Toxicosis, as a formidable companion of pregnancy, let us recognize the enemy in person. Toxicosis: signs, causes, treatment

It seems that there is not a single expectant mother who would not encounter toxicosis in the early stages of pregnancy. And the stories of friends who gave birth can even fill the entire period of pregnancy with gloomy expectations.

Toxicosis during pregnancy can be expressed in different ways: from mild morning sickness to vomiting 3-10 times a day, which requires medical observation and treatment. There are several signs of toxicosis, but the most noticeable and painful is nausea, which sometimes causes real suffering.

Why does toxicosis occur?

The beginning of pregnancy is a time of great change and a very exciting time.

Causes of toxicosis in early pregnancy:

1. hormonal changes in the body;
2. a woman’s fears and anxiety, her increased emotionality, even in the case of an expected pregnancy, therefore the “expulsion” of toxicosis is largely in the hands of the expectant mother herself;
3. response of the maternal immune system.

• The level of hormones in the blood rises quickly, but the nervous system does not have time to adapt after them;
• As a result, the functions of special areas of the brain - the so-called subcortical nuclei - are impaired;
• Special zones become active in them, which affect the vomiting centers and a painful symptom of nausea occurs;
• An embryo or fertilized egg is a foreign body for the mother’s body, which a woman carries for several months, and pregnancy itself is stressful;
• During the life of the fetus, certain organic substances are released into the blood;
• Toxicosis is the body's response to their appearance. The manifestation of this response is akin to poisoning: it causes attacks of nausea, vomiting and a general deterioration in well-being.

It is no coincidence that this condition is called toxicosis: from the word “toxin” - a poison of biological origin. But, of course, toxicosis in the first trimester of pregnancy is not poisoning. Rather, it is a special, individual condition, a peculiar protective reaction of the female body.

The “risk group” for toxicosis includes women over the age of 35, with gynecological diseases, surgeries and abortions in the past, kidney and (or) liver diseases, endocrine disorders, and smokers.

When toxicosis appears

Many women are concerned about the question of when does toxicosis begin during early pregnancy?

1. A normal pregnancy is characterized by the appearance of the first signs of toxicosis from the 4th to the 8th week;
2. Some mothers notice its signs literally from the first days of the delay and even a little earlier.

Know! Mild nausea in early pregnancy is normal. It begins at the 5th or 6th week, reaching a peak at the 12th, but does not require additional medical attention, but requires a calm attitude from the pregnant woman herself. The most severe period of toxicosis can last no more than 2 weeks.

The described phenomena do not accompany every pregnancy, and many women are practically unfamiliar with toxicosis.

When toxicosis goes away

The question of how long toxicosis lasts during pregnancy and what its severity depends on is very individual. By week 16, as a rule, early toxicosis stops and a noticeable improvement occurs.

At this time, the formation of the placenta ends. It softens the “hormonal attack” and the most unpleasant symptoms of toxicosis, since it is a kind of blood filter.

The duration and manifestations of toxicosis depend on:

• the woman's health status before pregnancy;
• her lifestyle, diet, bad habits;
• environmental situation in the area of ​​residence;
• heredity.

Confident, balanced women who have the opportunity not to go to work suffer less from toxicosis.

Women forced to work, especially those in leadership positions, suffer from toxicosis longer and it is more pronounced in them. It is also believed that women with an asthenic build are more susceptible to toxicosis: tall, thin, with long fingers, arms and legs.

What complicates toxicosis

It is ideal if you were preparing for pregnancy and know in advance about existing chronic diseases. In every tenth woman, symptoms of nausea are associated with diseases of the digestive tract.

Know! If you have had problems with your stomach, liver or pancreas, the situation with toxicosis may worsen.

