Preeclampsia , or toxemia of late - Causes, Symptoms and Treatment .MF .
late toxemia, or preeclampsia - a complication of pregnancy, resulting in the breakdown of vital organs and systems.Late toxicosis develops in the second half of pregnancy and progresses until delivery.
gestosis incidence is 10-15% of the total number of pregnant women.Despite many years of research, the exact cause of gestosis is still unknown.According to some researchers, preeclampsia develops due to disorders in the hormonal regulation of the vital organs.According to another version, preeclampsia occurs due to immunological incompatibility between mother and fetus.
Recently, the frequency of this complication of pregnancy is increasing every year.Most gynecologists associated gestosis growth with increasing number of late delivery (after 35 years).Unfortunately, at this age most women already have several chronic diseases, which significantly aggravates the course of pregnancy and childbirth.
The main diseases that provokes the development of late toxicosis include:
high blood pressure, obes
Symptoms of preeclampsia
Signs of preeclampsia varied.The first symptoms of late toxicosis expectant mother can be seen on 28-29 week of pregnancy.What they appear?First of all, swelling of the feet, hands and face.This is the so-called "dropsy pregnant" - the easiest manifestation of preeclampsia.If swelling unexpressed, the woman may not notice them.In order to determine whether there is swelling or not, you should closely monitor the weight gain.Normally, starting at 28 weeks of pregnancy, women can extend their weight by an average of 350-500 grams in a week.If the weight gain is more than 500 g per week, it could witnessed this fluid retention in the body, which is a sign of hydrocephalus.
more severe manifestation of preeclampsia - a nephropathy (damage of the parenchyma and renal glomerular apparatus), which is characterized by swelling, high blood pressure and the appearance of protein in the urine ( "proteinuria").The more protein in the urine, the worse the prognosis will be preeclampsia.As noted nephropathy?The main symptom is indicative of the progressive nephropathy - a decrease in urine output.It's quite a dangerous sign, on which the woman should pay attention in the first place.Most often, the first woman appear edema, increased blood pressure then and only then appears proteinuria.
Severe manifestations of preeclampsia include the development of pre-eclampsia and eclampsia.This is the last stage of preeclampsia.At untimely medical intervention such states pose a threat to the life of the mother and fetus.
When preeclampsia is disturbed microcirculation in the central nervous system.Clinically preeklamsiya, as well as nephropathy, manifested in the form of the main symptoms - high blood pressure, edema, protein in the development of preeclampsia moche.Tolko to these symptoms are added to signs of damage to the nervous system: headaches, blurred vision, feeling flashing "flies" or "'veil' 'before the eyes, nausea, vomiting.
If time does not stop this process, the pre-eclampsia becomes eklamsiyu - a pregnant suddenly appear attacks of convulsions with loss of consciousness, lasting 1-2 minutes.Eklamsiya can lead to death.
Given the potential risk of preeclampsia, in any, even the most minimal proyaleniyah woman disease should immediately refer to the obstetrician-gynecologist and give details of their complaints.
late diagnosis of preeclampsia
In order to reliably determine whether or not there preeclampsia, a visit to the doctor is not enough.It should be dynamic observation obstetrician-gynecologist.
Every visit to the doctor's pregnant necessarily measured blood pressure (BP) in both arms, pulse and body weight.Increased blood pressure above 135/85 may indicate preeclampsia.The doctor evaluates the weight gain pregnant, the presence or absence of edema, asks pregnant, if urine output decreased.
also for suspected preeclampsia appointed additional tests and studies:
- clinical and biochemical blood test;
- Doppler ultrasound fetal c, CTG (cardiotocography) fruit.
If the received analyzes and survey data raise suspicion of preeclampsia (blood pressure above 135/85, pronounced swelling and a large weight gain, protein in the urine) further prescribed:
- daily monitoring of blood pressure, ECG;
- Analysis of urine on Nechiporenko on Zimnitsky, analysis of daily urine for protein;
- consultation ophthalmologist, internist, nephrologist, neurologist.
Treatment of late gestosis
In milder forms of preeclampsia - edema, treatment is carried out on an outpatient basis.When kidney disease and more severe forms of the disease hospitalization pregnant obstetric department.
With minor swelling and normal analysis of treatment of preeclampsia is limited to compliance with recommendations on lifestyle and nutrition.
When edema c pronounced swelling and mild form of nephropathy is prescribed:
- sedatives (tincture of Leonurus, valerian);
- Antiplatelet agents (Trental chimes) to improve the rheological properties of blood;
- antioxidants (vitamin A and E);
- with an increase in blood pressure is used antihypertensive drugs with antispasmodic effect (Eufillin, Dibazol);
- fitosbory a diuretic effect.
In severe kidney disease, pre-eclampsia and eclampsia treatment is carried out with the participation of resuscitation in the intensive care unit.Spend fluid therapy to correct metabolic and electrolyte abnormalities - fresh frozen plasma are administered, reopoligljukin.In addition to these groups of drugs, in severe forms of gestosis also used anticoagulants (heparin).For a quick regulation of water-salt metabolism instead fitosborov used diuretics (furosemide).
