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Forms of early toxicosis of pregnant women. Toxicosis of pregnant women: early, late and rare types Early termination of pregnancy with early toxicosis is indicated

Work
30.06.2021

Update: November 2018

Toxicosis during early pregnancy causes a lot of problems for the expectant mother, disrupts her usual lifestyle and sleep, and in severe cases requires inpatient treatment. Early toxicosis during pregnancy is a fairly common phenomenon and is observed in 50 - 60% of expectant mothers, which is why many refer to the phenomena of early toxicosis as the first signs of pregnancy. In reality, pregnancy without toxicosis is absolutely normal, because pregnancy is not a disease and therefore it should not worsen a woman's condition.

Early toxicosis: define the concept

Early toxicosis refers to gestational complications, that is, due to the emergence and development of a new life in a woman's body. Early toxicoses are based on pathological conditions that reflect the negative impact of pregnancy on a woman's body. Toxicosis develops due to a violation of the adaptive processes of the female body to bear the fetus. This complication is manifested by numerous neuroendocrine disorders (disorders of the autonomic nervous system and brain, endocrine system and circulatory system, metabolic processes and immunological failures).

Classification of toxicosis

Toxicosis of pregnant women is also called gestosis and is divided into early and late. For convenience, the disorders that developed in the first half of pregnancy are called early toxicosis, and the occurrence of this complication after 20 weeks is called preeclampsia (late toxicosis).

Early toxicosis include:

  • vomiting of pregnant women (mild or moderate);
  • excessive (indomitable) vomiting of pregnant women;
  • ptyalism or hypersalivation (drooling).

Gestoses include:

  • dropsy (massive swelling);
  • nephropathy of mild, moderate and severe degree;
  • preeclampsia;
  • eclampsia.

There are still rare forms of toxicosis that can occur at any gestational age, but, as a rule, develop in the first trimester:

  • dermatoses or pruritus;
  • jaundice or acute yellow liver atrophy;
  • osteomalacia (softening of the bones);
  • tetany (cramps of limbs, face);
  • bronchial asthma.

Terms of occurrence

The timing of the development of toxicosis during pregnancy is different and falls on the first half of it, that is, up to 20 weeks. It is difficult to answer definitely when toxicosis begins, since its occurrence may be due to various additional factors. In a small number of women, signs of this condition appear even before the delay of menstruation, that is, about 2 weeks after unprotected intercourse, when the fertilized egg is attached to the wall of the uterus and begins to actively secrete hormones. But, as a rule, the symptoms of toxicosis begin to appear from 5 to 6 weeks of gestation.

How long does toxemia last during pregnancy? And there is no definite answer to this question. The duration of toxicosis depends on the number of fruits, the time of its appearance, concomitant diseases and other factors. Usually, the signs of complications gradually disappear by the end of the first trimester, that is, by 12-13 weeks. If there is a multiple pregnancy, then the effects of toxicosis are more pronounced and disappear by 15-16 weeks. The condition of a woman who does not have toxicosis is not considered a deviation from the normal course of pregnancy. Rather, it indicates her physical health and balance. Only the fact that the pregnancy proceeded, for example, with very strong toxicosis, which suddenly stopped, should alert. In such cases, a frozen pregnancy should be excluded when the fetus has stopped developing, but the miscarriage did not occur.

Causes

The causes of toxicosis during pregnancy come down to one thing - the presence of a fetal egg in the uterine cavity, which grows and develops. To date, there are many theories that try to explain the mechanism of the ongoing disorders in the mother's body with early toxicosis:

  • Neuroreflex theory

According to this theory, the occurrence of early toxicosis is due to a growing fetal egg, which irritates endometrial receptors, which leads to an increase in the excitability of subcortical formations. In these subcortical structures are the vomiting center and the center of smell, as well as areas that are responsible for the regulation of the digestive tract, blood circulation and respiration, and other body functions. As a result of irritation of the receptors of the uterine mucosa, vegetative reactions occur in the form of nausea and vomiting, tachycardia and salivation due to vasospasm. But by the end of the 1st trimester, the mother's body adapts to these irritations and the symptoms of toxicosis disappear.

  • Hormonal theory

Supporters of this theory explain the appearance of toxicosis by hormonal changes, in particular, an increase in the secretion of chorionic gonadotropin, which stimulates the growth and strengthening of chorionic villi, their penetration into the uterine wall and tissue decay in the placenta on the maternal side. By 12-13 weeks, the concentration of hCG in the blood begins to decrease and the symptoms of toxicosis subside.

  • Psychogenic theory

It has been noticed that early toxicosis develops much more often in emotional and impressionable women, whom the very fact of the onset of pregnancy plunges into an abyss of emotions.

  • immunological theory

This theory is based on the foreignness of the fetal egg for the mother's body. As a result, the pregnant woman's body begins to produce antibodies against the embryo, which provoke the appearance of toxicosis.

  • Toxic theory

This theory has existed for a long time and explains the signs of toxicosis (nausea and vomiting) by poisoning the mother's body with harmful substances, the production of which is produced by the fetus or placenta, or during metabolic disorders.

All existing theories have the right to exist and complement each other.

Predisposing factors

Why do half of the women have early toxicosis, while the other half is free from this unpleasant condition? A number of certain factors increase the risk of development and severe course of early toxicosis:

  • chronic somatic diseases (kidney pathology, hypertension, gastritis, peptic ulcer, colitis, obesity, CNS pathology, cardiovascular diseases);
  • overwork and prolonged or constant stress;
  • poor nutrition, starvation;
  • bad habits;
  • asthenic physique of a woman;
  • social disadvantage;
  • chronic inflammatory diseases of the genital organs;
  • history of abortion;
  • age (under 17 and over 35);
  • disturbed swallowing reflex and antiperistalsis of the esophagus in history;
  • increased activity of the vomiting center;
  • unwanted pregnancy or too desired (for example, after long-term fertility treatment).

Clinical manifestations

The onset of toxicosis, as already mentioned, coincides with the moment when a woman finds out about pregnancy, that is, approximately 5 to 6 weeks. The expectant mother experiences weakness, drowsiness during the day and insomnia at night, she is irritable and depressed. She also suffers from drooling and nausea, vomiting, and olfactory quirks. The appetite of a pregnant woman is reduced or absent, weight loss is also possible up to serious losses.

Early toxicosis cannot be classified by weeks of pregnancy, it is either there or not. The only thing that can be noted is that with an increase in the gestation period, the signs of complications appear more pronounced, but by the end of the 1st trimester they gradually disappear. The most common sign of complications is vomiting. It occurs no more than 3 times a day, often in the morning, on an empty stomach, but does not lead to a violation of the general condition of the pregnant woman.

Vomit

If there is vomiting, which happens more than three times a day and is not associated with food intake, plus there is a decreased appetite, changes in taste and smell sensations, lethargy and weight loss, they indicate early toxicosis. Vomiting of pregnant women is classified according to severity:

  • Light degree

The frequency of vomiting attacks reaches 5 per day, the woman loses weight from 1 to 3 kg per week, but the general condition does not suffer. Apathy and decreased work capacity are possible. Some shift in hemodynamics is noted: slight tachycardia (up to 90 per minute) and hypotension (110/60). Stool and diuresis do not suffer, general blood and urine tests are normal.

  • Average degree

With an increase in vomiting attacks up to 10 times a day, which is accompanied by a deterioration in the general condition, a metabolic disorder up to the development of ketoacidosis, they speak of moderate severity. Against the background of vomiting, salivation is often present, which exacerbates the loss of fluid and nutrients. The weight loss of a pregnant woman in a week is from 3 to 5 kg, exhaustion is possible. The expectant mother is experiencing significant weakness, apathetic. The skin is pale, the tongue is lined and dry. It is possible to increase the temperature to 37.5 degrees. The heartbeat increases to 90 - 100 per minute, blood pressure decreases (100/60). There may be a decrease in hemoglobin in the KLA (anemia), and a study of the acid-base composition of the blood confirms acidosis. Diuresis is reduced to 800 - 700 ml per day, some pregnant women have constipation.