1. The uterus begins to grow and the organs in the abdominal cavity are forced to adapt to the new position;
2. The growth of the uterus can cause changes in the position and shape of the stomach, which, in turn, can lead to fluctuations in the acidity of gastric juice. They are the ones that often cause a metallic taste in the mouth and attacks of lightheadedness in the morning;
3. Compression of the gallbladder and ducts can impede the flow of bile into the digestive tract, causing a bitter taste in the mouth and the urge to vomit (read the article on the topic: Bitterness in the mouth during pregnancy >>>);
4. Hormonal changes can provoke a lack of a special pancreatic enzyme that breaks down fats. As a result, fatty foods will be less digestible and cause poor health;
5. The most dangerous cause of lightheadedness and sudden frightening dizziness for a pregnant woman can be vascular spasms and fluctuations in blood pressure, which she may mistakenly take for manifestations of toxicosis.

Therefore, the doctor monitors blood pressure at every visit to him (read on the topic: What tests are taken during pregnancy?>>>).

When to worry

Toxicosis, which gives doctors real concern, can occur from the 18th week of pregnancy. Its signs are:

• continuous lightheadedness and painful vomiting up to 5-6 times a day;
• proteinuria - the presence of protein in the urine;
• complete inability to eat;
• lack of required weight gain;
• a sharp deterioration in health;
• swelling spreading from the feet (more about swelling of the feet during pregnancy >>>);
• increased blood pressure.

Attention! Cases of severe uncontrollable vomiting require medical supervision in a hospital and individually selected treatment.

How to treat toxicosis

How to deal with toxicosis during pregnancy? There is no special treatment for toxicosis in pregnant women, but under no circumstances should you endure its debilitating symptoms. Help for toxicosis depends on specific symptoms, health status and is always individual.

The doctor’s efforts in severe cases of toxicosis are aimed at:

1. blocking brain centers that are responsible for nausea;
2. maintaining the body's water metabolism;
3. maintaining organs of concern: most often the stomach, liver and kidneys.

When dealing with an expectant mother, the doctor cannot use the full arsenal of medications, so in general, they make do with prescribing herbal-based sedatives and a number of physiotherapy and acupuncture procedures.

What will help with toxicosis?

A universal remedy for toxicosis during pregnancy has not yet been found. An integrated approach to the problem helps to overcome painful attacks of lightheadedness: physical activity, fresh air and enjoyable food.

Important! Any product that does not cause rejection and nausea, that affects special sensitive points of the tongue - sour, tart, astringent, intense breathing through the mouth, and switching attention help reduce the severity of the attack.

In difficult times, the way out may be:

• sour candy;
• a handful of dried fruits;
• a slice of aromatic orange, ginger, a slice of persimmon;
• a glass of weak tea, preferably green, and it should be drunk in several doses, in small sips;
• Freshly squeezed juices of fruits and berries, which help relieve nausea associated with toxicosis during pregnancy, are also loaded with vitamins.

The only thing you don’t need to do if you have toxicosis during pregnancy is fast. Eating small portions helps with toxicosis. You shouldn't feel hungry. Let there always be a muesli bar, dry food or apple in your purse.

Honey is a real natural medicine that contains many microelements that are vital for the expectant mother. A spoonful of natural honey taken on an empty stomach will be perfectly absorbed and will calm the stomach (read the article

” №3/2009 04.08.11

Toxicosis is a depressing condition for the mother, complicating the course of pregnancy. Toxicosis in the early stages of pregnancy is so common that it has become almost an obligatory sign of pregnancy.

Symptoms and causes of early toxicosis

Vomiting with toxicosis. Do not confuse toxicosis with mild illness. Early toxicosis is considered a condition in which vomiting occurs (from 3 to 10-12 times a day), salivation increases, taste and olfactory sensations change, and appetite sharply decreases. It begins about a week after conception and can last up to 12–13 weeks (some experts believe that early toxicosis can last up to 20 weeks). A severe degree of toxicosis usually develops in the last third of pregnancy (from the 28th week), vomiting is repeated up to 20 or more times a day, accompanied by a significant deterioration in the condition of the pregnant woman. In severe forms of toxicosis, it is recommended to be observed in a hospital.

Toxicosis and hormones. is directly related to the development of the fetal egg and the hormonal, immunological and vascular changes accompanying this development in the body of the expectant mother. This ailment is a mysterious phenomenon - experts have not yet come to a consensus on the causes of the appearance and development of early toxicosis.

