Unfortunately, every second expectant mother has to deal with manifestations of toxicosis to a greater or lesser extent, and for many, nausea in the morning becomes the happy news that a new life has now arisen under the heart and a baby will appear in the family in about nine months. Early toxicosis, which torments pregnant women during the first ten weeks, is considered a normal phenomenon that accompanies the restructuring of the body, and it does not pose any danger. But late toxicosis is a completely different matter; this deviation often has an ominous appearance and serious consequences, and this pathology is called gestosis.

Today, this complication of pregnancy is considered a serious disease that threatens the life of the expectant mother and her baby (this is the main reason why gestosis is dangerous). If it is detected at an early stage, the pathology will be mild and can be eliminated even without hospitalization. The first “bells” that danger is approaching are swelling, and this seemingly harmless phenomenon is a clear sign of the development of a dangerous complication of pregnancy. Specific symptoms of pathology in the later stages require urgent measures to be taken both by doctors and by the expectant mother, which will avoid serious consequences.

Preeclampsia is diagnosed in approximately 20% of pregnant women, so how to treat it is a pressing question for many: some women are faced with a problem and want to know more about it in order to speed up recovery as much as possible; others are scared and want to protect themselves, knowing that prevention is the most rational and correct solution.

Preeclampsia in the third trimester of pregnancy and what provokes its development

So, gestosis is a complication of late pregnancy; it develops in the third trimester and is usually diagnosed in women carrying their first children. Symptoms of pathology can appear for no apparent reason, and also develop against the background of certain chronic diseases (obesity, hypertension, thyroid diseases) and intoxications. According to doctors, the development of gestosis in most cases is observed:

• in young mothers (under 18 years of age);
• during late pregnancies (in women over 35 years old);
• against the background of bad habits;
• with hereditary predisposition;
• during multiple pregnancy;
• as a result of numerous abortions;
• in case of immunological incompatibility of the tissues of the expectant mother and the fetus.

Gestosis during pregnancy is a complication in which the functioning of physiological systems and organs is disrupted, and the pathological condition disappears after delivery. According to studies, it is formed in the third trimester of pregnancy, but can occur earlier, from 4 to 20 weeks.

Preeclampsia, what is it and how does it manifest?

Preeclampsia has three characteristic symptoms, which are not difficult to make a primary diagnosis:

1. . Hidden and obvious, noticeable on the limbs and face.
2. Proteinuria. In urine analysis, the protein content is increased.
3. Hypertension. Increased blood pressure.

The pathology negatively affects the functioning of the cardiovascular, nervous and endocrine systems, and changes in blood composition occur. Preeclampsia develops after the 18th week and manifests itself by the end of the 27th week.

About a third of pregnant women experience manifestations of this complication. In some cases, it causes the death of the mother or baby.

Clinical manifestations are often consistent, so early gestosis occurs in the first half of pregnancy. The patient notes constant nausea, vomiting, and increased salivation (not to be confused with “normal”).

At a later stage, nephropathy, hydrops of pregnancy, preeclampsia and eclampsia appear. In the presence of a diseased liver, skin and nervous diseases, rare forms of pathology are formed.

Preeclampsia of the combined form appears with hypertension, endocrinopathy, biliary tract and kidney disease, and impaired lipid metabolism in the body.

Reasons for the formation of gestosis

There is no single theory about what contributes to gestosis during pregnancy, but some theories of the etiology of the disease have been proposed.

The cortico-visceral theory suggests the formation of neurosis in pregnant women, when there is a failure in the interaction between the cortex and the subcortical structure of the brain, leading to reflex changes. In practice, this theory is often confirmed; gestosis occurs as a consequence of nervous tension.

According to the immunological theory, with gestosis there is improper hormonal control of body functions. The immunological conflict between the fetus and mother is considered as the main cause. At the same time, vasospasm increases blood pressure and reduces the amount of blood necessary for the nutrition and functioning of cells.

Genetic theory suggests that women whose mothers suffered from preeclampsia are susceptible to complications. A lack of B vitamins and folic acid increases the content of homocysteine, an amino acid that increases blood clot formation. From its influence, microholes are formed in the vessels, through which plasma protein and liquid fall into the tissue.

Preeclampsia during pregnancy leads to swelling, the signs of which are not visible at the onset of the disease, but weight increases significantly. Plasma penetrates and stagnates in the tissues, resulting in swelling, increased blood pressure and decreased frequency of urination.

Similar microholes appear in the vascular walls of the kidneys, through which protein penetrates into the urine. A pregnant woman is regularly prescribed a general urine test. This helps in accurate diagnosis and allows treatment to begin immediately after pathology is detected.

When the inner lining of the vessel - the endothelium - is damaged, its permeability increases, which promotes the effusion of fluid into the body tissue. This changes the density of the blood, its thickness and coagulability. The risk of blood clots increases.

