What is the danger of late toxicosis in an expectant mother? Late toxicosis in pregnant women: causes and consequences Why late toxicosis is dangerous for a child

For pregnant women, the word “toxicosis” is usually associated with the first months of pregnancy. Although nausea, vomiting and drowsiness are quite inconvenient, in most cases they are not dangerous for the development of the fetus and the condition of the mother.

The main changes in gestosis are associated with disturbances in the functioning of the circulatory system. This causes oxygen starvation and fluid retention in the tissues.

The kidneys are very vulnerable. During their normal functioning, there should be no protein in the urine, but disruption of the blood supply to the vessels leads to a malfunction of the organs, and as a result, the appearance of protein in unacceptable quantities. Late toxicosis negatively affects the functioning of the nervous system. In severe cases, cerebral edema may develop.

There are several forms of the pathological condition: dropsy, nephropathy, preeclampsia, eclampsia. They are all different stages of the disease.

Dropsy

It belongs to the most common pathologies that occur in late gestation. It develops especially often with. The first signs are swelling of the feet and legs, worsening in the morning. Gradually, swelling spreads to the arms, sacrum and lower back, and face. A woman may notice that she has difficulty removing a ring from her finger or putting on previously loose shoes.

Another common sign of dropsy is a decrease in the total amount of urine produced per day. There is a sharp increase in weight, sometimes a feeling of heaviness in the body, shortness of breath, and tachycardia are felt. But in general, the general condition remains normal, there are no disturbances in the functioning of the liver or kidneys. After childbirth, the symptoms of dropsy disappear without treatment.

In the early stages of the disease, you can combat the symptoms of dropsy at home. This must be done, even if you feel generally satisfactory, since lack of treatment can lead to the transition of late toxicosis to the next stage of development.

Nephropathy

Occurs as a complication of dropsy. In addition to pronounced swelling of the whole body, a significant increase in blood pressure, dizziness, severe thirst, insomnia, a feeling of heaviness, pain in the sacrum and lower back are noted. Often there are disturbances in the functioning of the liver, which leads to an increase in its size, painful sensations in the right hypochondrium, and jaundice. The risk of developing nephropathy increases if a pregnant woman has other diseases, such as diabetes, hypertension, nephritis.

Nephropathy belongs to severe lesions that lead to the development and delay of its development, or complicated childbirth, bleeding.

Preeclampsia

The pathology is associated with dropsy and nephropathy of pregnancy. At this stage of late toxicosis, a significant increase in the amount of protein in the urine is noted. It can reach 0.5-1 g/l per day and higher. The woman experiences severe swelling throughout the body, pain in the temples and right hypochondrium, nausea and vomiting.

Patients complain of blurred vision, an unstable psychological state - from euphoria and excitement to lethargy and apathy. Pathological changes are also noticeable in a blood test: red blood cells are destroyed and the number of platelets decreases.

The woman’s condition poses a danger both to herself and to the unborn child, who does not receive the necessary nutrients due to impaired blood supply through the vessels of the placenta. As a result, the risk of fetal death or the development of diseases such as epilepsy or cerebral palsy increases.

Eclampsia

Accompanied by fainting, seizures and coma. Eclampsia develops rapidly; in some cases, after convulsive seizures, hemorrhage in the brain can occur, followed by irreversible coma. Seizures, despite their short duration, are also very dangerous because they can lead to sudden death.

Convulsive attacks of eclampsia begin with small tremors of the facial muscles. Then there is a sharp deterioration in the condition with the spread of seizures to the upper and lower limbs and torso. The duration of the seizure is about a minute, they can be repeated so often that the woman does not have time to regain consciousness.

The most severe and dangerous form of the disease is a coma, which can occur abruptly, often without preliminary convulsions.

When the woman regains consciousness, she complains of severe headaches, general weakness and weakness. In most cases (70%), eclampsia develops during pregnancy, but it may occur during childbirth (30% of cases) and in the postpartum period (about 2% of cases).

In addition to dropsy, all forms of gestosis require treatment in a hospital setting in the pathology department. In case of renal failure, premature placental abruption, acute fetal hypoxia, it is indicated.

Diagnostics

Knowing the dangers of late toxicosis, it is necessary to regularly visit an obstetrician-gynecologist throughout the entire gestation period. Every pregnant woman should regularly undergo a number of general activities:

• measuring blood pressure, especially important after exercise;
• passing a general urine test to detect protein, as well as tests according to Nechiporenko and Zemnitsky;
• conducting general and biochemical blood tests;
• controlling the amount of liquid you drink;
• weekly measurement of weight gain;
• visiting an ophthalmologist to measure fundus and visual acuity;
• consultation with a nephrologist and neurologist;
• Ultrasound of the kidneys and adrenal glands;
• conducting an electrocardiogram.

With minor swelling of the extremities and general satisfactory condition, they are limited to following the doctor’s general recommendations on lifestyle and dietary adjustments.

