Gestosis
Most women who are planning a pregnancy or are already pregnant are faced with completely new information and are doing everything possible to ensure that pregnancy proceeds without pathologies and complications. However, with the saturated pace of modern life, poor ecology, and the presence of bad habits, there may be a discrepancy between the requests of the fetus and the mother’s body. The female body may simply not have the physical ability to provide the child with the elements necessary for his life.
The content of the article:
Causes and mechanisms of gestosis development
Clinical symptoms of gestosis
Diagnosis of gestosis
Complications of gestosis
Treatment of gestosis
Prevention of gestosis
Gestosis
During pregnancy, a woman may encounter a similar phenomenon twice, which is called toxicosis. During early toxicosis, a woman suffers from many unpleasant symptoms, but her life is not in danger. Late toxicosis is much more complicated, develops for a very long time and can cause complications dangerous to the health of the mother and child. Late gestosis, toxicosis, dropsy — it’s all one disease. So let’s find out what is gestosis?
Gestosis is a disease that only pregnant women can suffer from. Pregnancy with gestosis occurs in 1/3 of women and can take place literally immediately after the birth of a child. Despite this prevalence, the disease is very complex and can occur with terrible complications and consequences such as the death of a mother or child during childbirth.
The manifestation of symptoms of gestosis is observed in the last trimester of pregnancy, after the twenty-eighth week, but there are cases of the development of the disease after the sixteenth week after fertilization. Gestosis appears exclusively in women who are in a position due to the stress to which the body is exposed. The restructuring of the body contributes to the formation of a specific substance in the placenta, which, due to its composition, makes small holes in the vessels. The holes allow plasma protein and fluid from the blood to enter the tissues, which leads to the formation of edema. Initially, the swelling is invisible, but it is enough to stand on the scales, as the problem will immediately manifest itself.
Similar holes are formed in the renal vessels, and already through the kidneys the protein enters the urine and leaves the pregnant woman’s body. The loss of protein in large quantities will lead to serious consequences and may pose a threat to both the life of the mother and the life of the child. In order to control possible protein losses and diagnose the appearance of gestosis in the early stages, the doctor regularly prescribes a general urine test to a pregnant woman.
After a large amount of fluid leaves the body, it is necessary to pump the remaining fluid in some way, so there is an increase in blood pressure. Accordingly, the blood thickens, which leads to an increased level of its coagulability and thrombosis.
Gestosis is a very complex disease, as it does not manifest itself for a very long time and a pregnant woman continues to feel absolutely healthy. At this time, precious time is lost for the treatment of gestosis, and not only the hands, face, and even the brain of the expectant mother succumb to edema, which causes convulsive seizures. The disease harms not only the pregnant woman, but also the fetus, since edema blocks the supply of oxygen to the fetus. The first gestosis symptoms may appear right before the seizures themselves, which can lead to the loss of the fetus and the death of the mother. As you can see, the disease is very insidious and difficult to diagnose, so doctors devote a lot of time to detect gestosis of pregnant women in time.
Causes and mechanisms of gestosis development
Until now, doctors have not been able to find out the true causes and mechanisms of the development of gestosis of pregnant women. There are several theories that can explain the occurrence of the disease:
Corticovisceral theory. Proponents of this theory suggest treating gestosis as a neurosis of the expectant mother. Due to nerve lesions, changes in the relationship between the cortex and subcortical formation of the brain occur. It is these disorders that lead to a deterioration in the functionality of vascular systems and blood circulation.
Endocrine theory under gestosis implies a violation of the cardiovascular system, insufficient supply of organs with blood and poor metabolism in the tissues and organs of a pregnant woman. The reason for all these deviations is a change in the functionality of the endocrine system, which is responsible for vascular tone and blood formula.
The immunological theory says that all disorders in the body of the expectant mother caused by gestosis are associated with the reaction of the mother’s immunity to the development of the fetus of the child in her body.
The genetic theory was confirmed due to the appearance of gestosis in women whose mothers also suffered this disease during pregnancy.
The placental theory is based on the fact that there are no changes in the uterine vessels that feed the placenta. That is why substances are released that lead to a violation of the functionality of the vessels of a pregnant woman.