Preeclampsia is dangerous due to disorders in the brain. Blood clots and minor hemorrhages form, intracranial pressure increases and nervous tissue degeneration occurs.

The appearance of gestosis in the early stages is difficult to notice; the condition is easily confused and mistaken for a mild ailment in pregnant women. Blood pressure increases slightly, causing headache, weakness, nausea and fatigue.

1. , the higher its content, the worse the manifestation of pathology.
2. Blood pressure exceeds 140/90 mmHg. Art.
3. Edema - when protein is detected in the urine, they indicate gestosis.

The disease affects most organs: kidneys and liver, heart, placenta and nervous system. The formation of constant hypoxia is possible, which leads to intrauterine growth retardation.

In the initial stage of gestosis (toxicosis), women vomit up to several times a day. There is constant nausea, loss of appetite, desire to eat spicy and salty foods. Bouts of vomiting do not affect weight. Temperature is within normal limits. These symptoms appear in the first months of pregnancy and then disappear on their own.

Rarely, vomiting may stop, and then becomes uncontrollable (more than 20 times per day). The patient is weakened, has an aversion to food, the pulse is thready, and the blood pressure drops. Acetone and protein are found in the urine. In serious cases, the temperature rises sharply and arrhythmia is possible.

At the end of pregnancy, gestosis develops gradually. Initially, dropsy forms, over time nephropathy develops, then severe forms: preeclampsia, eclampsia. In cases of dropsy, women experience swelling due to fluid retention. At this time, hidden and visible swelling occurs. Given the slowdown in diuresis, body weight increases very quickly.

The tumor is noticeable in the ankle joint, then spreads higher. Swelling of the face is noticeable. By evening, the limbs and lower abdomen swell.

Three symptoms of gestosis with nephropathy:

• edema;
• protein in urine;
• hypertension.

A woman may have a combination of any symptoms. Nephropathy occurs simultaneously with dropsy. Increased diastolic pressure is dangerous because it reduces placental blood flow. The fetus does not receive enough oxygen. Later, nephropathy can develop into a serious complication - eclampsia.

With preeclampsia, the central nervous system is affected. In addition to the three main symptoms of gestosis, heaviness in the back of the head, pain in the abdomen, head, nausea, and vomiting occur. A pregnant woman experiences visual impairment (flickering of spots), memory, and insomnia.

Symptoms of preeclampsia:

• pressure is more than 160/110 mm Hg. Art.;
• decreased urine output (< 500 мл), свертываемость крови хуже из-за снижения тромбоцитов, заметно нарушение функционирования печени.

Eclampsia is the worst phase of gestosis. The woman may experience attacks of painful cramps. Light and any sharp sounds are irritating, this lasts for several minutes, after which loss of consciousness is possible. There is a danger of developing a deep coma - this threatens placental abruption, bleeding, fetal hypoxia and premature birth. The life of the fetus is in danger.

It should be noted that with gestosis, the pregnant woman feels well for some time, complaining only of minor swelling and weight gain. However, edema does not only form in the extremities. The placenta suffers from it - this impairs the supply of oxygen to the fetus.

Preeclampsia during pregnancy is a serious condition; the first symptoms are the reason for an immediate visit to the doctor.

Diagnostics

Laboratory tests and the patient’s complaints help determine the condition of the pregnant woman. For diagnosis the following is carried out:

• coagulogram, which determines blood clotting time;
• blood test (biochemistry and general);
• changes in body weight;
• urine analysis (biochemistry and general);
• fundus examination;
• blood pressure dynamics;
• the volume of fluid excreted taking into account its consumption;

To determine the condition of the fetus, ultrasound and Doppler ultrasound are prescribed. To clarify the diagnosis, consultations with a nephrologist, therapist, ophthalmologist and neurologist are carried out.

It is advisable to hospitalize a patient at any stage of pregnancy. This is necessary to preserve the functions of the body systems and successful childbirth.

Outpatient observation is allowed only for stage 1 dropsy. In case of development of nephropathy, preeclampsia and eclampsia, hospitalization is required. Termination of pregnancy is carried out early for health reasons.

Therapy is aimed at preventing the development of complications and the formation of intrauterine disorders in the fetus.

To do this, normalize the work:

• nervous system;
• determine the condition of the vascular wall;
• improve blood circulation;
• normalize water-salt metabolism;
• reduce viscosity and increase blood clotting;
• regularly monitor blood pressure dynamics;
• normalizes metabolic processes in the body.

The duration of treatment directly depends on the severity of gestosis. A mild form will require a two-week hospital stay, while a moderate form will require a long stay. In difficult cases, the pregnant woman will have to remain under daily supervision until delivery.

Premature births are carried out, if observed:

1. Lack of positive dynamics from therapy for persistent nephropathy (moderate severity).
2. If the expected effect is not observed during resuscitation in the first 2 hours.
3. Disturbances in the development and growth of the fetus (with nephropathy).
4. Eclampsia, risk of complications.