Diagnosis of nephropathy, especially its severe forms, is not difficult, but in some cases it must be distinguished from diabetic and uremic coma.

Treatment

For mild nephropathy, drug therapy is prescribed, which includes:

• sedatives (tinctures of motherwort, valerian);
• antispasmodics (Papaverine, No-shpa);
• means for normalizing blood pressure (Eufillin, Dibazol, Clonidine);
• drugs to reduce the risk of blood clots and normalize blood circulation;
• diuretics to improve urination and eliminate swelling.

The duration of treatment in the hospital department is from 10 to 14 days. Complete normalization of the condition is a rather long process, usually it is completed only after the birth of the child. The woman’s blood pressure stabilizes, urine analysis returns to normal, and swelling disappears.

If there are symptoms of preeclampsia, the pregnant woman is hospitalized in the intensive care unit for antihypertensive and anticonvulsant treatment. The main task is to stabilize the condition and stop the seizures. Only after this can the question of delivery be raised. It can be performed either naturally or by caesarean section, if there are additional indications for this.

In the absence of immediate treatment, the consequences of severe late toxicosis may include:

• pulmonary edema;
• acute heart failure;
• stroke or paralysis;
• mental disorders;
• liver necrosis;
• cerebral edema and coma;
• death of the fetus and death for the mother.

Anticonvulsant therapy involves intravenous administration of magnesium sulfate (magnesia). But the only way to relieve a woman from the severe symptoms of late toxicosis is to induce labor.

For mild forms of preeclampsia, they are performed at 36-37 weeks of pregnancy. In severe forms of eclampsia, immediate delivery is necessary immediately after the seizures are relieved, regardless of the stage of pregnancy. If there are no additional indications () natural birth in this situation is more preferable.

Prevention

Nutrition and daily routine

It is impossible to completely eliminate the risk of developing late toxicosis, but following the rules of a balanced diet and a healthy lifestyle will allow women at risk to avoid severe forms of the disease.

In the second half of pregnancy, the expectant mother needs to minimize or completely abandon the consumption of smoked foods, dishes with a lot of spices and seasonings, and sweets. It is better to steam food or bake it in the oven.

If you are prone to edema, it is necessary to limit salt intake (no more than 3-4 g per day). A salt-free diet helps remove fluid and reduce swelling.

In the second half of pregnancy the following are useful:

• lean boiled meat and fish;
• cottage cheese and fermented milk products;
• liver, low-fat cheeses;
• vegetables (carrots, cabbage, beets), fruits (apples, apricots, lemons), nuts;
• porridge (except semolina);
• lingonberry or cranberry fruit drinks, dried fruit decoctions.

If you are prone to edema and excessive weight gain, your daily calorie intake should not exceed 3000. Careful adherence to the rules of balanced nutrition will help you not exceed the norm for weight gain per week - 350 grams. It is also necessary to monitor the amount of liquid consumed. It should be no more than 1-1.5 liters per day, including soups, compotes, teas.

An important condition for preventing the development of late toxicosis is adherence to a daily routine. You need to sleep at least 7-9 hours a day, of which 1 hour is a daytime nap. Slow walks in the fresh air are very beneficial.

The pathological condition can negatively affect the activity of the fetus. Therefore, it is important for the expectant mother to monitor the number of movements of the child throughout the day. Starting from week 25, the tremors should be clearly noticeable. If the child's activity is reduced, the doctor should be notified.

Other preventive measures

The risk of developing late toxicosis can be reduced if a woman pays close attention to her health. A prerequisite for every pregnant woman is timely registration at the antenatal clinic. The expectant mother must take all tests on time and adhere to the timing of visits to the doctor. During pregnancy, it is important to closely monitor your weight and lead a healthy lifestyle.

Pregnant women at risk should especially carefully follow the doctor’s instructions. These are women with kidney and liver diseases, endocrine pathologies, pregnant with twins, over 35 years old, who have had sexually transmitted infections. Any signs of poor health should be reported to a doctor, who will prescribe the necessary tests and appropriate treatment.

What's happened toxicosis during pregnancy? There are early and late toxicosis during pregnancy. Pregnancy is a joyful event, especially if it is planned in advance and is long-awaited. But the joy of the first realization that a woman will soon become a mother can be overshadowed by the appearance of toxicosis. Well, what joy can you experience from nausea, vomiting, increased salivation and decreased, or even complete lack of appetite?

What is toxicosis

Toxicosis during pregnancy a frequent phenomenon, which is characterized by nausea, vomiting, aversion to food, odor intolerance, and general weakness. Often with toxicosis there is excessive salivation, drowsiness, and weight loss.

A woman’s self-hypnosis plays a significant role in toxicosis, which increases the unpleasant sensations.

Who is at risk?

Any pregnant woman can be susceptible to early or late toxicosis. There are several factors that can cause toxicosis:

• heredity;
• multiple pregnancy;
• unstable psyche and through measured emotionality.
• the woman has kidney disease, endocrine system, hypertension, digestive system;
• age under 18 and after 35 years;
• sexual infections;
• excess weight;

Severity of toxicosis

Toxicosis can be mild, moderate or severe. The first two types can be somewhat alleviated in a fairly safe manner, but still be sure to tell the doctor about the sensations you experience - this is necessary in any case.

