Preeclampsia in pregnant women: symptoms, diagnosis, treatment and prevention. Preeclampsia during late pregnancy: symptoms and treatment

During pregnancy, it would seem that a woman should be happy and peaceful. But in fact, this is a very important period, nine months long before the baby is born. The body of a pregnant woman does a great job, in which almost all organs and systems are involved. Even the slightest failure in this process can provoke serious complications, and therefore the expectant mother needs to be very attentive to her health. After all, during pregnancy, many diseases that a woman might not even know about before can become aggravated, complications can appear and ailments develop. But the most serious complication of pregnancy is gestosis. They always scare pregnant women, justifying the need to take endless tests throughout pregnancy and not miss consultations with obstetrician-gynecologists and monitor weight.

Preeclampsia of pregnant women is a late toxicosis. Normally, preeclampsia appears in the third trimester of pregnancy after 35 weeks and proceeds in a mild form for 1-3 weeks (the so-called "pure preeclampsia"). In more severe cases, preeclampsia of the second trimester may also develop, appear at 20-24 weeks and last 4-6 weeks ("combined preeclampsia"). And even after childbirth, late preeclampsia can be observed within 2-3 weeks.

The main symptoms of preeclampsia during pregnancy are:

the occurrence of edema (the so-called dropsy of pregnant women);
protein is detected in the urine test;
there is an increase in blood pressure.

Gestosis creeps up imperceptibly. Against the background of general well-being, edema occurs, to which a woman may not immediately pay close attention, attributing them to the heat or to the herring eaten the day before with pickles. And then, for some reason, an analysis came from the laboratory with the conclusion that protein was found in the urine. But she feels good until the pressure starts to rise. And the following signs of preeclampsia during pregnancy join - sleep disturbance and headaches, convulsions and nausea. This condition requires medical attention.

Oddly enough, despite the many different theories and judgments, medicine still does not know the true cause of preeclampsia, which is why it is also called the "disease of theories." It is believed that the manifestation of this disease contributes to a combination of various factors, chronic diseases and genetic characteristics of the body.

There is a risk group for pregnant women who may develop preeclampsia more likely than others:

the age of the pregnant woman is up to 18 and from 35 years;
complications in the first trimester of pregnancy;
burdened somatic, gynecological and obstetric anamnesis;
neuroendocrine pathologies, diabetes mellitus, problems with the kidneys, liver, etc.;
preeclampsia is more common during the first pregnancy, preeclampsia of the second pregnancy is much less common;
there is also a high probability of manifestation of gestosis in multiple pregnancies.

And many other factors. However, even a pregnant woman who does not belong to any of the risk groups may develop preeclampsia as a result of past infections or immunocomplex pathology.

The fact is that official medicine is inclined to the theory of the vascular cause of preeclampsia. That is, a malfunction of the vessels, or rather in their inner shell - the endothelium leads to microthrombosis in the woman's organs - the kidneys, brain, etc., as well as the placenta.

What is dangerous gestosis during pregnancy

Do not panic, be afraid, diagnose yourself with "preeclampsia" on your own and start self-treatment. Entrust the diagnosis of your condition to the doctor. At the initial stage, the disease is quite easily coordinated with medications under the supervision of a physician. If it is started, more severe degrees of preeclampsia of pregnancy may develop. Their severe course is fraught with danger to the life of both the mother and the child, therefore, in some cases, if the duration of pregnancy allows, a decision is made on emergency delivery. Edema of the visible parts of the body is not such a problem compared to the fact that the placenta swells along with all the organs. This causes oxygen starvation of the fetus, up to its death in especially severe cases. The pregnant woman herself may develop cerebral edema. That is why, at the slightest suspicion of the occurrence of preeclampsia, you should immediately inform the doctor about it.

Stages of preeclampsia during pregnancy

There are four stages or degrees of preeclampsia during pregnancy:

The so-called dropsy of pregnancy. It flows quite easily. Of the visible symptoms - only swelling of the hands or swelling of the legs. But by this sign alone, one should not judge preeclampsia, it just needs to be announced to the doctor at the next scheduled visit.
Nephropathy, which can affect the kidneys. A sharp jump in pressure is added to the swelling. Nephropathy can quickly turn into eclampsia - the most severe degree of preeclampsia. This stage requires immediate treatment and medical supervision.
Preeclampsia, which disrupts the blood supply to the central nervous system. Accompanied by symptoms such as protein in the urine and high blood pressure. Nausea and vomiting, severe headaches, visual disturbances are possible. Against the background of preeclampsia, even varying degrees of mental disorders occur.
Eclampsia is the most severe condition in which convulsions occur, even a stroke, cerebral edema can occur, and the work of many organs is disrupted. Rapid aging is observed, placental abruption, fetal hypoxia and even fading are possible.

For the fetus, preeclampsia is dangerous due to oxygen starvation, as blood circulation in the placenta is disturbed. All three last stages are very dangerous and flow from one to another very quickly.

In fact, no one is immune from the manifestation of gestosis. To one degree or another, its course is noticed in almost 30% of pregnant women, but, thanks to modern drugs and the supervision of doctors, serious consequences can be avoided and most often it goes almost unnoticed.

