Late toxicosis

This pathology of pregnancy includes a number of severe conditions that appear in the second half of pregnancy. They are dangerous both for the child and for the mother herself.

The heavier the manifestations of toxicosis and its course, the more likely that the birth will proceed abnormally, with complications. However, it is worth noting that after the birth all manifestations of toxicosis pass without a trace. There are many theories that explain the occurrence of these states. It is noted that they often develop in women suffering from concomitant diseases, for example, myopia, hypertension, kidney disease, etc., as well as chronic diseases of the reproductive system. Infectious diseases transferred in childhood, such as rubella, measles, chickenpox, mumps, etc., contribute to the development of toxicosis. Adverse effects on the whole body, especially during the carrying of the child, are obesity, smoking, alcohol. All of the above reasons violate the neural connections in the hypothalamic-pituitary region of the brain, thereby violating the normal formation of the neural connections that are formed during pregnancy. This is the basis on which, under the influence of external concomitant factors, toxicosis can develop.

It should be noted that most toxicosis occurs in women who are waiting for their first child.

There are several variants of late toxicoses, different in severity and simultaneously being stages of one process, transient one to another: dropsy of pregnant women, nephro-

patia, preeclampsia and eclampsia, which will be discussed in more detail below. Very often, these manifestations are preceded by changes in early gestosis: indomitable vomiting, drooling.

Doctors distinguish pathological conditions:

1) arising in the body of a healthy future mother;

2) in women with chronic diseases of various organs and systems.

This separation is important, because if a future mother has any concomitant illnesses, the outcome of gestosis can be much worse. Let's talk in more detail about each of the stages of late gestosis.

A dropsy of pregnant is the first stage of late gestosis. It is persistent, not passing even after rest and night sleep, swelling. First they appear only on their feet, but as the disease develops, more and more areas are captured, moving to the hips, trunk, face. Edema occurs due to a violation of the excretion of fluid, which begins to accumulate in the tissues, mainly in the subcutaneous fat. With increasing edema, the body weight of the pregnant woman also increases. There are situations when there is no visible swelling, but the body weight is still steadily rising. This is due to the presence of so-called hidden edema. The woman feels quite satisfactory, complains of the heaviness in her legs, the rapid fatigue, the impossibility of long walks. In some cases,

tea even without treatment, swelling pass independently before delivery. The dropsy of pregnant women is dangerous because in the absence of treatment it can go to the next stage - nephropathy, which is far from being so harmless. To avoid this and in time to detect violations in the body, the expectant mother is regularly weighed. This helps to detect a sudden sharp increase in weight associated with the accumulation of water in the tissues. Pregnant, suffering from dropsy, it is recommended to follow a diet with the restriction of salt and liquid. Food should be full, rich in minerals and vitamins. Fats should be limited. With bed rest, swelling may decrease somewhat. With persistent swelling, inpatient treatment is necessary.

Nephropathy of pregnant is a violation of renal function, manifestation of which is the detection of protein in the urine, increased blood pressure, sometimes to very high digits, and swelling. The diagnosis of nephropathy is also made if there are only two symptoms:

1) increased blood pressure. A woman often dizzy, flies flies before her eyes, a weakness is felt. And we must remember that the manifestation of nephropathy will be even normal pressure, in the case if before pregnancy for a woman was characterized by a decreased;

2) protein in the urine. It can be detected only by conducting a urinalysis. First, only traces of protein are found, but over time this index reaches higher and higher values. The pregnant woman herself may notice that the amount of urine has significantly decreased. In addition to these signs, the blood content of acidic metabolic products increases, which leads to oxidation - acidosis. And this, in turn, adversely affects not only the health of the mother, but also the condition of the fetus, causing his oxygen starvation( intrauterine hypoxia), the child can be born prematurely. In the most unfavorable cases, even a spontaneous abortion is possible, or the fetus dies in utero. During the delivery itself, nephropathy can suddenly go on to its next stage - pre-eclampsia and eclampsia. This creates significant difficulties in the management of labor, especially if there is already no possibility of resorting to cesarean section and it is necessary to lead births in a natural way. If nephropathy is detected, urgent hospitalization is necessary, where the necessary treatment will be performed.

