Gestosis after delivery: how to cope with it

Gestosis after pregnancy and during it has symptoms known to doctors: increased blood pressure, edema, and, in connection with them, a rapid and large weight gain, as well as protein in the urine. With severe preeclampsia, a woman experiences nausea and vomiting, and severe headache. Since pathology can cause a lot of problems, more than one doctor decides how to treat preeclampsia after childbirth. It all depends on what organs of the mother he struck.

Gestosis (late toxicosis) is one of the most severe pathologies in expectant mothers. It is directly related to pregnancy. It begins in the second, and more often the third trimester and is the main cause of maternal and child mortality. It is not treated with medication, only delivery. All that doctors can do is to help prepare the child as much as possible for life outside the womb (with the rapid early progression of pathology, the child is born prematurely) and to prevent (though not in all cases) eclampsia, a formidable complication of gestosis in the mother.

Gestosis that occurs in the mother at a period of 24-28 weeks, as a rule, leads to an emergency caesarean section due to her serious condition and the child to save them. If late toxicosis occurs after 30-32 weeks, there is a chance that gestosis will not have time to harm the mother and child too much. Mild preeclampsia rarely has consequences. Usually, all its symptoms go away in the first 1-2 days after the baby is born.

Childbirth with gestosis can be natural or operative, it depends on many factors. However, this situation is always under the control of doctors and anesthesiologists. About half of cases of eclampsia (severe seizures) occur in the postpartum period, in the first 28 days after birth. Moreover, eclampsia is more often diagnosed in women who gave birth on time.

With a period of less than 32 weeks and severe preeclampsia (severe preeclampsia), a woman is given C-section... After 34 weeks are possible natural childbirth if the baby has no health problems and is in the correct position in the uterus.
During childbirth, as a prevention of eclampsia, a woman receives an epidural anesthesia, that is, gives birth only with anesthesia, as well as drugs that lower blood pressure.

Doctors are required to prevent prolonged labor and severe uterine bleeding after them. Therefore, a uterine contraction drug is used - "Oxytocin".

On the first day after childbirth, a woman suffering from severe gestosis is in the intensive care unit, where resuscitators are closely monitoring her condition. At this time, she receives anticonvulsant therapy in the form of "magnesia", which is familiar to many women. This drug not only relieves the tone of the uterus, but is also a good preventive measure against eclampsia. The woman's condition is closely monitored. They take urine and blood tests from her, and often measure blood pressure.

In the first days after childbirth, women physiologically increase the volume of circulating blood, and for those who suffer from preeclampsia, this is an additional risk factor for arterial hypertension. Depending on the level of blood pressure and the severity of preeclampsia, the mother is prescribed drugs for pressure. Compatible with lactation if possible. For example, "Dopegit", "Nifedipine". Treatment of postpartum gestosis continues after discharge from the hospital. The increase in pressure can persist up to about two months, but normally the condition should gradually return to normal. Cancellation of the drug occurs by slowly reducing the frequency of administration and dosage.

Postpartum edema is common. And not only in those suffering from preeclampsia. A sign of preeclampsia is considered to be a rapid increase in swelling of the hands and face. If the ankles are swollen, this is not so scary. It will go away in a few days or weeks. At the same time, women who are breastfeeding should not use diuretics (diuretics), as this will lead to a decrease in lactation - a lack of breast milk.

What to do if gestosis does not go away after childbirth

You need to know the symptoms that require urgent medical attention:

• headache;
• visual impairment, flashing of flies in the eyes;
• pain between the ribs or in the right hypochondrium (liver);
• rare urination;
• increase in pressure.

If the protein in the urine remains 6-8 weeks after childbirth, consultation with a urologist or nephrologist is required.
If there was eclampsia, a CT scan of the brain should be done. In addition, donate blood for antiphospholipid antibodies, lupus anticoagulant, and undergo a test for thrombophilia.
Observation of at least a gynecologist and therapist is required.

The consequences of gestosis for the child and mother

The woman is explained that she is in the risk category for the development of arterial hypertension, renal and hepatic failure, diabetes mellitus in the future. Gestosis after cesarean and childbirth can eventually turn into coronary heart disease, cause a stroke.

As for a new pregnancy, there is a risk of repeating the scenario of the previous one. For prophylaxis, a woman is prescribed aspirin in small doses from 12 weeks of pregnancy until the end. Sometimes with calcium supplements.

The interval between pregnancies should not be more than 10 years, since this is also a risk factor for developing eclampsia when carrying a child.

Gestosis in pregnant women also has a negative effect on the child's body - after childbirth, gestosis in mothers passes, but the baby's problems may remain. Most often, with the nervous system. Children whose mothers have suffered severe gestosis are almost always born low in weight, with signs of intrauterine growth retardation and chronic hypoxia.

Usually, early gestosis is usually called toxicosis of pregnant women, these are its classic signs with nausea and vomiting, intolerance to strong odors, weakness and severe drowsiness. However, doctors consider toxicosis not as dangerous for the fetus as the development of the so-called late gestosis.

Gestosis of pregnancy or toxicosis are painful changes during pregnancy caused by hormonal fluctuations, various pathologies and diseases. At the time when a problem may arise, early preeclampsia during pregnancy and late are allocated.

Causes of preeclampsia in pregnant women

Although the manifestations of gestosis have been studied for a long time, to this day it has not been possible to identify the exact causes of this pathology. Often pregnant women suffer from gestosis with disorders of the nervous system and brain, with problems with the heart and blood pressure. Associations with kidney pathologies and the development of gestosis, with the presence of allergies, endocrine and metabolic failures, as well as the presence of bad habits before conception.

Very young expectant mothers or age-related mothers often suffer from gestosis - this is explained either by immaturity or age-related changes bodies, as well as those who carry twins, who have excess weight and pressure, or who on the female line also had gestosis in the genus.

According to the severity of the manifestations and the severity of the course, it is customary to distinguish three degrees in late gestosis.

Preeclampsia 1 degree during pregnancy

Usually, mild gestosis during pregnancy is usually called dropsy of pregnant women. These are initial, relatively mild manifestations. At the same time, pronounced, rather serious edema is formed throughout the body; they give large gains in body weight. Edema is visible on the limbs, on the body and even on the face, they intensify in the evening, progress and are difficult to correct. Against the background of dropsy, the phenomena of nephropathy can be added - kidney damage when they do not cope with their tasks.

Preeclampsia 2 degrees during pregnancy

It is the development of nephropathy (kidney damage) with the progression of edema and an increase in blood pressure, the manifestation of protein in the urine is referred to as severe preeclampsia. Such changes indicate that the body cannot cope with the stress that pregnancy imposes on it, and malfunctions. Gradually, with the progression of the process, extremely severe manifestations of preeclampsia may occur - preeclampsia and eclampsia. These are serious lesions of the nervous system against the background of all the changes occurring - swelling, pressure, loss of protein by the kidneys. These changes give the most severe and life-threatening consequences of gestosis during pregnancy.

Why is gestosis dangerous in late pregnancy?

Gestosis develops exclusively in pregnant women - they are directly related to the bearing of the fetus. After childbirth, gestosis usually disappears, but often, in severe cases, the consequences of gestosis remain even after childbirth. However, gestosis is dangerous during pregnancy, especially in the third trimester. They can lead to eclampsia, a severe, life-threatening seizure. With them, the pressure goes off scale, the kidneys fail, the whole body swells. This condition requires immediate resuscitation and the birth of a baby in order to save the lives of both.

The consequences of gestosis for the mother

But often, even after delivery, as a result of severe complications of pregnancy, there are serious consequences of gestosis for the mother after childbirth. It can be severe postpartum hemorrhage leading to anemia, as well as complications such as the development of strokes or brain lesions against the background of seizures, irreversible damage to the kidneys with the development of kidney failure, visual impairment, persistent headaches due to high blood pressure, and much more.