  • Severe degree

Severe or excessive vomiting is accompanied by the development of severe multiple organ disorders. The frequency of vomiting reaches 20 times a day, there is profuse salivation, constant nausea. The condition of the pregnant woman is severe, food and liquid do not stay in the stomach, sleep is disturbed. The woman complains of headaches and muscle pain, dizziness. There is adynamia, the pregnant woman quickly loses weight, up to 3 kg per week. The subcutaneous fat layer becomes thinner, the skin is flabby and dry, the tongue is dry, lined, the smell of acetone is felt from the mouth. There is an increase in temperature up to 38 degrees. Tachycardia and hypotension are significant (below 90/60 and above 110 beats per minute). Diuresis is reduced and is less than 700 ml per day.

In the biochemical analysis of blood, residual nitrogen, urea and bilirubin increase. In KLA and leukocytes. Albumins, cholesterol, potassium and chlorides are also reduced. OAM contains protein and casts, urobilin and bile pigments, erythrocytes and leukocytes. Significant ketonuria (reaction to acetone).

Ptyalism

In second place among the signs of early toxicosis is salivation, which can be either an independent form of complication or accompany vomiting. With intense salivation, a pregnant woman loses more than one and a half liters of saliva, which is accompanied by severe dehydration, a decrease in proteins and mineral salts, and psychological discomfort.

Dermatosis

It is rare and, as a rule, manifests itself as diffuse or local (in the region of the vulva) skin itching. Intense itching disturbs sleep, causes depression and irritability. Differential diagnosis is carried out with thrush, allergic reactions and diabetes mellitus.

Bronchial asthma

Cases of the development of bronchial asthma in pregnant women as one of the forms of toxicosis are quite rare. The course of the disease is severe. Manifested by attacks of suffocation and dry cough. Differentiate from ordinary bronchial asthma, which took place before conception.

Osteomalacia and tetany

These complications develop due to a violation of calcium and phosphorus metabolism in a woman's body. With osteomalacia, the bone tissue loosens, which is fraught with bone fracture. With tetany, muscle cramps are noted: spasm of the muscles of the arm ("obstetrician's hand") and spasm of the muscles of the leg ("ballerina's leg"), with spasm of the facial muscles - "fish mouth".

The relationship between toxicosis and the number of pregnancies

Most women believe that if the first toxicosis occurred, that is, during the first pregnancy, it will definitely occur in the next period of gestation. Actually this is a delusion. All pregnancies (meaning the same woman) proceed differently, which depends on many factors (the age of the expectant mother, the number of embryos, past illnesses, chronic pathology, living conditions, etc.). For example, in the first pregnancy, which proceeded without complications and ended in spontaneous childbirth, this complication was not. But this does not mean that there will also be no toxicosis during the second pregnancy.

Are toxicosis and the sex of the child related?

Future mothers are superstitious people and firmly believe in all the signs associated with the period of gestation. Many believe that early toxicosis necessarily occurs during pregnancy with a girl, although this statement has not been scientifically confirmed. Guessing who will be born, a boy or a girl, is certainly interesting, but relying on the shape of the abdomen, the severity of certain signs of pregnancy, the intensity of toxicosis is a hopeless occupation. To date, it is possible to determine the sex of the unborn baby only by ultrasound, but this method does not provide a 100% guarantee. The doctor may mistakenly take the loops of the umbilical cord in the perineal region of the fetus for the scrotum and say that the pregnancy is a boy, or, conversely, not see the testicles in the male fetus, as he “hid” them (located in an uncomfortable position for examination).

It becomes clear that neither the likelihood of this complication nor the intensity of symptoms depend on the sex of the child. The severity of toxicosis rather depends not on the sex of the embryo, but on their number.

Treatment

I was tormented by toxicosis, how to deal with it? A similar question is often heard by gynecologists of antenatal clinics, in addition, expectant mothers ask relatives and friends. Of course, constant nausea and vomiting is not a pleasure, but following simple recommendations will help alleviate toxicosis:

  • dieting;
  • taking multivitamin complexes;
  • creating a calm environment, taking light sedatives (infusion of valerian and motherwort);
  • walks in forest park areas, frequent trips out of town;
  • frequent airing of the room, especially before going to bed;
  • full sleep (at least 8 hours a day);
  • physiotherapy;
  • aromatherapy;
  • observance of the regime of the day with obligatory daytime rest;
  • giving up bad habits, including being in smoky places.

Diet

Compliance with certain rules in the diet of a pregnant woman with this complication will help get rid of or at least reduce nausea and vomiting:

  • food temperature

Do not take too hot (more than 60 degrees) or cold (less than 15 degrees) food. Food should be at room temperature or slightly warm. Hot or cold food not only disrupts digestion, but also irritates the stomach lining and provokes nausea and vomiting.

  • Diet

Eating with toxicosis should be fractional, the frequency of meals should be up to 5-6 times a day and in small portions. Such a diet allows better absorption of nutrients, does not increase the load on the digestive tract, helps to normalize the stool and alleviates the symptoms of this complication (unpleasant sensations increase on an empty stomach). It is important to observe the time of the last meal, no more than two hours before bedtime.

  • Culinary processing

It is recommended to give preference to boiled, baked or steamed food. Quenching is allowed. Fried foods should be excluded, as they not only inhibit the process of digestion and absorption of food, but also increase the load on the liver and stomach, thereby provoking bouts of vomiting. All foods in dishes should be pureed or finely ground, which contributes to their better absorption.

  • Drinking regime

Free fluid intake is not 2 liters per day. Preference should be given to mineral alkaline waters without gas, herbal teas and decoctions, ordinary boiled water. It is worth giving up tea, coffee and cocoa, as well as sugary carbonated drinks. You should not consume liquid 30 minutes before meals, during meals and 1.5 hours after. A good remedy for toxicosis is green tea and infusions of chamomile, mint or sage.

  • Refusal of semi-finished products, spicy foods and smoked meats

All preservatives, dyes and stabilizers contained in semi-finished products are chemicals that disrupt digestion and exacerbate toxicosis. It is worth refusing to take fatty and spicy dishes, smoked meats, sausages, canned food and fast food.

  • Little fasting

Even if thoughts about food provoke nausea and vomiting, it is useful to starve for 3-4 days and not take medication.

  • There is only what you want

Do not suppress your desires by forcing yourself to eat. If you do not want this or that dish, then you do not need it. You can pamper yourself and eat what you want at the moment - there is a high probability that the food will be digested.

  • Thorough chewing of food

Slow and thorough chewing will not only make you feel full with less food, but also promote better absorption of nutrients and suppress nausea and food aversion.

  • "Dry Diet"

With moderate vomiting, when food is only partially absorbed, it is useful to switch to the so-called dry diet, that is, to give up soups and semi-liquid cereals. They can be replaced with boiled potatoes and eggs, bread (preferably dried or yesterday's) with butter or pate (fish, meat). It is advisable to take food in a reclining position.

  • First breakfast

Take care of the first breakfast should be in advance. In the evening, you need to put dry biscuits, a banana or a handful of dried fruits on the bedside table. Immediately after waking up, without getting out of bed, you should have a snack. This is especially useful for those women who are overcome by nausea in the morning.

With salivation, rinsing the mouth with a decoction of oak bark, infusion of chamomile, mint or sage is effective. Chewing mints and hard candies will also help reduce salivation and nausea. A future mother suffering from constant nausea and vomiting will be helped out by an “ambulance kit”, which is not difficult to always carry in her purse. It can be a bag of crackers, crackers or nuts, the same dried fruits (dried apricots and prunes) and a bottle of slightly acidified drink (low-brewed tea with a slice of lemon, water with a little lemon juice and honey, diluted cranberry juice). Sour drinking undoubtedly increases salivation, but effectively suppresses nausea.