Toxicosis of varying severity is characterized by:

In the first degree of severity, the urge to vomit is infrequent, maximum 5 times a day, weight loss is within normal limits;

The second degree of toxicosis is manifested by frequent vomiting, weight loss within 5 kg;

In the third degree of severity, vomiting torments a woman up to 20 times a day, while the woman’s general well-being worsens, the temperature often rises, and the heartbeat quickens. Often a pregnant woman loses 10 kg or more. With such severe toxicosis, mandatory hospitalization is indicated, otherwise a miscarriage may occur.

Types of toxicosis

Toxicosis in pregnant women is divided into early and late. The first type of toxicosis is more common and has much fewer complications. Toxicosis in the last months of pregnancy is called. It is manifested by increased intracranial pressure, and rapid weight gain. This can lead to premature and difficult labor and is generally dangerous to the health of both mother and baby. Preeclampsia is divided into four types:

Early toxicoses: when they begin, causes and symptoms

When does toxicosis begin in pregnant women?

Early toxicosis can occur simultaneously with pregnancy and lasts approximately sixteen weeks, during which time the placenta is fully formed and takes on the role of protector of the fetus. At what week of pregnancy does toxicosis begin?? Most women begin to experience toxicosis at 7-8 weeks of pregnancy.

In 1-2% of cases, early toxicosis is very severe.

In severe forms of early toxicosis, weakness, high fever, weight loss and tachycardia (more than 90 beats per minute) are observed.

It happens that pregnancy proceeds without manifestations of toxicosis. This indicates the woman’s ideal health, her body has fully adapted to the new conditions and is ready to bear a baby.

Causes of early toxicosis

The causes of early toxicosis can be of different nature:

• heredity;
• presence of multiple pregnancy;
• diseases of the digestive system;
• unstable psyche and overwhelming emotions.

The cause of toxicosis in the early stages may be the body’s adaptation to the presence of an embryo. The female body begins to restructure itself at the biochemical level, and many new organic substances are produced. A woman's hormonal background changes completely immediately after conception. Also, in the first stages of pregnancy, the placenta is formed, which later, starting from the second trimester of pregnancy, takes on the protective functions of the fetus from toxins.

Symptoms and treatment of early toxicosis

The main (clinical) symptoms are nausea and vomiting. Non-clinical include:

• Jaundice is liver damage, which leads to a yellowish coloration of the skin. In this case, emergency hospitalization is required.
• dermatoses - itching all over the body, eczema may appear;
• asthma (suffocation attacks);
• ptyalism is increased salivation (up to 1 liter per day, which can cause maceration of the mucous membranes and skin);
• cramps and osteomalacia (softening of the bones) occur due to a decrease in calcium levels in the blood.

Toxicosis during early pregnancy: how to deal with it?

If these symptoms are detected, the following is indicated:

• Physical and emotional peace;
• Taking vitamins;
• Antiemetic therapy;
• Taking solutions for dehydration;
• Taking sedatives;
• Taking liver protective medications.

Late toxicosis: when it starts, causes and symptoms

When does late toxicosis begin?

At what stage of pregnancy does toxicosis begin?(late)? It appears from the 18th week of pregnancy and lasts until childbirth.

In late pregnancy, especially if it is the first, as a rule, the symptoms of toxicosis manifest themselves much more strongly.

Causes of late toxicosis

The causes of late toxicosis can be:

• the woman has kidney disease, hypertension;
• age under 18 and after 35 years;
• multiple pregnancy;
• sexual infections;
• toxicosis in previous pregnancies;
• overweight;
• smoking and hazardous working conditions before pregnancy.

As a result of increased pressure, the blood thickens, clotting increases, and therefore blood clots can form. Due to edema, fetal hypoxia occurs; cerebral edema can lead to eclampsia, which is fatal. To save the life of mother and child they resort to caesarean section.

Symptoms and treatment of late toxicosis

Doctors identify three main (clinical) symptoms:

• The main symptom is swelling in different parts of the body, as well as swelling inside the body;
• Increased protein content in urine;
• Weight gain as a result of water retention in the body.

If these symptoms are detected, it is indicated hospital treatment. It includes:

• Bed rest (full);
• A special diet, mainly plant and dairy foods. Limiting fat, water and salt;
• Reducing edema with diuretics;
• Reduced blood pressure.

How to relieve the symptoms of toxicosis?

And don’t think that toxicosis is the lot of all pregnant women. If you convince yourself that you will be able to avoid it, you will not experience such unpleasant symptoms. The main thing is to tune in to a positive result. Believe me, it will help.

It is better to exclude factors that can provoke the appearance of unpleasant sensations. Of course, neither sounds that cause irritation, nor foods and smells that cause gagging can be completely ignored or avoided. But keeping them to a minimum is already good. And always be in a calm state, breathe correctly and be distracted by something else. How to get rid of toxicosis during pregnancy?