Most scientists see the main reason for the development of early toxicosis in the central nervous system. With the onset of pregnancy, the functioning of the nervous system changes, its interaction with internal organs is manifested by nausea, vomiting, etc.

With the development of symptoms of toxicosis, a connection is also noted with the main hormone of pregnancy - human chorionic gonadotropin (hCG), in response to the production of which a release of toxins appears in the body.

Some tend to see a psychological basis in this phenomenon. A woman (most often without realizing it) suppresses her anxieties and fears and even rejection of her new position, which is expressed in symptoms of toxicosis.

But no matter what the theory of toxicosis, all experts have come to the following conclusion: all manifestations of early toxicosis are a natural protective reaction of the pregnant woman’s body, which makes it possible to protect the child from various threatening dangers.

Hereditary theory of the appearance of early toxicosis. The appearance of toxicosis may depend not only on the woman’s concomitant diseases, but also on heredity and immunity. If a pregnant woman’s mother suffered from toxicosis, then in 20-25% of cases she runs the risk of “getting sick.”

How to avoid toxicosis in the first half of pregnancy

Alcohol and smoking during pregnancy. The problem of toxicosis does not affect all pregnant women. It is believed that the risk group includes those who had health problems before pregnancy - primarily diseases of the gastrointestinal tract, thyroid gland, liver, and various chronic diseases. The occurrence of toxicosis is also influenced by nervous overload and stress, unbalanced diet, smoking and alcohol abuse before pregnancy.

Gastrointestinal diseases and toxicosis. Experts say that the condition of toxicosis can be prevented. When planning a pregnancy, you need to consult a gastroenterologist, put your digestive tract in order, and use nutritional therapy. It is also important to eliminate all bad habits and avoid stressful situations.

Treatment of toxicosis

Despite the fact that toxicosis is considered a kind of sign of pregnancy, a woman has the power to alleviate its manifestations.

1. A pregnant woman needs to spend enough time outdoors. It is recommended to walk for at least half an hour during the day and before bed to ensure healthy, sound sleep.

2. You need to wake up slowly. If nausea overcomes immediately after waking up, it is recommended to eat a handful of nuts or crackers, placed on the table by the bed in the evening.

3 . If possible, you should have breakfast while lying in bed and do not rush to get up after eating. For breakfast it is recommended to eat eggs and dairy products - yogurt, cheese, kefir, yogurt.

4. It is better to eat little by little, in small portions, but often (every 2-3 hours).

5. You need to listen to your body and eat foods that are well tolerated. Often even thinking about an unwanted product causes nausea. Basically, for toxicosis, experts recommend cereals, plant foods, foods rich in protein (beans, grains, nuts, seeds, fish, meat, milk).

6 . It is worth limiting the consumption of chocolate, smoked meats, fatty, spicy and salty foods. 7 . Also, do not eat too hot or, conversely, too cold food.

8 . You should drink still mineral water, weak tea with lemon, herbal teas and infusions (mint, lemon balm, chamomile flowers, yarrow). Cranberry juice, freshly squeezed apple juice, rosehip infusion, or just water with lemon juice are also useful.

9. In the evening before bed, you can drink an infusion of valerian, it will relieve nervous tension and improve sleep.

10 . As for vitamins, doctors advise taking prenatal vitamins containing folic acid, or this vitamin separately. Folic acid reduces the manifestations of toxicosis.

11 . Exercise therapy using breathing exercises helps in the treatment of toxicosis. Gymnastics activates blood circulation, saturates tissues with oxygen, which improves the mood and well-being of a pregnant woman. For relaxation, it is useful to massage the scalp and collar area - this reduces the excitability of the brain centers, including the vomiting one.

No matter how unpleasant the symptoms of early toxicosis may be, remember that it is temporary. Experts have their own thoughts about why you need all this suffering.

According to doctors, early toxicosis regulates the hormonal balance in a woman’s body: nausea and vomiting provide a low level of the hormone, which the fetus does not currently need. Rejecting everything unnecessary, the body consumes only what is necessary for the development of the child. Do not forget that this is just a small nuisance compared to the happiness that you will experience when you become the mother of your long-awaited child.