Prevention of gestosis during pregnancy

Unfortunately, there is no recipe with which to prevent the appearance of preeclampsia in the second half of pregnancy. However, general guidelines must be followed. And this: do not overwork, do not be nervous, observe the daily routine, sleep enough, walk more in the fresh air, eat right. It is necessary to limit salty, smoked and sweets, monitor weight gain. Don't eat for two, but don't starve either. There must be moderation in everything. Physical activities are good, but only in the form of hiking, swimming in the pool and exercises only under the supervision of an instructor for pregnant women. And in the event that there are no contraindications from the doctor who leads the pregnancy.

For a pregnant woman, an elementary seasonal infection or flu can turn into big trouble. Every effort must be made not to get sick. To do this, avoid crowded rooms, especially during the epidemic.

If the expectant mother works, there is no need to risk her health and work after the onset of 30 weeks of pregnancy. Before this period, it is also desirable to work in a more gentle mode.

Treatment of preeclampsia during pregnancy

Most importantly, at the first suspicion of a manifestation of preeclampsia, immediately consult a doctor! At the initial stage of late gestosis during pregnancy, it is quite possible to get by with treatment at home, provided that all the doctor's recommendations are followed. However, you need to be prepared for the fact that the doctor will insist on hospitalization. There is no need to be stubborn and question the expediency of this appointment.

Most likely, you will first have to pass a large number of tests and be examined by several specialists to assess the condition of the body. After that, treatment will be more accurately prescribed.

However, in advanced cases, the appearance of preeclampsia can be put in a hospital immediately and closer to resuscitation. Therefore, there is no need to delay treatment in the early stages.

When diagnosed with preeclampsia, a woman should drink no more than one liter per day and follow a diet. The diet should contain a sufficient amount of proteins and vitamins, salty and smoked meats are prohibited. All this is aimed at controlling the accumulation of fluid in the body.

The practice of treating gestosis during pregnancy most often consists in prescribing sedatives, depending on the condition of the patient, it is possible to prescribe diuretics and reduce blood pressure. Prevention of placental insufficiency is also carried out, as well as drugs that improve blood flow in the vessels and, directly, in the placenta.

The main task of every pregnant woman is to follow the general recommendations of doctors, not to miss consultations and to take the prescribed tests on time. And also lead a healthy lifestyle and eat right in accordance with their position. But, most importantly, he is attentive to his well-being and report all ailments to the doctor. And then, even if preeclampsia of pregnant women does not bypass, its serious consequences can be avoided. And along with the end of pregnancy, preeclampsia will definitely pass.

Preeclampsia in pregnant women occurs, as a rule, in the second half of pregnancy. Due to physical changes in the body during this critical period for a woman, the functioning of the most important organs and systems becomes incorrect. An alarming signal of the presence of preeclampsia are edema. The peculiarity of the course of preeclampsia is that its presence often does not harm the body in the early stages. Early detection of this problem is one of the tasks of an obstetrician-gynecologist who monitors a woman's pregnancy in a antenatal clinic. The diagnosis of "preeclampsia" occurs on the basis of rapid weight gain.

Since puffiness is quite common among pregnant women, many of them no longer pay attention to it, considering the presence of edema to be the norm in their condition. However, indifference during pregnancy is unacceptable: the gradual accumulation of fluid in all tissues of the body of the expectant mother threatens the unborn child, since excess fluid also ends up in the placenta. If protein is present in the urine of a pregnant woman, this becomes evidence of impaired kidney function. So preeclampsia shows its second "face". Abnormal functioning of the organs cannot but have a negative impact on the circulatory system. So, the third signal indicating the presence of preeclampsia is high blood pressure.

To prescribe treatment, for an experienced gynecologist, the presence of even one symptom is enough, because it is impossible to predict the further development of preeclampsia. Of course, the disease in its development may not advance further than edema and high blood pressure, but you should not count on this. In some cases, preeclampsia can become a provocateur of convulsive seizures and even completely disrupt the functioning of internal organs. Naturally, this is very dangerous both for the expectant mother and for the fetus developing in her womb. Pathological cases are different: bleeding, exfoliation of a healthy placenta, hypoxia, fetal fading. That is why it is necessary to start the fight against this disease as early as possible.

What is preeclampsia in pregnancy?

Preeclampsia today is understood as a phenomenon previously referred to as late toxicosis. Developing in about 16% of the total number of all pregnancies, it took 2nd - 3rd place among the various causes of death of expectant mothers, thereby becoming the cause of illness and death of newborns. Risk factors for the development of gestosis are as follows:

the presence of preeclampsia during a previous pregnancy;
the age of the pregnant woman is 20 - 35 years;
first pregnancy or pregnancy from a new sexual partner;
multiple pregnancy;
hereditary predisposition;
chronic infections, stress, intoxication;
bad habits.

Preeclampsia of pregnant women

Considering preeclampsia as a pathology during pregnancy, it is worth highlighting its types. The so-called pure preeclampsia occurs for no apparent reason, while "combining" preeclampsia develops against the general background of diseased organs, hypertension, obesity and hormonal disorders. In medical practice, the following division of preeclampsia also takes place:

Early gestosis, observed, as a rule, in the first trimester. It is also called early toxicosis, as it is accompanied by vomiting of varying complexity.
Late preeclampsia, starting from the second half of pregnancy, passes with edema and high blood pressure. There is a protein in the blood test.
A rare form of the disease. May occur at any stage of pregnancy. In addition to the main symptoms, it is accompanied by dermatosis, asthma, jaundice, psychopathy and other diseases.

