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Pregnancy Pregnancy, what is it? - symptoms, treatment and prevention

Pregnancy in pregnancy is a complication in which the work of physiological systems and organs is disrupted, and the pathological condition disappears after delivery. According to the research, it is formed in the third trimester of pregnancy, but it can occur earlier, beginning at 4 and ending with 20 weeks.

Content

Gestosis, what is it and how is it manifested?

Pregnancy during pregnancy is

Gestosis has three characteristic symptoms, according to which it is not difficult to put a primary diagnosis:

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

Pathology negatively affects the functioning of the cardiovascular, nervous and endocrine systems, the blood composition changes. The development of gestosis is after 18 weeks, manifested by the end of the 27th week.

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

Clinical manifestations are often consistent, so early gestosis is formed in the first half of pregnancy. The patient notes a constant nausea, vomiting, increased salivation (not to be confused with "normal" toxicosis during pregnancy ).

At a late stage there is nephropathy, dropsy of pregnant women, preeclampsia and eclampsia. In the presence of a diseased liver, skin and nervous diseases, rare forms of pathology are formed.

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

The causes of gestosis

A unified theory that promotes gestosis in pregnancy is not yet available, but some theories of the etiology of the disease have been proposed.

Cortico-visceral theory suggests the formation of neurosis in pregnant women, with failure in the interaction between the cortex and subcortical structure of the brain, resulting in reflex changes. In practice, this theory often finds confirmation, gestosis arises as a consequence of nervous tension.

According to the immunological theory, with gestosis, there is an abnormal hormonal control of the body's functions. Immunological conflict between the fetus and the mother is considered as the main reason. In this case, spasmodic vascular increases blood pressure and reduces the amount of blood necessary for nutrition and functioning of cells.

Genetic theory suggests that women whose mothers suffered from preeclampsia are affected. The lack of vitamins of group B and folic acid increases the content of homocysteine, an amino acid that enhances thrombus formation. From its effect, micro-holes are formed in the vessels, through them plasma protein and liquid fall into the tissue.

Pregnancy during pregnancy leads to swelling, signs of which at the beginning of the disease is not visible, but the weight is significantly increased. Plasma penetrates and stagnates in the tissues resulting in edema, increased blood pressure and decreased frequency of urination.

Similar micro-holes arise in the vascular walls of the kidneys, through them the protein penetrates into the urine. Regularly, a common urinalysis is prescribed. This helps to accurately diagnose and allows you to begin treatment immediately after the detection of pathology.

When the inner shell of the vessel - the endothelium is affected - its permeability increases, which contributes to the effusion of fluid in the body tissue. This changes the density of blood, its density and coagulability. Increased risk of thrombosis.

Gestosis is dangerous for violations in the brain. Clots form, small hemorrhages, intracranial pressure and dystrophy of the nervous tissue increase.

The first signs of gestosis

The first signs of gestosis

The appearance of gestosis at an early stage is difficult to notice, the condition is easily confused and mistaken for mild malaise in pregnant women. Slightly increased blood pressure, causing headache, weakness, nausea and rapid fatigue.

  1. In urine are found increased protein , the higher its content, the worse the manifestation of pathology.
  2. The arterial pressure exceeds 140/90 mm Hg. Art.
  3. Edema - if a protein is found in the urine, they indicate gestosis.

Symptoms of gestosis in pregnant women

Symptoms of gestosis in pregnant women

The disease affects most organs: kidney and liver, heart, placenta and nervous system. Possible the formation of permanent hypoxia, which leads to a delay in intrauterine development.

In the initial stage of gestosis (toxicosis), women vomit several times a day. There is constant nausea, a decrease in appetite, a desire to eat spicy and salty foods. Vomiting attacks do not affect weight. The temperature is within the normal range. These symptoms manifest themselves in the first months of pregnancy, then disappear on their own.

Rarely, but vomiting can stop, and then becomes uncontrollable (more than 20 times a day). The patient is weakened, has an aversion to food, the pulse is threadlike, blood pressure drops. In the urine, acetone and protein are found. In severe cases, the temperature jumps sharply, arrhythmia is possible.