Folk remedies in the treatment of toxicosis

Honey for toxicosis. Honey is a natural product of nature, unique in its composition and effect on the human body. When treating early toxicosis of pregnant women (vomiting), it is recommended to take 1 tbsp of honey. spoon on an empty stomach.

Pumpkin for toxicosis. Pumpkin juice also has an antiemetic effect. You can also drink pumpkin infusion with lemon.

Citrus fruits for toxicosis. Take 300-400 ml of orange or grapefruit juice as a medicine. Thanks to a large amount of minerals, fructose, and vitamin C, juices flush the body and enhance the effectiveness of enzymatic systems that free it from toxic products.

You can save yourself from toxicosis simply by drinking lemon. So, if nausea occurs, a pregnant woman can eat a slice of lemon or drink tea with it.

Dried fruits for toxicosis. A decoction of prunes and dried apricots is useful for toxicosis, and you should drink the decoction, not the compote, that is, without sugar (take 200 g of prunes or dried apricots per 1 liter of water).

Cranberry for toxicosis. Prepare cranberry juice. Wash 150 g of cranberries, mash, squeeze the juice through cheesecloth. Pour hot water over the remaining pulp and boil for 10-20 minutes. Strain the broth, stir 100 g of sugar in it and cool. Pour berry juice into the drink and squeeze the lemon. Drink slowly, in small sips, when you feel nauseous.

Rosehip for toxicosis. Rosehip infusion will help cleanse the body of the end products of hormonal and other biologically active substances, whose metabolism increases during pregnancy, leading to toxicosis.
Pour 1 tablespoon of rose hips with 2 cups of boiling water, heat for 15-20 minutes in an enamel pan under a lid in a water bath, leave for an hour in a thermos. Drink 1/2 cup of warm infusion with a teaspoon of honey 2-3 times a day after meals.

But it is precisely this period of pregnancy that is often complicated by early toxicosis. According to statistics, every second expectant mother suffers from this disease. Many people mistakenly consider it the norm, but this is not so: toxicosis is a pathology.

Usually the word “early toxicosis” refers only to nausea, vomiting and drooling. The medical understanding of this word is somewhat different from the everyday one: in textbooks on obstetrics, toxicosis is considered to be all pathological changes in a woman’s body that can appear in the first trimester of pregnancy. These include not only nausea and vomiting, but also some other unpleasant phenomena that are much less common (dermatoses - skin lesions, tetany - muscle cramps, osteomalacia - softening of bones, jaundice, bronchial asthma of pregnant women, etc.).

Causes

Despite numerous studies, the cause of toxicosis has not yet been found. But some hypotheses exist:

The most popular and most substantiated theory of the occurrence of toxicosis is the so-called neuro-reflex a theory according to which disturbances in the relationship between the central nervous system and internal organs play an important role in the development of the disease. Everyone knows that during pregnancy many women become more capricious, irritable, and whiny. This happens because during pregnancy, the historically “older” subcortical structures of the brain begin to work more intensively than usual, whereas usually a person at the highest stage of evolution has a more active cortex. But subcortical structures form the majority of protective reflexes, and wise nature, protecting pregnancy, forces this part of the expectant mother’s brain to work with greater efficiency. The subcortical structures contain the vomiting center, as well as olfactory zones and cells that “control” internal organs, including the stomach, heart, blood vessels, lungs, and salivary glands. Therefore, nausea and vomiting may be preceded by such phenomena as deepening of breathing, increased heart rate, increased amount of saliva, and pallor caused by vasospasm.

Immune theory. From the first days of intrauterine life, the baby is an organism different from the mother in its antigenic composition, to which the pregnant woman produces antibodies that supposedly cause toxicosis.

Hormonal theory. Significant hormonal changes occur in a pregnant woman's body. In particular, a new organ that produces hormones appears - the placenta. The appearance of a new “leader” is not always liked by the nervous system and internal organs of a pregnant woman, and they react to this with symptoms of toxicosis. With vomiting of pregnant women, there is a temporary coincidence of the onset of vomiting with a peak in the content of hCG (placental hormone), and a decrease in corticosteroids in the adrenal cortex is often observed.