Many experts believe that there is no single mechanism for the development of gestosis. The appearance and development of the disease occurs against the background of the influence of a whole complex of factors leading to changes in the functionality of the organs of the expectant mother. The main changes in the female body when exposed to gestosis are considered: spasms of blood vessels carrying blood, deterioration of blood circulation, increased blood clotting and microcirculation disorders. During the course of gestosis, the work of the heart worsens, respectively, and the supply of blood to organs, which leads to dystrophic changes in tissues and deterioration of the functionality of the body as a whole. The kidneys, liver and brain suffer the most from insufficient blood supply. The placenta under the influence of gestosis is not able to deliver oxygen and nutrients to the child, which leads to oxygen depletion of the fetus and stopping its development in the womb.
Clinical symptoms of gestosis
The main sign indicating the manifestation of gestosis is the appearance of watermarks, which indicate water retention in the body and permanent edema. Initially, the swelling is latent, and it can only be detected by constant monitoring of the number of kilograms gained over a certain period. A woman may not feel well, but an extra 300 g on the scales should arouse suspicion.
The appearance of watermarks indicates the presence of problems in the mother’s body, so there is a small systematization of the stages of watermarks, depending on the area in which they manifest themselves:
swelling of the feet and shins — stage 1 dropsy;
edema not only of the legs, but also of the front of the abdomen — stage 2 dropsy;
swelling of the legs, abdomen, arms and face of a pregnant woman — stage 3 dropsy;
universal edema — stage 4 dropsy.
Classification of dropsy shows that the formation of edema occurs on the ankles and only then they develop further. There are cases when swelling immediately appears on the face, and only then spreads throughout the body. In the morning, puffiness may be imperceptible, because during sleep, all the fluid in the body is evenly distributed. However, at the end of the day, the fluid sinks down, and the swelling now passes to the abdomen and lower extremities.
Dropsy almost does not affect the well-being of a pregnant woman, but when the swelling develops, the woman feels constant thirst, weakness and heaviness in the lower extremities.
The development of edema is indicated by an abnormal increase in the body weight of a pregnant woman. Gestosis causes a woman to consume more fluid than her body can take out.
Nephropathy of pregnant women suffering from gestosis has the following symptoms: high blood pressure, detection of protein in the urine and swelling. The presence of only two symptoms may indicate nephropathy.
With gestosis, the development of nephropathy is indicated by the appearance of dropsy in pregnant women, an uncharacteristic increase in blood pressure. The pathology of high blood pressure is considered to be raising its index to 30 mm Hg.ct in comparison with indicators before pregnancy. Complications caused by gestosis are the result of pressure drops. The rise of diastological pressure during gestosis also indicates poor blood circulation and oxygen starvation of the fetus.
Proteinuria is a confirmation of the progression of the disease and affects the reduction of diuresis of a pregnant woman. The lower the urine volume, the worse the prognosis for a positive outcome of pregnancy. The development of nephropathy together with hypertension, nephritis and heart disease leave almost no chance of continuing pregnancy.
In the absence of treatment or improper therapeutic measures, nephropathy can move to the next level of development — preeclampsia. This stage of gestosis can develop kidney failure, cause bleeding and lead to premature birth or fetal death. Preeclampsia of pregnant women is manifested from severe forms of nephropathy. Symptoms indicating this stage of gestosis are headaches, heaviness in the back of the head, nausea, vomiting, memory disorders, sleepiness or insomnia, deterioration of the functions of the visual organs, apathy.
The most severe gestosis of pregnant women is eclampsia, which combined the signs of nephropathy, preeclampsia and added new syndromes: fainting and convulsive seizures. A cramp can be a reaction to any external factor — a loud bang, a difference in the brightness of lighting, a stressful situation. The seizure begins from the facial muscles, then the cramp passes to the limbs and other parts of the body. Its duration is up to 2 minutes. At this stage of gestosis, the life of the mother and child is threatened, since eclampsia causes complications in the form of swelling of the brain, lungs, placental abruption, retina, outpouring of blood into internal organs and even coma. It is this form of the disease that can lead to death.
Diagnosis of gestosis
The procedure for diagnosing gestosis always begins with a general and biochemical analysis, which will help to find out the level of protein in the body and its presence in the urine. The expectant mother must pass tests for the number of platelets and the level of blood clotting.
Edema can be noticed only with constant monitoring of the weight gained by a pregnant woman. On average, a woman should gain about 350 g in weight, but not more than 0.5 kg, however, such indicators are used in cases when the patient did not suffer from gestosis in the second trimester of pregnancy. It is also necessary to monitor the amount of fluid entering the body and its excretion.
It is not superfluous during the diagnosis of gestosis to be examined by an optometrist and examined by ultrasound for fetal hypoxia. It is necessary to monitor the blood pressure on each arm, as the indicators may be different. Every pregnant woman should regularly donate blood and urine for tests, undergo the procedure of weighing and measuring blood pressure.