Particular attention should be paid to fresh fruits and vegetables. With moderate vomiting, fruits are best consumed baked. Vegetable fiber is necessary for the normal functioning of the intestines, regular stools, in addition, fresh fruits (cranberries, kiwi, currants, cherries, lingonberries, pomegranates - that is, berries and fruits “with sourness”) and vegetables contain a large amount of vitamins.

Physiotherapy and non-traditional methods

From physiotherapeutic procedures, endonasal electrophoresis with B vitamins, electrosleep and brain galvanization are used. Such procedures suppress the activity of the vomiting center in the brain.

Of the non-traditional methods, acupuncture, aromatherapy (inhalation of citrus oils, peppermint and sea buckthorn oils) and homeopathic remedies are used, but only after consulting a doctor.

Hospitalization

Pregnant women with moderate and indomitable vomiting are subject to hospitalization. Expectant mothers with severe vomiting are in the intensive care unit. In the hospital, intensive infusion therapy is prescribed to restore the volume of circulating blood (eliminate dehydration), detoxification and parenteral nutrition. Crystalloids (Ringer's and glucose solutions, trisol, disol) and fat emulsions with amino acids are prescribed. Also shown is the introduction of vitamins (riboflavin and thiamine, ascorbic acid) and actovegin.

Therapeutic and protective regime and the exclusion of negative emotions in the hospital allows you to normalize the work of the central nervous system. In order to block the gag reflex, the following are prescribed:

  • atropine;
  • neuroleptics (droperidol, haloperidol);
  • diphenhydramine and pipolfen (due to a pronounced sedative effect);
  • hofitol, essentiale (improve liver function);
  • splenin (normalizes nitrogen metabolism);
  • tablets for toxicosis: polyphepan and activated charcoal (adsorb toxins from the intestines);
  • metoclopromide (cerucal) is prescribed only in extreme cases, as it is contraindicated in the 1st trimester (it can provoke spontaneous abortion).

Question answer

How to get rid of toxicosis, in particular, constant nausea?

If only nausea, without vomiting, bothers you, you should not resort to drugs. It is worth following the general recommendations (diet, frequent walks, good sleep).

I vomit even while brushing my teeth. What to do?

You need to change your toothpaste. If vomiting continues to bother, for a while, abandon this procedure, replace the mouth rinse with infusions of medicinal herbs or tooth balms and elixirs.

I constantly want pickles or tomatoes. Isn't it harmful?

If you want salty, then the body does not have enough sodium. If pickles or tomatoes do not provoke nausea and vomiting, then they are not prohibited, but, of course, within reason.

I am already 23 weeks old, but I still have nausea and vomiting, as in the early stages. What to do?

It is necessary to undergo an examination by a gastroenterologist and a neurologist, who will rule out diseases of the digestive tract and disorders of the nervous system. If the pathology is not detected, you should reconsider your diet.

TOXICOSIS OF PREGNANT WOMEN(Greek toxikos, which serves to lubricate arrows, i.e., poisonous) - diseases that occur during and in connection with pregnancy and usually disappear with its completion or in the early postpartum period.

It is customary to distinguish between early and late toxicosis of pregnant women. Toxicosis occurring up to 20 weeks. pregnancy, called early, after 20 weeks - late. However, this limit is conditional. The fundamental difference between early and late toxicosis is the main type of disorders in the body of a pregnant woman: for most forms of early toxicosis, disorders of the functions of the digestive system are characteristic, for late toxicosis - vascular disorders.

Separate forms of toxicoses of pregnant women were identified in the 19th century. So, in 1841 G. I. Korablev, and in 1874 I. P. Lazarevich considered eclampsia as a specific disease of pregnant women; in 1886, E. Leiden proposed the term "kidney of pregnant women", and a little later, Lelein (M. H. F. Lohiein) and Kermauner followed him (Kermauner) introduced the term "nephropathy of pregnant women", which has been preserved in modern obstetric literature. The term "toxicosis of pregnant women" was proposed at the beginning of the 20th century. Freynd (W. A. ​​Freund), to-ry considered T. b. as manifestations of a single patol. process. However, the word "toxicosis" is not quite accurate, because so far it has not been possible to detect toxic substances that cause the disease. Therefore, other terms "allergosis", "hypertensive syndrome of pregnant women", "neurosis of pregnant women" are proposed; in foreign literature, the terms "ERN-gestoses" are used (from Edema, Proteinuria, Hypertonia s and "toxemia of pregnant women".

There are many various classifications of T. b., the symptomatology of a disease is the cornerstone to-rykh. For a long time, obstetricians used the Seitz classification, which includes, along with the classical forms of toxicosis, other diseases that occur in pregnant women. There are great disagreements about the classification of individual forms of late toxicosis of pregnant women.

Etiol. the factor contributing to the occurrence of toxicosis is the fetal egg and the placenta, however, for the development of the disease, predisposing moments are necessary associated with the state of the body of the pregnant woman and the influence of the environment on it.

Early toxicosis

There are many theories of early toxicosis of pregnant women: neurogenic, cortico-visceral, hormonal, allergic, immune. In a crust, time, early toxicosis is considered as a consequence of a violation of neuroendocrine regulation and metabolism associated with previous diseases, features of this pregnancy, and the influence of unfavorable environmental factors on the body. The leading role belongs to the functional state of c. n. s., violations of the reflex reactions of the body of a pregnant woman in response to irritation of the nerve endings of the uterus by impulses coming from the fetal egg.

The wedge, forms of early toxicosis include vomiting of pregnant women, salivation (ptyalism), dermatoses, tetany, bronchial asthma, osteomalacia, jaundice of pregnant women, acute yellow atrophy of the liver.

Vomiting pregnant- one of the frequent complications of early pregnancy. It occurs in about 50-60% of pregnant women, but only 8-10% of them need treatment (see Vomiting, Vomiting of Pregnancy).

Salivation often accompanies vomiting of pregnant women, rarely occurs as an independent form of toxicosis. With severe salivation, the loss of saliva per day can exceed 1 liter. Abundant salivation has a depressing effect on the psyche of a pregnant woman, leads to dehydration, hypoproteinemia. Treatment of severe salivation should be carried out in a hospital setting. Assign rinses with infusion of sage, chamomile, oak bark, atropine. With significant hypoproteinemia, plasma transfusion is indicated. Hypnosis has a positive effect.

Dermatoses. The most common form of dermatoses of pregnant women is itching, which can be local and limited to the vulva or spread throughout the body. Itching is sometimes painful, causes insomnia, irritability. Itching of pregnant women must be differentiated from others patol. conditions accompanied by pruritus: diabetes mellitus (see Diabetes mellitus), fungal skin diseases (see), trichomoniasis (see), allergic reaction (see Allergy). Treatment is reduced to the appointment of sedatives, hyposensitizing agents, UV irradiation.

Jaundice of pregnant women is observed with excessive vomiting of pregnant women, with the renal hepatic syndrome of pregnant women that occurs with eclampsia (see). N. A. Farber singled out a special form of jaundice in pregnant women, which he called cholestatic hepatosis. It often occurs at the beginning of the second trimester of pregnancy, is progressive, stops with abortion, can be repeated with each pregnancy and is an indication for abortion. Jaundice of pregnant women is accompanied by skin itching, increased levels of cholesterol and alkaline phosphatase in the blood with a normal content of alanine aminotransferase. With this form of toxicosis, miscarriage is possible (see), Bleeding during childbirth (see), developmental anomalies are observed in children. Jaundice of pregnant women should be differentiated from jaundice that occurs in a pregnant woman due to viral hepatitis (see Viral hepatitis), as well as as a result of cholelithiasis (see) or hemolytic anemia (see). Treatment is the same as for hepatitis (see). Vitamins, glucose, protein preparations, etc. are prescribed. Sometimes they resort to abortion.