Psychogenic theory. It is believed that toxicosis can be the result of negative emotions: fears for the baby, fear of childbirth.

Risk factors

Although no one is immune from toxicosis, it has been noted that most often it occurs in expectant mothers suffering from chronic diseases of the gastrointestinal tract, liver, thyroid gland, as well as in women who have undergone induced abortions, chronic inflammatory diseases of the genital organs. Predisposing factors are frequent nervous stress and poor nutrition, asthenic type of constitution. In addition, severe forms of early toxicosis more often occur during multiple pregnancies.

How does it manifest?

The most common manifestation of toxicosis is vomit, which can occur with varying frequency, depending on the severity of toxicosis.

In mild cases of toxicosis, vomiting occurs no more than 5 times a day, and may be accompanied by a prolonged or constant feeling of nausea. Vomiting occurs on an empty stomach and can be caused by food intake or unpleasant odors. In this case, the loss of body weight is either absent or small - 1-3 kg (up to 5% of body weight before pregnancy). This condition can be easily treated at home.

In more severe cases, vomiting occurs up to 10-20 times a day and is accompanied by drooling, while the woman’s general condition significantly worsens, weakness and apathy occur. A significant amount of fluid is lost through vomit and saliva, dehydration occurs, and metabolism is disrupted. The skin becomes dry, pale, blood pressure decreases, the pulse quickens, constipation occurs, the amount of urine discharge decreases, and the temperature rises. Loss of body weight can be up to 8-10 kg or more (up to 10% of initial body weight). With the progression of this form of toxicosis, a violation of water-salt, protein, carbohydrate and fat metabolism, acid-base and vitamin balance, and the functions of the endocrine glands gradually develops. In such a situation, the supply of nutrients to the fetus is sharply disrupted, and it is during this period that the laying and formation of all the main organs and systems of the baby takes place.

Salivation(ptyalism) can accompany vomiting of pregnant women, less often it occurs as an independent form of early toxicosis. With severe drooling, a pregnant woman can lose 1 liter of fluid per day. Excessive drooling leads to dehydration of the body, loss of proteins, and negatively affects the mental state of a woman.

By 12 weeks of pregnancy, as a rule, the symptoms of early toxicosis disappear.

Diagnosis and treatment of toxicosis

Even with mild manifestations of toxicosis, the doctor will refer you for tests. You will need to undergo a urine test for acetone and ketone bodies, biochemical and general blood tests. In case of severe disease, the patient will be admitted to a hospital. For mild, the most common degree of toxicosis, you will be treated at home under the supervision of a antenatal clinic doctor.

To eliminate discomfort, you need to pay attention diet. With toxicosis, appetite is not always impaired, sometimes it is even increased, but more often than not even the sight of food does not evoke positive emotions, and sometimes you have to make significant efforts to force yourself to swallow even a piece. Therefore, you can satisfy your culinary whims by introducing coveted pickles, sweet buns or exotic fruits into your diet. Food should be taken frequently, 5-6 times a day, but the portions should be small and the menu varied.

It should be borne in mind that very hot or very cold food will more quickly provoke vomiting. Products should be easily digestible and contain sufficient amounts of vitamins. It is better to drink mineral alkaline water and mint tea.

If you note that it is significantly increased saliva production, you will be helped by rinsing your mouth with tanning solutions that reduce this process, for example, infusions of sage, chamomile, and mint. If nausea and vomiting occur in the morning, immediately after waking up, try having breakfast in bed, placing a few crackers, lemon slices or mint gum next to the bed. It’s especially nice if in this situation the future dad shows himself to be a gentleman and serves you a light and healthy breakfast.

If nausea starts in the afternoon, then most likely this is due to nervous tension and fatigue. In this case, you can drink a soothing tea, motherwort or valerian.

If these measures do not help, be sure to inform your obstetrician-gynecologist.