The consequences of gestosis for the child

Naturally, when the mother is in serious condition, the developing baby will suffer with her. The development of gestosis during pregnancy is no less dangerous and the consequences for the child. Naturally, the most dangerous complication there will be intrauterine fetal death as a result of hypoxia and nutritional deficiencies. This is due to severe placental edema or detachment, bleeding and premature birth.

The influence of preeclampsia in the mother on the development of the fetus is expressed. Such children are weakened, they suffer from chronic hypoxia, lag behind in growth and development, can often and for a long time get sick after birth.

Given the need for the development of pathology to carry out childbirth earlier than the term, you can add here another answer - what is the danger of gestosis for the fetus. When a child is born much earlier than the term, he is completely unprepared for an independent life and requires special care, may have deviations in health and developmental delay.

Quite often, pregnancy is accompanied by various pathological conditions. In our article we will tell you what gestosis is, why it occurs, how it develops, describe its symptoms, talk about the diagnosis, treatment and prevention of this condition.

Gestosis during pregnancy is a complication of the gestational period. It develops during gestation, during childbirth or in the first days after them. Gestosis is accompanied by a pronounced disruption of the work of vital organs. This condition is based on the impaired adaptation of the woman's body to pregnancy. As a result of a cascade of reactions, vasospasm occurs in all tissues, their blood supply is disrupted, and dystrophy develops. The nervous system, heart and blood vessels, placenta and fetus, kidneys and liver are affected.

The urgency of the problem

Gestosis in pregnant women develops in 12-15% of cases. This main reason death of women in the third trimester of pregnancy. With the development of this complication on later dates and

up to a third of all children die in childbirth. In women, after a complication, the kidneys suffer, chronic arterial hypertension develops.

What is the danger of gestosis for the fetus? It causes intrauterine hypoxia (lack of oxygen) and growth retardation. The consequences of gestosis for a child are a lag in physical and mental development.

V modern conditions more and more atypical gestosis occurs. They are characterized by the predominance of one symptom, early onset, early formation of placental insufficiency. Underestimation of the severity of the condition in this case leads to delayed diagnosis, delayed treatment and late delivery.

Classification

The classification of preeclampsia has not been sufficiently developed. In Russia, the division of the disease into the following types was most often used:

• dropsy of pregnant women (with a predominance of edema);
• mild, moderate and severe nephropathy;
• preeclampsia;
• eclampsia.

The main disadvantage of this classification is the vagueness of the term "preeclampsia", which does not allow specifying the severity of the condition.

Today, gestosis is divided into forms in accordance with the International Classification of Diseases 10 revision:

• О10: hypertension (high blood pressure) that existed before pregnancy and complicated the course of gestation, childbirth, and the postpartum period;
• О11: preexisting high blood pressure with addition of proteinuria (protein in the urine);
• О12: the appearance of edema and protein in the urine during pregnancy at normal pressure;
• A13: development of high blood pressure during pregnancy in the absence of protein in the urine;
• A14: hypertension during pregnancy in combination with a large amount of protein in the urine;
• O15: eclampsia;
• O16: unspecified hypertension.

This classification solves some of the working points of diagnosis and treatment, but does not reflect the processes taking place in the body.

With "pure" gestosis, pathology occurs in earlier healthy woman... This type is observed in only 10-30% of women. The combined forms are difficult. They develop against the background of previously existing diseases: hypertension, kidney and liver pathology, metabolic syndrome (obesity, insulin resistance), endocrine pathology ( diabetes, hypothyroidism and others).

This condition is characteristic only for the period of gestation. Gestosis after childbirth passes, with the exception of severe complications. This suggests that the source of problems is precisely the fetus and the placenta. Gestosis occurs only in humans. This disease does not occur in animals, not even in monkeys, so it cannot be studied experimentally. This is associated with a large number of theories and questions regarding the nature of this state.

Why does gestosis occur?

Consider the main modern theories of the development of this condition:

1. Cortico-visceral theory. According to her, gestosis is very similar to a neurotic state with disruption of the cerebral cortex and a subsequent increase in vascular tone. This theory is confirmed by an increase in the incidence of illness in pregnant women after mental trauma, as well as data obtained using electroencephalography.
2. Endocrine theory considers an abnormally proceeding pregnancy as a chronic stress that causes overstrain and depletion of all endocrine systems of the body, including those that regulate vascular tone.
3. Immunological theory states that trophoblast tissue (the outer shell of the fetus that forms the placenta) is a weak antigen. The body produces the corresponding antibodies, which also interact with the cells of the kidney and liver of the woman. As a result, the vessels of these organs are affected. However, autoimmune processes are not recorded in all women with preeclampsia.
4. The genetic theory is based on the fact that women whose mothers have had preeclampsia pathological condition develops 8 times more often than the average. Scientists are actively looking for "eclampsia genes."
5. The placental theory assigns the main importance to a violation of the formation of the placenta.
6. Thrombophilia and antiphospholipid syndrome can cause damage to the vascular walls throughout the body, and they also lead to a violation of the formation of the placenta.

Scientists believe that a unified theory of the origin of gestosis has not yet been developed. The most promising are the immunological and placental versions.

The following factors significantly increase the risk of gestosis:

1. Extragenital diseases, namely hypertension, metabolic syndrome, kidney and gastrointestinal tract diseases, frequent colds and endocrine pathology.
2. Multiple pregnancy.
3. Previously postponed gestosis.
4. The woman's age is under 18 and over 30 years old.
5. Poor social conditions.

How does the disease develop?

The onset of the disease occurs even in the most early dates pregnancy. When the embryo is implanted (implanted) into the wall of the uterus, the arteries located in the muscle layer do not change, but remain in a "pre-pregnant" state. Their spasm occurs, the inner lining of the vessels - the endothelium - is affected. Endothelial dysfunction is the most important triggering factor for preeclampsia. It leads to the release of powerful vasoconstrictor substances. At the same time, the viscosity of the blood rises, microthrombi are formed in the spasmodic vessels. Disseminated intravascular coagulation syndrome (DIC syndrome) develops.

Vascular spasm leads to a decrease in the volume of blood circulating in the body. As a result, the tone of peripheral vessels reflexively increases. The intensity of blood flow decreases in all organs, including the kidneys, liver, heart, brain and placenta. These disorders cause a clinical picture of gestosis.

Symptoms of gestosis

External signs usually manifest preeclampsia in the second half of pregnancy. However, we found out that the disease develops much earlier. Early preeclampsia is considered a preclinical stage, which can be detected using special tests:

• measurement of pressure with an interval of 5 minutes in the position of a woman lying on her side, on her back, again on her side. The test is positive if the diastolic ("lower") pressure changes by more than 20 mm Hg. Art .;
• violation of uteroplacental blood flow according to the data;
• a decrease in the number of platelets less than 160 × 10 9 / l;
• signs of increased blood clotting: an increase in platelet aggregation, a decrease in the activated partial thromboplastin time, an increase in the concentration of fibrinogen in the blood;
• a decrease in the concentration of anticoagulants, in particular, its own heparin;
• decrease in the relative number of lymphocytes to 18% and below.

If a woman finds two or three of the listed symptoms, she needs treatment for preeclampsia.

The classic signs of gestosis that appear in the second half of pregnancy and especially in the 3rd trimester:

• swelling;
• arterial hypertension;
• proteinuria.

Gestosis is characterized by a variety of options for its course. The classic triad occurs in only 15% of women, and one in three symptoms - in a third of patients. More than half of patients suffer from protracted forms of the disease.

One of the most early signs diseases - excess weight gain. It usually starts at 22 weeks of gestation. Normally, any woman within 15 weeks should add no more than 300 g weekly. Then, for patients under 30 years old, this increase should be no more than 400 grams per week, for older women - 200-300 grams.

An increase in blood pressure usually occurs at 29 weeks. For a more accurate diagnosis, all measurement rules should be followed, the pressure on both arms should be recorded, and the size of the cuff should be correctly selected.

