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What is preeclampsia in pregnancy
Preeclampsia is a pathology of pregnancy that occurs most often in the third trimester of pregnancy, but can also appear after 16-20 weeks. Without medical attention, preeclampsia can threaten the life and health of both the expectant mother and the fetus, as well as lead to premature birth. Most often, preeclampsia manifests itself in the form of a sharp increase in blood pressure, increased protein in the urine and edema. The work of many organs and systems in a pregnant woman is disrupted, which affects the prenatal state of the baby.
Doctors distinguish three degrees of preeclampsia in pregnant women.
Easy form characterized by high blood pressure (up to 150/90 mm Hg), swelling of the legs, and the level of protein in the urine does not exceed 1 g/l.
RџSЂRё medium pressure rises to 170/110 mm Hg. Art., and the level of protein in the urine – up to 5 g / l. The level of blood creatinine also rises significantly (up to 100 – 300 µmol / l), which indicates a violation of the kidneys. Not only the legs are swollen, but also the stomach and arms.
RџSЂRё severe the pressure is very high (above 170/110 mm Hg), and the protein in the urine is above 5 g / l, the creatinine in the blood is more than 300 μmol / l. A pregnant woman complains of a severe headache, abdominal pain, visual impairment (blurring, fuzzy picture), almost the entire body swells, even the face and nasal mucosa.
Causes of Preeclampsia in Pregnancy
Doctors have not yet come to a consensus on what is the cause of preeclampsia – both genetic, endocrine, and neurological factors are called. Most experts believe that the pathology is directly related to the violation of the attachment of the developing placenta to the uterus, due to which the fetus may experience hypoxia (oxygen starvation). At the same time, special substances are released into the maternal circulatory system that damage the walls of blood vessels (become permeable). There is a spasm of blood vessels, increased viscosity and blood clotting. Gradually, damage to the internal organs of a pregnant woman begins, which can lead to multiple organ failure. Often, the only option to save the lives of the mother and child is childbirth, but in the early stages, the baby may simply not survive.
The main risk factors for developing preeclampsia include:
- arterial hypertension;
- kidney disease (nephritis, glomerulonephritis);
- problems with the endocrine system: obesity, diabetes, thyroid disease;
- autoimmune diseases (eg, systemic lupus erythematosus);
- first birth;
- multiple pregnancies;
- pregnancy in girls under 18;
- age over 35-40 years;
- chronic infections;
- proliferation of placental tissues;
- unfavorable living conditions.
Symptoms of Preeclampsia in Pregnancy
Sometimes preeclampsia can “hide” and not manifest itself in any way. The patient may feel well, however, according to the results of the tests, the doctor will see the developing pathology. And sometimes preeclampsia can develop instantly – a pregnant woman complains of a severe headache, nausea and vomiting, drowsiness, lethargy. But very soon, preeclampsia can develop into eclampsia, and this is already a life-threatening condition!
The main symptoms of preeclampsia are:
- high blood pressure (from 140/90 mm Hg);
- proteinuria (protein in the urine more than 0,3 g / l in a daily sample);
- edema.
Associated signs:
- Strong headache;
- impaired vision;
- noise in ears;
- abdominal pain.
– Preeclampsia is a multisystem pathological condition that occurs in the second half of pregnancy (after 20 weeks), manifested by arterial hypertension in combination with significant proteinuria – the presence of protein in the urine, as well as multiple organ dysfunction. Often, preeclampsia is accompanied by edema. But just the presence of edema does not mean that preeclampsia develops, but high blood pressure and protein in the urine are mandatory symptoms, notes obstetrician-gynecologist of the highest qualification category Natalya Belyaeva.
Treatment of preeclampsia in pregnancy
Preeclampsia always requires urgent medical attention, so it is very important for a pregnant woman to be attentive to her condition, not to ignore alarming symptoms, and in no case self-medicate.
Diagnostics
At the appointment, the doctor will first listen to complaints – when the pregnant woman first felt unwell, whether the pressure had risen before and to what numbers, whether swelling appeared, what weight gain, and also collect an anamnesis if the patient came to him for the first time for an appointment. Usually, a complete history, including information about chronic diseases, past infections, the number of births, etc., is collected when the pregnant woman is registered with the antenatal clinic. Also, the doctor will definitely measure blood pressure (if it is higher than 160 per 100, an ambulance is called).
Before each appointment, a pregnant woman should pass a general urine test, which determines the level of sugar, white blood cells and protein in the urine. Protein in the urine is one of the main symptoms of preeclampsia. Elevated sugar can be a symptom of diabetes, and the presence of white blood cells in the urine indicates an infection in the kidneys, which increases the risk of developing preeclampsia. If necessary, the doctor prescribes a daily urine test, which will determine the amount of protein (the higher the protein level, the higher the risk of complications). A general and biochemical blood test, a coagulogram (blood clotting test) and ultrasound of the fetus and internal organs are also prescribed.
Modern treatments
Preeclampsia is usually treated in an inpatient setting. With a mild form, a woman is prepared for planned hospitalization. If there is a threat to the life of the mother and child, emergency hospitalization is carried out. In the later stages and with a severe degree of preeclampsia, the issue of early birth can be decided (to avoid eclampsia, a severe pathology that affects the entire nervous system and can result in the death of a woman and fetus).
A pregnant woman must be prescribed bed rest, a diet with salt and fluid restriction, in order to relieve the load on the kidneys. Antihypertensive drugs are prescribed to lower blood pressure. Medical support is provided for the work of the heart, lungs, liver and kidneys, as well as to improve uteroplacental blood flow in order to avoid hypoxia in the child.
Prevention of preeclampsia in pregnancy at home
The development of preeclampsia is sometimes impossible to predict, so it is very important for a pregnant woman to be attentive to her health. It is necessary to visit a gynecologist on time, take all the tests, undergo examinations, screenings, follow all the recommendations of the attending physician and immediately inform him if you feel alarming symptoms: swelling, headache, high blood pressure.
At home, a pregnant woman can also follow a few simple rules: you need to monitor weight gain, limit the consumption of sweets and pastries, include as many fresh vegetables, fruits, protein foods as possible in the diet. Very useful walks in the fresh air. You also need to limit yourself as much as possible from stress and worries.