Preeclampsia manifests itself in four degrees of severity:

Dropsy of pregnancy. Edema, which first appeared on the knees, gradually spread to the thighs, abdomen, face and body. If the weight gain is more than 300 g per week, or the weight is constantly changing, it is worth thinking about the possible formation of edema.
Nephropathy. Its nature is to increase blood pressure, as well as the appearance of protein in the urine with swelling preceding the development of these pathologies. Often a woman does not complain about anything. In severe cases, nephropathy can progress to the next degree.
Preeclampsia. Its manifestations are similar to nephropathy, but complications are in the defeat of the central nervous system. A pregnant woman may notice “flies” before her eyes, experience abdominal pain and headache. These symptoms pose a serious threat to a woman's health, indicating the development of cerebral edema. If appropriate measures are not taken in time, the disease will quickly move to the next stage.
Eclampsia is characterized by seizures and loss of consciousness. In this case, it is advisable to resort to emergency delivery for the benefit of the mother and her child.

Symptoms of preeclampsia

Symptoms of gestosis are quite diverse. The first manifestations of late toxicosis can be observed at 28-29 weeks of gestation. Basically, it is swelling of the limbs and face. Such a "dropsy" is considered the easiest manifestation of preeclampsia. In the absence of a pronounced expression, a woman may not even pay attention to these changes. In order to determine the presence or absence of edema, it is necessary to carefully monitor your weight gain during pregnancy at all its stages. An increase of 350 - 500 g per week is considered normal not earlier than from the 28th week of pregnancy. In the event that this range is exceeded, this may mean fluid retention in the body, showing dropsy.

Nephropathy, affecting the parenchyma and glomerular apparatus of the kidneys, is already a more severe manifestation of preeclampsia. Here, edema is already pronounced, blood pressure is elevated and there is protein in the urine, the amount of which determines the prognosis of the disease. The main symptom of progressive nephropathy is a small amount of urine. A pregnant woman should pay her attention to this very dangerous sign in the first place. An approximate scheme for the development of preeclampsia here is as follows: edema - blood pressure - proteinuria (protein in the urine). The 3 and 4 stages of preeclampsia discussed above are the most dangerous. Therefore, having noticed even the most minimal manifestations of the disease, the pregnant woman should contact the gynecologist observing her as soon as possible and draw an accurate picture of what is happening.

The mechanism of development of preeclampsia

Since the causes of preeclampsia are quite diverse, scientists have developed several theories for the development of this pathology. According to one of them, the disease is caused by disharmony of the cerebral cortex and subcortical formations. This is manifested by reflex changes in the vascular system and impaired blood circulation. An important prerequisite for the development of gestosis is a violation of the hormonal regulation of the functions of organs and systems important for human life. A significant role in the development of preeclampsia is played by the immunological incompatibility of maternal tissues with fetal tissues. Most scientists agree with the opinion about the role of hereditary predisposition in the occurrence of preeclampsia. But most researchers have another opinion, from which it follows that there is no single mechanism for the development of preeclampsia. But the combined effect of various damaging factors on the development of this pathology is quite possible.

Considering all kinds of mechanisms for the development of preeclampsia, it is necessary to attach importance to the spasm of all vessels, leading to impaired blood circulation in tissues and organs with a breakdown in their functions. Elevated blood pressure just reflects vasospasm. The defeat of the endothelium - the inner layer of blood vessels, also deserves special attention. This phenomenon causes a decrease in the synthesis of substances in the endothelium that affect vascular tone, as well as the blood coagulation system, with a simultaneous change in sensitivity to them from the side of the vascular wall.

Preeclampsia is accompanied by severe renal impairment, which manifests itself in different ways - from the appearance of protein in the urine to acute renal failure. With gestosis, the liver also ceases to perform its functions normally: circulatory disorders occur in the liver tissues, dead areas appear, and hemorrhages occur. The brain of a pregnant woman undergoes structural and functional changes for the worse:

microcirculation is disturbed;
blood clots appear in the vessels, accompanied by the development of dystrophic changes in nerve cells;
small-point or small-focal hemorrhages occur;
edema is accompanied by an increase in intracranial pressure.

With gestosis in pregnant women, pronounced changes in the placenta are also observed, which are the cause of the development of a chronic form of hypoxia and delayed fetal development. All these changes are accompanied by a decrease in fetal-placental blood flow.

Diagnosis of preeclampsia

If preeclampsia is suspected, in order to make an accurate diagnosis, a pregnant woman should pass a general and biochemical urine test to determine the protein in her daily norm, as well as to check the number of platelets and the state of the entire blood coagulation system. The detection of edema is facilitated by continuous monitoring of body weight, and the state of the vascular system and the level of blood pressure are judged by pressure, which is necessarily measured on both hands. Of particular value for a diagnostic study is an examination by an ophthalmologist of the fundus, as well as ultrasound of the fetus in order to detect hypoxia. Pregnancy obliges every woman to regularly donate urine and blood, weigh herself and measure blood pressure. However, close attention from physicians deserves women who are at risk: primiparous, bearing several fetuses, over 35 years of age, carriers of sexually transmitted infections and suffering from chronic diseases.

Treatment of preeclampsia

The essence of the treatment of preeclampsia is to restore the normal state of women's health. In the second half of pregnancy, in the event of the development of preeclampsia, the main rule of behavior is the timely appeal to a specialist without attempting self-treatment. Only a doctor can prescribe the correct treatment for preeclampsia, taking into account the fact that some drugs, as a result of their use, can further aggravate the condition of the pregnant woman and the fetus she is carrying. An example is a situation when a pregnant woman, wanting to get rid of edema, begins to take diuretic pills on the advice of her relatives. However, she will not be able to achieve a positive result, since the cause of edema here is pathological vascular permeability. Such an incorrect approach to treatment worsens the condition even more.