Hospitalization

If the doctor discovers changes in the tests, the scale arrow stubbornly deviates to the left every day, and your health worsens, most likely will have to go to hospital. The doctors' first task will be to restore lost fluid, protein, and salts. You will be given an IV to ensure that nutrients and vitamins go directly into your blood. To suppress vomiting and nausea, drugs that block the gag reflex are used. Since, as already mentioned, the state of the nervous system has a significant impact on the severity of toxicosis, a protective treatment regime will be created in the hospital for your peace of mind. In addition, you will be prescribed medications that have a calming effect, and if there is increased salivation, medications that inhibit the action of the salivary glands. It is possible that non-drug methods will also be used: acupuncture, hypnotherapy and psychotherapy, herbal and aromatherapy. This will help reduce the number of drugs that can have undesirable effects on the developing embryo.

When, as a result of treatment, weight gain becomes obvious, daily diuresis (the amount of urine excreted), as well as pulse, blood pressure and temperature are normalized, vomiting stops or becomes less frequent, and you can return to your usual home environment. In rare cases, complex treatment over several days turns out to be completely ineffective, and then the pregnancy has to be terminated.

Toxicosis of pregnant women is a pathological condition that occurs only during pregnancy, complicates its course and, as a rule, disappears with its interruption or independently during treatment.

Causes of toxicosis

To date cause of toxicosis insufficiently studied. There is no exact data on the origin of this pathological condition. The International Association of Obstetricians and Gynecologists has identified the most likely causes of toxicosis:

1. Hormonal changes. From the first days after conception, great changes occur in a woman’s body due to changes in the amount of hormones released. Against this background, the pregnant woman’s well-being may worsen;
2. Presence of chronic diseases. It is noted that toxicosis occurs more often in women with weakened immunity and diseases of various organs (especially diseases of the digestive, respiratory and endocrine systems). Therefore, women planning a pregnancy are advised to undergo a full medical examination in advance;
3. Psycho-emotional state of a woman. , lack of sleep, heavy mental stress contribute to the development of toxicosis and aggravate the severity of their manifestation;
4. : , drug use;
5. Woman's age. It has been noted that early pregnancy (mother's age up to 20 years) and late pregnancy (over 35 years) more often occur with various forms of toxicosis;
6. Heredity. Genetic predisposition plays a significant role here: if a woman’s mother, aunt or grandmother suffered from toxicosis, then there is a high probability of developing preeclampsia in this woman.

There are three forms of toxicosis:

1. Early (develops in the first trimester of pregnancy);
2. Late (occurs in the second and third trimester, more often in the last two to three months);
3. Rare (usually begins in the first trimester, but can occur at any stage of pregnancy).

Early toxicoses: types, timing, treatment

Early toxicoses occur at the beginning of pregnancy and end by the end of the first trimester. Most often, symptoms begin at 5-6 weeks of pregnancy, less often at an earlier date (some women feel a deterioration in their health almost immediately after conception, even before the start of delayed menstruation). Highlight two forms early gestosis:

Vomiting of pregnancy

• Lightweight;
• Moderate;
• Excessive.

Drooling (salivation).

Vomiting of pregnancy– the most common form of early toxicosis. In the first weeks of pregnancy, many women experience nausea and vomiting, which occurs in the morning, not every day, and does not in any way affect the condition of the pregnant woman. Such vomiting is not classified as toxicosis and does not require treatment.

Information Gestosis includes vomiting, which is repeated several times during the day, accompanied by severe nausea, a sharp decrease or absence of appetite, changes in taste preferences and olfactory sensations.

According to severity they are distinguished:

1. Light form. Vomiting repeats up to 5 times a day, more often after meals, slightly worsens the woman’s well-being, is easily treatable or goes away on its own by 10-12 weeks of pregnancy;
2. Moderate form. Vomiting occurs up to 10 times a day, is not associated with food intake, and is accompanied by a significant deterioration in the woman’s condition and general weakness. With proper treatment, this form of toxicosis gradually stops. Subsequently, pregnancy develops normally.
3. Excessive form. Vomiting occurs up to 20 times or more per day and contributes to the development of a woman’s serious condition. Fasting and dehydration lead to decreased body weight, exhaustion, and increased temperature and pulse. Emergency treatment is required, failure to do so can result in death.