Edema during preeclampsia is associated with sodium retention, a decrease in the concentration of proteins in the blood, and the accumulation of under-oxidized metabolic products in the tissues. Swelling can only be on the legs, spread to the abdominal wall, or cover the entire body. Signs of hidden edema:

• excretion of the bulk of urine at night;
• a decrease in the amount of urine excreted in comparison with the volume of fluid consumed;
• excess weight gain;
• "Ring symptom" - a woman becomes not enough of her wedding or other familiar ring.

Proteinuria is the excretion of protein in the urine. It is caused by damage to the glomeruli due to lack of oxygen and vasospasm. The release of more than 1 gram of protein in any portion of urine is a danger sign. At the same time, the level of protein in the blood decreases.

Severe forms of the disease

Dysfunction of the nervous system - preeclampsia and eclampsia - poses a particular danger to the mother and child.

Preeclampsia symptoms:

• headache in the back of the head and temples;
• "Veil", "flies" before the eyes;
• pain in the upper abdomen and in the right hypochondrium;
• nausea and vomiting, fever, itching of the skin;
• nasal congestion;
• drowsiness or increased activity;
• redness of the face;
• dry cough and hoarseness of the voice;
• tearfulness, inappropriate behavior;
• hearing impairment, difficulty speaking;
• chills, shortness of breath, fever.

With the progression of this condition, eclampsia develops - a seizure, accompanied by hemorrhages and cerebral edema.

Complications

Late gestosis can cause serious complications that can even lead to the death of the mother and child:

• eclampsia and coma after it;
• intracerebral hemorrhage;
• acute renal failure;
• respiratory failure;
• retinal detachment and loss of vision in a pregnant woman;
• premature;
• hemorrhagic shock and disseminated intravascular coagulation.

There are more rare forms that complicate preeclampsia. This is the so-called HELLP syndrome and acute fatty hepatosis of pregnant women.

HELLP syndrome includes hemolysis (breakdown of red blood cells), a decrease in the number of platelets responsible for blood clotting, and a malfunction of the liver with an increase in its enzymes in the blood. This complication occurs mainly after 35 weeks of pregnancy, especially against the background of nephropathy, and often causes the death of the woman and the fetus.

Symptoms develop quickly. The woman begins to complain of headache, vomiting, pain in the abdomen or in the right hypochondrium. Jaundice, bleeding appears, the patient loses consciousness, she begins to have convulsions. There is a rupture of the liver with bleeding in abdominal cavity, placental abruption. Even if a woman is urgently operated on, due to blood clotting disorders, she may die in the postoperative period from severe bleeding.

Acute fatty hepatosis of pregnant women develops mainly during the first pregnancy. Within 2-6 weeks, a woman is worried about weakness, lack of appetite, abdominal pain, nausea and vomiting, weight loss, itching. Then liver and kidney failure develops, which is manifested by jaundice, edema, uterine bleeding and fetal death. Often there is a hepatic coma with impaired brain function.

Assessment of the severity of the condition

According to the Russian classification, the severity of the disease is determined by the condition of the kidneys.

Preeclampsia 1 degree usually accompanied by edema of the legs, slight proteinuria, an increase in blood pressure up to 150/90 mm Hg. Art. In this case, the fetus develops normally. This condition usually occurs at 36-40 weeks.

Preeclampsia 2 degrees characterized by the appearance of edema on the abdomen, proteinuria up to 1 g / l, an increase in pressure up to 170/110 mm Hg. Art. There may be degree 1 fetal malnutrition. This form occurs at 30-35 weeks.

Diagnosis of a severe form is based on the following symptoms:

• increase in blood pressure up to 170/110 mm Hg. Art. and higher;
• excretion of more than 1 gram of protein per liter of urine;
• decrease in urine volume up to 400 ml per day;
• widespread edema;
• violation of blood flow in the arteries of the uterus, brain and kidneys;
• delayed fetal development;
• violation of blood clotting;
• increased activity of liver enzymes;
• development up to 30 weeks.

In such a serious condition, treatment in a hospital is necessary.

Treatment of gestosis

The main directions of therapy:

• medical and protective regime;
• delivery;
• restoration of the functions of internal organs.

The following drugs are prescribed for a woman:

• sedatives, sedatives (valerian, motherwort), in severe cases - tranquilizers and antipsychotics (Relanium, Droperidol), barbiturates, anesthetics;
• antihypertensive drugs (mainly calcium antagonists - Amlodipine, beta-blockers - Atenolol, as well as Clonidine, Hydralazine and others);
• magnesium sulfate, which has a hypotensive, anticonvulsant, sedative effect;
• replenishment of the volume of circulating blood using intravenous infusions;
• antiplatelet agents (Curantil) and anticoagulants (Fraxiparine) under strict control of blood coagulation;
• antioxidants (vitamins C, E, Essentiale).

Medication with a mild degree can be carried out for 10 days, with moderate severity - up to 5 days, with a serious condition - up to 6 hours. If the treatment is ineffective, urgent delivery is necessary.

Delivery with gestosis is carried out through the natural birth canal or by means of a cesarean section. A woman can give birth herself with a mild illness, good condition of the fetus, the absence of other diseases, the effect of medications. In more severe cases, a planned operation is used. In case of severe complications (eclampsia, renal failure, placental abruption, and so on), an emergency caesarean section is performed.

After a cesarean section, drug treatment is continued until all body functions are fully restored. Women are discharged home no earlier than 7-15 days after giving birth.

Prevention of gestosis during pregnancy

A pregnant woman should avoid nervous and physical overload, fully rest, and not take medications without a doctor's prescription. Nutrition should be complete, as hypoallergenic as possible. Severe fluid restriction and reduced salt diets are not indicated. Only in severe cases of renal failure is the patient recommended to reduce the amount of protein consumed with food.

The key to preventing preeclampsia is regular observation by a doctor, weight control, blood pressure, blood and urine tests. If necessary, the woman is hospitalized in a day hospital or in a sanatorium, where preventive treatment is carried out.

If the condition worsens, the appearance of edema, headache, pain in the right hypochondrium, the patient should consult a doctor as soon as possible. Self-medication in this case is unacceptable. Untreated acute preeclampsia is an immediate threat to the life of the mother and child.

In vitro fertilization (IVF) is modern technology artificial insemination, with the help of which many couples have a chance to have a child. Even 10 - 15 years ago people.

Many clinics are now open in the country that can provide such services.

For a cesarean section to be successful, you need to prepare for it accordingly. In this article, we'll talk about getting ready for a caesarean section.

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Preeclampsia after childbirth

Gestosis after delivery: how to cope with it

Gestosis after pregnancy and during it has symptoms known to doctors: increased blood pressure, edema, and, in connection with them, a rapid and large weight gain, as well as protein in the urine. With severe preeclampsia, a woman experiences nausea and vomiting, and severe headache. Since pathology can cause a lot of problems, more than one doctor decides how to treat preeclampsia after childbirth. It all depends on what organs of the mother he struck.

Gestosis (late toxicosis) is one of the most severe pathologies in expectant mothers. It is directly related to pregnancy. It begins in the second, and more often the third trimester and is the main cause of maternal and child mortality. It is not treated with medication, only delivery. All that doctors can do is to help prepare the child as much as possible for life outside the womb (with the rapid early progression of pathology, the child is born prematurely) and to prevent (though not in all cases) eclampsia, a formidable complication of gestosis in the mother.

Gestosis that occurs in the mother for a week, as a rule, leads to an emergency caesarean section due to her serious condition and the child to save them. If late toxicosis occurs after a week, there is a chance that gestosis will not have time to harm the body of the mother and child too much. Mild preeclampsia rarely has consequences. Usually, all its symptoms go away in the first 1-2 days after the baby is born.

Childbirth with gestosis can be natural or operative, it depends on many factors. However, this situation is always under the control of doctors and anesthesiologists. About half of cases of eclampsia (severe seizures) occur in the postpartum period, in the first 28 days after birth. Moreover, eclampsia is more often diagnosed in women who gave birth on time.

With a period of less than 32 weeks and severe preeclampsia (severe gestosis), a woman is given a cesarean section. After 34 weeks, natural childbirth is possible if the baby does not show any health problems and is in the correct position in the uterus.