It is not often possible to meet such a lucky expectant mother who, while waiting for her baby, did not encounter such an unpleasant phenomenon as toxicosis.

There is no need to rush to rejoice if in the first weeks of pregnancy you managed to avoid food hatred, dizziness, and weakness in the morning. It is quite possible that you will have to become familiar with the concept of toxicosis at the end of pregnancy. We are talking about late toxicosis. What is this phenomenon? How to deal with late toxicosis? We will try to answer these and some other questions in this article.

So, late toxicosis, otherwise gestosis, is a complication of pregnancy, which is characterized by disruption of the functioning of important organs, in particular blood flow and the vascular system. Late toxicosis is called because it occurs towards the end of pregnancy - in the second or third trimester. This condition is based on disturbances in the functioning of the vascular system, gross disturbances in the water-salt balance, changes in the composition and viscosity of the blood. All this leads to difficulties in the functioning of the liver and kidneys, to disturbances in the blood supply and nutrition of the fetus, and to exacerbations of chronic diseases.

Experts still cannot come to a consensus on what exactly causes gestosis. However, we can talk about a number of factors that have a significant impact on the occurrence and severity of late gestosis. It's about:

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- about hereditary predisposition;
- about overweight, obesity;
- about the age of the pregnant woman (risk group: women under 20 years and after 35 years);
— about the immune conflict between the fetus and the mother;
— about diseases of internal organs (heart, liver, kidneys), diabetes mellitus, hypertension;
- about changes in hormonal balance;
- about stress loads;
- about polyhydramnios, multiple pregnancies, about overstretching of the uterus by a large fetus.

You need to understand that severe forms of gestosis pose a very serious risk to the health of both the expectant mother and her child, and therefore it is very important to diagnose gestosis in a timely manner. If treatment for late toxicosis is not started in time, the expectant mother may experience convulsions and may even lose consciousness. In addition, very often late toxicosis causes chronic starvation of the fetus, which, of course, has a very negative effect on its development.

When is it time to start sounding the alarm?

With the development of gestosis, the expectant mother begins to experience swelling, which is especially pronounced in the morning. In addition, late toxicosis is characterized by an increase in blood pressure, and it is not always possible to reduce blood pressure with medications. It makes sense to talk about late toxicosis if the pressure rises above 140/90 mmHg.

During gestosis, the walls of blood vessels become permeable not only to the liquid component of blood, but also to blood proteins, which leads to the fact that the kidneys begin to remove proteins from the body - accordingly, when examining urine taken for analysis, specialists will find protein.

Symptoms of late toxicosis may also include general weakness, fatigue, dizziness, headache, tinnitus, spots before the eyes, nausea and vomiting, pain in the hypochondrium and stomach.

Even if you observe only some of the symptoms listed above, this is a good reason to consult a doctor. Remember that not only your health, but also the health and life of your baby will depend on your responsibility.

But remember also that it is easier to prevent any disease than to waste time, money, and nerves on treatment. Preventive measures will allow you to reduce the risk of gestosis to a minimum.

First of all, you need to pay special attention to your daily routine, in particular to sleep: you just need a good eight-hour sleep at night, do not neglect the opportunity to rest during the day.

You also need to take care of proper nutrition. From the very first days of your pregnancy, eliminate from your diet canned foods, carbonated and strong drinks, products containing dyes, preservatives and other harmful substances.

Starting from the fourth to fifth months of pregnancy, you need to begin to reduce the amount of fish and meat consumed, replacing these dishes with vegetable ones. After the expiration, you should completely abandon fermented milk, dairy products, fish and meat dishes, replacing them with vegetables, cereals, fruits, legumes, and herbs.

And of course, you shouldn’t force yourself to eat, just as you shouldn’t go on a strict diet.

It is also necessary to learn how to drink water properly during pregnancy. Try to drink as much plain, clean water as possible. You should not wash down your food with water or juices: at least half an hour should pass between meals and water. It is better to drink little by little, but often - two or three sips every half hour - this will allow you to avoid swelling, and at the same time rid your body of substances it does not need.

By following these simple rules, you can reduce the risk of late toxicosis to a minimum and be able to give birth to a healthy baby.

Late toxicosis or gestosis is a serious disease that occurs in late pregnancy. With this disease, there are severe disruptions in the functioning of the main systems and organs.

Gestosis: what is it?

The disease in question occurs mainly in the later stages.

Preeclampsia is a complication of pregnancy that causes disruption of vital organs and blood flow. It is characterized by malfunctions in the functioning of the brain, blood vessels, kidneys and other organs of a woman.

In more than 90% of situations, toxicosis develops towards the end of the period, after the 34th week. Girls with their first pregnancy are most susceptible to the disease. The occurrence of the disease at a later date is an alarming signal. In general, the later the disease occurs, the better the prognosis.