Specialists pay special attention to the “gestational risk group” — previously unborn, carrying several fetuses at the same time, older pregnant women, women with sexually infectious and with advanced chronic diseases.
Complications of gestosis
Complications of gestosis carry the threat of death of both mother and child. Gestosis can develop kidney and heart failure, lead to severe pulmonary edema, cause blood to flow into the liver and other vital organs. Most often, complications of the disease consist in early detachment of the placenta, placental insufficiency, which will lead to difficulties in the development of the fetus and its hypotrophy or hypoxia. During a severe manifestation of gestosis, it is possible to manifest syndromes associated with a decrease in the level of platelets in the blood, an increased amount of liver enzymes.
Treatment of gestosis
It is possible to start treatment of gestosis only after receiving the results of clinical and laboratory studies. With timely registration, early diagnosis of the disease will help determine the correct treatment and improve the condition of the pregnant woman. Visiting a pregnant woman for routine examinations will allow specialists to note any fluctuations in the functioning of the organs of the expectant mother.
If the doctor has doubts about the presence of gestosis in a pregnant woman, then you need to be prepared for a number of measures to confirm or exclude the diagnosis. If the diagnosis is confirmed, then treatment will definitely be based on hospitalization of the pregnant woman, compliance with the regime and measures prescribed by the doctor, restoration of the functioning of organs and vital systems that have suffered from the development of gestosis. In order to protect the health and development of the fetus, specialists may make a decision — to carry out a careful, albeit premature birth.
Treatment of the disease at home is possible only at the first stage of dropsy. The presence of severe gestosis obliges a pregnant woman to be hospitalized with the obligatory presence of equipment in the hospital that will help to leave premature babies. If the disease has given complications, then termination of pregnancy is possible.
All measures related to the treatment and prevention of gestosis are aimed only at eliminating and correcting disorders in the body of a pregnant woman and fetus. The main goal of treatment is always the need to put a woman’s nervous system in order, normalize the level of circulation and blood clotting, blood pressure readings, improve water-salt metabolism and metabolism in the body.
The duration of therapeutic measures depends only on the stage of its development. The mild degree of gestosis is treated for at least two weeks, the average — up to one month, but with further monitoring of the health of the mother and child. In severe forms of gestosis, it is necessary to constantly monitor the pregnant woman until the very birth with the participation of specialists from the intensive care unit.
Premature birth is indicated in cases when the treatment of gestosis does not give results for more than 10 days, with the observation of fetal development delay and complications for both the pregnant woman and the fetus. A woman can give birth on her own only with an improvement in the state of health and the effectiveness of the therapeutic measures carried out.
When diagnosing gestosis, a woman should follow absolutely all the doctor’s prescriptions that were developed specifically for her body and not self-medicate.
Prevention of gestosis
Prevention of gestosis is a very important aspect when planning pregnancy and carrying a fetus. It is impossible to cure the disease, so it is necessary to take all possible measures to maintain the well-being of the mother and child. It is necessary to regularly attend a women’s consultation, undergo weighing, keep blood pressure under control, take all the tests that the doctor prescribes.
Every pregnant woman should monitor her diet, which affects weight. To build the right system, it is necessary to study the principles of nutrition and figure out why our body needs certain elements. For the development of the bone structure, the fetus needs the necessary amount of protein. The diet of the expectant mother should contain foods rich in protein: chicken, fish, eggs, cottage cheese, etc. It is necessary to reduce the consumption of salty food, which contributes to water retention in the body, replace the fast carbohydrates of sweets, flour products with seasonal fruits, which are so rich in vitamins.
If a woman has a predisposition to edema even before pregnancy, then you can drink herbal teas, rosehip decoctions, cranberry juice. Additionally, the doctor may prescribe elements that the body lacks: curantil, lipoic acid, vitamin E, etc. The use of such drugs is possible only with the permission of the attending physician.
Be sure that a pregnant woman should find time for hiking in the fresh air. Today, almost every fitness club has groups for expectant mothers, where they get the opportunity to practice yoga, Pilates and other gentle types of physical activity.
If gestosis has been diagnosed, then the importance of preventive measures doubles. To prevent the disease from developing, you need to take care of your well-being and be responsible for the health of the child.
Many experts advise women to give birth to children under the age of 35, because with age the reproductive function becomes weaker. Late pregnancy is usually more difficult, as the female body is preparing for the transition to a new hormonal level.