Preeclampsia in the second half of pregnancy requires constant medical supervision. Unattended childbirth is allowed only if the woman’s condition is satisfactory, there are no abnormalities in the fetus and if the results of therapy are positive. In all other cases, a caesarean section is prescribed.

Consequences of gestosis

A pregnant woman is at risk of deteriorating kidney and heart function, and pulmonary edema cannot be ruled out. Hemorrhages in internal organs are possible.

Preeclampsia is dangerous due to placental abruption during pregnancy, a lack of oxygen and nutrients to the developing fetus. This threatens developmental delays and dangerous fetal hypoxia.

Prevention of gestosis during pregnancy

If a woman has diseases of the internal organs, preventive measures begin in the second trimester of pregnancy.

The importance needs to be explained:

• proper rest and sleep;
• balanced diet;
• physical activity;
• daily walks;
• restriction of salt and sometimes fluid.

Women with predisposing factors are required to register with the antenatal clinic at an early stage of pregnancy and follow the doctor's instructions. Be sure to undergo all laboratory tests to monitor your condition. Medicines are prescribed only in the presence of concomitant diseases and individual indicators.

You can plan your next pregnancy after gestosis at any stage, as soon as the woman feels strong and capable. It is impossible to predict how pregnancy will develop. It is worth considering previous experience, assessing risk factors and finding a gynecologist you can trust.

Gestosis during late pregnancy: signs and consequences

Gestosis during pregnancy is a complication of gestation that occurs in the later stages. The condition significantly disrupts the functions of the mother’s body and brings suffering to the child.

Therefore, at the first manifestations of pathology, it is necessary to do an examination, and if the problem is confirmed, take measures to eliminate it.

Let's consider in more detail: toxicosis during pregnancy - what it is, why it occurs in the later stages, its signs and consequences (for the pregnant woman herself and for the baby).

Gestosis during pregnancy - what is it?

Gestosis during late pregnancy is a pathological condition that some pregnant women experience; its outdated name is late toxicosis. It is accompanied by a distortion of the functioning of interconnected organs and systems.

Treatment of gestosis in the second half of pregnancy

With the first degree of toxicosis in the second half of pregnancy, the patient is prescribed outpatient treatment. It is recommended to lie more on your left side so that the uterus is better supplied with blood and oxygen. To normalize brain function, herbal sedatives are prescribed. In certain cases, mild tranquilizers, such as Phenazepam, may be needed.

Inpatient treatment: indications and methodology

Hospitalization is indicated for a woman with any degree of gestosis that is higher than the first. Also, inpatient treatment is suggested when outpatient treatment does not bring positive dynamics.

The hospital therapy technique involves the injection into a vein of drugs (magnesium sulfate, pentoxifylline, aminophylline) that relieve spasms, lower blood pressure and prevent the occurrence of convulsive syndrome. Medicines to lower blood pressure, as well as blood thinners, are prescribed as complementary agents. The treatment period for mild and moderate gestosis is variable and ranges from 2 to 4 weeks. The patient is in serious condition in the hospital until delivery.

Consequences for mom

The main danger of gestosis for a woman is the disruption of the functioning of vital organs. Hepatic, renal and cardiac dysfunction threatens subsequent distortion of the functioning of other systems. The most serious consequence of gestosis during pregnancy is death or eclamptic coma. There is a risk of pulmonary edema and hemorrhages in organs. The prognosis depends on the degree of the disease, the clinical picture and the initial health status of the patient.

Consequences of gestosis during pregnancy for a child

Medical practice shows that the closer to childbirth gestosis begins, the more favorable its prognosis will be. Women whose problem appeared at 35 weeks are more likely to have a successful resolution than pregnant women with gestosis that began at 20 weeks. The main danger for the baby is oxygen starvation. Hypoxia can lead to irreversible consequences:

• cerebral circulatory disorders;
• fetal malnutrition;
• intrauterine death.

The likelihood of recurrence of gestosis in later stages in subsequent pregnancies

Preeclampsia may recur during the next pregnancy. Moreover, the likelihood of relapse is directly proportional to the time of onset of symptoms. If a woman’s gestosis began at 20 weeks, then recurrence is almost guaranteed. When an expectant mother encounters signs of late toxicosis just before giving birth, the likelihood of a relapse is reduced significantly.

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Preeclampsia during pregnancy - what is it, symptoms

The first months of pregnancy are most often accompanied by early toxicosis (preeclampsia). Nausea and dizziness are symptoms of pregnancy for many. This pathology is quite safe, but it should still be under medical supervision.

Late gestosis during pregnancy is a more dangerous disorder that threatens fetal hypoxia and premature birth. If your legs become swollen and the rings become small, be sure to check your urine for the presence of protein. Treatment of toxicosis in the third trimester is inpatient.