Types of gestosis:

Vodyanka. The main symptom is fluid retention in the body, which manifests itself in the form of edema and weight gain. You should be especially concerned about swelling of the ankles and scanty urination.

Nephropathy. In this type of gestosis, swelling, increased pressure, and the presence of protein in the urine are also observed. The danger of this disease is that it can go to the next stage - a convulsive attack - causing disturbances in the functioning of internal organs, and even the death of the child.

Preeclampsia. This term refers to a type of gestosis in which a disorder of the central nervous system occurs. Characteristic symptoms: heaviness in the back of the head, pain in the head, stomach, under the ribs, nausea, vomiting. In advanced cases, memory impairment, weakened vision, “sparks” or blurred vision are possible due to circulatory problems and damage to the retina.

Eclampsia- this is the most terrible type of gestosis. Its symptoms are a mixture of nephropathy and preeclampsia; convulsions are possible with sharp sounds, stress, and bright light.

Symptoms of gestosis

Usually:

• pressure rises,
• protein is detected in a urine test,
• visual disturbances appear,
• nausea, vomiting, headache.

Toxicosis can manifest itself in different ways.

• The first signs of the disease are most often detected around the 29th week.

First of all, swelling occurs in the face and limbs - "dropsy of pregnancy." This manifestation is the least severe of all existing symptoms. Patients often don’t even notice mild swelling. To determine the presence of swelling, a girl must regularly monitor her body weight.

Under normal conditions, body weight after the 28th week increases by 300-500 grams within 7 days. If a girl gains more than half a kilogram in 7 days, this most often occurs due to insufficiently effective removal of fluid from her body.

• A more serious sign of late toxicosis in pregnant women is nephropathy.

With this disorder, there is a failure of kidney function, against which edema forms, protein is detected in a urine test, and blood pressure increases. It is very important to control the concentration of protein in the urine - as it increases, the chances of successful pregnancy and natural childbirth decrease.

The main symptom of nephropathy is a decrease in urine volume. This symptom is extremely alarming. It is to this that the patient should first of all pay her attention. Usually the situation develops like this:

Swelling occurs;

Blood pressure increases;

The volume of urine excreted decreases.

• Severe symptoms also include preeclampsia and eclampsia.

At the same time, the listed deviations are the final stages of the disease. If they are detected, it is extremely important to consult a doctor in time and take the required measures, because These conditions directly threaten the life of the child and the woman herself.

Preeclampsia is characterized by disruptions of microcirculation in the nervous system. The main signs of such a deviation are standard manifestations - detection of protein in the urine, swelling, increased pressure. Problems with vision are added, as well as nausea, severe headaches, “veils” or “floaters” before the eyes.

In the absence of timely help, preeclampsia develops into a more dangerous condition - eclampsia. A woman experiences sudden convulsions, often accompanied by loss of consciousness. Eclampsia is very dangerous, sometimes it even ends in the death of the patient.

Thus, toxicosis is an extremely dangerous disease.

Even with mild symptoms such as headache and blood pressure, you should immediately go to the hospital

and tell the specialist in detail about all the disturbing points, because the sooner the required measures are taken, the greater the likelihood of maintaining the pregnancy and the birth of a full-fledged baby.

Why is gestosis dangerous?

The disease negatively affects the condition of the woman and the fetus. Malfunctions in the functioning of organs and systems may occur. Vascular spasms occur, microcirculation is disrupted, microthrombi appear that can cause cerebral hemorrhage, vascular thrombosis, cerebral and pulmonary edema, problems with the kidneys, heart and liver appear, and the patient may fall into a coma.

Due to constant vomiting, a woman’s body becomes dehydrated. Placental abruption may occur, asphyxia and premature birth are possible.

When a severe degree of the disease is diagnosed, premature birth occurs in approximately 20% of situations. If the disease progresses to eclampsia, almost every third baby is born prematurely.

Regardless of the form of the disease, it causes many problems to the fetus. In case of placental abruption, the fetus may even die - this happens in almost every third situation.

Due to sluggish toxicosis, oxygen deficiency occurs, against which the baby’s development is delayed. More than a third of children born to patients with toxicosis are underweight.

Due to oxygen deficiency, the baby’s development is delayed in mental and psychological terms. Such children get sick more often.

If the disease progresses to eclampsia - the most severe form - they resort to either termination of pregnancy or emergency delivery. Induced delivery, however, is not always safe for the premature fetus.

Rarely, but sometimes a very serious complication occurs, known as acute liver dystrophy. A woman can die because of him.

Toxicosis can also lead to heavy bleeding after childbirth.

Why does late toxicosis appear?

The exact causes of the pathology in question have not been determined. Among the predisposing points can be noted:

• insufficient adaptation of the woman’s body;
• disruptions from the endocrine, as well as cardiovascular systems;
• vasospasm, circulatory disorders;
• hormonal imbalance, incompatibility between fetus and mother;
• diseases of the liver, kidneys, bile ducts;
• constant stress;
• excessive weight;
• intoxication with nicotine, alcohol and drugs;
• manifestations of an allergic and immunological nature.
• factor of heredity. An unproven factor, but practice shows that such cases also exist.