Acute yellow atrophy of the liver is extremely rare as an outcome of excessive vomiting during pregnancy or severe jaundice in pregnancy (see Toxic Liver Dystrophy).

Late toxicosis

The pathogenesis of late toxicosis is complex. In a crust, time it is considered as result of disturbance of mechanisms of adaptation of an organism of the woman connected with changes of reactivity of c. n. from. (cortico-visceral theory). The immune and vascular theories are also recognized. The pathogenesis of late toxicosis is based on vascular disorders characterized by impaired hemodynamics, microcirculation, vascular permeability, leading to an increase in blood pressure and a sharp violation of peripheral circulation. Circulatory disorders in various vascular pools lead to hypoxia of organs and tissues, the development of metabolic acidosis. Disorders of cerebral circulation cause subsequent violations of the central regulation of the vital functions of the body - vascular tone and respiration. Significant changes develop in the kidneys: spasm of the adductor arterioles contributes to a decrease in renal blood flow, a decrease in glomerular filtration, sodium retention and excess fluid in the body. Hypoxia leads to a decrease in the detoxification, protein-forming and urea-forming functions of the liver. Late toxicosis is accompanied by circulatory disorders in the uteroplacental circulation system, leading to disseminated intravascular coagulation, thrombosis of the intervillous spaces and spiral arteries of the myometrium, partial or complete exclusion of certain sections of the placenta from hemodynamics. At the same time, placental insufficiency develops, its transport, endocrine, and barrier functions are disrupted, and immunotolerance between the organism of the mother and fetus decreases. These disorders lead to the development of hypoxia and fetal hypotrophy. The frequency of late toxicosis of pregnant women reaches 17.6% of the total number of pregnancies. It is manifested by various wedges, forms - dropsy of pregnant women (see), nephropathy of pregnant women (see), preeclampsia and eclampsia (see Eclampsia). Nek-ry scientists allocate a hypertension of pregnant women. Foreign researchers distinguish two wedges, forms of late toxicosis: preeclampsia and eclampsia. Late toxicosis is subdivided into "pure", which arose in a practically healthy woman, and "combined", which developed against the background of any hron. diseases. Late toxicosis of pregnant women can be accompanied by various obstetric complications: preterm birth (see), weakness of labor forces (see Childbirth), premature detachment of the placenta (see), bleeding. It has an adverse effect on the condition of the fetus. Depending on the severity of toxicosis, perinatal mortality (see. ) ranges from 38 to 90%0; hypoxia (see Asphyxia of the fetus and newborn), malnutrition (see), fetal abnormalities are more common than in uncomplicated pregnancy.

In modern conditions, the course of late toxicosis has certain features: it manifests itself early, in the second trimester of pregnancy, is often observed with arterial hypotension, eclamptic seizures occur with relatively low hypertension and the symptoms of previous nephropathy are erased. The seasonality of late toxicosis is clearly traced: in winter and spring it is observed more often. The most severe course has a combined toxicosis, especially in diseases of the kidneys, cardiovascular system, endocrine system.

The basic principles of the treatment of late toxicosis are the mandatory hospitalization of a pregnant woman in the department or ward of the pathology of pregnant women of the maternity hospital, the creation of a therapeutic and protective regimen, antihypertensive therapy, correction of water-electrolyte metabolism and acid-base balance. In recent years, in the treatment of late toxicosis, infusion therapy has been widely used to eliminate hemodynamic disorders, microcirculation disorders and normalize the rheological properties of blood, as well as measures to combat hypoxia and fetal hypotrophy.

Obstetric tactics in late toxicosis is determined by the degree of its severity and involves the choice of the time and method of delivery. In the absence or insufficient effect of the ongoing therapy for severe late toxicosis, it is advisable to terminate the pregnancy as early as possible, especially in patients with combined toxicosis. In present time due to the development of obstetric anesthesiology, indications for caesarean section are expanding (see).

Now obstetricians distinguish the preclinical stage of late toxicosis - protoxicosis, characterized by specific general and local changes and reflecting the initial violations of adaptive mechanisms in pregnant women. The wedge, manifestations of pretoxicosis include increased hydrophilicity of tissues, an increase in blood pressure by 10 mm Hg. Art. after dosed physical activity (in the absence of a decrease to the initial level at rest), changes in a number of blood parameters (increased erythrocyte aggregation and blood clotting), traces of protein in the urine. Pretoxicosis often develops in pregnant women at high risk for the development of late toxicosis (pregnant women with various extragenital diseases, women with a first pregnancy over 30 years old, and women with a history of late toxicosis).

The prognosis after suffering late toxicosis depends on the quality of treatment and rehabilitation measures in the early postpartum period, since these women often have impaired renal function, and in the future the development of hypertension (see).

Prevention of late toxicosis consists in the systematic monitoring of all pregnant women, starting from the early stages of pregnancy, in the implementation of recreational activities (compliance with the protective regimen, rational nutrition of the pregnant woman, vitamin therapy), early detection and systematic treatment of pretoxicosis and diseases predisposing to its development. Women who have undergone severe forms of late toxicosis need dispensary observation. It is desirable to prevent another pregnancy within two years.

Bibliography: Barkhatova T. P. and Kadieva V. A. Vomiting of pregnant women, Midwives. and gynec., .M 12, p. 48, 1980; B e to-k e r S. M. Pathology of pregnancy, L., 1975; In and x l I e ​​in and E. M. Volemic disorders in the obstetric and gynecological clinic and their correction, M., 1977; Gr and shch en to V. I. Late toxicosis of pregnant women, Kyiv, 1968; Nichol a-e in A. P. Late toxicosis of pregnant women, M., 1972; P e tr about in - M and with l and - to about in M. A. and With about t n and nova L. G. Late toxicosis of pregnant women, L., 1971; With and in e l e in and G. M. Infusion therapy in obstetrics and gynecology, M., 1976; Farber N. A. Jaundice and pregnancy, Akush. and gynec., No. 12, p. 52, 1982; Burrow G. N. a. Ferris, T. F. Medical complications during pregnancy, p. 60, Philadelphia a. o., 1975; Erkrankungen wahrend der Schwanger-schaft, hrsg. v. H. Kyank u. M. Giilzow, S. 229, Lpz., 1979; Rippmann E. T. EPH-Gestose, B.-N. Y., 1972.

T. P. Barkhatova.

State budget educational institution

Secondary vocational education

Medical College No. 4

Moscow Department of Health

Abstract on the topic:

"Early toxicosis of pregnant women"

Performed:

Student 302 group

Mammadova Aishan

Early toxicosis of pregnant women (toxicosis in early pregnancy)

Early toxicosis of pregnant women (synonym - early gestosis)- this is a common pathology that develops in the first trimester of pregnancy (up to 12 weeks) due to neuroendocrine disorders in the body of a pregnant woman.

To date, there are many theories explaining the causes of toxicosis in early pregnancy. The essence of all these theories boils down to the fact that with the onset of pregnancy, physiological changes occur in the body of a woman, which are regulated by the nervous system and hormones. Hormones are produced by the placenta and endocrine glands (pituitary gland, thyroid gland, gonads, etc.). Early toxicosis occurs mainly due to failures in the regulation of the neuroendocrine system. Because of this, the body of a pregnant woman cannot normally adapt to the pregnancy that has arisen and toxicosis develops. That is why gynecologists call toxicosis “adaptation disease”.

Causes of early toxicosis of pregnant women

The provoking factors leading to the development of early toxicosis during pregnancy include:

Chronic diseases of the digestive system, kidney disease;

Stress, increased nervous irritability, depression;

hereditary predisposition;

High blood pressure

Obesity.