All doctor's prescriptions can be easily performed at home if preeclampsia is mild. However, severe forms require observation by hospital specialists, in which they will provide any medical care in a timely manner. An important stage in the treatment of preeclampsia is the timely delivery. If the condition of the pregnant woman does not improve, fetal hypoxia is detected, and there is no effect from therapy, childbirth becomes the only way out in this situation. In mild forms of preeclampsia, the birth of a child in a natural way is quite realistic, however, there is a risk of a deterioration in the woman's condition during attempts with an increase in the load on the body of the woman in labor. In most cases, a caesarean section is performed, especially for kidney or liver failure, stroke, eclampsia, and retinal detachment.

The implementation of preventive measures for preeclampsia is an important point, since a complete cure for this disease is not possible. The task here is one - to prevent the situation from worsening. The key is early detection. Pregnant women should approach all tests and examinations in the office responsibly in order to control the course of pregnancy.

When you are in an "interesting position", even if it proceeds normally, it is important to properly develop a diet and stick to it. So, fiber and proteins should prevail in food products, but it is desirable to reduce the consumption of fatty and starchy foods. Pregnant women should be outdoors as much as possible, but walking should not be tiring. A "gestotic" pregnant woman will help not only herself, but also the baby growing in her, since these activities help to improve blood supply to tissues and reduce hypoxia.

From the foregoing, it follows that not a single expectant mother is immune from the development of preeclampsia, however, protection from its formidable complications is quite possible. To do this, you just need to take care of your health, listening to the slightest changes in it, and also feel full responsibility, both for your own and for the health of the unborn baby.

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

About what is preeclampsia in pregnant women can be said ambiguously. These are conditions that develop simultaneously and are manifested by a deterioration in the functioning of several vital organs and systems at once:

nervous;
cardiovascular;
liver;
kidneys.

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

What is the danger of the state

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

hepatic bleeding;
placental abruption;
pulmonary edema;
acute renal failure.

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

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

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

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

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

Knowing what preeclampsia is during pregnancy and why it is dangerous allows you to diagnose complications in a timely manner and avoid maternal and infant mortality.

Causes of late occurrence

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

allergic;
renal;
placental;
hormonal;
immunological.

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

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

age - under 19 or over 35;
burdened heredity;
features of the profession;
the presence of harmful production factors;
bad ecology;
bad habits of the mother during pregnancy;
inadequate or malnutrition;
unwanted pregnancy;
liver disease;
the presence of gynecological pathology;
persistent increase in blood pressure;
gestosis in previous pregnancies.

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

Symptoms in the 3rd trimester

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

Another common symptom is a persistent increase in blood pressure. It is associated with impaired microcirculation. This condition is manifested by fatigue, headaches, flies before the eyes.

The most severe sign of preeclampsia in late pregnancy is the HELLP syndrome. It is usually found at 35 weeks. Symptoms develop very quickly:

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

The outcome is a convulsive attack, turning into a coma.

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

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

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

Forms of pathology

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

Mild and severe gestosis

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

Table. Stages of toxicosis of pregnancy according to the characteristic manifestations.

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

Kidney dysfunction is the latest symptom of toxicosis. Its appearance is of great danger in terms of prognosis. To determine latent edema, the patient is regularly weighed. In a normal pregnancy, a woman adds no more than 400 grams per week. In severe cases, accompanied by impaired renal function, weight gain reaches 2 kg in 7 days.

How to treat preeclampsia during pregnancy

Treatment of preeclampsia during pregnancy in the 3rd trimester is carried out pathogenetically and symptomatically. Etiotropic therapy is an emergency delivery, it is used only in very severe cases. For the treatment of preeclampsia during pregnancy, an integrated approach is used, it is carried out in stationary conditions.

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

Therapeutic tactics is aimed at the maximum possible preservation of pregnancy. Indications for urgent termination of pregnancy are:

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

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

Sedative drugs. They affect the central nervous system, eliminating excessive excitability, anxiety, normalize sleep. Assign Relanium, Sibazon, Seduxen inside or intramuscularly.
Antihistamines. Act as a sedative enhancer, improve sleep. Use Fenkarol, Suprastin orally or intramuscularly.
Antispasmodics. They help to reduce the tone of the uterus, dilate blood vessels, reducing pressure. Apply No-shpu or Papaverine intramuscularly.
Antihypertensive agents. Normalize the level of blood pressure. Pregnant women are allowed to take Dibazol and Dopegit, the dosage is selected in accordance with the value of blood pressure.
Magnesium sulfate. A complex action drug that has the ability to reduce pressure, calm the central nervous system, and eliminate convulsions. The drug is prescribed intramuscularly, in severe cases - intravenously.
Means for improving microcirculation. Assign Trental, a solution of sodium chloride intravenously. Drugs thin the blood, improve its fluidity.
In severe gestosis, infusion therapy is necessary. It consists in the intravenous administration of solutions - Reopoliglyukin, Hemodez, glucose solution.
Hepatoprotectors. The drugs improve liver function, preventing the development of HELLP syndrome. Assign Essentiale or Solcoseryl in the form of intravenous infusions.