There are many theories about the appearance of toxicosis, among which the most relevant are the following:

1. Corticovisceral . In accordance with its provisions, gestosis occurs against the background of disorders of the brain, as well as the nervous system. A woman's body is trying to adapt to pregnancy. As a result of the above and additional accompanying failures, the circulatory system stops working correctly and the disease in question begins to develop.

2. Hormonal, she is endocrine. In accordance with this theory, toxicosis appears due to various types of endocrine disruptions. Along with this, many researchers are confident that such failures occur against the background of toxicosis.

3. Placental. Adherents of this theory see disturbances in the functioning of the placenta and uterus as the root causes of the disease.

4. Immunogenetic. It is considered closest to the truth. In accordance with its provisions, the appearance of the disease in question is caused by an incorrect response of the immune system to fetal proteins. The female body regards them as foreign bodies and tries to destroy them.

5. Genetic. Studies confirm that patients whose immediate relatives suffered from late toxicosis are 7-8 times more likely to develop the disease.

Risk factors for the development of late toxicosis

Among the risk factors that can provoke the occurrence of the disease are:

• constant stress and overwork;
• pregnancy at the age of less than 18 and more than 35 years;
• frequent abortions;
• intoxication;
• infectious diseases;
• poor environmental conditions around;
• poor quality nutrition;
• bad habits.

Diagnosis of toxicosis

It is necessary to regularly visit an antenatal clinic

To confirm or refute the presence of a disease, it is not enough to simply go to the doctor and tell him about the disturbing circumstances. First of all, you need to undergo regular examination by a gynecologist.

At each visit, the woman must have her body weight, heart rate and blood pressure measured. During pregnancy, even a relatively small increase in pressure can be a sign of the disease in question.

The doctor assesses the dynamics of the patient’s weight gain, checks her for the presence of edema, and inquires about changes in the volume of urine excreted.

If there is a suspicion of gestosis, the pregnant woman is referred for more detailed studies and tests. Standard list:

• Analysis of urine;
• blood test for biochemistry;
• ultrasonography;
• kidney function, fundus condition;
• dynamics of weight change;
• cardiotocography and Doppler.

The following activities are also usually prescribed:

• urine test for protein content. Additionally, analyzes are carried out according to Zimnitsky and Nechiporenko;
• regular measurements of heart rate and blood pressure;
• hemostasiogram.

Treatment methods for gestosis

The treatment procedure is established only after the patient has completed the required examinations and passed the necessary tests. Remember: a course of therapy can only be prescribed by a qualified specialist.

Self-medication in such cases is unacceptable, because... By doing this you only risk harming yourself and your child.

Treatment of mild manifestations of toxicosis is usually carried out on an outpatient basis. In case of nephropathy and more serious problems, the pregnant woman is hospitalized and taken under constant supervision in the obstetric department.

If the swelling is insignificant and the test results are normal, no therapeutic measures are used except for recommendations for adjusting diet and lifestyle.

For severe swelling and mild nephropathy, the doctor may prescribe:

• sedatives (usually mild ones, like valerian, motherwort, etc.);
• antioxidants;
• disaggregants that help normalize blood rheological parameters;
• diuretics (usually natural plant based).

If headaches and increased blood pressure are present, antispasmodic antihypertensive drugs are prescribed.

Treatment of severe forms

Severe complications are treated intensively, with the involvement of a resuscitator. To normalize electrolyte and metabolic processes, infusion therapy techniques are used, during which the patient receives rheopolyglucin and fresh frozen plasma.

Anticoagulants are used to treat severe forms of the disease. If it is necessary to quickly normalize water-salt metabolic processes, herbal infusions are replaced with diuretics.

Regardless of the form of toxicosis, to prevent the development of hypoxia and premature birth, the doctor prescribes selective sympathomimetics.

Often you have to make a decision about the safest and most optimal method of delivery. So, if the patient is in a relatively normal condition and there is no threat to the child, judging by CTG and ultrasound, the birth is carried out without cesarean. If the therapy does not give the desired result, in the presence of chronic hypoxia and other serious complications, they resort to cesarean section.

Treatment methods are used not only before childbirth, but also after pregnancy, until the patient’s body condition is completely normalized.

The girl must make every effort to prevent the development of toxicosis.

• Firstly, she needs to adhere to the optimal sleep and rest patterns, remain at rest, avoid stress and other situations that could negatively affect the baby’s condition.
• Secondly , you can't be nervous. She should spend more time outdoors and walk. It is important to prevent hypothermia of the body and promptly deal with any stool disorders.

The most important preventive tool against gestosis is proper, balanced, regular and nutritious nutrition. The diet must include the required amount of protein. It is best obtained from fresh dairy products, meat and eggs. You can eat boiled fish. Read more about proper nutrition during pregnancy

Even if edema appears, you should not limit your fluid intake, because... when it is deficient, the blood thickens, which promises many problems for the patient and her baby. The recommended fluid intake is 2 liters per day.