Symptoms of early toxicosis of pregnant women

Symptoms of early toxicosis of pregnant women often appear after a woman finds out about her pregnancy, at about 5-6 weeks of pregnancy. The most persistent symptoms are nausea, vomiting, and excessive salivation. According to various estimates, about 60% of pregnant women have similar symptoms in early pregnancy.

Depending on the severity of the vomiting symptom, 3 degrees of severity of toxicosis are distinguished:

mild degree of early toxicosis of pregnant women - vomiting up to 5 times a day,

early toxicosis of pregnant women of moderate severity - vomiting up to 10 times a day,

severe early toxicosis of pregnant women - indomitable vomiting up to 25 times a day.

With any degree of early toxicosis of pregnant women, a decrease in the weight of the pregnant woman is observed, with moderate and severe degrees, blood pressure decreases, the pulse rises, drowsiness, weakness, and irritability occur. Most pregnant women with toxicosis complain of reduced appetite, even the smell of food causes a gag reflex. Excessive salivation leads to dehydration, the skin becomes flabby and dry.

At the first signs of toxicosis, it is urgent to contact an obstetrician-gynecologist. A severe form of toxicosis poses a threat to the life of the pregnant woman and the fetus.

Diagnosis of early toxicosis of pregnant women

The diagnosis does not present certain difficulties and is based on the complaints of the pregnant woman. In order for the doctor to be able to assess the severity of toxicosis and prescribe adequate treatment, it is necessary to pass tests:

Clinical and biochemical analysis of blood;

General urine analysis.

With a mild degree of early toxicosis, all tests should be within the normal range.

With moderate toxicosis, the level of hemoglobin, leukocytes and hematocrit slightly increases. Due to the disturbed water and electrolyte balance, hyperkalemia and hyponatremia are observed. Acetone is determined in the urine, the relative density of urine increases.

In severe early toxicosis of pregnant women, laboratory tests show significant deviations from the norm. In the blood test, in addition to increasing hemoglobin, hematocrit and leukocytes, the amount of total protein, glucose and ESR decreases; the content of urea, creatinine, ALT and AST increases. Protein, acetone and ketone bodies are detected in the urine.

Treatment of early toxicosis of pregnant women

With a mild form of early toxicosis of pregnant women, treatment is carried out on an outpatient basis, with a moderate and severe degree of the disease, hospitalization of the pregnant woman is indicated. Accordingly, the treatment of toxicosis will vary depending on the severity.

With a mild degree of toxicosis, a pregnant woman first of all needs psychological and physical rest. Sedatives are prescribed - tincture of motherwort or valerian (25 drops 3 times a day), vitamins, hepatoprotectors (Hofitol, Essentiale) and antiemetic therapy (Cerukal). In most cases, drug treatment is limited to this and the woman's well-being improves significantly.

With moderate toxicosis in a hospital, a pregnant woman is given infusion therapy with a glucose solution in combination with antiemetics, hepatoprotectors, vitamins and sedative treatment.

Treatment of severe forms of toxicosis is carried out in the intensive care unit under strict control of hemodynamic parameters and laboratory tests. Antiemetics, infusion therapy in a volume of up to 3 liters, hepatoprotectors and vitamins are administered intravenously. If, despite the ongoing treatment, the condition of the pregnant woman does not improve, then termination of pregnancy is indicated due to increasing multiple organ failure.

How to get rid of toxicosis during pregnancy

Features of nutrition and lifestyle of a pregnant woman with toxicosis is a whole science! With strict adherence to all recommendations, you can successfully get rid of toxicosis or prevent its occurrence without taking any drugs.

Nutrition, diet for early toxicosis of pregnant women

A pregnant woman is recommended to stick to a diet - eat often and little by little - 5-6 times a day. Food should be warm, not cold and not too hot. It is recommended to temporarily exclude spicy, sour, fried foods, as well as carbonated drinks from the diet, as this can provoke nausea and vomiting. This is especially true for pregnant women with chronic diseases of the digestive system.

If nausea and vomiting are still bothering, a dry diet is recommended - a hard-boiled egg, a baked potato with butter, a sandwich with butter, and so on. Try to consume more dairy products, vegetables, fruits, fish dishes and boiled meat.

You can relieve nausea in the morning by sucking on a rye cracker, and only then get out of bed. Drink mineral water in small sips throughout the day.

In addition to nutrition, daily walks in the fresh air for at least an hour are recommended. Night sleep should be at least 8 hours a day. If during the day you want to sleep - it is better to lie down, relax. And, as already mentioned, it is recommended, if possible, to limit the psychological and physical stress on the body.

Physiotherapy for early toxicosis of pregnant women

Regardless of the severity of toxicosis, in the active stage of the disease and during the rehabilitation period, physiotherapeutic procedures are useful - endonasal electrophoresis with B vitamins, galvanization of the brain with a course of 8-10 procedures.

Non-traditional means of treatment of early toxicosis of pregnant women

Of the non-traditional methods of treatment for toxicosis, acupuncture and Chinese acupressure are used. Unconventional methods are especially good for pregnant women, in whom toxicosis is due to psychological reasons.

Folk remedies for the treatment of early toxicosis of pregnant women

Folk remedies are very effective for toxicosis of pregnant women, especially with mild manifestations of the disease. The most effective for toxicosis are infusions of chamomile, mint and lemon balm. 2 tablespoons of pharmaceutical chamomile are poured with boiling water (about half a liter) and left overnight in a thermos. In the morning, filter and take 3 times a day 30 minutes before meals. Melissa and mint are also brewed and used in the same way. You can add a spoonful of honey and lemon to the infusion. In the summer, when there is fresh mint or lemon balm, you can carry a few leaves with you and chew them to relieve nausea.

If the attacks of toxicosis are very pronounced, you should not experiment with folk remedies, it is more advisable to consult an obstetrician-gynecologist. In addition, prolonged and excessive “leaning” on herbs can lower blood pressure.

Complications of early toxicosis:

Multiple organ failure, which in case of untimely termination of pregnancy can lead to death;

Untimely treatment of early toxicosis can provoke the development of late gestosis at the end of pregnancy and placental abruption.

Prevention of early toxicosis of pregnant women

Prevention of toxicosis should be carried out before pregnancy, it includes:

Timely treatment of chronic diseases that provoke toxicosis;

Rejection of abortion;

Healthy lifestyle;

Psychophysical preparation for the upcoming pregnancy.

Almost every woman, being in an “interesting” position, suffers from such an unpleasant phenomenon as toxicosis. What are the causes of toxicosis and can its symptoms be alleviated?

Toxicosis (intoxication) is a painful condition that occurs due to exposure to the body of exogenous toxins or harmful substances of endogenous origin. Toxicosis during pregnancy can manifest itself in the form of nausea, vomiting, salivation, drowsiness, feeling unwell, irritability and depression. Quite rare manifestations of early toxicosis can also be observed: tetany, acute yellow liver atrophy, osteomalacia, dermatoses of pregnant women, bronchial asthma of pregnant women. Toxicosis of pregnant women can occur both in early and late pregnancy. Early toxicosis, as a rule, does not last long; by the twelfth or thirteenth week of pregnancy, its symptoms usually leave the woman. Much more dangerous is toxicosis in late pregnancy or, as it is also called, preeclampsia.

Most often, toxicosis bothers women in the first trimester of pregnancy, almost from the first days of conception (nausea). During the first month after fertilization, the hormonal background of a woman has not yet undergone any changes, so she does not experience any discomfort. But with the development of the fetal egg in the next eight weeks, endocrine restructuring occurs in the body, which causes early toxicosis. Gradually, the hormonal background returns to normal and the symptoms of toxicosis disappear. If early toxicosis drags on, which indicates a violation of the functioning of the liver and other internal organs, there is a significant risk of premature birth, and the life of the mother and fetus is also endangered.

If the pregnancy proceeds normally, then nausea and vomiting in a pregnant woman can occur no more than 2-3 times a day in the morning, most often on an empty stomach. But at the same time, there is no deterioration in the general condition of the woman.