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

How to treat preeclampsia after childbirth

A woman who has undergone toxicosis of pregnancy, after childbirth, is transferred under supervision to the antenatal clinic. In 98% of women, preeclampsia resolves on its own after childbirth, so special treatment is not required. How long preeclampsia lasts after childbirth and when it passes in the remaining 2% of patients depends on the severity of their condition.

A woman is advised to refrain from pregnancy for the next 3-5 years. How to treat preeclampsia after childbirth depends on how it proceeded during pregnancy. With persistent edema, diuretics are prescribed. If protein continues to be excreted in the urine for two months, a nephrologist and urologist should be consulted.

Prevention of gestosis during pregnancy

Prevention of the development of early gestosis of pregnant women consists in the following activities:

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

Conclusion

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

Usually, early gestosis is 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 so-called late gestosis.

Gestoses of pregnancy or toxicosis are painful changes during pregnancy caused by hormonal fluctuations, various pathologies and diseases. According to the time when a problem may arise, early gestosis during pregnancy and late are distinguished.

Causes of gestosis in pregnant women

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

Very young future mothers or age-related ones often suffer from gestosis - this is explained either by immaturity or age-related changes in the body, as well as those who carry twins, who are overweight and pressure, or who also had gestosis in the female line.

According to the severity of 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 called dropsy of pregnant women. These are the initial, relatively mild manifestations. At the same time, pronounced, rather serious edemas are formed throughout the body; they give a large increase in body weight. Edema is visible on the limbs, on the body and even on the face, they increase in the evening, progress and are difficult to correct. Against the background of dropsy, the phenomena of nephropathy can join - kidney damage when they do not cope with their tasks.

Preeclampsia of the 2nd degree during pregnancy

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

What is dangerous gestosis in late pregnancy

Gestoses develop 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, severe seizures that are life-threatening. 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 to save both lives.

The consequences of preeclampsia for the mother

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

The consequences of gestosis for a child

Naturally, in a difficult condition of the mother, the developing baby will suffer along with her. The development of preeclampsia during pregnancy is no less dangerous and the consequences for the child. Naturally, the most dangerous complication will be intrauterine death of the fetus as a result of hypoxia and nutritional deficiency. This is due to severe placental edema or placental abruption, 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, and can often and for a long time get sick after birth.

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

Preeclampsia is a complication that occurs in many pregnant women. It disappears after childbirth. Pathology is considered a formidable disease, as it sometimes causes maternal death. Complication is most often detected in the third semester of pregnancy.

This is an insidious disease that may not cause concern. But at some point, a woman has an attack of convulsions (eclampsia), which threatens the health of the mother and baby.

Currently, doctors are trying to prevent such phenomena. By regularly visiting a gynecologist, you can keep your health under control. Read on for everything about complications during pregnancy: signs of occurrence, nuances of treatment, what prevention and consequences of the disease can be advised.

What are the signs and symptoms of preeclampsia

Main features

swelling or dropsy (hands and feet swell first);
the appearance of protein in the urine;
blood pressure is above normal.

Dangerous symptoms - harbingers of an attack of seizures

nausea;
headache;
stomach ache;
lethargy and drowsiness;
flashing "flies" before the eyes.

The combination of such symptoms is characteristic of preeclampsia, which is the result of preeclampsia. Against the background of seizures, the following conditions may occur: stroke, heart attack, placental abruption, pulmonary edema, renal failure, placental abruption, retinal detachment. These complications develop very quickly and can be present in pregnant women of any age.

Groups

Edema of pregnant women

They can be overt and covert. The latter appear in the early stages of the disease. Occur due to the retention of fluids in the tissues. Self-medication is not allowed here. Diuretic drugs cannot eliminate the problem, but only worsen the condition of the pregnant woman and the fetus. Not all swelling during pregnancy is associated with a disease. Only a specialist can identify complications.

Preeclampsia

This condition most often occurs after the 20th week of pregnancy. Sometimes preeclampsia occurs at the end of the first week after childbirth. Its symptoms are hypertension, edema and proteinuria. In severe cases, the blood supply to the brain is disrupted. This is manifested by severe headache, vomiting and impaired visual function.

Eclampsia

This is the most severe form. It has a whole range of symptoms, the most dangerous of which is convulsions.

Gestosis can manifest itself in different ways. Some women have minimal symptoms. Others suffer from fulminant attacks that have catastrophic consequences.

The cause of the disease - the opinions of doctors

Doctors cannot accurately name the causes that cause complications. But there is an unequivocal opinion that such a complication rarely occurs in healthy women. Most often, preeclampsia develops against the background of existing diseases of the mother. An increase in pressure, a violation of the functions of the kidneys or liver, as well as other somatic diseases are indirect causes of toxicosis in pregnant women.

It is impossible to give a more precise reason. A pregnant woman experiences malfunctions in the body, which can lead to serious problems. In some cases, doctors resort to early delivery in order to save the life of the child and mother. Therefore, before conception, a woman must undergo an examination.

Immunological diseases, blood clotting disorders, kidney disease, vegetative-vascular dystonia, anemia, diabetes mellitus - these and many other disorders often lead to preeclampsia

This will allow you to predict possible complications that may arise during the period of bearing a baby. If necessary, a woman is prescribed a course of treatment before pregnancy. Immunological diseases, blood clotting disorders, kidney disease, vegetative-vascular dystonia, anemia, diabetes mellitus - these and many other disorders often lead to the manifestation of the disease.

If you have problems with your kidneys, thyroid, or blood pressure, be sure to visit a doctor.

The risk group includes

women over 30 and under 18;
those who often had abortions;
women who have given birth many times;
those who have a short break between births.