During childbirth, as a prevention of eclampsia, a woman receives an epidural anesthesia, that is, gives birth only with anesthesia, as well as drugs that lower blood pressure.

Doctors are required to prevent prolonged labor and severe uterine bleeding after them. Therefore, a uterine contraction drug is used - "Oxytocin".

On the first day after childbirth, a woman suffering from severe gestosis is in the intensive care unit, where resuscitators are closely monitoring her condition. At this time, she receives anticonvulsant therapy in the form of "magnesia", which is familiar to many women. This drug not only relieves the tone of the uterus, but is also a good preventive measure against eclampsia. The woman's condition is closely monitored. They take urine and blood tests from her, and often measure blood pressure.

In the first days after childbirth, women physiologically increase the volume of circulating blood, and for those who suffer from preeclampsia, this is an additional risk factor for arterial hypertension. Depending on the level of blood pressure and the severity of preeclampsia, the mother is prescribed drugs for pressure. Compatible with lactation if possible. For example, "Dopegit", "Nifedipine". Treatment of postpartum gestosis continues after discharge from the hospital. The increase in pressure can persist up to about two months, but normally the condition should gradually return to normal. Cancellation of the drug occurs by slowly reducing the frequency of administration and dosage.

Postpartum edema is common. And not only in those suffering from preeclampsia. A sign of preeclampsia is considered to be a rapid increase in swelling of the hands and face. If the ankles are swollen, this is not so scary. It will go away in a few days or weeks. At the same time, women who are breastfeeding should not use diuretics (diuretics), as this will lead to a decrease in lactation - a lack of breast milk.

What to do if gestosis does not go away after childbirth

You need to know the symptoms that require urgent medical attention:

• headache;
• visual impairment, flashing of flies in the eyes;
• pain between the ribs or in the right hypochondrium (liver);
• rare urination;
• increase in pressure.

If the protein in the urine remains 6-8 weeks after childbirth, consultation with a urologist or nephrologist is required.

If there was eclampsia, a CT scan of the brain should be done. In addition, donate blood for antiphospholipid antibodies, lupus anticoagulant, and undergo a test for thrombophilia.

Observation of at least a gynecologist and therapist is required.

The consequences of gestosis for the child and mother

The woman is explained that she is in the risk category for the development of arterial hypertension, renal and hepatic failure, diabetes mellitus in the future. Gestosis after cesarean and childbirth can eventually turn into coronary heart disease, cause a stroke.

As for a new pregnancy, there is a risk of repeating the scenario of the previous one. For prophylaxis, a woman is prescribed aspirin in small doses from 12 weeks of pregnancy until the end. Sometimes with calcium supplements.

The interval between pregnancies should not be more than 10 years, since this is also a risk factor for developing eclampsia when carrying a child.

Gestosis in pregnant women also has a negative effect on the child's body - after childbirth, gestosis in mothers passes, but the baby's problems may remain. Most often, with the nervous system. Children whose mothers have suffered severe gestosis are almost always born low in weight, with signs of intrauterine growth retardation and chronic hypoxia.

Gestosis in pregnant women: symptoms, treatment and degree of danger to the fetus and mother

Quite often, pregnancy is accompanied by various pathological conditions. In our article we will tell you what gestosis is, why it occurs, how it develops, describe its symptoms, talk about the diagnosis, treatment and prevention of this condition.

Gestosis during pregnancy is a complication of the gestational period. It develops during gestation, during childbirth or in the first days after them. Gestosis is accompanied by a pronounced disruption of the work of vital organs. This condition is based on the impaired adaptation of the woman's body to pregnancy. As a result of a cascade of reactions, vasospasm occurs in all tissues, their blood supply is disrupted, and dystrophy develops. The nervous system, heart and blood vessels, placenta and fetus, kidneys and liver are affected.

The urgency of the problem

Gestosis in pregnant women develops in 12-15% of cases. It is the leading cause of death for women in the third trimester of pregnancy. With the development of this complication at a later date and

up to a third of all children die in childbirth. In women, after a complication, the kidneys suffer, chronic arterial hypertension develops.

What is the danger of gestosis for the fetus? It causes intrauterine hypoxia (lack of oxygen) and growth retardation. The consequences of gestosis for a child are a lag in physical and mental development.

In modern conditions, atypical gestosis is increasingly common. They are characterized by the predominance of one symptom, early onset, early formation of placental insufficiency. Underestimation of the severity of the condition in this case leads to delayed diagnosis, delayed treatment and late delivery.

Classification

The classification of preeclampsia has not been sufficiently developed. In Russia, the division of the disease into the following types was most often used:

• dropsy of pregnant women (with a predominance of edema);
• mild, moderate and severe nephropathy;
• preeclampsia;
• eclampsia.

The main disadvantage of this classification is the vagueness of the term "preeclampsia", which does not allow specifying the severity of the condition.

Today, gestosis is divided into forms in accordance with the International Classification of Diseases 10 revision:

• О10: hypertension (high blood pressure) that existed before pregnancy and complicated the course of gestation, childbirth, and the postpartum period;
• О11: preexisting high blood pressure with addition of proteinuria (protein in the urine);
• О12: the appearance of edema and protein in the urine during pregnancy at normal pressure;
• A13: development of high blood pressure during pregnancy in the absence of protein in the urine;
• A14: hypertension during pregnancy in combination with a large amount of protein in the urine;
• O15: eclampsia;
• O16: unspecified hypertension.

This classification solves some of the working points of diagnosis and treatment, but does not reflect the processes taking place in the body.

With "pure" gestosis, pathology occurs in a previously healthy woman. This type is observed in only 10-30% of women. The combined forms are difficult. They develop against the background of previously existing diseases: hypertension, kidney and liver pathology, metabolic syndrome (obesity, insulin resistance), endocrine pathology (diabetes mellitus, hypothyroidism, and others).

This condition is characteristic only for the period of gestation. Gestosis after childbirth passes, with the exception of severe complications. This suggests that the source of problems is precisely the fetus and the placenta. Gestosis occurs only in humans. This disease does not occur in animals, not even in monkeys, so it cannot be studied experimentally. This is associated with a large number of theories and questions regarding the nature of this state.

Why does gestosis occur?

Consider the main modern theories of the development of this condition:

1. Cortico-visceral theory. According to her, gestosis is very similar to a neurotic state with disruption of the cerebral cortex and a subsequent increase in vascular tone. This theory is confirmed by an increase in the incidence of illness in pregnant women after mental trauma, as well as data obtained using electroencephalography.
2. Endocrine theory considers an abnormally proceeding pregnancy as a chronic stress that causes overstrain and depletion of all endocrine systems of the body, including those that regulate vascular tone.
3. Immunological theory states that trophoblast tissue (the outer shell of the fetus that forms the placenta) is a weak antigen. The body produces the corresponding antibodies, which also interact with the cells of the kidney and liver of the woman. As a result, the vessels of these organs are affected. However, autoimmune processes are not recorded in all women with preeclampsia.
4. The genetic theory is based on the fact that in women whose mothers have had preeclampsia, the pathological condition develops 8 times more often than on average. Scientists are actively looking for "eclampsia genes."
5. The placental theory assigns the main importance to a violation of the formation of the placenta.
6. Thrombophilia and antiphospholipid syndrome can cause damage to the vascular walls throughout the body, and they also lead to a violation of the formation of the placenta.

Scientists believe that a unified theory of the origin of gestosis has not yet been developed. The most promising are the immunological and placental versions.

The following factors significantly increase the risk of gestosis:

1. Extragenital diseases, namely hypertension, metabolic syndrome, kidney and gastrointestinal tract diseases, frequent colds and endocrine pathology.
2. Multiple pregnancy.
3. Previously postponed gestosis.
4. The woman's age is under 18 and over 30 years old.
5. Poor social conditions.

How does the disease develop?