In severe forms of toxicosis, attacks of vomiting in the morning occur constantly. In addition, in these circumstances, the pregnant woman reacts sharply (nausea) to many smells (food, perfume, etc.) and may refuse food altogether. The severity of these symptoms depends on the degree of intoxication. A serious complication of toxicosis is excessive vomiting (up to 20 times a day), which occurs both during the day and at night, and causes dehydration of the body, as a result of which the pregnant woman begins to lose weight dramatically. The body temperature rises, the skin becomes very dry and flabby in appearance, bad breath appears, blood pressure decreases and the pulse rate increases. In some special cases, this condition forces specialists to raise the issue of artificial termination of pregnancy.

According to medical practice, toxicosis occurs in women who will become a mother for the first time. With the wrong lifestyle during pregnancy, the risk of preeclampsia in the second half of pregnancy increases, which is much more dangerous.

Causes of toxicosis during pregnancy.
A few weeks after conception, with the development of the fetus, the placenta begins to develop, which is formed by about sixteen weeks of pregnancy. Until this moment, the placenta has not reached such a development that it is possible to protect the woman's body from the metabolic products secreted by the fetus. Therefore, these substances penetrate directly into the blood, which leads to intoxication. Each expectant mother feels it on herself in different ways: someone is just sick, someone is sick and vomits, someone has an aversion to smells, etc.

Another cause of toxicosis is called an increase in the level of the hormone human chorionic gonadotropin (hCG) in the body of a pregnant woman. This hormone in the first trimester of pregnancy stimulates the formation of hormones necessary for the development and maintenance of pregnancy (progesterone, estrogens (estradiol and free estriol)). In the case of a normal pregnancy, the placenta will produce these hormones in the future. The placenta also produces the hormone placental lactogen, which actively affects metabolism. Under its influence, in the body of a pregnant woman, the supply of amino acids for the “building” of the tissues of the child increases, and in her she causes nausea, headache and fatigue.

The cause of toxicosis can also be hormonal changes in the body, which are characteristic of the period of pregnancy. Because of this, the centers of smell, touch, and laryngeal tissues responsible for the gag reflex acquire higher sensitivity and excitability. During this period, a woman may also experience vomiting, nausea, or aversion to certain odors that previously did not affect the woman.

Many obstetricians and gynecologists believe that heredity plays an important role in the manifestation of toxicosis. For example, if the mother of a pregnant woman did not have acute attacks of toxicosis during pregnancy, then her daughter will easily endure them.

Poor health of a pregnant woman (nausea, vomiting) may be the result of immunological incompatibility between mother and child, that is, when "alien" (daddy's) particles of the fetus affect the mother's body. Gradually, the body of the expectant mother "gets used" to the fetus, and the discomfort disappears as quickly as it arose.

The body of the expectant mother does not always adapt to new conditions for him, as a result of which the nervous system can malfunction, due to which signs of toxicosis appear. In women who suffer from chronic diseases of the gastrointestinal tract, liver, asthenic syndrome, the risk of developing early toxicosis during pregnancy is significantly increased.

Sometimes with the development of toxicosis and toxic conditions of the 2nd, 3rd and subsequent pregnancies (in the absence of toxicosis during the first pregnancy), the age of a woman after thirty years is associated.

Toxicosis of the second half of pregnancy (gestosis).
To date, toxicosis in late pregnancy is a disease of the whole organism, expressed in violation of the functions of the most important organs and systems. Violation of the functions of the central nervous system is the cause of the development of complex pathological processes characteristic of toxicosis during pregnancy.

In general, in the second half of pregnancy, toxicosis, as such, should not be. In rare cases, any food gives rise to bouts of nausea and vomiting. However, if this happens all the time, then experts call this condition preeclampsia, when a pregnant woman develops edema, protein in the urine, body weight rapidly increases (more than 400 grams per week) and blood pressure rises over 130/100.

The stronger the symptoms, the more difficult the condition of the pregnant woman. If timely measures are not taken to stop these signs, then the situation can end badly. Most often, a woman who regularly visits a gynecologist is warned about the onset of preeclampsia. As a rule, in this case, a woman is offered treatment in a hospital. In the treatment of preeclampsia, they proceed from the specific situation of its severity.

Usually, drugs are prescribed, the action of which is aimed at lowering blood pressure, improving microcirculation of blood flow and normalizing the functions of the kidneys of the expectant mother.

Most often, the cause of preeclampsia in late pregnancy is the wrong lifestyle of the expectant mother. Eating a large amount of salty foods (everyone's favorite pickles) leads to disruption of the kidneys, fatty, spicy sweet foods - to weight gain of more than 10 kilograms during pregnancy. In this case, there is an accumulation of excess fats, which the body must supply with blood. All this leads to an increase in pressure, spasms of blood vessels, the excretion of substances in the urine that are necessary for the body, an increase in the load on the lungs, heart, and kidneys. And when the body's reserves are exhausted, it begins to replenish them from the unborn child, and then it stops working itself. To prevent this scenario, you should eat right, lead a healthy lifestyle and strictly follow the doctor's recommendations.

It is worth noting that gestosis will not necessarily recur during your second and subsequent pregnancies, during which it can be absolutely calm.

Means of combating toxicosis during pregnancy.
The most important thing in toxicosis is to remain calm and optimistic. After all, toxicosis is just a small phenomenon of your pregnancy. It is worth learning to relax, this valuable quality will come in handy during childbirth.

In the first weeks of pregnancy, doctors recommend that you be patient and endure the manifestations of toxicosis. If the frequency of vomiting attacks interferes with normal life, the gynecologist prescribes soft herbal preparations aimed at reducing the intoxication of the pregnant woman's body, while in some way not affecting the fetus. One drawback: during the treatment, the woman feels normal, but after the end of taking the drugs, the manifestations of toxicosis return.

In the fight against toxicosis, homeopathy can also be used. It is aimed at activating the body's defenses and optimizing the work of all organs and systems of the body. To achieve a result, a small point effect is often enough, for example, swallowing a couple of homeopathic balls in the first weeks of pregnancy, as a result of which the body begins to work independently. That is why the course of treatment with homeopathic medicines, most often, is small. But supervision by a specialist should be carried out constantly.

Homeopathic treatment at the beginning of pregnancy in many women eliminates nausea before it ends, and in some women significantly reduces nausea and vomiting. It is worth noting that the treatment with homeopathic remedies in each case is different, depending on the nuances. For example, some women feel nausea in the morning, and only then vomiting occurs. There is a feeling of disgust for the perfume of one line, food smells. Other women also start the morning with nausea, but there are no bouts of vomiting, but there is a very demanding appetite. When, after a long choice of what they will eat, they eat a few spoonfuls and that's it, their appetite disappears. In the third women, the first days of pregnancy coincided with the occurrence of financial difficulties, as a result of which, against the background of growing anxiety and irritability, nausea becomes around the clock. As a result, all these women suffer from toxicosis of the first trimester, but the treatment with homeopathic remedies will be different.

Immunocytotherapy has proved to be an effective method in the fight against toxicosis during pregnancy, in which blood cells (lymphocytes) of her husband are injected into the skin of the forearm of a pregnant woman. Before such an event, a man must be examined for the presence of various infections: hepatitis B and C, HIV, Wasserman's reaction. After immunocytotherapy, the condition of the pregnant woman improves significantly in a day.

In extremely severe cases of toxicosis, the doctor may prescribe Essentiale forte, cerucal, glucose with vitamin C (dropper), Splenin (injections), Polyphepan.