At the end of pregnancy, gestosis develops gradually. Initially formed dropsy, with the passage of time develops nephropathy, then severe forms: pre-eclampsia, eclampsia. In the case of dropsy, women develop swelling due to fluid retention. At this time, hidden and visible swelling occurs. Given the slowing of diuresis, body weight increases very quickly.

The tumor is noticeable in the ankle, then spreads higher. Noticeable swelling of the face. In the evening, limbs and lower abdomen swell.

Three symptoms of gestosis with nephropathy:

  • edema;
  • protein in the urine;
  • hypertension.

A woman can have a combination of any symptoms. Nephropathy occurs simultaneously with dropsy. Elevated diastolic pressure is dangerous, it reduces placental blood flow. Fetus receives less oxygen. Later nephropathy is able to go into a serious complication - eclampsia.

With pre-eclampsia, the central nervous system suffers. In addition to the three main symptoms of gestosis, there is a heaviness in the back of the head, pain in the abdomen, head, nausea, vomiting. The pregnant woman experiences visual disturbances (flickering of flies), memory, insomnia.

Symptoms of pre-eclampsia:

  • pressure more than 160/110 mm Hg. p.
  • a decrease in the volume of excretion of urine (<500 ml), blood coagulability is worse due to a decrease in platelets, a marked disruption in the functioning of the liver.

Eclampsia is the worst phase of gestosis. A woman may have attacks of painful cramps. Light and any sharp sounds annoying, it lasts for a few minutes, after a possible loss of consciousness. There is a danger of developing a deep coma - it threatens with placental abruption, bleeding, fetal hypoxia and premature birth. The life of the fetus is in danger.

It should be noted that with gestosis for some time, the pregnant woman feels well, complaints only about minor puffiness, weight gain. Nevertheless, edema is formed not only in the limbs. Suffering from her placenta - it worsens the supply of oxygen to the fetus.

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

Diagnostics

The laboratory tests and complaints of the patient help determine the condition of the pregnant woman. For the diagnosis:

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

To determine the condition of the fetus, ultrasound and doplerography are prescribed. Clarification of the diagnosis consults with a nephrologist, therapist, ophthalmologist and neurologist.

Treatment of Gestosis

Treatment of Gestosis

A patient at any term of pregnancy is advisable to be hospitalized. This is necessary to preserve the functions of the body systems and successful delivery.

Out-patient observation is allowed only at the first stage of dropsy. In the case of development of nephropathy, pre-eclampsia and eclampsia necessarily placement in a hospital. Interruption of pregnancy is carried out ahead of schedule according to vital indications.

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

For this, the work is normalized:

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

The duration of treatment directly depends on the severity of gestosis. An easy form will require a two-week stay in the hospital, the average degree requires an extended stay. In difficult cases, the pregnant woman will have to remain under daily supervision until delivery.

Pre-term labor is carried out if observed:

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

The gestosis of the second half of pregnancy requires constant monitoring of the doctor. Independent births are allowed only with a satisfactory condition of the woman, no violations in the fetus and with positive results of therapy. In all other cases, a caesarean section is prescribed.

Consequences of Gestosis

Pregnant menace the worsening of the kidneys and heart, do not rule out pulmonary edema. Possible hemorrhage in internal organs.

Gestosis is dangerous by detachment of the placenta in pregnancy, lack of oxygen and nutrients to the developing fetus. This threatens to delay development, it is dangerous hypoxia of the fetus.

Prevention of gestosis in pregnancy

If a woman has internal diseases, preventive measures are started from the second trimester of pregnancy.

It is necessary to clarify the importance:

  • full rest and sleep;
  • balanced diet;
  • physical activity;
  • daily walks;
  • restriction of salt, and sometimes liquid.

Women with predisposing factors are required to register with a woman's consultation at an early stage of pregnancy and follow the doctor's instructions. Be sure to pass all laboratory tests to monitor the condition. Medication is prescribed only if there are concomitant diseases and individual indices.

Planning for the next pregnancy after gestosis is possible at any time, as soon as a woman feels the strength and capabilities. To foresee how pregnancy will develop. It is necessary to take into account previous experience, assess risk factors and find a gynecologist, whom you can trust.

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