Gestosis during pregnancy
Sometimes during pregnancy there are various pathologies. One of the most common is gestosis. We understand what this complication is and how serious it can be

Preeclampsia is a serious complication of predominantly late pregnancy, childbirth or the postpartum period. Pathology is a violation of the vital organs of a woman: a spasm of blood vessels appears in all tissues, the nervous system, kidneys, heart, and liver are affected. In addition, the poor condition of the mother’s body negatively affects the fetus.

According to statistics, in Our Country, the incidence of preeclampsia in pregnant women ranges from 7% to 20%, and in the structure of causes of maternal death, this pathology ranks third (13%). Without timely measures, a complication can lead to irreversible consequences, and sometimes even lead to the death of the child and mother. However, thanks to modern diagnostic methods, today pathology can be successfully predicted and promptly prevented. Together with obstetrician-gynecologist Irina Shiryaeva, we find out what symptoms you need to pay attention to during pregnancy in order to seek help from a doctor in time. (one)

Symptoms of preeclampsia

The main clinically diagnosed sign of preeclampsia in pregnant women is considered to be an increase in blood pressure by more than 140/90 mm Hg, regardless of the indicators before pregnancy, in combination with the appearance of protein in the urine of more than 0,3 grams per day. In most cases, the pathology occurs after 34 weeks during the first pregnancy. But with severe complications, preeclampsia can occur after the 20th week or at the end of the second trimester.

There are 4 main stages of the disease, which are classified according to severity depending on the symptoms: dropsy, nephropathy, preeclampsia, eclampsia. In most cases, at an early stage, preeclampsia can be seen by such basic symptoms as edema, the appearance of protein in the urine, and an increase in blood pressure. (2)

1. Edema

The first stage of gestosis (dropsy) often remains undiagnosed due to the fact that it is characterized only by the appearance of edema. The occurrence of edema is the very first and main symptom of preeclampsia. They can be seen by a slight numbness in the fingers and difficulty in putting on the rings. First of all, the feet begin to swell, then the swelling spreads upwards, to the shins, abdomen, neck and face. Edema can be hidden, for example, when the abdominal wall swells. Puffiness can also be detected by weighing. It will be noticeable with a pathological weight gain of more than 350 grams per week. Therefore, all pregnant women are weighed during each visit to the antenatal clinic.

2. Proteinuria

The second stage of preeclampsia (nephropathy) is characterized by proteinuria – the appearance of protein in the urine. At this stage, kidney damage occurs, so if the patient is not treated, complications may appear. With normative indicators of protein in the urine of a pregnant woman should not be. The appearance of protein in the urine of more than 0,3 grams per day is considered a pathology. To determine this symptom, at each visit to the antenatal clinic, pregnant women give a general urine test. However, if the urine has become cloudy, has acquired a dark shade or is covered with foam, it is worth taking tests without waiting for an appointment with a doctor.

3. Increased blood pressure

The third stage of preeclampsia (preeclampsia) is characterized by an increase in blood pressure and the occurrence of corresponding symptoms: headache, nausea, a feeling of heaviness in the back of the head, flashing flies before the eyes, impaired vision and memory. Also at this stage, you can notice increased irritability, insomnia, lethargy, cramps in the abdomen and in the right hypochondrium. An increase in blood pressure to a level of 140/90 mmHg is already considered abnormal. Usually, more attention is paid to diastolic pressure, that is, at the moment of contraction of the heart, since it indicates vasospasm. When studying the work of the body of a pregnant woman, it is important to take into account not only an increase in the level of pressure, but also its sudden drops, which can lead to placental abruption and the death of a child or the occurrence of bleeding.

4. Convulsions

The fourth stage of preeclampsia (eclampsia) is the most dangerous. At this stage of the disease, convulsions appear in a pregnant woman, placental abruption, heart attack and other serious complications can occur. Seizures can be triggered by various factors: harsh sounds, bright lights, stress, or pain. The duration of the attack takes an average of one to two minutes. Seizures can be either tonic with pulling sensations or clonic with small muscle twitching. Usually the attack of a spasm comes to an end with a loss of consciousness.

Treatment of preeclampsia

If the first symptoms occur, you should immediately consult a doctor. Self-medication in this matter can lead to high health risks for both the mother and the child and lead to irreversible consequences. A pregnant woman is assigned certain additional examinations:

  • general blood analysis,
  • general urine analysis,
  • McLure-Aldrich test,
  • ECG,
  • Doppler examination of the fetus
  • Ultrasound of the kidneys.

The results of the tests will help to make the correct diagnosis. Quite often, the mother has a decrease in the number of platelets, a violation of the uteroplacental blood flow and a decrease in the concentration of anticoagulants.

According to the results of the diagnostic examination, a conclusion is formed about the state of health of the pregnant woman. If preeclampsia is diagnosed, certain medications are prescribed, including sedatives and antihypertensives, anticoagulants, and antioxidants. Intravenous infusions can be given to replenish the amount of circulating blood. Most pregnant women with gestosis acquire disorders in the hemostasis system, therefore, with the development of the disease, it is important to involve a hemostasiologist. If the treatment does not lead to the desired results, then they resort to delivery by caesarean section.