In all forms of gestosis, to prevent the threat of premature birth and fetal hypoxia, used selective sympathomimetic (ginipral)
No less pressing question about the method of delivery in preeclampsia.
If a satisfactory condition of the pregnant and the fetus is not suffering from the data of US and KTG- the labor is performed vaginally.In the absence of the effect of therapy in severe forms of preeclampsia and fetal chronic hypoxia indicated cesarean section.
preeclampsia Treatment is carried out not only before birth, but also during childbirth and the postpartum period before full stabilization women.
Nutrition and diet for preeclampsia
Lifestyle and Nutrition in gestosis are very important for successful treatment.In the presence of edema and abnormal weight gain pregnant should follow a special diet.It is necessary to exclude from the diet of spicy, salty and fried food.Consume less salt.Preference should be given boiled dishes, slightly salted insufficiently.Try to consume foods of both vegetable and animal origin, as well as dairy products, fruits and vegetables.On average, pregnant with a tendency to edema should consume no more than 3000 calories per day.Limit not only food intake, but also liquid.It should drink no more than one and a half liters of fluid per day.It is necessary to pay attention to urine output is the number of the discharged liquid should be more than drunk.
restless lifestyle, stress also provokes preeclampsia.In the second half of pregnancy a woman should sleep at least 8-9 hours a day.If you wish to sleep during the day, it is also better to lie down to rest.But at the same time, lack of exercise can also trigger preeclampsia.Therefore, she will need to make daily walks in the fresh air for at least an hour, to engage in a special fitness for pregnant women.
Folk remedies for preeclampsia
Traditional medicine in the treatment of gestosis very relevant, especially in dropsy, many herbs have a diuretic effect.When preeclampsia prescribe kidney tea, cranberry juice or cranberry juice, broth hips.You can use herbal preparations, such as Kanefron or Cystone.Sedatives tincture of motherwort or valerian can be used, starting with 13-14 weeks of pregnancy for the prevention and treatment of gestosis.In severe forms of gestosis folk remedies are not effective, so use only medicines.
Complications of preeclampsia:
- premature birth;
- detachment of normally situated placenta, resulting in fetal death;
- fetal hypoxia, which also leads to fetal death;
- hemorrhage and detachment of the retina;
- heart failure, pulmonary and cerebral edema, heart attacks and strokes;
- development of renal hepatic failure, hepatic coma.
Prevention of preeclampsia:
- implementation of the reproductive function of up to 35 years;
- timely treatment of chronic diseases, triggering preeclampsia;
- a healthy lifestyle.
Consultation of obstetrician on late preeclampsia:
1. I'm 38 weeks pregnant.I discovered a small protein in the urine and appointed dropper.But the swelling and I have no pressure.Do I have to do treatment in my case?
Treatment in this case it is necessary to prevent the development of nephropathy.It is not necessary that there is pressure or swelling.
2. I have 37 weeks of pregnancy.For 2 weeks I lay in the hospital because of swelling and protein in the urine.Despite treatment, the swelling enlarged and protein as being so remained.What to do?
In your case, most likely, will take place only preeclampsia after delivery, but the treatment must be continued until delivery, to preserve the fruit.For you, the important thing now is under the supervision of doctors.
3. Do I have to go to the hospital with a large weight gain?
If no marked edema, pressure, and protein in the urine, it is not necessary.
4. Normally, my blood pressure is 120/80.When it increased to 130/90, really a headache.What to do, what to take?
This pressure is the upper limit of normal, but if it hurts the head - this may indicate a complication of preeclampsia, so I recommend full-time to consult with your gynecologist and if you recommend - go to the hospital.
5. Can I have preeclampsia itself, or necessarily make cesarean Cross Section?
Preeclampsia is not an indication for caesarean section.The operation was done only in emergency cases with disease progression.
6. the 28th week have added 10 kg.The doctor has appointed Eufillin, but I do not want to drink it.All assays were in my normal.Maybe you can do without aminophylline?
can not use Eufillin only in the case if you strictly adhere to diet and other recommendations to reduce manifestations of preeclampsia.
7. How dangerous protein in the urine?How does this affect the fetus?
protein in the urine indicates a loss of protein and impaired renal function.Fruit in this case is not enough material to build its own cells.This may result in a delay of the fetus.
8. How much can you drink fluids a day for preeclampsia?
If there is swelling - no more than one and a half liters a day.
9. I have swollen feet.Doctor naznachilaTrental.But in the instructions it is written a lot of side effects of this drug, I'm afraid to drink.How does Trental on the fetus?
Trental is safe for the child.
10. What allowable rate of protein in the urine?
In normal protein in the urine in general should not be.
Obstetrician-gynecologist, Ph.D.Christina Frambos