Drooling (ptialism) is increased salivation and loss of more fluid (up to 1 liter or more per day). Ptyalism can occur as an independent form of toxicosis or accompany vomiting of pregnant women. With severe drooling, a woman’s well-being worsens, sleep is disturbed, weight loss and dehydration of the body due to fluid loss are possible. Due to the constant secretion of saliva, maceration of the skin and mucous membranes occurs.

Treatment ptyalism and mild vomiting are carried out on an outpatient basis. If there is no effect, the woman must be hospitalized and further examination and treatment is carried out in a hospital setting. For moderate and excessive vomiting, hospitalization should be immediate.

Special treatment of early toxicosis consists of the following measures:

1. Ensuring complete physical and emotional peace;
2. Proper diet (eating high-calorie foods in fractional portions every 2-3 hours);
3. Taking sedatives (,);
4. Antiemetic therapy;
5. Vitamin therapy;
6. Hepatoprotectors;
7. Intravenous drip infusions of solutions to combat dehydration.

Important If the treatment does not give the desired effect and the pregnant woman’s condition worsens, then emergency termination of pregnancy is indicated.

Late toxicoses: types, timing of occurrence, treatment

Late toxicosis develops most often after 30 weeks of pregnancy. In rare cases, it appears already in the second trimester and then becomes more malignant and less treatable. The following are distinguished: forms of gestosis:

1. Dropsy of pregnancy(fluid retention in the body and the appearance of persistent edema);
2. Nephropathy(clinically manifested by three symptoms: swelling, high blood pressure);
3. Preeclampsia(transitional stage from nephropathy, characterized by dysfunction of the nervous system);
4. Eclampsia(the final stage of late gestosis with the occurrence of convulsions and loss of consciousness).

Dropsy of pregnancy occurs when fluid is retained in the tissues. Its main clinical manifestation is edema, which progresses with the development of the disease. Highlight three degrees of severity of dropsy:

1. First degree. Swelling appears on the legs; when pressure is applied to the tissue in the area of ​​the tibia, visible impressions remain;
2. Second degree. The swelling spreads further to the torso, but water does not stagnate in the abdominal cavity. Indentations remain when pressing on the abdomen;
3. Third degree. Swelling appears on the torso and face. The general condition of the pregnant woman worsens: increased fatigue, shortness of breath, and rapid heartbeat appear.

Treatment this stage of toxicosis includes:

1. Limiting liquid (no more than 1 liter per day) and table salt when preparing food;
2. Exclusion from the diet of all foods that can retain water in the body: smoked, fatty, spicy, salty;
3. (furosemide, hypothiazide, etc.).

In most cases, the treatment is effective and takes no more than 6-8 days for mild to moderate toxicosis and 10-12 days for severe toxicosis.

Nephropathy most often develops against the background of undiagnosed or improperly treated hydrocele in pregnant women. This form of late toxicosis is characterized by triad of symptoms:

1. Edema;
2. Hypertension (increased blood pressure);
3. Proteinuria (increased protein in the urine).

Nephropathy can be monosymptomatic (only one symptom is observed - hypertension or albuminuria) or polysymptomatic (two or three signs appear simultaneously).

Treatment nephropathy should be carried out only in a hospital setting. Therapy consists of the following activities:

1. Complete bed rest, a state of physical and emotional peace;
2. Normalization of nutrition. A pregnant woman is prescribed a predominantly dairy-vegetable diet, with strict restriction of fluid, salt and fat intake. Once a week, fasting days are carried out (fruit or);
3. Normalization of sleep by taking sedatives;
4. Taking diuretics to reduce swelling;
5. Consultation with a therapist and taking antihypertensive drugs to lower blood pressure.

If treatment is unsuccessful, it is necessary to carry out early delivery, because further prolongation of pregnancy can threaten the health and life of the woman.

The final stages of development of gestosis are preeclampsia And eclampsia. At preeclampsia headaches, blurred vision, drowsiness, and increased fatigue appear. Some patients experience abdominal pain, nausea, vomiting,... These symptoms are associated with profound changes in cerebral circulation and increased intracranial pressure.