Causes of gestosis during pregnancy

The reasons for the appearance of signs of gestosis throughout pregnancy have not been precisely identified. Scientists offer at least 30 theories about the factors that provoke early and late toxicosis.

Modern gynecologists tend to trust the following versions:

Cortico-visceral. Toxicosis is provoked by disturbances in the functioning of the cerebral cortex and circulatory disorders. As a result of getting used to pregnancy, late gestosis develops.

The second theory connects gestosis with pathologies of the endocrine system. Due to a lack of hormones, malfunction of the adrenal glands, ovaries and pathology of the blood vessels of the placenta, disruptions in the normal course of pregnancy occur.

Immunological version. Proponents of this theory see the root cause of gestosis in the mother’s body’s rejection of a foreign fetal protein.

Genetic. If the mother and grandmother had gestosis during pregnancy, there is a high probability of developing pathology.

Placental. Early gestosis of pregnancy develops due to insufficient development of the placenta and the entry of fetal waste products into the woman’s body.

Pathology also occurs in women who became pregnant before the age of 17, and who suffer from obesity, kidney and liver diseases. If a pregnant woman abuses alcohol and smokes, is often nervous, or does not get enough vitamins, she will experience complications.

Signs of gestosis in later stages

Preeclampsia, which appears at 30-35 weeks, has obvious signs. During an examination by a gynecologist, a woman’s legs and arms must be examined and her blood pressure measured. The main symptoms of toxicosis in late pregnancy:

• Swelling of the limbs.
• The blood pressure is constantly elevated, increased by 20% of the woman’s normal blood pressure.
• Detection of protein in urine (proteinuria).

All three symptoms practically do not occur; the presence of only one sign of gestosis indicates a pathological course of pregnancy. If there is an excessive increase in body weight in the first trimester, there is a risk of late toxicosis.

A severe form of gestosis is accompanied by fever, general weakness, headaches, nausea, swelling of the limbs, abdomen, and face. In this case, the woman needs urgent hospitalization and treatment.

Diagnostics

A pregnant woman must register and visit a gynecologist at least once a month. During the examination, the doctor notes any health changes and refers you for tests. The main procedures by which gestosis is detected:

1. general blood and urine tests;
2. weighing and measuring abdominal volumes;
3. examination of the limbs using pressure on the skin;
4. pressure measurement, comparison with initial values;
5. blood test for clotting.

If the presence of protein in the urine is detected, and the legs and arms become swollen, the woman is sent for a fetal ultrasound. Once the diagnosis is confirmed, it is necessary to undergo hospital treatment and also register with a neurologist and nephrologist.

How to treat late gestosis

Edema of the lower extremities cannot be ignored. The pathological condition disrupts the course of pregnancy and threatens premature birth.

Treatment of gestosis during pregnancy includes the following medical procedures:

Treatment regimen. A woman needs to spend more time lying down or reclining, resting and sleeping at least 8 hours a day. Stressful situations are excluded.

Correct diet. The daily menu should contain dishes rich in beneficial microelements. Vitamin complexes are prescribed. The amount of fluid consumed is not reduced.

Drug therapy. The drugs are aimed at improving blood circulation in the uterus and placenta and lowering blood pressure. Diuretics are used in extreme cases: diseases of the cardiovascular system, pulmonary edema.

Delivery. In some cases, there is no time to treat gestosis, and delay threatens the health of the mother and child.

Depending on the patient’s condition, the obstetrician-gynecologist determines the duration of therapy. If grade 1 gestosis is detected, the pregnant woman can stay at home, provide herself with bed rest and proper nutrition.

Medication

If a mild degree of gestosis is detected, a course of drug therapy is prescribed, which lasts up to 10 days. In case of complicated development of toxicosis, treatment is carried out immediately before delivery and can last from 5 hours to 4 days.

Drugs that will eliminate signs of pathology:

• sedatives to calm the nervous system;
• drugs that lower blood pressure;
• a dropper with magnesium to eliminate seizures and lower blood pressure;
• intravenous blood infusions;
• antioxidants that protect the body from toxins;

During treatment, doctors monitor the condition of the fetus; if something threatens its life or health, an emergency caesarean section is performed. Natural birth is possible if the therapy is effective and the baby’s intrauterine development is sufficient.

Folk remedies for gestosis

Treatment of late gestosis at home is possible only in the first two stages of the disease. Traditional recipes are used in combination with drug therapy.

Herbal teas. It is beneficial to drink chamomile and mint tea throughout the day.

Decoctions from medicinal herbs. Pharmaceutical preparations that have sedative and diuretic properties are brewed in the following proportion: 2 tablespoons of herbs per liter of boiling water.

Tinctures. The medicine is prepared in water, with the addition of coltsfoot, rowan, mint, motherwort, plantain, geranium, and string.

Traditional medicine prescriptions should be taken with caution. Be sure to consult your doctor and monitor your health. In any case, the pregnant woman should undergo medication treatment.