  • It is useful in the morning on an empty stomach to drink a glass of water, this will reduce nausea and eliminate malaise. You can add a teaspoon of apple cider vinegar and a teaspoon of honey to the water.
  • You should not immediately get out of bed in the morning, try to eat some nuts or liver first, which are better prepared in advance in the evening by the bed.
  • Try to spend more time outdoors.
  • You can eat whatever you want, but the food should be easily digestible and highly fortified (cereals cooked in water without oil, fruits, bread).
  • It is necessary to limit the consumption of fried, salty, sweets, in particular chocolate, as well as hard-to-digest foods.
  • You should eat little, but often, every 2-3 hours.
  • Frequent snacks (nuts, dried fruits, mints, lemon, tangerines, caraway seeds) reduce nausea.
  • It is useful to eat foods rich in proteins (fish, beans, seeds, grains, nuts, meat, milk and dairy products).
  • Vitamin B6 reduces the manifestations of toxicosis, so eat more foods in which they are present in large quantities (skinless chicken, fish, nuts, eggs, legumes and avocados).
  • A good remedy for vomiting attacks is ginger and products with its addition. Ginger root can be added to tea.
  • During the first months of pregnancy, it is useful to eat more liquid and semi-liquid food in a warm (not hot!) form.
  • After a meal, you should lie down a bit.
  • Many pregnant women are helped to reduce the symptoms of toxicosis by special vitamins for pregnant women, which they drink before bed at night.
  • Eating should not be combined with the simultaneous intake of drinks.
  • Every day, alkaline mineral water should be present in the diet of a pregnant woman.
  • Excellent help in the fight against toxicosis infusions of calendula, valerian, yarrow and mint. In addition, they have a beneficial effect on the gastrointestinal tract and nervous system. Take two teaspoons of dry mint, a teaspoon of valerian root, two teaspoons of calendula flowers and yarrow herb, pour 400 ml of boiling water and insist for half an hour, then strain. It is necessary to take such an infusion 2-3 tablespoons six times a day for 25 days. The course of treatment is three sets of 25 days with a 15-day break between each.
  • When salivation is recommended to rinse your mouth with infusion of chamomile, sage, mint.
  • With toxicosis, it is important to drink plenty of fluids, but in small portions. It can be chamomile tea, cranberry juice, freshly squeezed apple juice, green tea with lemon, rosehip infusion.
As a rule, after the sixteenth week of pregnancy, the condition of the expectant mother returns to normal, the hormonal background stabilizes.

With not strong toxicosis, you can use folk remedies, but only after consulting a doctor.

Folk remedies to combat toxicosis during pregnancy.
According to traditional medicine, honey is considered a good remedy for nausea and vomiting. Due to the high content of vitamins, microelements, glucose, fructose in its composition, which are easily absorbed by the body, honey has a healing effect. To combat bouts of vomiting during early toxicosis during pregnancy, you need to take one tablespoon of honey on an empty stomach.

Pumpkin juice is also considered an excellent antiemetic. It is recommended to drink a decoction of pumpkin with the addition of lemon juice.

Charcoal is also a common folk remedy for toxicosis. Take activated charcoal one to two tablets half an hour before meals. However, it is worth noting that constipation or diarrhea may occur when using it. Since activated charcoal has the ability to absorb not only toxins, but also nutrients, its frequent use inevitably leads to a lack of vitamins, fats, and proteins.

From toxicosis, freshly squeezed citrus juice (orange, grapefruit) will help. Take 300-400 ml. These juices enhance the work of enzymatic systems that free the body from toxins. If nausea occurs, a pregnant woman can also eat a slice of another citrus fruit - lemon or drink tea with lemon.

Cranberry juice is also effective in combating bouts of vomiting and nausea. To prepare it, take 150 g of washed cranberries, mash and squeeze the juice. Pour the rest of the squeezed berries with hot water, put on fire and boil for 10-20 minutes from the moment of boiling. Strain the resulting broth, add 1000 g of sugar and cool. Add squeezed juice and lemon juice of one lemon to the drink. Drinking such a fruit drink should be in small and slow sips at the time of nausea attacks.

To cleanse the body of toxic substances, which, in fact, cause toxicosis, 0.5 g of vitamin C and rosehip infusion will help. A tablespoon of rose hips should be poured with half a liter of boiling water, put in a water bath and boiled for fifteen to twenty minutes in an enameled bowl under a lid. Then the resulting broth insist for an hour in a thermos. It should be consumed two or three times a day in the form of heat in half a glass with the addition of a teaspoon of honey after meals.

Aromatherapy is also an effective remedy for toxicosis. It is useful to inhale the essential oils of jasmine, anise, neroli, rose, lemon. The first aromatherapy procedure should be carried out no more than twenty minutes. Every day, the duration of the session should be increased by 20-30 minutes, gradually bringing the inhalation time to three hours.

Acupuncture can help fight discomfort in the first trimester of pregnancy. The effectiveness of this method is quite high, while this method does not harm the fetus. Acupuncture is also recommended as a preventive measure, as its sessions improve the elasticity of the cervix, resulting in a faster and less painful birth process.

Significantly facilitate the manifestations of toxicosis during pregnancy, taking infusions of diuretic herbs. The course of admission is two to three weeks. For example, pour two tablespoons of horsetail into a glass of boiling water, close the lid and wrap well. Insist in a warm place for about half an hour. The resulting infusion should be consumed 50 g three to four times a day. Or another recipe: one tablespoon of herbal collection of cornflower flowers, licorice root and bearberry leaves, taken in a ratio of 1:1:3. Pour a glass of boiling water, insist in a warm place for twenty minutes, strain. Take one tablespoon three to four times a day. According to this recipe, you can use other herbal preparations. For example: mix licorice root, juniper berries and bearberry leaves in a ratio of 1:1:2.

You can also prepare other charges. For example: a collection of bearberry leaves, horsetail and juniper fruits, taken in equal proportions, or a collection of horsetail, kidney tea and knotweed, also taken in the same proportion. To prepare the infusion, take a tablespoon of any of the proposed herbal mixtures and brew with a glass of boiling water. Insist in a thermos for five to six hours. Take the resulting infusion before meals, 1/3 cup 3 times a day.

If you have bouts of nausea in the morning, accompanied by a headache, this means that you have increased intracranial pressure against the background of early toxicosis. It is necessary to address to the neuropathologist and to make US of a brain - an echoencephalography. If the diagnosis is confirmed, the doctor prescribes light diuretics. And following folk medicine, in this case, before going to bed, you should drink half a glass of low-fat kefir and eat an apple, since they have the ability to remove excess fluid from body tissues.

Is it possible to prevent toxicosis during pregnancy?
If you will soon become a mother or are just planning this important moment, try to follow some medical recommendations. To begin with, all existing health problems should be eliminated. In this case, it would be better if for this you give preference not to medications, but to herbal medicine, homeopathic treatment, hirudotherapy. Alcohol, cigarettes, coffee, strong tea should also be excluded, although this is not easy. Also, try to eliminate foods such as soda, canned foods, spicy foods, spices, GMOs, and foods with artificial additives, flavors, and colors from your diet.

Every day, give the body physical activity, in particular, do gymnastics - this will improve the functioning of the cardiovascular system and have a stimulating effect on metabolism.

Be sure to follow the daily routine and, most importantly, get enough sleep. A woman in an interesting position needs 8-10 hours of full night sleep, as well as rest for half an hour - sixty minutes in the daytime.

To prevent the development of toxicosis even before pregnancy, which is very important, you should undergo a course of cleansing the body. Many experts insist on this aspect, as well as centers for preparing women for childbirth. Therefore, it is necessary to prepare for pregnancy in advance, providing for all the nuances.

The most important thing is not to despair and to wait patiently. After all, this suffering is short-lived. In addition, with the advent of the baby, you will instantly forget about the suffering suffered.

The waiting time for a baby is joyful, however, it does not always bring only positive emotions. Early toxicosis during pregnancy is observed in many women . It is manifested by bouts of nausea, in some cases vomiting and increased secretion of the salivary glands.