During pregnancy, you should not rely on salt-free diets, but excessive amounts of salty foods are also unacceptable. The rate of salt consumption is up to 6-8 g per day.

You can take diuretics only as prescribed by a doctor.

You can take any kind of diuretic to eliminate edema only as prescribed by a doctor.

With uncontrolled use of such drugs, important microelements will be washed out of the body. Diuretics also help thicken the blood. Even the relatively safe herb bear's ears is contraindicated in the presence of toxicosis.

Late toxicosis is an extremely dangerous and rather insidious disease, so

self-medicate and take any kind of action without first discussing it with your doctor prohibited.

Remember: your health and the life of your unborn baby directly depend on how responsibly you approach compliance with medical prescriptions, adhere to a rest regime, and follow a diet.

If you notice the first signs of illness, consult a doctor. Left unattended, toxicosis can not only have a bad effect on your well-being, but even lead to death. Health to you and your baby!

Pregnancy itself poses a serious burden on a woman’s body, so gynecologists strongly recommend preparing for this condition in advance and undergoing a comprehensive examination before conception. This will help you bear and give birth to a healthy baby and prevent many unpleasant complications, one of which is toxicosis.

A distinction is made between early toxicosis, which occurs in most women from 6-7 weeks and lasts until the end of the first trimester, and late toxicosis, which usually occurs in the 3rd trimester. Late toxicosis during pregnancy is a cause of great concern for doctors, since this condition entails life-threatening disorders for the child and requires mandatory hospitalization in a hospital.

Late toxicosis or gestosis is a pathology that occurs in the second half of pregnancy and is accompanied by disturbances in the functioning of the nervous system, endocrine, cardiovascular, hematopoietic and other systems. As a result of progressive gestosis, pregnancy can end in premature birth or fetal death in utero. Most often, toxicosis in late pregnancy is accompanied by edema, proteinuria and increased blood pressure.

Fortunately, gestosis does not occur very often; according to obstetric statistics, this pathology is detected in approximately 10% of pregnant women.

Important! Late toxicosis in pregnant women can occur latently or its symptoms will be mild, and the expectant mother simply will not attach any importance to them. Pathology can be identified by regularly taking urine tests and measuring blood pressure, and for this, a pregnant woman should regularly visit an antenatal clinic.

The risk group for the development of gestosis in the second half of pregnancy includes:

• women with kidney and thyroid diseases;
• women suffering from arterial hypertension;
• pregnant women who have gained too many kilos in a few months;
• woman's age over 35 years;
• pregnant women who carry several fetuses at once;
• Iron-deficiency anemia;
• Rh conflict between mother and fetus;
• women who are diagnosed with intrauterine growth retardation;
• pregnant women who smoke (including passively) or drink alcohol.

Also susceptible to the development of gestosis are pregnant women who experienced late toxicosis earlier when they were carrying a previous pregnancy.

How does toxicosis of the second half manifest itself and when does it begin?

Women at risk are interested in the answer to the question: when does late toxicosis begin and how to recognize the pathology? The timing of the development of gestosis in each pregnant woman is purely individual, but in most cases this pathology develops after the 30th week of pregnancy, when the fetus is rapidly growing in the uterus and the load on all organs and systems increases.

Forms of late toxicosis are divided into typical and atypical. Typical forms include:

• dropsy;
• nephropathy (1-3 degrees);
• preeclampsia;
• eclampsia.

These forms of gestosis are considered as manifestations of pathology of varying severity. Atypical forms of late toxicosis are characterized by monosymptomatic nephropathy in pregnant women, nephropathy with two symptoms and eclampsia without seizures.

Dropsy

Hydrops of pregnancy is characterized by the appearance of edema, which is most often localized on the lower extremities in the ankles, arms, anterior abdominal wall and face. Dropsy is the initial stage of late toxicosis.

As a rule, few women pay attention to this symptom and turn to a gynecologist unscheduled only when swelling is accompanied by increased thirst, heaviness, rapid fatigue, and limitation of full movements of the limbs.

At this stage, the symptoms of late toxicosis are practically not expressed, with the exception of edema, blood pressure remains within normal limits. If you do not pay attention to this condition, then dropsy gradually turns into nephropathy.

Nephropathy

Nephropathy is accompanied by a triad of symptoms - edema, the appearance of protein in the urine and increased blood pressure. Signs of late toxicosis here are based on hypertension, since blood pressure readings can rise to 200/160 mmHg. and higher.

Preeclampsia

Preeclampsia is a severe form of gestosis, which is characterized by a triad of symptoms, as with nephropathy and the addition of additional manifestations:

• headache;
• dizziness;
• nausea;
• feeling of squeezing of the temples;
• pain in the back of the head;
• insomnia;
• flickering of flies before the eyes;
• noise and ringing in the ears;
• vomiting, abdominal pain;
• lethargy;
• loss of consciousness sometimes.