Prevention of gestosis during pregnancy

Late toxicosis not only leaves the expectant mother uncomfortable, but also threatens fetal hypoxia and premature birth. To prevent gestosis and its negative consequences, doctors recommend taking preventive measures: you should not drink a lot of liquid, as well as salty foods; physical activity should be moderate; good sleep; rational nutrition; ensure a calm pregnancy without stress and nervous disorders.

For the correct course of pregnancy, it is necessary to lead a moderately active lifestyle. Take a walk in the fresh air, do gymnastics for pregnant women. Also strictly monitor your weight gain, weekly no more than 400 grams.

Complications and prognosis

Mandatory treatment of gestosis is associated with the possible serious complications it causes.

If you ignore the symptoms of dropsy, a woman will experience the following complications:

• a sharp increase in blood pressure, coma;
• intracerebral bleeding;
• manifestations of respiratory failure;
• rapid development of renal failure;
• placental abruption, premature birth;
• failure of the body's vital systems, coma.

Visual disturbances, up to complete loss of vision, are also observed. Deadly complications are HELLP syndrome and acute fatty hepatosis. Sharp abdominal pain, vomiting and nausea in the last months of pregnancy are symptoms of a dangerous condition.

Nephropathy

Nephropathy is the second stage of gestosis and is treated with medication in a hospital. In addition to swelling of the legs and arms, an increase in blood pressure is observed, and proteinuria is diagnosed.

The presence of protein in the urine is combined with its decrease in the blood. Proteinuria indicates impaired renal function, vasospasm of the placenta and uterus, and lack of oxygen to the body of the woman and the fetus. Due to constantly elevated blood pressure or sudden changes in indicators, placental abruption is provoked, which threatens premature birth or death of the child.

Preeclampsia

If left untreated, nephropathy quickly progresses to the next degree of gestosis – preeclampsia.

In addition to the main symptoms of late gestosis, the following are observed:

• signs of intoxication;
• headaches;
• spots before the eyes, dizziness;
• lack of air;
• insomnia, memory impairment;
• behavioral disorder: aggressiveness or indifference.

The woman feels sharp pain in the abdomen and back of the head. If bleeding and lower back pain occur, you should call an ambulance. Treatment is carried out inpatiently, depending on the stage of pregnancy, it takes up to 5 to 10 days.

Eclampsia

Eclampsia is the last stage of gestosis, in which a pregnant woman experiences convulsive seizures and blood pressure rises to 160/120. Any loud sound or sudden movement can trigger this symptom. Pathology can lead to fetal hypoxia, maternal stroke, internal bleeding, swelling of internal organs, coma, and death.

Eclampsia without seizures is also sometimes observed. In this case, the woman immediately falls into a coma. Treatment must be urgent; intramuscular and intravenous drugs are used.

In short, gestosis is one of the complications that can occur during pregnancy. The concept of gestosis describes a large complex of symptoms that manifests itself in cases when the body of a pregnant woman cannot meet the needs of the growing fetus.

This condition is a big problem in modern gynecology, since it can cause serious complications and is quite difficult for a woman. In developed countries, due to the active development of obstetric practice, as well as a high standard of living, only 6% of pregnancies occur against the background of gestosis. In Russia, according to studies published in journals, the incidence rate is growing and amounts to 19% of all pregnancy cases.

This means that at this stage of development of obstetrics in Russia, it is not possible to completely eliminate all risk factors that lead to the development of this disease. A careful study of medical histories allows us to speak with confidence about the relationship of risk factors with this condition.

Determining the disease should not be a problem for a qualified gynecologist. The classic complaints of a pregnant woman, as well as the characteristic clinical picture, make it possible to relatively quickly make the correct diagnosis and begin treatment measures.

Difficulty in pregnant women

Classification of gestosis according to ICD-10

In the international classification of diseases, gestosis belongs to the section “Swelling, proteinuria and hypertensive disorders during pregnancy, childbirth and the postpartum period” under codes O10-O16.

In Russia, a new classification of gestosis according to clinical course is used to a greater extent.

So, according to this, the following types of disease are distinguished.

1. Clean. The classic form of the disease, which is not complicated by other somatic pathologies.
2. Combined. It occurs in pregnant women who previously suffered from pathologies that cause hypertension.
3. Unclassified. There is a characteristic clinical picture, but there is not enough data to establish the cause.

If we talk about classification specifically according to the ICD, the following types of gestosis are distinguished:

The ICD classification does not represent a refined diagnosis that takes into account absolutely all the characteristics of the condition. The International Classification of Diseases is necessary to simplify the work of doctors around the world.

Forms and stages of gestosis by severity

In addition to classification according to the clinical course (pure, combined and unclassified gestosis), classification is also used according to the severity of the patient’s condition.

So, according to the degree of severity, the following types are distinguished.