The onset of the disease occurs at the earliest stages of pregnancy. When the embryo is implanted (implanted) into the wall of the uterus, the arteries located in the muscle layer do not change, but remain in a "pre-pregnant" state. Their spasm occurs, the inner lining of the vessels - the endothelium - is affected. Endothelial dysfunction is the most important triggering factor for preeclampsia. It leads to the release of powerful vasoconstrictor substances. At the same time, the viscosity of the blood rises, microthrombi are formed in the spasmodic vessels. Disseminated intravascular coagulation syndrome (DIC syndrome) develops.

Vascular spasm leads to a decrease in the volume of blood circulating in the body. As a result, the tone of peripheral vessels reflexively increases. The intensity of blood flow decreases in all organs, including the kidneys, liver, heart, brain and placenta. These disorders cause a clinical picture of gestosis.

Symptoms of gestosis

External signs usually manifest preeclampsia in the second half of pregnancy. However, we found out that the disease develops much earlier. Early preeclampsia is considered a preclinical stage, which can be detected using special tests:

• measurement of pressure with an interval of 5 minutes in the position of a woman lying on her side, on her back, again on her side. The test is positive if the diastolic ("lower") pressure changes by more than 20 mm Hg. Art .;
• violation of uteroplacental blood flow according to Doppler sonography;
• a decrease in the number of platelets less than 160 × 10 9 / l;
• signs of increased blood clotting: an increase in platelet aggregation, a decrease in the activated partial thromboplastin time, an increase in the concentration of fibrinogen in the blood;
• a decrease in the concentration of anticoagulants, in particular, its own heparin;
• decrease in the relative number of lymphocytes to 18% and below.

If a woman finds two or three of the listed symptoms, she needs treatment for preeclampsia.

The classic signs of gestosis that appear in the second half of pregnancy and especially in the 3rd trimester:

Gestosis is characterized by a variety of options for its course. The classic triad occurs in only 15% of women, and one in three symptoms - in a third of patients. More than half of patients suffer from protracted forms of the disease.

One of the earliest signs of the disease is excess body weight gain. It usually starts at 22 weeks of gestation. Normally, any woman up to 15 weeks should add no more than 300 g every week. Then, for patients under 30 years old, this increase should be no more than 400 grams per week, for older women, grams.

An increase in blood pressure usually occurs at 29 weeks. For a more accurate diagnosis, all measurement rules should be followed, the pressure on both arms should be recorded, and the size of the cuff should be correctly selected.

Edema during preeclampsia is associated with sodium retention, a decrease in the concentration of proteins in the blood, and the accumulation of under-oxidized metabolic products in the tissues. Swelling can only be on the legs, spread to the abdominal wall, or cover the entire body. Signs of hidden edema:

• excretion of the bulk of urine at night;
• a decrease in the amount of urine excreted in comparison with the volume of fluid consumed;
• excess weight gain;
• "Ring symptom" - a woman becomes not enough of her wedding or other familiar ring.

Proteinuria is the excretion of protein in the urine. It is caused by damage to the glomeruli due to lack of oxygen and vasospasm. The release of more than 1 gram of protein in any portion of urine is a danger sign. At the same time, the level of protein in the blood decreases.

Severe forms of the disease

Dysfunction of the nervous system - preeclampsia and eclampsia - poses a particular danger to the mother and child.

• headache in the back of the head and temples;
• "Veil", "flies" before the eyes;
• pain in the upper abdomen and in the right hypochondrium;
• nausea and vomiting, fever, itching of the skin;
• nasal congestion;
• drowsiness or increased activity;
• redness of the face;
• dry cough and hoarseness of the voice;
• tearfulness, inappropriate behavior;
• hearing impairment, difficulty speaking;
• chills, shortness of breath, fever.

With the progression of this condition, eclampsia develops - a seizure, accompanied by hemorrhages and cerebral edema.

Complications

Late gestosis can cause serious complications that can even lead to the death of the mother and child:

• eclampsia and coma after it;
• intracerebral hemorrhage;
• acute renal failure;
• respiratory failure;
• retinal detachment and loss of vision in a pregnant woman;
• premature placental abruption;
• hemorrhagic shock and disseminated intravascular coagulation.

There are more rare forms that complicate preeclampsia. This is the so-called HELLP syndrome and acute fatty hepatosis of pregnant women.

HELLP syndrome includes hemolysis (breakdown of red blood cells), a decrease in the number of platelets responsible for blood clotting, and a malfunction of the liver with an increase in its enzymes in the blood. This complication occurs mainly after 35 weeks of pregnancy, especially against the background of nephropathy, and often causes the death of the woman and the fetus.

Symptoms develop quickly. The woman begins to complain of headache, vomiting, pain in the abdomen or in the right hypochondrium. Jaundice, bleeding appears, the patient loses consciousness, she begins to have convulsions. There is a rupture of the liver with bleeding into the abdominal cavity, placental abruption. Even if a woman is urgently operated on, due to blood clotting disorders, she may die in the postoperative period from severe bleeding.

Acute fatty hepatosis of pregnant women develops mainly during the first pregnancy. Within 2-6 weeks, a woman is worried about weakness, lack of appetite, abdominal pain, nausea and vomiting, weight loss, itching. Then liver and kidney failure develops, which is manifested by jaundice, edema, uterine bleeding and fetal death. Often there is a hepatic coma with impaired brain function.

Assessment of the severity of the condition

According to the Russian classification, the severity of the disease is determined by the condition of the kidneys.

Grade 1 gestosis is usually accompanied by edema of the legs, slight proteinuria, an increase in blood pressure up to 150/90 mm Hg. Art. In this case, the fetus develops normally. This condition usually occurs off-board.

Gestosis of the 2nd degree is characterized by the appearance of edema on the abdomen, proteinuria up to 1 g / l, an increase in pressure up to 170/110 mm Hg. Art. There may be degree 1 fetal malnutrition. This form occurs inline.

Diagnosis of a severe form is based on the following symptoms:

• increase in blood pressure up to 170/110 mm Hg. Art. and higher;
• excretion of more than 1 gram of protein per liter of urine;
• decrease in urine volume up to 400 ml per day;
• widespread edema;
• violation of blood flow in the arteries of the uterus, brain and kidneys;
• delayed fetal development;
• violation of blood clotting;
• increased activity of liver enzymes;
• development up to 30 weeks.

In such a serious condition, treatment in a hospital is necessary.

Treatment of gestosis

The main directions of therapy:

• medical and protective regime;
• delivery;
• restoration of the functions of internal organs.

The following drugs are prescribed for a woman:

• sedatives, sedatives (valerian, motherwort), in severe cases - tranquilizers and antipsychotics (Relanium, Droperidol), barbiturates, anesthetics;
• antihypertensive drugs (mainly calcium antagonists - Amlodipine, beta-blockers - Atenolol, as well as Clonidine, Hydralazine and others);
• magnesium sulfate, which has a hypotensive, anticonvulsant, sedative effect;
• replenishment of the volume of circulating blood using intravenous infusions;
• antiplatelet agents (Curantil) and anticoagulants (Fraxiparine) under strict control of blood coagulation;
• antioxidants (vitamins C, E, Essentiale).

Medication with a mild degree can be carried out for 10 days, with moderate severity - up to 5 days, with a serious condition - up to 6 hours. If the treatment is ineffective, urgent delivery is necessary.

Delivery with gestosis is carried out through the natural birth canal or by means of a cesarean section. A woman can give birth herself with a mild illness, good condition of the fetus, the absence of other diseases, the effect of medications. In more severe cases, a planned operation is used. In case of severe complications (eclampsia, renal failure, placental abruption, and so on), an emergency caesarean section is performed.

After a cesarean section, drug treatment is continued until all body functions are fully restored. Women are discharged home no earlier than 7-15 days after giving birth.

Prevention of gestosis during pregnancy

A pregnant woman should avoid nervous and physical overload, fully rest, and not take medications without a doctor's prescription. Nutrition should be complete, as hypoallergenic as possible. Severe fluid restriction and reduced salt diets are not indicated. Only in severe cases of renal failure is the patient recommended to reduce the amount of protein consumed with food.