No one is 100% safe from preeclampsia. Therefore, experts strongly advise to regularly come for a checkup. Control of pressure and weight, blood and urine tests are the measures that allow early detection of complications.

No one is 100% safe from preeclampsia

The excellent health of a pregnant woman is not yet an indicator of good health. Sometimes test results show poor results in the absence of external signs of the disease.

Why gestosis appears in pregnant women

Preeclampsia or toxicosis is a complication that is associated with pregnancy. It may be early or late. Early toxicosis is known to all pregnant women. It shows up at the earliest. Its main symptoms are nausea and vomiting. The early stage is usually non-aggressive.

All its signs are noticed not only by the pregnant woman herself, but also by the people around her. Late toxicoses are more insidious. They lead to dangerous complications. Late preeclampsia is the leading cause of maternal mortality. This complication is less noticeable.

It manifests itself in three main features:

swelling;
protein in the urine;
high blood pressure.

Not all women show the full range of symptoms. Only one of them can tell about the presence of pathology. Visible here are only edema. Pressure rises may not be very significant. In this case, the woman does not feel them. Changes in the composition of urine also do not bother the pregnant woman. Therefore, by the end of the term, doctors measure blood pressure weekly and carry out weighing.

Late gestosis sometimes have an unpredictable development. Sometimes they begin to progress rapidly. In this scenario, the woman's health is rapidly deteriorating. A pregnant woman may feel worse and worse every hour. Pathology in this form is treated only in stationary conditions.

Today, about 27% of pregnant women experience the disease. Its symptoms subside after childbirth. The complication occurs due to the fact that the mother's body cannot optimally adapt to bearing a child. As a result, various violations occur.

The disease is characterized by spasm of the smallest blood vessels. As a result, the amount of blood that carries nutrients and oxygen to the cells is drastically reduced. The work of organs and systems is disrupted. Spasm of small vessels leads to an increase in blood in large vessels. All this leads to an increase in blood pressure.

There are changes in the kidneys, which entails the appearance of protein in the urine. The brain also suffers. This is manifested by nausea, headaches, flashing "flies". If a pregnant woman experiences dry skin and itching, then this is a clear sign of changes in the liver.

A woman has swelling, and the blood becomes thicker. Such processes are reflected in the condition of the fetus. Its growth and development is slowed down. The baby experiences a lack of oxygen (hypoxia).

Diagnostic methods

If the doctor suspected preeclampsia, he prescribes the following procedures:

general and biochemical blood tests;
urine tests (daily, biochemical and clinical);
weighing;
measurement of blood pressure;
examination of the fundus;
Ultrasound and dopplerometry of the fetus.

The patient needs to be examined by a general practitioner, a neurologist, an ophthalmologist and a nephrologist. A serious problem is considered a significant deviation of pressure from the norm.

A special group is made up of hypertensive patients, in whom the pressure is increased initially. They are under constant medical supervision. If a woman has only edema, then she is at risk for a more severe form of preeclampsia.

Doctors must take into account the initial pressure of a woman with blood pressure in the second period of pregnancy

From the moment edema appears, specialists begin to take measures to prevent complications. The success of treatment depends on the body of the pregnant woman.

When diagnosing edema, a specialist evaluates weight gain for the entire duration of pregnancy, as well as for a month and a week. An increase of about 300-400 grams is considered the norm. Pathological increase indicates hidden edema. In this case, measures are taken to correct nutrition and water-salt metabolism.

The gynecologist recommends sticking to a diet and spending fasting days. If this does not help, then the doctor prescribes special drugs. If a pregnant woman has a significant weight gain, but there is no swelling, then she can be given an MCO test (McClure-Aldrich test).

It consists in the fact that a woman is injected with saline under the skin. The doctor notes the time during which the papule resolves. If the interval does not take 35 minutes, then there is swelling in the body.

The first sign of edema is slight numbness of the fingers.. It is difficult for a woman to unbend her fingers, she can hardly put on rings. With small swelling of the legs, the gynecologist prescribes treatment, which is carried out on an outpatient basis. If the arms, legs and face swell, the pressure is increased, and there is also protein in the urine, then you need to go to the hospital.

In this case, the condition of a woman can deteriorate dramatically at any time. Self-medication is not allowed here. Some women start taking diuretics on their own, which worsens the situation even more.

Complication of the second half of pregnancy (starting closer to the third trimester)

Late toxicosis occurs for many reasons. Violation in the endocrine system, obesity, sexual diseases, hypertension - all these factors can contribute to the development of preeclampsia in the second half of pregnancy. Sometimes it is a consequence of the flu or SARS.

Improper nutrition can also give impetus to the development of late toxicosis. It is impossible to cure it at home. The woman needs hospital treatment. She is given droppers and prescribed medications that help to make up for the lack of fluid in the vessels.

The cause of late toxicosis is often a pathology in the placenta. In this case, childbirth is considered the most effective solution to the problem. With formidable complications resort to caesarean section.

The initial symptoms of late toxicosis are detected at the next examination in the antenatal clinic. The doctor assesses weight gain, measures blood pressure, examines urine analysis and calculates the fetal heartbeat. Based on the data obtained, he can conclude that preeclampsia is present or absent.

If the doctor insists on hospitalization, then you can not refuse. The late degree does not go away on its own. The symptoms will only get worse. If you miss the time, you may experience preeclampsia or more severe complications (seizures).

