Toxicosis in pregnancy: causes and treatment

Toxicosis of pregnant women is a complication of the gestational period.

It is accepted to isolate several of its clinical forms:

• vomiting of pregnant
  
• salivation
  
• dermatitis
  
• skin itch, etc.

However, most often in obstetrical practice occurs vomiting of pregnant women. Therefore, in this article it will be about it.

Early and late toxicosis

In obstetrics, early toxicosis was divided into:

• early
  
• late.

Subsequently, the latter term was replaced by gestosis or preeclampsia. The difference between early and late toxicosis is the timing of onset and clinical manifestations.

Early toxicosis develops in the first trimester and usually ends at 13 weeks, but it can sometimes be delayed up to 16 weeks.

Late toxicosis( pre-eclampsia according to modern beliefs) begins after 20 weeks and poses a serious danger to the health of both the woman and the child who is in utero. Its main manifestations are the presence of high blood pressure and protein in the urine( proteinuria).

Causes of Toxicosis in Pregnancy

Until now, the final causes of early toxicosis in pregnancy have not been clarified. Therefore, the so-called predisposing factors that significantly increase the likelihood of the development of this complication are singled out:

• increased psycho-emotional stress on the woman( persistent stresses, unsettled family life, problems at work, etc.)
  
• chronic diseases of the gastrointestinal tract
  
• hormonal disorders
  
• prolificpregnancy
  
• pregnancy that occurred against the background of stimulation of the ovaries, as well as in the case of in vitro fertilization
  
• abortions, etc.

This or that causative factor leads to increased impulse in the medulla oblongata, where the center of vomiting is located. His excitement leads to the appearance of a vomiting reflex, which is accompanied by nausea.

It can also cause the involvement of other regulatory centers in the pathological process, which causes the connection of other complications during pregnancy.

Symptoms of toxicosis in pregnancy

Clinical signs of early toxicosis are the following:

• nausea
  
• vomiting more than 2 times a day
  
• weight loss
  
• lack of appetite
  
• increased salivation
  
• appearance of acetone odor from the mouth
  
• decrease in skin turgor
  
• changes in the biochemical composition of the blood and t.

Physiological vomiting, which is a symptom of pregnancy, should be distinguished from abnormal vomiting, which is a sign of an early toxicosis.

In the first case, vomiting is observed in the morning no more than 2 times a day. The reason for this lies in the increased level of chorionic gonadotropin and progesterone. If vomiting is observed more than 2 times a day, then a detailed examination and appointment of appropriate treatment is necessary.

As a rule, in this case we are talking about early toxicosis.

Diagnosis of Toxicosis

Diagnostic search for suspected early toxicosis consists in the following additional research methods:

1. 1) A general blood test with hematocrit determination that reflects the degree of blood thickening on the background of dehydration as a result of vomiting
   
2. 2) Biochemical blood test with mandatory glucose determination, proteins, bilirubin
   
3. 3) Urine analysis for acetone
   
4. 4) Ultrasound examination to exclude multiple pregnancies.

At the same time:

1. 1) Daily weighing of the patient, which allows to evaluate the effectiveness of the treatment. In addition, the weight of the body can determine the severity of early toxicosis.
   
2. 2) Measurement of blood pressure and heart rate
   
3. 3) Control of urine output - the amount of urine output.

Based on clinical and laboratory data, the severity of early toxicosis is determined( distinguish between mild, moderate and severe course).It depends on it the intensity of the therapy.

For mild to moderate symptoms the following symptoms are characteristic:

• vomiting throughout the day is observed no more often than 3 times
  
• predominantly occurs in the morning hours
  
• appetite reduced
  
• general condition remains satisfactory
  
• body weight loss slightly
  
• in urine is determined by acetone in a small amount
  
• good efficacytreatment.

Vomiting of moderate severity has more pronounced clinical manifestations:

• during the day, vomiting becomes more frequent 10 times a day
  
• it is not associated with food intake
  
• body weight decreases by 2 kilograms or more
  
• pronounced general weakness
  
• apathy - loss of interest in the surrounding
  
• lack of appetite
  
• skin becomes dry
  
• appears odor of acetone from mouth
  
• increases the amount of acetone in urine
  
• increases pulse while background volume of circulating plasma decreases
  
• decreasesI the amount of urine released during the day.

Severe vomiting has a marked effect on the general condition of women, which is manifested by symptoms such as:

• vomiting worse( 10 to 20 times during the day)
  
• appetite completely absent
  
• state of pregnant heavy
  
• significantly decreased body weight
  
• appears sharp odor of acetone
  
• in urine acetone in large quantity
  
• skin turgor reduced
  
• tongue coated with white coating
  
• pronounced weakness
  
• body temperature rise on dehydration
  
• sharply decreased diuresisto be the total absence of urine.

Treatment of toxicosis in pregnancy

Treatment of early toxicosis during pregnancy is carried out in the following areas:

1. 1) Detoxification therapy. It can be carried out in the form of an increase in the volume of the liquid being drunk( an advantage is given to alkaline mineral water) or as an intravenous fluid.
   
2. 2) Vitaminotherapy, which allows to normalize the disturbed metabolism and restore the cycle of oxidation-reduction phosphorylation. Advantage is given to vitamins from group B, which are cofactors of many enzymes.
   
3. 3) Molecules - energy donors, which include the drug ATP.They provide an opportunity to receive energy in pure form, which is necessary for all processes occurring in the body.
   
4. 4) Antiemetic drugs that act on the brain( the center of vomiting) and normalize the motor function of the upper gastrointestinal tract.
   
5. 5) In case of increased psychoemotional arousal, women are shown to use sedative drugs, and in severe cases - and tranquilizers.

In parallel to improve the effectiveness of the therapy should follow such recommendations as:

• to take food in small portions so as not to create conditions for stomach overflow
  
• during the day you need to eat 5-6 times
  
• to exclude from the food ration fat and fried
  
• to exclude preservatives and t.

Sometimes toxicosis has a very severe course, when conservative therapy is ineffective. As a result, this leads to a significant deterioration in the state of the pregnant woman with the development of the insufficiency of many organs. In such a situation, the interruption of pregnancy is shown in the interests of the woman. This allows her to save her life.

Complications of

In case of ineffectiveness of the treatment, a number of complications may develop. These include the following:

• exacerbation of chronic gastrointestinal diseases
  
• dehydration
  
• cardiac rhythm disorder
  
• spontaneous abortion
  
• water-electrolyte disorders, etc.

In conclusion, it should be noted that toxicosis of pregnant women can complicate the course of pregnancy in the first trimester. However, the vomiting that accompanies it must be distinguished from physiological vomiting, which does not need treatment. Therapy of toxicosis is carried out taking into account the severity of this pathological condition.

However, in all cases, it requires an integrated approach, affecting the main links in the development of vomiting.

I weighed 92 kg! Fat went 3 kg a week! For this, I drank a glass before bed. ..

The nail fungus is afraid of this as a fire! If in cool water. ..

Varicose veins disappear in a few days! Just need once a day to smear your feet. ..

"Dedovskiy" method to quit smoking! In 7 days you will forget about cigarettes forever!