The key to preventing preeclampsia is regular observation by a doctor, weight control, blood pressure, blood and urine tests. If necessary, the woman is hospitalized in a day hospital or in a sanatorium, where preventive treatment is carried out.

If the condition worsens, the appearance of edema, headache, pain in the right hypochondrium, the patient should consult a doctor as soon as possible. Self-medication in this case is unacceptable. Untreated acute preeclampsia is an immediate threat to the life of the mother and child.

Gestosis before and after childbirth. Gestosis in pregnant women - symptoms and prevention. Treatment of preeclampsia in pregnant women women's health

Preparing to become a mother, a woman thereby sets herself a very important task - to give birth to a healthy person. And towards this goal she goes day after day, experiencing all the joyful moments of pregnancy and steadfastly enduring the accompanying unpleasant "surprises". But when most of the path has been passed, and it is not long before the baby is born, the expectant mother may face another complication of pregnancy - preeclampsia. This disease is very dangerous for both the unborn baby and the health of the pregnant woman herself. Therefore, it is very important not to miss its first signs, diagnose preeclampsia in time and immediately begin its treatment. And for this you need to know what this disease is, how it manifests itself. And what can you do expectant mother to minimize the risk of developing preeclampsia in her.

What is gestosis? Gestosis of pregnant women or late toxicosis is a complication inherent in the second half of pregnancy, which is associated with disruption of the vital organs and systems in the woman's body. Only pregnant women can suffer from gestosis, and gestosis passes after childbirth, after a while. Signs of this disease are detected in 13-16% of women in position. Its seriousness is evidenced by the fact that for a fairly long period of time, gestosis has been called one of the three main causes of maternal mortality in our country.

Gestosis can develop only in the th week of pregnancy. But most often - in the third trimester, that is, after 28 weeks. This is a very insidious disease - at first, a woman may not have any manifestations of gestosis at all. And even after the detection of its main symptoms, the well-being of the expectant mother can remain normal. But in no case should gestosis be ignored, because untimely delivery medical care fraught with serious consequences for the health of the mother and the unborn baby.

What happens in a woman's body with gestosis? Water-salt metabolism is disturbed and water and sodium are retained. The permeability of the vessel walls increases, due to which the liquid from them enters the tissues. Blood circulation is impaired and the supply of oxygen and nutrients to tissues is reduced. The placenta, kidneys and brain are the first to react to insufficient blood supply in the body of the expectant mother. Because of all these changes, the baby also suffers - poor blood supply to the placenta causes placental insufficiency, and this, in turn, causes intrauterine growth retardation.

How does it manifest? Gestosis develops in stages. Persistent edema due to fluid retention in the body of the expectant mother - his early symptom... They mean that dropsy has begun, the first stage of gestosis. Depending on the extent of the edema, there are different degrees of dropsy. Swelling is not only obvious, that is, noticeable to the eye, but also hidden. An uneven or pathological (more than a week) weight gain in the expectant mother speaks about them. In the morning, the puffiness is not so noticeable - at night the excess fluid is evenly distributed over the woman's body. But towards the end of the day, swelling begins to appear on the legs and lower abdomen.

If high blood pressure is added to the edema in a pregnant woman, and tests show the presence of protein in the urine, this indicates the development of nephropathy, which usually begins after dropsy, if its treatment was not started on time. The blood pressure indicator for the expectant mother is 135/85 mm Hg. Art. and higher is a clear sign of nephropathy. However, the starting point is always the baseline blood pressure of the pregnant woman. Complications of gestosis in pregnant women are no longer due to high blood pressure, but due to its sharp fluctuations.

Nephropathy is a very dangerous condition, because it can flow into eclampsia - a convulsive attack, as well as provoke bleeding in the expectant mother, placental abruption, the onset of premature birth, fetal hypoxia or even its death.

The next stage of preeclampsia is preeclampsia. With him, the pregnant woman experiences a feeling of heaviness in the back of the head, headaches and pains in the stomach, nausea, vomiting, impaired vision, memory. She may be tormented by insomnia or, conversely, drowsiness, lethargy and irritability. The expectant mother feels a veil before her eyes, the flickering of "flies" and sparks are the consequences of damage to the retina of the eyes and circulatory disorders in the occipital cortex. The blood pressure indicator can reach 160/110 mm Hg. Art. and higher. Here it is important to react very quickly to the woman's condition in order to prevent the development of the next stage of gestosis, which can take the life of both the mother and the baby.

At the most severe stage of gestosis, eclampsia, seizures lasting 1-2 minutes are added to the symptoms of nephropathy and preeclampsia. In some cases, eclampsia proceeds without seizures, then the expectant mother complains of a headache, darkening in the eyes and may fall into a coma.

In order to avoid the severe consequences of gestosis and to save the life of the mother and baby, in some cases, doctors have to resort to an extreme method - premature delivery.

Risk group Which of the expectant mothers is most at risk of developing preeclampsia? - Women preparing to become a mother for the first time, pregnant women under the age of 18 and over 35 (due to aging of the tissues of the reproductive system), with chronic diseases (VSD, diabetes mellitus, obesity, hypertension, pyelonephritis) or genital infections, inflammatory diseases genital area, endocrine disorders.

The likelihood of developing gestosis is also high with multiple pregnancies, large fruit and polyhydramnios, if the interval between childbirth is less than two years, as well as with previous abortions. If the expectant mother is constantly overworked, is in a state of chronic stress, she is also at risk.

However, preeclampsia can occur in an absolutely healthy pregnant woman. This usually happens during the week of pregnancy. The reason for this may be a failure of adaptive mechanisms due to the increased load on the body, not proper nutrition pregnant, lack of a regimen, and even banal ARVI.

About treatment With a mild form of preeclampsia (dropsy of the first degree), the doctor may confine himself to outpatient treatment. If a pregnant woman has severe dropsy, she will be shown hospital treatment. With nephropathy, preeclampsia and eclampsia, the expectant mother is hospitalized in a hospital where there is an intensive care unit and a department for premature babies. If the doctor, upon detecting gestosis, insists on treating the expectant mother in the hospital, she should not refuse. Because in this way she endangers the health and life of the baby and her own.

While on hospitalization, the expectant mother usually undergoes a series of examinations - she takes blood tests (general, biochemistry, to determine coagulability), urine tests (general, which determines the daily loss of protein, Zimnitsky's test). The attending physician will necessarily assess the condition of the fetus using ultrasound, cardiotocography and Doppler measurements. If necessary, the pregnant woman is examined by an ophthalmologist and a neurologist.

Treatment of gestosis involves several directions:

A diet with limited fluid (up to 1 liter per day) and salt, enriched with proteins and vitamins;

Intravenous therapy to improve blood circulation in small vessels, including placental vessels;

Therapy aimed at lowering blood pressure;

Administration of drugs for the prevention of placental insufficiency;

The expectant mother will also be prescribed sedatives, diuretics medications and prescribe bed rest. The duration of inpatient treatment depends on how severe the form of gestosis is detected in the pregnant woman. If the treatment of severe forms is ineffective within a certain period of time, the doctor may decide to perform a caesarean section.

To resist preeclampsia An expectant mother is able to follow some simple rules, and then there is a possibility that the diagnosis of "Gestosis" will not appear in her medical record. What do we have to do?

1. Monitor your weight. Starting from the 28th week, the weekly weight gain of the pregnant woman should not exceed 350 g, maximum g.

2. Follow a diet. At the same time, lean on foods rich in protein, limit (or better refuse) flour and sweets.

3. Limit fluid intake (1-1.5 liters during the day along with liquid food and juicy fruits) and salty foods.

4. Lead an active lifestyle. Hiking in the fresh air, and if there are no contraindications, yoga, swimming for pregnant women is what you need to keep fit.

5. Engage in self-control. Keep, for example, a diary where the expectant mother can record the daily weight gain, as well as the number of movements of the crumbs within a certain period of time.