Treatment preeclampsia is the same as for nephropathy, but all injections and intravenous infusions should be carried out only under anesthesia (inhalation of nitrous oxide and oxygen) so as not to provoke an attack of eclampsia.

Eclampsia manifested by the sudden appearance of convulsions and complete loss of consciousness. A seizure occurs in three stages:

1. First stage. Small contractions of the facial muscles appear, which move to the muscles of the upper limbs. This period lasts 20-30 seconds;
2. Second phase. Severe cramps of all muscles occur, breathing is disrupted until it stops completely, and the woman loses consciousness. The stage lasts no more than 25 seconds.
3. Third stage. The convulsions stop, and the pregnant woman falls into a coma. Upon returning to consciousness, the patient does not remember anything and complains of severe fatigue and muscle pain. The duration of the third stage is up to 1.5 minutes.

Therapeutic measures in case of eclampsia, they must be urgent and take place with the obligatory presence of resuscitators. Therapy includes:

1. Relief of seizures by inhalation of oxygen, nitrous oxide and ether;
2. Reducing blood pressure by intravenous administration of antihypertensive drugs (the woman must be under anesthesia at this time);
3. Sleeping pills (the pregnant woman is put into a state of medicated sleep for 1-2 days).

Intensive care in the intensive care unit should last about 10 days. If attacks recur during treatment, the woman is prescribed emergency delivery.

Rare forms of toxicosis: types, timing, treatment

Rare forms of toxicosis most often begin in the first trimester, but can occur at any stage of pregnancy. This type of toxicosis includes:

1. Dermatoses (various skin diseases);
2. Jaundice of pregnancy (jaundiced discoloration of the skin and visible mucous membranes);
3. Yellow liver atrophy (acute liver disease with degeneration of liver cells);
4. (a disease of the respiratory tract, manifested by difficulty breathing, shortness of breath and periodic attacks of suffocation);
5. Tetany (convulsive attacks caused by impaired calcium metabolism in the body);
6. Osteomalacia (a disease characterized by softening and deformation of the skeletal system due to disruption of phosphorus-calcium metabolism in the body).

Dermatoses pregnant women include a group of skin diseases that occur only during pregnancy. The most common pregnancy itch is pregnancy itch, which can spread throughout the body. The woman’s general health deteriorates, irritability appears, and sleep is disturbed. Less common is eczema (an inflammatory skin disease manifested by a profuse rash, itching and burning). Treatment is carried out in a hospital. A pregnant woman is recommended to follow a gentle diet with the exception of spicy and smoked foods. To reduce itching and burning, vitamin therapy and calcium supplements are prescribed. Locally, lotions with a solution of potassium permanganate are applied to the affected areas.

Jaundice It is quite rare in pregnant women. Its main clinical manifestations are liver damage, icteric discoloration of the skin, and itching. When a diagnosis is made, the pregnant woman is urgently hospitalized and the pregnancy is terminated at any stage.

Yellow liver dystrophy– an extremely dangerous form of rare toxicosis. It is very difficult and often leads to death. Liver damage occurs, jaundice increases, a sudden onset of convulsions and a coma occur. Immediate termination of pregnancy is indicated, which can help save the woman’s life.

Bronchial asthma as a manifestation of toxicosis occurs in isolated cases. It responds well to treatment, and pregnancy can be maintained. Pregnant women are prescribed vitamin therapy, sedatives and calcium supplements.

Tetany of pregnant women occurs when the parathyroid glands malfunction, which leads to a significant disruption of calcium metabolism in the body. Clinically, the disease manifests itself in the form of muscle spasms of the upper and lower extremities, and less commonly of the muscles of the face and torso. For treatment, parathyroidin (a hormone produced by the parathyroid glands) and calcium supplements are taken. In most cases, treatment is successful and the pregnancy continues.

Osteomalacia occurs as a result of a violation of the metabolism of phosphorus and calcium in the body. Clinically manifested by decalcification and softening of bones (usually the spine and pelvis), which leads to severe pain and deformation of the skeleton. Treatment includes vitamins D and E, physiotherapy (ultraviolet irradiation). If there is no effect of therapy, termination of pregnancy is indicated.