How is childbirth

The severity of the disease affects the choice of time and method of delivery. The doctor takes into account the condition of the mother and child.

The most favorable births are those that occur through the natural birth canal. This is a truth that all gynecologists and obstetricians have supported for centuries. But for such childbirth, the following conditions are needed: a mature cervix, the proportionality of the mother's pelvis and the head of the fetus, head presentation of the fetus, the woman's age is not older than 30 years, the absence of diseases in the mother and other factors.

With gestosis, childbirth can be accompanied by complications. Therefore, they are carried out very carefully, using antispasmodics and painkillers. Delivery is considered stressful for the fetus and mother.

With gestosis, childbirth can be accompanied by complications

Studies conducted by specialists have shown that with this disease, the woman and the fetus have reduced anti-stress resistance. Any aggressive impact during childbirth (fatigue, hyperstimulation of the uterus, painful manipulations) can have sad consequences. A woman has every chance of suffering from fulminant and critical hypertension.

As a result, cerebral blood flow may be disturbed, leading to eclampsia. Statistics show that eclampsia in childbirth occurs quite often. It can occur not only during childbirth through the natural birth canal, but also during caesarean section.

Typical complications at the birth of a child

fetal asphyxia;
premature detachment of the placenta;
heavy bleeding in the postpartum period.

Childbirth is considered the main way to save a woman from preeclampsia. But for an immature and premature baby, delivery before the due date is not a very favorable outcome. But in some cases, the baby is more likely to survive outside the mother's body. Then the only strategy of doctors is delivery. It allows you to save the life of the child and mother.

Childbirth in the presence of the disease is carried out against the background of stabilization of laboratory and clinical parameters.

Indications for preterm birth (regardless of gestational age)

non-convulsive or convulsive eclampsia, seizures;
preeclampsia, which progresses even with hospital treatment;
the rapid deterioration of a woman's health;
retinal disinsertion;
placental insufficiency, which progresses;
placental abruption;
signs of hepatopathy.

Doctors carry out a gentle and quick delivery. Preference is given to childbirth through the natural birth canal. This avoids the stress that surgery and anesthesia cause. The woman is given anesthesia.

Caesarean section is performed if there are absolute indications: preeclampsia and eclampsia, placental abruption, oliguria, coma.

Illness after childbirth

After childbirth, some women have symptoms of pathology. Such patients are prescribed appropriate treatment, which is continued until their condition stabilizes. The treatment regimen is determined individually.

Degrees and classifications

Specialists distinguish between early and late gestosis. The first occurs at a period of 22-24 weeks and lasts quite a long time. The second may appear when the period is 36 weeks. The late form of the disease usually does not have severe complications. During this period, the baby has already formed and delivery is not accompanied by dangerous symptoms.

Late preeclampsia usually does not have severe complications.

Severity:

light,
average,
heavy
eclampsia.

Doctors also distinguish pregestosis or the preclinical stage of the disease. There is also a division into combined and pure gestosis. This is where comorbidities matter. Pregnant women with extragenital ailments that were not detected in time are included in the group of women suffering from a pure form of the disease.

If complications arose against the background of an existing disease, then we are talking about a combined form. In practice, 70% of women have exactly the combined form. The most adverse symptoms are observed in pregnant women who have liver disease, kidney disease, endocrine disorders, hypertension and metabolic syndrome.

Edema plays an important role in the diagnosis. They may vary in severity.:

grade I - edema of the lower extremities;

degree II - swelling of the lower and upper extremities, as well as the abdominal wall;

degree III - edema extends to the internal organs.

Edema may be hidden. They may be accompanied by proteinuria and arterial hypertension. The course of the disease is determined by conducting a study of blood and urine. In this case, the doctor monitors the condition of the fetus. The severity of the pathology can be judged by the number of heartbeats of the baby.

Early

Early preeclampsia or toxicosis worries many pregnant women. It occurs in the first half of the term. Doctors cannot name the reasons for it.

The main manifestations of toxicosis:

dizziness,
nausea,
salivation,
vomit.

They can be expressed with different strengths. If the disease manifests itself too brightly, then doctors prescribe treatment. Toxicosis is so widespread that its symptoms are considered normal during pregnancy.

In fact, the phenomenon has a pathological basis. Normally, pregnancy in a healthy woman should not be accompanied by nausea and vomiting. Pregnancy is a physiological normal state of the body. This is not a pathology.

The mechanisms of development of the early form have not been studied. Experts believe that it is a pathological reaction of a woman to pregnancy. Immune, allergic, toxic, reflex and neurogenic mechanisms are involved in the development of toxicosis.

In some cases, the disease in early pregnancy takes the form of asthma, dermatosis, tetany or osteomalacia.

Late preeclampsia

This is a complication that occurs in the second half of pregnancy. It develops until birth. Such toxicosis leads to a breakdown of the systems and organs of a woman.

Many obstetricians associate the occurrence of preeclampsia with an increased number of late births.

The reasons for the development of late getosis have not been studied by science. According to some versions, preeclampsia occurs due to the immunological incompatibility of the fetus and mother. Other experts believe that hormonal processes are to blame. Late form in recent years is detected very often.

Many obstetricians attribute this to the increased number of late births. Women who give birth after the age of 35 have chronic diseases that complicate the course of pregnancy and childbirth.

A woman may notice the first signs of a late disease at the 28th week. Usually pregnant women find edema. This is the mildest manifestation of the disease. Edema is also called "dropsy of pregnancy." In more severe cases, the complication is manifested by nephropathy.