Pre-eclampsia can develop not only as the next stage of nephropathy, but also immediately after dropsy. All the symptoms characteristic of nephropathy, continue to be present, but more

more amplified. At this stage, there are symptoms associated with spasm of cerebral vessels, the eye fundus: headache, flies flies before the eyes, heaviness in the forehead and occiput. The pregnant woman is in an excited state or, on the contrary, is drowsy. When examining the vessels of the fundus, small hemorrhages in the retina are revealed. In the future, these changes can lead to more serious visual impairment, up to retinal detachment. A woman can complain about hearing loss and nasal congestion, which is also associated with impaired cerebral circulation. The acidosis of blood rapidly increases, strengthening the hypoxia of tissues, there may be pain in the abdomen, nausea and vomiting. Pre-eclampsia is very dangerous for the health and future mother and fetus. Quite often it is accompanied by hemorrhages in vital organs, including the brain. Premature detachment of the placenta may occur, intrauterine hypoxia of the fetus increases sharply. Pre-e-lampia requires urgent hospitalization in a specialized hospital. For the patient, all conditions must be created, excluding the slightest stimuli, such as light, sounds. In addition to special treatment, she is prescribed a diet containing only juices and a small amount of fruit. If the treatment was carried out correctly, in most cases the condition of the woman is significantly improved and the next stage of gestosis - inflammation is avoided. However, in some

cases, you have to have an abortion, as there is a threat to the health and life of a woman. Indications for interruption of pregnancy are hemorrhage into the fundus, a sharp decrease in the amount of excreted urine or its complete absence, a high protein content in the urine, and inefficiency of the treatment for 4-5 days.

Eclampsia is the final stage in the development of gestosis and carries a real threat to the life of the expectant mother. As a rule, it is preceded by dropsy of pregnant women, nephropathy and preeclampsia. The risk group for eclampsia is made up of older women, especially if they are their first child, as well as pregnant women with concomitant pathology of various organs and systems. With this form of pathology, fluid retention in the body causes cerebral edema. Usually eclampsia occurs suddenly during labor, but can manifest itself both during pregnancy and in the postpartum period. Her manifestations are seizures with complete loss of consciousness. Before the attack, it is possible to increase headache, a sharp increase in blood pressure. The pregnant woman complains that she suddenly began to see badly. She becomes nervous, does not sleep well. In the study of urine, a sharp increase in the protein content is detected. At the beginning of the attack, a woman suddenly rolls her eyes so that only the whites are visible, all the facial muscles begin to tinkle slightly-

.Approximately 30 seconds later, tonic cramps of the muscles of the whole body, including respiratory ones, start, which makes breathing cease for a short time, the face becomes cyanotic. The arterial pressure is further increased. Body temperature can also significantly exceed normal values. The whole body strains and stretches out into the arc. This is very dangerous for the life of the mother and child. Then the muscles of the body begin to break violently and chaotically. Breathing resumes. If you do not take action, then a woman can bite her tongue. After this, the seizure comes to an end, but the patient is unconscious for some time. At this time, another seizure may occur, and then another one. It is caused by the slightest stimuli, such as light, loud sound, smell. The total number of seizures sometimes reaches 10, but with proper treatment rarely exceeds 2-3.In this case, the woman herself, after she regains consciousness, does not remember anything about what happened. The whole attack lasts 1-2 minutes. There is also a special, bessoundless form of eclampsia, in which the pregnant woman falls into a coma, but seizures are not observed. This form is especially unfavorable for the mother and child, but, fortunately, it occurs rarely. During the attacks of eclampsia, the management of labor is significantly hampered, hemorrhages may occur in vital organs, including the brain. Hypoxia intensifies, all

internal organs suffer from it, especially the kidneys, liver, central nervous system. Possible development of heart failure and pulmonary edema. During a seizure, a woman may fall, which in turn often ends with fractures and bruises. Often there is a partial detachment of the placenta, which, against the background of a threatening state of the mother, carries a real threat to the life of the fetus. It is worth knowing that the fatal outcome of eclampsia does not depend on the number of seizures and may occur even after the seizure has succeeded, at first glance, resolved. If the labor has ended safely, then in the future the woman often has changes from the nervous system, high blood pressure, renal and cardiovascular pathology.