Treatment of more severe stages of preeclampsia is carried out in a hospital. The main goals of treatment are to reduce blood pressure, improve microcirculation and prevent seizures. In the treatment, infusion therapy is used, based on the introduction of medicinal solutions into the bloodstream (depending on the severity of the course of the disease, from 400 ml to 2500 ml of a crystalloid solution per day). And with eclampsia, antihypertensive and anticonvulsant therapy is prescribed.

Consequences of preeclampsia

The last stage of preeclampsia or eclampsia can lead to serious complications for the mother:

  • intracerebral hemorrhage;
  • pulmonary edema;
  • heart failure;
  • acute renal insufficiency;
  • premature placental abruption;
  • hemorrhagic shock;
  • disseminated intravascular coagulation syndrome;
  • retinal detachment and loss of vision;
  • cerebral coma after convulsions.

The gestosis transferred by the mother in the last stage can also leave serious consequences for the development of the child:

  • developmental delay syndrome;
  • intrauterine oxygen deficiency (hypoxia);
  • antenatal death.

Do not forget that all people are different and the course of the disease may differ somewhat, as well as the consequences of the pathology. Nevertheless, it is possible to avoid the occurrence of the above problems by undergoing a constant examination by an experienced doctor and being observed in the antenatal clinic.

Prevention of gestosis

Prevention of preeclampsia can be taken even when planning pregnancy. Particular attention to the methods of prevention of pathology should be paid to women who are in high-risk groups. There are certain groups of women who have some predisposition to the occurrence of preeclampsia:

  • age under 18 and over 30;
  • diabetes;
  • multiple pregnancies;
  • previously transferred gestosis;
  • extragenital diseases;
  • the presence of obesity.

It is unlikely that gestosis will occur during the second pregnancy if it was not present in the first pregnancy. Nevertheless, despite the fact that scientists have not yet determined the causes of preeclampsia, this issue should be given more attention in order to protect yourself and your child.

Before pregnancy, it is recommended to undergo a complete examination in order to understand the degree of readiness of the woman’s body. The most common and effective method of preventing preeclampsia is considered to be taking a balanced multivitamin complex, which contains vitamins A, C, B and E, group B, magnesium, folic acid and progesterone, starting from the stage of pregnancy planning.

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It is necessary to prepare for conception systematically, to eliminate stress and bad habits. In order to prevent the occurrence of preeclampsia, it is periodically necessary to conduct a comprehensive examination and regularly attend doctor’s consultations to predict the disease, determine the pathology and (if necessary) carry out treatment. During pregnancy, the following preventive measures should be followed:

  • sufficient night sleep (8-10 hours a day);
  • daytime rest one to two hours;
  • decrease in the level of physical activity;
  • drinking regimen (at least one and a half liters of water per day);
  • exclusion of stressful situations;
  • healthy eating (eliminating fatty, smoked and fried foods from the diet, reducing the amount of salt);
  • positive psycho-emotional background. (3)

Also of no small importance are walks in the fresh air at least twice a day, physiotherapy exercises for pregnant women, swimming, yoga, breathing exercises and massage of the cervical-collar zone and head. All this allows you to stabilize the processes of inhibition and excitation in the centers of the brain and increase the level of blood oxygen saturation.

Popular questions and answers

To finally understand the features of the occurrence and course of gestosis, obstetrician-gynecologist Irina Shiryaeva answered the most frequently asked questions about the dangerous complication.

How is gestosis different from toxicosis?

Previously, preeclampsia was often called late toxicosis, but now this name is considered outdated and incorrect. There is no connection between preeclampsia and toxicosis. Unlike preeclampsia, toxicosis is detected at an early stage of pregnancy and does not require treatment, as it is a variant of the norm.

Why does gestosis occur?

The reasons for the development of preeclampsia are still not entirely clear. There is a theory about the so-called “incomplete invasion of the trophoblast”, which occurs at the initial stages of the formation of the placenta during pregnancy, which subsequently triggers an increase in pressure, that is, the process of development of preeclampsia. At the same time, genetic predisposition and immunological intolerance between mother and child are considered to be the most likely causes.

What are the first signs of gestosis?

As the first facts by which it is possible to determine the presence of a complication in order to consult a doctor, the following can be distinguished: persistent asymmetry of blood pressure on the hands, pulse pressure, an increase in blood pressure by a value of 140/90 mm Hg, a decrease in the amount of urine per day up to 900 ml, excessive weight gain in the second half of pregnancy.

Sources of

  1. Gridchik A. L. Maternal mortality in the context of the reorganization of health care in the Moscow region (state, trends, prevention): Abstract of the thesis. dis. Dr. med. Sciences. M. – 2002. – 36 p.
  2. Kostenko I.V., Olenko E.S., Rogozhina I.E., Kodochigova A.I., Subbotina V.G. The possibility of developing preeclampsia in the second half of pregnancy in clinically healthy women // International Journal of Applied and Fundamental Research. – 2013. – No. 8-3. – S. 105-105.
  3. Egorenko A.A. Psychoemotional state of women with preeclampsia // FORCIPE. – 2020. – №S. – URL: https://cyberleninka.ru/article/n/psihoemotsionalnoe-sostoyanie-zhenschin-s-gestozom-beremennosti

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