in the second half of pregnancy

Gestosis is a dangerous disease, especially its late form. To ensure a successful pregnancy, pay attention to signs of discomfort. If you have the slightest suspicion of late toxicosis, be sure to consult a doctor, otherwise there is a risk of harm to your health. You can learn more about such a dangerous disease as gestosis by watching a video on the topic.

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.