1. Easy. The duration of gestosis is relatively short, about two weeks. It manifests itself as swelling in the lower legs, as well as a slight increase in body weight. Proteinuria is insignificant or absent. Pressure up to 150/90. It is usually diagnosed in the last weeks of pregnancy.
2. Average. Lasts up to one month. It is necessary to carry out therapeutic measures. Swelling appears in the abdomen. Pressure up to 170/110. Most often occurs between 30 and 35 weeks. Accompanied by exacerbation of chronic somatic diseases.
3. Heavy. The duration of the condition is more than a month. Often requires immediate delivery to preserve the health of the pregnant woman.

Often, all forms of gestosis are accompanied by oligohydramnios or problems with the placenta. It is the disruption of blood circulation between the uterus and placenta that becomes a common cause of the formation of mild forms of the disease.

Carefully!
Separately from the forms of gestosis, according to the degree of severity, preeclampsia and eclampsia should be distinguished. These two conditions require immediate medical intervention, with the aim of providing emergency medical care and subsequent hospitalization in a hospital.

In the early stages

Preeclampsia does not occur during such a period. If manifestations of this condition are observed before the 20th week, that is, in the first trimester, it is customary to say that the woman had a chronic disease, against the background of which an increase in blood pressure was detected. That is, we cannot talk about the classic form of gestosis.

Some women mistake toxicosis for an early form of gestosis, but this is completely wrong. Toxicosis is a condition in a pregnant woman that develops in the first half of pregnancy and is manifested by nausea and vomiting. The condition does not pose a risk to the health of the pregnant woman and fetus and does not require emergency medical intervention.

If there is an increase in blood pressure in the early stages, you must immediately seek help from a specialist to avoid exacerbation of somatic diseases and timely initiation of treatment measures.

In the later stages

Preeclampsia develops precisely in this period of pregnancy, starting from 20-22 weeks. For a long time, this condition occurs without visible changes. It begins with the stage of formation of edematous syndrome. A pregnant woman's body experiences significant fluid retention, which leads to pathological weight gain.

Swelling also appears in stages.

1. Swelling of the legs.
2. Swelling of the abdomen.
3. Swelling of the face.
4. Widespread swelling.

To determine whether there is swelling or not, you need to carry out a simple manipulation. Press on a free area of ​​skin with one finger. If the white mark remains for more than a few seconds, then there is swelling in this area.

Observation
Further progression of gestosis leads to the appearance of protein in the urine and the development of nephropathy. This usually occurs at 30-32 weeks, but can be earlier, depending on when the symptom complex began to develop. If the condition is not treated, preeclampsia develops, requiring immediate medical attention.

Severe form

It develops against the background of other serious pathologies, such as diabetes.

It has been proven that the disease is often one of the reasons for the development of such forms of gestosis as.

1. HELLP syndrome. With this pathology, there is pronounced hemolysis of red blood cells, a decrease in platelet levels, and an increase in liver enzymes.
2. Yellow atrophy of the liver. In this case, liver cells are replaced by adipose tissue. There are no signs of organ inflammation. As a result, significant impairment of liver function occurs, up to the formation of failure.
3. Liver failure. Against the background of prolonged eclampsia, as well as the addition of other complications, such as bleeding, infectious processes, serious dysfunction of the organ is possible, up to its failure.

Together with other diseases

All of the above forms are extremely dangerous for both the mother and her unborn child. It is extremely important to be hospitalized in a timely manner and begin specific treatment.

Rare forms of gestosis

All severe types of the disease are rare.

In addition to them, the following can be included:

• jaundice of pregnant women;
• chorea;
• tetany;
• dermatosis

The above types of disease are not always life-threatening for the fetus and mother, but also require immediate treatment.

The exact factors have not been identified

Causes

The pathogenesis of the development of gestosis during pregnancy is not fully understood.

According to experts, this condition can develop due to several reasons, namely.

1. Corticovisceral factor. According to this theory, changes leading to gestosis occur against the background of disruptions in connections between cortical and subcortical structures.
2. Hormonal background. Changes in the endocrine background during pregnancy can also lead to a number of disorders, against the background of which the formation of late gestosis occurs.
3. Immune theory. According to these data, changes in the body and the development of gestosis are facilitated by an incorrect reaction of the immune system to tissue antigens secreted by the fetus.
4. Placental theory. With insufficient development of the placenta, nutritional deficiency may occur and the development of this condition.

Expert opinion
Borovikova Olga
The genetic factor also plays a major role in the formation of late gestosis. According to research data, if there is a family history of cases of gestosis, the risk of developing this condition increases significantly.

Psychosomatics plays a role in the formation of many diseases and gestosis is no exception. Constant stressful situations also significantly increase the risk of developing this condition.

At-risk groups

The main goal of the antenatal clinic is to prevent the formation of gestosis. This requires preventive measures. Not all women are subject to this, but only those who are at risk for the development of gestosis.