The most significant period of pregnancy is considered to be the first trimester. At this time, the embryo is strengthened in the uterus, it develops, and the internal organs of the baby are also formed. The well-being of the expectant mother depends on how long early toxicosis lasts, which is important for the intrauterine development of the child.

Most women are trying to discover the fact of conception in themselves on the basis of signs that accompany the period when early toxicosis begins. They believe that the development or absence of certain symptoms indicates the presence of pregnancy. However, not every expectant mother feels early toxicosis.

Doctors have established the following terms for this condition accompanying gestation:

  • initial signs occur in the first days after fertilization or at 5-6 weeks;
  • early toxicosis often ends by the end of the first trimester, when an important stage of laying all the organ systems of the unborn baby passes, but it can last up to 13-15 weeks, which depends on the individual characteristics of the course of pregnancy.

Causes of early toxicosis

Obstetrician-gynecologists do not have unequivocal explanations why some women develop toxicosis in the early stages. It can only be stated with accuracy that intoxication at the beginning of pregnancy indicates a pathological reaction of the mother's body to the developing embryo, which is perceived by the body as a foreign substance.

Scientists and doctors have formulated several theories that suggest possible causes of toxicosis:

  • Nervous reflex- the hypothesis says that an imbalance occurs between the nervous system and internal organs. In the subcortical structure, the olfactory and vomiting centers are located, which intensify their work to preserve the embryo. This is a subconscious reaction of the body, originating from ancient times.
  • immune- from the first days of intrauterine life, the child produces its own antibodies, which can be perceived by the protective systems of the pregnant woman as foreign.
  • Hormonal- a new organ develops in the female body - the placenta, which synthesizes hormones, including chorionic gonadotropin (CG) and placental lactogen (PL). The ongoing changes are not always positively perceived by the body, which is why various reactions occur.
  • Psychogenic- the assumption that initial toxicosis develops due to fear of future childbirth, worries about the health of the baby, or with a negative perception of pregnancy.

Some women from the first days after conception feel nausea, drowsiness and fatigue, while others do not feel worse. There are prerequisites that increase the likelihood of developing toxicosis.

Some of the risk factors include:

  1. Smoking.
  2. Insufficient amount of sleep.
  3. Fatigue.
  4. Inadequate diet.
  5. Alcohol consumption.

Signs by severity

Depending on the severity of the symptoms, early toxicosis of pregnant women is classified into several groups:

  1. First degree- rare vomiting that occurs after a morning meal, the frequency of which does not exceed five times a day. The loss of body weight is no more than 3 kg, the general well-being of the woman is not disturbed.
  2. Second degree- nausea occurs about ten times a day, while its occurrence is not associated with the use of food. Over a two-week period, a pregnant woman loses about 3-4 kg in weight. The woman points to a deterioration in well-being: arterial hypotension occurs, the pulse grows, fatigue appears.
  3. Third degree- Vomiting attacks are frequent and prolonged. They exhaust a woman, because she is sick up to 20-25 times within 24 hours. Weight loss reaches 10 or more kg due to loss of water, as well as the inability to eat. This negatively affects the health of the expectant mother. She may experience hyperthermia, an increase in heart rate, and inhibition of the reaction is observed.

From the moment of fertilization of the egg, the female body begins to respond to the changes that have occurred, changes the rhythm of work and tunes in to maintain a new life. Symptoms of early toxicosis worsen the woman's well-being, while she complains of weakness, drowsiness, nausea or vomiting, which can occur even from the look or memories of certain foods, she has no appetite, hypersalivation is observed. Sometimes the weight loss of a pregnant woman depends on how long early toxicosis lasts.

The most unpleasant manifestations of the body's reaction to bearing a child include vomiting, however, in addition to it, there are other symptoms:

  1. Dermatosis- a pregnant woman is worried about diffuse pruritus, sometimes even in the genital area. If it is detected, the possibility of the presence of diabetes, an allergic reaction, or should be excluded.
  2. Tetany and osteomalacia- muscle spasms and softening of the bones occurs due to a violation of calcium and magnesium metabolism. If you experience these symptoms, be sure to tell your obstetrician-gynecologist about them.
  3. Hypersalivation- increased secretion of saliva occurs due to changes in the secretion of glands. In especially severe cases, about one and a half liters are released. This symptom often accompanies vomiting.
  4. Bronchial asthma- appears extremely rarely, while the expectant mother experiences asthma attacks and a dry cough. A feature of the disease is that it was not there until the moment of pregnancy.

Diagnostics

Early toxicosis of pregnant women is easily determined based on the woman's complaints. But in severe cases, when there are serious changes in the functioning of internal organs, clinical research methods will be required.

Diagnosis and treatment of early toxicosis during pregnancy is carried out by the presence of symptoms such as nausea, regurgitation, increased salivation. But even when determining standard signs, it is necessary to perform additional medical tests that make it possible to exclude other diseases that have a similar clinical picture.

First of all, it is necessary to pass a general urine test for ketone bodies, as well as blood for biochemistry and its main indicators, after which, if deviations from the norm are found, additional diagnostics are prescribed.

What to do with early toxicosis?

When a woman is tormented by early toxicosis, then how to deal with this disease can only be determined empirically, because all expectant mothers are saved in various ways. The main manifestations of intoxication usually occur in the morning when blood sugar levels are low.

By following certain tips, you can choose your own method treatment of early toxicosis:

  • before getting out of bed, chew on a cracker or any dried fruit, which will help to cope with the feeling of nausea and increase the glucose content in the body;
  • ask loved ones to brew mint tea, which will soothe the receptors of the oral cavity and prevent vomiting;
  • in the evening, place slices of lemon or orange on the bedside table, because after chewing citrus fruits, you can overcome the developing feeling of nausea;
  • chew mint gum, this will increase saliva production and muffle unpleasant vomiting;
  • drink only those drinks that you enjoy: herbal infusions, juices, tea or just water;
  • eat a spoonful of honey as soon as you feel the first symptoms of toxicosis;
  • do not take a horizontal position immediately after eating - give the food time to digest;
  • eat often, but in small quantities, this will prevent distension of the stomach and eliminate the likelihood of overeating.

In what cases it is necessary to see a doctor?

When early toxicosis during pregnancy is manifested not only by digestive disorders or drowsiness, but more severe symptoms occur, you should immediately inform the doctor about this, because some signs indicate the development of a serious pathology or even.

Early toxicosis of pregnant women complicates its course, and when a sharp deterioration in well-being begins, while laboratory tests show a deviation from the norm, then in order to eliminate such manifestations, you will have to undergo inpatient treatment. The primary task of doctors is to replenish the electrolyte balance in the body, as well as restore protein and salts.

You should immediately visit a doctor when a pregnant woman:

  • severe vomiting, repeated many times during the day;
  • the amount of urine excreted is reduced, while its color and smell have changed;
  • concerned about pain in the abdomen;
  • any food eaten comes out with vomiting, and the woman cannot eat for half a day;
  • weight loss in 14 days is more than 3 kg.

Relief of a woman's condition is observed when early toxicosis passes, which usually happens at the end of the first trimester.

Prevention

In order to prevent early toxicosis of pregnant women and not to wonder how to deal with it in the future, it is necessary to monitor your nutrition and health from the first days of bearing a child.

It is a big misconception that the less there is, the less pronounced the symptoms of early toxicosis will be. It is in the first trimester that the developing fetus needs a full range of vitamins and minerals for the full formation of systems and organs. In addition, regular consumption of the same products can provoke an allergic reaction in mother and baby. Therefore, it is important to review your eating habits and create a balanced diet.

  1. Eliminate such food, the appearance and smell of which causes bouts of regurgitation. This most often includes meat and dairy products.
  2. Moderate consumption of salty foods in the early stages will make up for the loss of minerals due to increased excretion of fluid from the body, so pickles or fish in reasonable quantities will be beneficial.
  3. In the last trimester, on the contrary, it is not recommended to use salt because of the likelihood of developing