You can consult a doctor regarding the use of rosehip broth, cranberry juice, kidney tea, which have a weak diuretic effect and help prevent edema. For the same purpose, the doctor can also prescribe a number of medications for a pregnant woman.

Also, one should not forget about the organization of the diet and rest of the pregnant woman, sufficient night's sleep, regular walks in the fresh air. The mom-to-be must stay in good mood and be in a calm environment.

Gestosis in pregnant women - symptoms and treatment

Most women tolerate pregnancy easily, but there are those for whom carrying a child is associated with the risk of losing health, and sometimes life. This is observed in about 12 - 27% of expectant mothers.

The functional inconsistency of all systems of the woman's body with the needs of the fetus in late pregnancy is called gestosis, that is, the woman's body cannot cope with the task of providing the fetus with nutrients and oxygen, and this condition is associated precisely with the onset of pregnancy.

Gestosis of pregnant women used to be called late toxicosis or dropsy. It is observed after 20 weeks of pregnancy and can continue for another 2-3 weeks after delivery.

The mechanism of development of preeclampsia

To date, the reasons for the development of preeclampsia in pregnant women are not fully understood, there are several theories: endocrine (the effect of hormones), immunological (the reaction of the mother's body to the fetus), genetic and cortical-visceral. None of these theories can 100% explain all the processes that occur during gestosis in pregnant women.

But the changes occurring in the body during gestosis have been well studied. Under the influence of toxic substances, damage to the walls of blood vessels is observed, the liquid part of the blood, together with the protein, "leaves" in the tissue, so edema occurs.

The kidneys are an organ where there are a lot of blood vessels, the protein through them enters the urine. This phenomenon is called proteinuria.

As a result of a decrease in the amount of circulating blood in the vessels, their narrowing (spasm) occurs, which leads to an increase in blood pressure.

With vasospasm, oxygen starvation of all organs is observed, the kidneys, liver and brain are the most "in need" of it; in a pregnant woman, the placenta must be added to this list. As a result, not only the mother's body suffers, but also the fetus, hypoxia and developmental delay occur.

To date, there are several classifications of preeclampsia in pregnant women, all of them are intended for the convenience of doctors. The tactics of management and treatment depend on the correct diagnosis and determination of the severity of the course of gestosis during pregnancy.

There are three main symptoms of gestosis: edema, proteinuria and increased blood pressure. Gestosis in a pregnant woman can be manifested by one symptom, but their combination is also possible.

Doctors call the presence of all three symptoms nephropathy. And in the classifications it is called preeclampsia (divided into 3 degrees of severity).

Distinguish between pure gestosis and combined, that is, arising against the background of another disease (pyelonephritis, diabetes mellitus, obesity, hypertension), moreover, combined forms appear up to 20 weeks (early gestosis), proceeding more difficult compared to late gestosis.

The most severe and formidable condition is eclampsia - a convulsive condition that doctors try to prevent.

Edema is the earliest symptom of preeclampsia that a woman herself can notice. They can be mild, affecting only the legs, or they can be noticeable on the face. Swelling is also observed with a normal current pregnancy, so you should not panic from the very beginning.

It is necessary to weigh yourself regularly, too fast weight gain (more than 0.5 kg per week) should be alerted, since edema can be not only obvious, but also hidden (the abdominal wall swells, and the abdominal enlargement is interpreted incorrectly).

PREECLAMPSIA (nephropathy) - preeclampsia during pregnancy, combining edema, proteinuria (protein in the urine) and increased blood pressure. Distinguish between mild degree (blood pressure - 150/90 mm Hg, protein in urine - up to 1.0 g / l, edema is noticeable only on the legs), medium degree (blood pressure - 170/100 mm Hg urine - 1.0-3.0 g / l, swelling of the legs and abdominal wall occurs), severe (blood pressure - more than 170/100 mm Hg, protein in the urine - more than 3.0 g / l, legs swell, abdominal wall and face) nephropathy.

Objectively, a woman feels a headache, nausea, there may be vomiting, heaviness in the occipital region and a mental disorder.

The blood pressure level must be measured in dynamics and compared with the initial value, and, moreover, you need to pay attention to the diastolic pressure, it is this that reflects the vasospasm. A small difference between systolic and diastolic blood pressure (less than 30 mm Hg) is a poor prognostic sign and requires hospitalization.

ECLAMPSIA is the most severe manifestation of gestosis of a pregnant woman, in which convulsions of the whole body are observed. Sharp fluctuations in blood pressure at this moment are dangerous, since this leads to rupture of cerebral vessels (stroke), placental abruption, followed by hypoxia and fetal death. A pregnant woman may experience acute respiratory failure (shortness of breath, difficulty breathing, agitation).

The course of gestosis can be long with minor symptoms, but sometimes it develops within a few days to a state of eclampsia. In both cases, fetal hypoxia occurs.

Symptoms of preeclampsia In order to diagnose preeclampsia in pregnant women, it is necessary to pass general analysis and biochemical analysis of urine, determine protein in daily urine, check the number of platelets and the state of the entire blood coagulation system.

Control over body weight will help to identify edema, normally, if there is no gestosis, in the second half of pregnancy, a woman adds 350 grams per week (no more than 500 grams). You can also track the amount of fluid you drink and excreted (in the form of urine).

The level of blood pressure and the state of the vascular system can be judged by the pressure measured on two hands (with gestosis, a difference is possible on two limbs). A valuable diagnostic study will be an examination by an ophthalmologist of the fundus and an ultrasound examination of the fetus to detect hypoxia.

Each pregnant woman donates blood and urine, is weighed and regularly measures blood pressure. But women from the risk group for the development of gestosis are subject to the closest attention from doctors, these include first-borns, women with multiple pregnancies, late pregnancy- over 35 years old, women with genital infections and chronic diseases (obesity, diabetes mellitus, pyelonephritis, arterial hypertension).

Treatment of preeclampsia consists in restoring the normal state of health of a woman. The most important rules for the development of gestosis in the second half of pregnancy is a timely visit to a doctor and the absence of any self-medication. Only a doctor knows how to treat preeclampsia, since taking some medicines can only aggravate the already difficult condition of the pregnant woman and the fetus. For example, to get rid of edema, some begin to drink diuretic pills, but the cause of edema during gestosis is pathological vascular permeability, and not excess fluid, thus, the condition worsens even more.

With milder forms of gestosis, you can follow all the doctor's prescriptions at home. But with a severe course of gestosis, it is better to be under the supervision of specialists in a hospital, where they will promptly provide medication (reduce pressure, relieve convulsions).

Timely delivery is also important in the treatment of preeclampsia, because preeclampsia is a condition caused by pregnancy. If the condition of a pregnant woman worsens or severe fetal hypoxia, the absence of the effect of therapy, childbirth is the only right decision. With mild gestosis, the birth of a child is possible naturally, but in this case there is a risk of deterioration during attempts, when the load on the woman's body is greatly increased.

Most often, a cesarean section is performed, especially when there is eclampsia, stroke, retinal detachment, renal or hepatic failure in a woman in labor.

Prevention of gestosis is an important point during pregnancy, since it is not possible to cure the disease at all, it remains only to prevent the deterioration of the condition. The most important thing is to identify it in time.

Every responsible woman should regularly undergo weighing, control blood pressure measurement, and donate urine for protein content. Even with a normal pregnancy, it is important to have proper nutrition with a predominance of proteins and fiber, a reduced content of fatty and starchy foods, as well as a long stay in the fresh air, walking on foot. And with gestosis, these measures are vital not only for the expectant mother, but also for the little man inside her, since this improves the blood supply to the tissues and reduces hypoxia.

Thus, no one is immune from the development of preeclampsia, but one can protect oneself from formidable complications. To do this, it is enough to take good care of yourself and feel responsible for your own health and the health of the child.

Treatment of gestosis in pregnant women

In order to reliably determine whether or not there is gestosis, one visit to the doctor is not enough. Dynamic observation of an obstetrician-gynecologist is necessary.