This group includes those who have one or more risk factors from the following list:

• gestosis during a previous pregnancy;
• complicated heredity (preeclampsia in the mother or grandmother);
• age 40 and older;
• long interval between births;
• diabetes mellitus and other endocrine diseases;
• cardiac pathology and other somatic diseases;
• early first birth.

The likelihood of developing gestosis is not always present, even in the presence of several risk factors. Such women simply have a higher chance of developing this condition.

The main thing is to start treatment on time

Symptoms

Preeclampsia is a complex disease that manifests itself as a triad of symptoms. The first manifestation is high blood pressure. In addition to changes in the tonometer readings, the patient may complain of headache, deterioration in health, dizziness, and weakness. Some patients experience joint pain.

During an attack of high blood pressure, a serious sign is a significant increase in symptoms, as well as the lack of effect from the use of antihypertensive drugs.

The second sign that the disease manifests itself is the appearance of protein in the urine. Outwardly it is not possible to distinguish this. This symptom can only be confirmed after a urine test. The appearance of protein in the urine is an alarming sign that may indicate not only gestosis, but also severe inflammatory kidney diseases.

The last sign is swelling. The first thing you need to understand is that edema syndrome occurs in most women whose pregnancy proceeds physiologically.

If a doctor diagnoses late gestosis, a bad prognostic sign is the following:

• no swelling;
• increased swelling in the lumbar region.

Knowing how the disease manifests itself is important to remember. If its signs appear, you should immediately seek help from a specialist. Only timely initiation of treatment can avoid complications.

Diagnosis of gestosis

In most cases, clinical manifestations of the disease are sufficient, as well as routine examination methods and further evaluation of the results.

The first routine examination that a doctor should conduct if gestosis is suspected is measuring blood pressure. Normally, it should not exceed 130/90. It is recommended to take measurements twice with an interval of several minutes. The next test to confirm the presence of gestosis is a general urine test. The main indicator that a specialist can determine for this disease is the appearance of protein in the urine.

To assess the severity of gestosis, doctors use the so-called Savelyeva scale. In this scale, depending on the results of the examination and tests, scores are assigned that determine the severity of the pathology.

How to get tested

To properly prepare for testing, you must follow the following rules.

1. Blood must be donated on an empty stomach.
2. It is not recommended to drink tea, coffee and natural juices.
3. A few days before the examination, completely eliminate fatty foods.
4. 24 hours before taking a general urine test, do not consume food that is colored, alcohol, or drinks containing caffeine.
5. Urine should be collected in special containers.
6. When collecting urine at home, the container must be delivered to the laboratory no later than 2 hours later.

By following these rules, you can significantly reduce the risk of false results in tests. This will allow the doctor to make a more accurate diagnosis and correctly determine the severity of the disease.

What's happening, symptoms

Decoding

Urine, normally, should be characterized by the following indicators:

• color yellow;
• transparent;
• no pungent odor;
• sugar and protein should normally not exceed 0.085 µmol/l and 0.033 g/l, respectively;
• leukocytes 0-5;
• red blood cells 0-1;
• cylinders 1-2.

With gestosis, there will be a significant increase in the level of protein in the urine. So-called proteinuria is detected.

In the blood during gestosis, we are interested in the level of hemoglobin, as well as liver tests.

Normally, the following values ​​should be:

• Hb 120-140;
• Platelets 180-320;
• AST until 10-40;
• ALT up to 31;
• alkaline phosphatase up to 240.

Expert review
Borovikova Olga
In case of gestosis, specialists are more interested in the ALT and AST indicators. In severe cases of the disease, a significant increase in their level is noted. A general blood test is not decisive in making a diagnosis, but a drop in platelet levels below 100 also indicates a severe course of the disease.

Treatment of gestosis in pregnant women

The protocol for the treatment and diagnosis of late gestosis includes two main activities.

1. Anticonvulsant therapy.
2. Therapy aimed at lowering blood pressure.

Preeclampsia does not always require hospital treatment. In some cases, it is possible to manage the disease on an outpatient basis.

Modern methods of managing pregnant women with gestosis determine the following indications for hospitalization:

• severe preeclampsia;
• gestosis complicated by liver pathology or HELLP syndrome.

In these conditions, emergency hospitalization of the pregnant woman is necessary. Otherwise, serious complications may develop, including death.

Drugs

The following drugs can be used in the treatment of gestosis:

• magnesia (necessary for the relief of convulsive syndrome);
• nifedipine and urapidil (drugs of choice for lowering blood pressure in pregnant women);
• vitamins C and E (occasionally used as preventive treatment, but their effectiveness has not been proven).

If an infectious process has developed against the background of gestosis, it is possible to prescribe antibacterial drugs such as Ceftriaxone or Josamycin. They do not have a teratogenic effect, therefore they are absolutely safe for use during pregnancy.