Attention! Preeclampsia is a reason for urgent hospitalization of a pregnant woman in the intensive care unit. The expectant mother needs complete rest, otherwise this condition may be complicated by eclampsia.

Eclampsia

Eclampsia is a severe complication of late toxicosis, characterized by a convulsive seizure. The condition poses a threat to the life of the fetus and often leads to premature placental abruption.

Clinical manifestations of eclampsia can be divided into 4 stages; this is presented in more detail in the table:

Important! Pregnant women at risk, as well as those patients who have disappointing urine tests and blood pressure readings, should be in the department of pathology of pregnant women under the supervision of a doctor. Such measures will help provide adequate assistance in the event of a seizure and save the life of an unborn child.

Complications of gestosis in pregnant women

Why is late toxicosis dangerous?

The progression of gestosis and the development of preeclampsia and eclampsia in most cases leads to the following complications:

• pulmonary edema in a pregnant woman;
• development of heart failure;
• development of acute liver failure;
• coma;
• abruption of a normally located placenta and massive bleeding;
• development of placental insufficiency - this complication leads to acute fetal hypoxia, intrauterine growth retardation, premature birth, hemolysis of red blood cells, degeneration of liver cells, and a decrease in the number of platelets.

In the absence of timely medical care, the pregnant woman and the fetus may die.

How to treat late toxicosis of pregnant women?

Early and late toxicosis in pregnant women is a reason for increased monitoring of the expectant mother, frequent visits to the antenatal clinic, and regular testing. This will help to identify whether toxicosis is developing, and if so, take appropriate measures in time.

Treatment of gestosis largely depends on the form of the pathology and the severity of its course. Edema or dropsy can be treated at home, following all the doctor’s recommendations.

The main principle of therapy in this case is limiting salt in the diet and drinking enough clean water. Spices, spicy foods, fatty foods, flour, baked goods are excluded from the diet - all these products contribute to fluid retention in the body and the progression of edema.

Nephropathy, preeclampsia and eclampsia require hospitalization of the expectant mother in the pregnancy pathology department or in the intensive care unit of the maternity hospital.

Treatment of severe gestosis consists of following the following recommendations and prescriptions:

• providing the pregnant woman with complete psychological and physical peace

  – the light should be dim, conversations should be in a low voice;

• droppers with glucose solution and B vitamins

  to support the child;

• drugs that improve placental function

  (the instructions for the drug describe in detail the properties and composition of the drug);

– a pregnant woman’s diet should be light, but fully balanced, in order to satisfy the body’s daily need for proteins, carbohydrates, fats, and vitamins.

With the progression of gestosis and the development of eclampsia, the doctor decides to deliver the woman by cesarean section and nurse the child in special conditions. Of course, the gestational age is also taken into account; it is important that the baby is born viable.

Indications for cesarean section for late gestosis are the following conditions:

• severe nephropathy in pregnant women, which is not eliminated with medication and progresses;
• preeclampsia and eclampsia;
• comatose state of a pregnant woman;
• retinal detachment due to high blood pressure;
• hemorrhages in the eyes;
• anuria – absence of urine for more than 8-12 hours, this symptom in most cases indicates the development of acute renal failure;
• hemorrhages in the brain or spinal cord;
• placental abruption, acute fetal hypoxia.

Is it possible to avoid late toxicosis during pregnancy?

The best prevention of the development of gestosis in pregnant women is parenthood planning and a comprehensive examination of the woman before conception. Tests, ultrasound, consultation with an endocrinologist and gynecologist will allow you to identify existing problems and undergo a course of treatment if necessary - this significantly reduces the risk of complications during pregnancy, because many chronic pathologies create preconditions for the development of toxicosis.

If the pregnancy occurs unplanned, and the woman does not know whether she is healthy, then the first thing she needs to do is register with the antenatal clinic as soon as possible. If the examination reveals chronic diseases or disorders in the functioning of internal organs, the gynecologist will take measures at the very early stage of gestation to prevent pregnancy complications, including early and late toxicosis.

Particular attention is paid to collecting anamnesis, so a woman should be prepared to answer the following questions:

• whether there were pregnancies before, how they proceeded, at what stage the child was born and with what body weight;
• is there anyone in your family with arterial hypertension or diabetes;
• whether the woman suffers from chronic diseases.

A pregnant woman must be examined by an ophthalmologist (ophthalmologist). During the examination, the doctor uses a special device to check the condition of the fundus of the eye. Changes in the fundus are the first sign of the development of toxicosis in pregnant women or a high tendency of the expectant mother to this pathology, even if nothing bothers the patient.

In the video in this article, a specialist explains how to reduce the likelihood of developing toxicosis during pregnancy and what consequences the progression of this complication and the careless attitude of the expectant mother to her health may have for the fetus. Women at risk should not delay registering their pregnancy and should do this before the 11th week, or better yet, even earlier. If these recommendations are ignored, the cost may be too high for both mother and child.