Blood pressure control - prevention of gestosis At every visit to the doctor, a pregnant woman must measure blood pressure (BP) on both arms, pulse and body weight. An increase in blood pressure above 135/85 may indicate gestosis. The doctor assesses the weight gain of the pregnant woman, the presence or absence of edema, asks the pregnant woman if the amount of urine excreted has decreased.

Also, if you suspect gestosis, additional tests and studies are prescribed:

Clinical and biochemical blood test;

General urine analysis;

Fetal ultrasound with dopplerometry, CTG (cardiotocography) of the fetus.

If the obtained analyzes and examination data raise suspicions of gestosis (BP is higher than 135/85, pronounced edema and a large weight gain, protein in the urine), they are additionally prescribed:

24-hour monitoring of blood pressure, ECG;

Urine analysis according to Nechiporenko, according to Zimnitsky, daily urine analysis for protein;

Consultation with an ophthalmologist, therapist, nephrologist, neurologist.

Treatment of late gestosis

With mild manifestations of gestosis - dropsy, treatment is carried out on an outpatient basis. With nephropathy and more severe manifestations of the disease, hospitalization of the pregnant woman in the obstetric department is indicated.

With minor edema and normal analyzes, the treatment of preeclampsia is limited to adherence to recommendations for lifestyle and nutrition.

For dropsy with severe edema and mild nephropathy, appoint:

Sedatives (tinctures of motherwort, valerian);

Disaggregants (Trental, Curantil) to improve the rheological properties of blood;

Antioxidants (vitamins A and E);

With an increase in blood pressure, antihypertensive drugs with an antispasmodic effect (Euphyllin, Dibazol) are used;

Herbal tea with a diuretic effect.

In severe nephropathy, preeclampsia and eclampsia, treatment is carried out with the participation of a resuscitator in the intensive care unit. Infusion therapy is carried out to correct metabolic and electrolyte disturbances - fresh frozen plasma, rheopolyglucin is injected. In addition to the above groups of drugs, with severe forms anticoagulants (Heparin) are also used for gestosis. For the rapid regulation of water-salt metabolism, diuretics (Furosemide) are used instead of phyto-assemblies.

For all forms of gestosis, in order to prevent the threat of premature birth and fetal hypoxia, selective sympathomimetics are used (Ginipral)

No less relevant is the question of the method of delivery with gestosis.

If the condition of the pregnant woman is satisfactory and the fetus does not suffer at the same time, based on the data of ultrasound and CTG, then childbirth is carried out through the natural birth canal. In the absence of the effect of therapy, with severe forms of gestosis and chronic fetal hypoxia, a cesarean section is indicated.

Treatment of gestosis is carried out not only before childbirth, but also during childbirth and in the postpartum period until the woman's condition is completely stabilized.

Nutrition and diet for gestosis

Lifestyle and nutrition with gestosis are very important for successful treatment. In the presence of edema and pathological weight gain, a pregnant woman should follow a special diet. It is necessary to exclude spicy, salty and fried foods from the diet. Eat less salt. Preference should be given to boiled dishes, slightly undersalted. Try to eat foods of both plant and animal origin, as well as fermented milk products, fruits and vegetables. On average, a pregnant woman with a tendency to edema should consume no more than 3000 calories per day. It is necessary to limit not only the consumption of food, but also liquid. You need to drink no more than one and a half liters of liquid per day. You should pay attention to diuresis - the amount of excreted fluid should be more than drunk.

A restless lifestyle, stress also provokes gestosis. In the second half of pregnancy, a woman should sleep at least 8-9 hours a day. If you want to sleep during the day, it is also better to lie down to rest. But at the same time, a sedentary image can also provoke preeclampsia. Therefore, a woman is recommended to take daily walks in the fresh air for at least an hour, to engage in special fitness for pregnant women.

Folk remedies for preeclampsia

Traditional medicine in the treatment of preeclampsia is very relevant, especially with dropsy, many medicinal plants have a diuretic effect. With gestosis, renal tea, cranberry or lingonberry juice, rosehip decoction are prescribed. Herbal preparations such as Canephron or Cyston can be used. Sedative tinctures of motherwort or valerian can be used, starting with pregnancy for the prevention and treatment of preeclampsia. With severe forms of gestosis folk remedies are not effective, therefore only medications are used.

Detachment of a normally located placenta, leading to fetal death;

Fetal hypoxia, which also leads to intrauterine fetal death;

Retinal hemorrhage and detachment;

Heart failure, pulmonary and cerebral edema, heart attacks and strokes;

Development of renal-hepatic failure, hepatic coma.

Reproductive function up to 35 years old;

Timely treatment of chronic diseases that provoke preeclampsia;

Healthy lifestyle.

Gestosis - what is it?

Gestosis is a complication of pregnancy that develops after 20 weeks and can be observed within 2 or 3 days after childbirth. The cause of preeclampsia is not fully understood. Signs of preeclampsia are the appearance of edema (dropsy of pregnancy), protein in the urine and increased blood pressure. If the disease progresses, preeclampsia occurs, in which the central nervous system is affected.

A woman has a headache, “flies” before the eyes, abdominal pain, nausea or vomiting. This indicates the development of cerebral edema. Without treatment, the disease progresses to the next stage, and eclampsia occurs (convulsions against the background of loss of consciousness).

Gestosis is a dangerous condition that can lead to fetal death due to oxygen starvation, since normal blood circulation in the placenta is disrupted. Also, the disease threatens the life of the mother. Usually the development of eclampsia is an indication for emergency delivery earlier. due date in the interests of both the woman and the child.

Gestosis occurs in about 13-16% of all pregnancies. The disease develops due to the fact that during pregnancy there are substances that can damage blood vessels. As a result, plasma fluid and protein seep into the tissue, resulting in severe edema. The woman is gaining weight despite her usual diet. In addition, through the vessels of the kidneys, protein enters the urine. Blood pressure rises due to vasospasm.

Gestosis is more common in women who are carrying their first child or twins, women over 35 years old and suffering from chronic diseases. For the timely detection of preeclampsia, it is necessary to regularly weigh the expectant mother, conduct urine tests and measure blood pressure.

Gestosis is divided into two main types. Pure gestosis occurs if a woman does not have other background diseases. The disease appears after 35 weeks of pregnancy and lasts 1-2 weeks. Combined preeclampsia develops in women with other chronic diseases. It occurs within a week of pregnancy and lasts up to 6 weeks.

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In our article, we will tell you how to gain weight after childbirth using the example of a specific woman. Before giving birth, Galina's weight was 50 kg with a height of 172 cm. Pregnancy went well, but after giving birth, her weight changed dramatically, and she began to weigh 40 kg. I visited the endocrinologist: all hormone tests are normal. The gastroenterologist also found nothing terrible. The gynecologist said that this is a hormonal imbalance, although with women.

After pregnancy and childbirth, very often there is such a disease - DAIRY (or scientifically, candidiasis). At its core, thrush can be easily treated with antibiotics. However, antibiotics are contraindicated when breastfeeding. Here the question arises: what to do?

After resting a little after the childbirth procedure, the young mother wants to put herself in order. And first of all, he runs to the mirror, looks ... and sees there something red that looks like an alien. What happened? The eyes are red, and there are many brownish dots on her face, as if my mother had participated in a big fight the day before ...

Everyone knows that labor is usually preceded by labor pains. Labor ends with attempts, when.

Butter women's health"Aphrodite" activates the natural synthesis of its own estrogen and restores hormonal balance in the woman's body. In nature, there are estrogen-rich plants that can compensate for the lack of their own estrogen in the body. Moreover, different plants contain different types estrogens (estradiol, anethole, scareol) and here it is best not.

Thrush is a disease that almost every woman faces at least once in her life. Very rare in men. There are different causes of thrush in women. Be that as it may, it is caused by fungi belonging to the genus Candida, therefore another name for thrush is Candidiasis. Normally, these fungi are found in any person in the oral cavity, intestines and genital tract; but disease they are.