Extremely serious condition

Early gestosis

The concept implies ordinary toxicosis. No specific activities are required. In this case, the body will cope on its own. In case of severe toxicosis, you can consult a specialist to identify concomitant diseases that may require treatment. Typically, toxicosis goes away on its own and is rarely severe.

Severe gestosis

Develops from 34 to 39 weeks of the disease. It must be remembered that while mild preeclampsia can be treated on an outpatient basis, the development of eclampsia requires emergency hospital treatment.

In addition to administering medications, emergency delivery may be necessary.

It is carried out in the presence of the following indications:

• severe eclampsia, difficult to treat with medication;
• deterioration of the fetus;
• a sharp increase in the manifestation of the disease.

If the pregnancy has reached 37 weeks, delivery is mandatory. If after stimulation there is no effect, a caesarean section is performed.

Severe gestosis is an extremely serious condition that can be fatal. Therefore, it is a mistake to believe that gestosis and toxicosis are the same thing. Toxicosis does not require serious therapeutic measures and extremely rarely leads to serious complications.

How to treat gestosis during pregnancy at home

It is important to remember that you should never self-medicate. The first thing to do is to immediately seek help from a doctor. If proper treatment is started quickly, complications can be avoided.

There is no specific first aid that can be provided to a patient at home.

If gestosis is complicated, the following must be done.

1. Call an ambulance.
2. Place the patient on the bed.
3. Ensure a sufficient flow of oxygen (open the window, remove the pregnant woman from restrictive clothing.
4. Try to calm the woman down.

After the ambulance arrives, the pregnant woman will be provided with all the necessary assistance, and if indicated, she will be hospitalized.

The diet is prescribed based on examination

Care

The most important thing is to carefully monitor her condition and measure her blood pressure. This will allow you to notice deterioration in a timely manner.

It is also necessary to reduce the stress component and make the woman’s life more comfortable. Normalizing the psychological component of a pregnant woman’s life can reduce the risk of complications significantly.

To ensure that a pregnant woman receives proper and nutritious nutrition. It cannot be said that the diet can cure gestosis, but it reduces the risk of complications.

Diet

There is no specific nutrition for gestosis. There are rules that every pregnant woman at increased risk of this condition must adhere to.

To reduce the risk, you must adhere to the following rules.

1. Eat small portions. In total, there should be 5-6 meals in one day.
2. Avoid foods with strong odors.
3. Do not drink a lot of fluids and refrain from drinking liquids 20 minutes before meals.
4. Monitor weight changes carefully. If a woman gains more weight in a week than necessary, fasting days should be arranged.
5. The menu must include soups made with chicken and vegetable broths, as well as stewed or steamed dishes. It is better to avoid fried and fatty foods.

The diet is always individual and should be prepared under the supervision of the attending physician. To ensure proper nutrition, it is better to consult a specialist.

Complications

Preeclampsia is a serious pathology that, if severe, can lead to serious complications for both the mother and the fetus.

A pregnant woman may experience the following complications:

• thrombosis;
• stroke;
• formation of DIC syndrome;
• kidney damage;
• retinal detachment;
• pulmonary edema;
• coma.

Such serious complications arise in cases where a pregnant woman does not follow the recommendations of a specialist and does not treat the disease. To reduce the risk of complications, it is important to carry out preventive measures, as well as treat manifestations of gestosis.

A very serious complication of this condition is HELLP syndrome. This syndrome includes hemolysis of red blood cells, elevated liver enzymes, and thrombocytopenia.

The occurrence of this condition is possible only if gestosis is accompanied by DIC syndrome, as well as liver and kidney failure. The main problem is high mortality. Only with timely diagnosis and immediate delivery can the prognosis of complications be improved.

Early prevention

Consequences for the child

Preeclampsia also affects the fetus. It is dangerous for the fetus not so much due to its consequences during pregnancy as in the postpartum period.

The following complications are possible in newborns:

• respiratory distress syndrome;
• severe hypoxia;
• malnutrition;
• underdevelopment of internal organs.

All these conditions develop against the background of the fact that during gestosis, the function of the placenta is disrupted and there is an insufficient supply of nutrients to the fetus.

Can gestosis recur during a second pregnancy?

One of the risk factors is the presence of this condition in a previous pregnancy. If there is a case of gestosis in the gynecological history, the risk of developing this condition during a future pregnancy increases significantly.

To reduce the risk of recurrence, it is recommended to carry out preventive measures, as well as register with the antenatal clinic in a timely manner.

Prevention

Women at risk must be identified.

To prevent the formation of gestosis, the following recommendations must be followed:

• sleep at least 8 hours;
• frequent walks in the fresh air;
• reduction of stress factor;
• careful monitoring of the pregnant woman's condition.

Drug prevention includes taking acetylsalicylic acid from 12 to 36 weeks. The use of this drug is recommended in low doses in women at risk.

Prevention does not allow gestosis to be completely avoided. However, it reduces the risk of its formation and facilitates its course. Any woman planning a pregnancy should know about preventive measures.