Easy

A mild degree of the disease is characterized by a slight increase in blood pressure. It exceeds the norm by 20%. Protein in urine is 1.0 g/l. Of the signs, edema is present. The woman is undergoing outpatient treatment.

Heavy

Blood pressure exceeds the norm by 40% and more. Protein content - 3.0 g/l. The health of the pregnant woman worsens. She develops a headache, swelling increases and protein in the urine increases.

Sleep may also be disturbed and vision may be impaired. The patient is admitted to the hospital. If the condition is very serious, then the pregnant woman is sent to intensive care. The tactics of treatment depends on the condition of the woman and the fetus.

The pathogenesis of preeclampsia

The basis of the pathogenesis of the disease is a generalized spasm of blood vessels. This is manifested by an increase in pressure. Spasm occurs due to damage to the endothelium. Dystrophic changes occur in the organs and tissues of the patient. The functions of the liver, kidneys and nervous system are impaired, and the fetus and placenta also suffer.

The mechanism of development of pathology is a controversial issue. Many experts adhere to the hormonal theory. The cause of complications in this case is considered a violation of the functions of the adrenal glands, a change in the production of estrogens or the hormonal status of the placenta.

There are doctors who support the renal theory of the occurrence of gestosis. The kidneys are squeezed by the growing uterus, which entails a number of disorders in the body. But this theory is refuted by facts that claim that toxicosis occurs in pregnant women and without squeezing the kidneys.

There is also an immunogenetic theory, which states that placentation is disturbed in some pregnant women due to genetic characteristics.

What is the danger of the disease during pregnancy

Gestosis is dangerous for its complications. If it is accompanied by vomiting, then the pregnant woman may be dehydrated. The functions of many organs and systems are impaired. The kidneys, liver and heart suffer. The most severe complication is acute yellow liver atrophy, which can be fatal. But this pathology develops very rarely. If preeclampsia is extremely severe, then the pregnancy is terminated.

With a favorable course of early toxicosis, its symptoms disappear by the 12th week. If it continues, then doctors talk about pathology. This may be caused by an exacerbation of chronic diseases or any obstetric pathology.

Any form of late onset of the disease is dangerous to the fetus. In the vessels of the placenta, blood circulation is disturbed. The acute form causes its detachment, premature birth or death of the child. Sluggish preeclampsia causes a delay in intrauterine development of the baby.

What are the principles of treatment

Modern doctors cannot completely eliminate the disease. In many cases, they control this complication. Timely treatment helps to prevent the development of serious complications. Self-medication is an unacceptable measure. Without the help of a professional, preeclampsia goes into a difficult stage.

Basic principles of treatment:

maintaining a medical and protective regime;
taking sedative drugs (valerian, motherwort or stronger drugs);
drug treatment of internal organs;
careful and timely delivery.

If the treatment does not lead to positive changes, and the condition of the mother and child worsens, then the question of childbirth arises.

If preeclampsia is treatable and does not progress, then labor induction is not used. Premature birth is a forced measure that is used in severe cases. If the treatment does not lead to positive changes, and the condition of the mother and child worsens, then the question of childbirth arises.

The treatment regimen for toxicosis is developed individually. Doctors take into account many nuances: the severity of the disease, concomitant diseases, the condition of the fetus, etc. A mild degree of toxicosis begins to be treated in the antenatal clinic.

If after a week the woman's condition has not improved, then she is sent to the hospital. Medicines in the presence of a disease are used necessarily. It is impossible to cure it with herbs and diets.

Pregnant women with edema that accompany moderate and mild preeclampsia are treated in a hospital (department of pathology of pregnant women). In severe form with signs of preeclampsia, the woman is placed in the intensive care unit and resuscitation.

The duration of treatment depends on the severity of the disease. The best treatment for a severe form is delivery. Therefore, three hours after an unsuccessful treatment for preeclampsia, the patient is given a caesarean section.

Prevention

proper nutrition;
active lifestyle (it is useful for pregnant women to do yoga, swimming, fitness);
frequent walks in the fresh air;
lack of bad habits and stress;
taking prophylactic drugs as prescribed by a doctor (Magne-B6, vitamin E, chimes, etc.);

Diet

Proper nutrition can improve the condition of a pregnant woman. On the table, a woman should have useful products. Emphasis should be placed on food rich in protein. These are lean meat, cottage cheese, fish and eggs. Sweet, fatty, fried, smoked and salty should be excluded.

Under the strictest ban fast food. The daily menu should include fresh vegetables, fruits, juices and herbs. Eat more fiber foods to relieve constipation.

If there is swelling, then the doctor makes a diet. He recommends monitoring the amount of fluid you drink and excrete. Pregnant women need to control the amount of food they eat. Otherwise, there will be a strong weight gain, which can lead to a number of complications.

Pregnant food should be rich in vitamins and minerals. You should drink purified water, excluding coffee, strong tea and carbonated drinks. Doctors usually prescribe special vitamin complexes for pregnant women. They must be accepted without fail.

Pregnancy food should be rich in vitamins and minerals

What could be the consequences

Preeclampsia is a dangerous condition that can lead to sad consequences. It ranks second among the causes of death of mothers (the first place is given to bleeding). A complication is perinatal mortality (its rate reaches 32%).

Women suffering from the disease get endocrine disorders, hypertension, kidney pathology. Children born to such mothers experience problems with psycho-emotional and physical development. Many babies often get sick in early childhood.