In this section you will learn:

• What is toxicosis
• Types of toxicosis of pregnancy
• Causes of toxicosis
• Symptoms of toxicosis
• Diagnostics
• Treatment of toxemia of pregnancy
• Possible consequences and prevention

Toxicosis is not just a habitual companion of pregnancy, but a common name for pathological conditions that negatively affect the course and outcome of pregnancy. nine0005

What is toxicosis

Toxicosis of pregnant women appears at the stage of gestation as a pathological condition of the body. This is a whole complex of gestational complications resulting from the formation of the fetal egg. Manifestations of toxicosis are a consequence of a violation of the body's adaptation to pregnancy.

Types of toxicosis of pregnant women

Each pregnant woman manifests toxicosis in her own way. Despite this, gynecology classifies toxicosis of pregnant women according to the period of occurrence as follows:

• Early

This form of gestational complications is characteristic of pregnancy up to 22-23 weeks and is the most common. Early toxicosis is characterized by nausea and vomiting of varying degrees, as well as ptyalism - increased salivation.

• Late

It is called preeclampsia. Preeclampsia begins development from 26–27 weeks and is manifested by dropsy of pregnant women, nephropathy, preeclampsia and eclampsia. Uncontrolled late toxicosis poses a serious danger to pregnancy and a woman's health. nine0005

• Rare forms

These are jaundice, dermatosis, tetany, osteomalacia and bronchial asthma - they can manifest themselves at any time during pregnancy, so there is no certain period of occurrence in rare types of toxicosis.

Early toxicosis: causes

The body reacts with early toxicosis to the formation of an embryo in the uterine cavity, and there are a lot of theoretical justifications for this process. Each theory has the right to exist and gives quite reasonable explanations for the appearance of toxicosis:

• Toxic

This theory explains the development of toxicosis of pregnant women with toxic substances that can be formed as a result of the vital activity of the fetus or metabolic disorders.

• Neuroreflex

The developing fetus serves as an irritant for the endometrium, which increases the sensitivity of the subcortical structures of the brain. The vomiting and olfactory centers, the zones of control of digestion, secretion and other functions of the body are located precisely in the subcortical regions, therefore they immediately respond to stimuli with known symptoms: nausea, vomiting, etc. By the third trimester, the body adapts to pregnancy, and toxicosis stops. nine0005

• Hormonal

This theory positions the main cause of toxicosis as a high level of hCG in the blood, which is caused by the development of the corpus luteum of pregnancy in the ovaries. And it is provoked by the growth of the chorionic villi due to the active reproduction of the hormone chorionic gonadotropin.

• Psychogenic

The theory is based on the fact that toxicosis of pregnancy occurs in women with mental disorders who cannot fully control their emotions. As a rule, these are very sensitive and vulnerable women; under the pressure of stress and experiences, they develop toxicosis. nine0005

• Immunological

This theory considers the embryo as a foreign body, which differs in type of antigens from the body of a pregnant woman. As a result, the active production of antibodies that cause toxicosis begins.

The above theories complement each other and can be used in combination to determine the causes of toxicosis. Also, medical statistics reveals the following reasons for the complex course of toxicosis of pregnant women:

• burdened somatics;
• psychological trauma;
• overwork;
• malnutrition;
• bad habits;
• past abortions and inflammation of the reproductive organs;
• problems of the digestive system.

With the above factors, the violation of the body's adaptation is observed long before pregnancy, and with its onset it intensifies.

Symptoms of early toxicosis

Toxicosis is detected in more than half of pregnant women and more often manifests itself at 5-6 weeks. Medicine distinguishes between mild, moderate and excessive toxicosis. Signs are very diverse and appear in different combinations:

• Nausea and vomiting

The intensity of these symptoms becomes the main parameter for differentiating toxicosis. With a neurotic mild stage, vomiting is possible up to five times a day. In the moderate stage, it occurs up to ten times a day, while in the severe excessive stage, which is called dystrophic, vomiting is indomitable and can be repeated more than twenty times a day. If food and liquids are not retained in the body for the necessary time for digestion, nausea and vomiting can cause problems with pregnancy and exhaustion of the body. nine0005

• Increased salivation

It is both an independent manifestation of toxicosis and a companion of vomiting. In itself, increased salivation is fraught with the loss of up to 1 liter of water per day by the body, so it must be controlled with the help of the right treatment.

• Change in taste and smell, loss of appetite

A certain degree of change in taste and smell is observed with each form of toxicosis, including intolerance to certain smells and foods. Loss of appetite is typical only for serious types of toxicosis. With moderate toxicosis, food and liquids are retained in a small amount in the stomach, excessive toxicosis makes digestion almost impossible. nine0005

• Lethargy, drowsiness

These signs are observed in varying degrees in moderate and severe forms. Deterioration of general well-being and sleep disorders are characteristic symptoms for these types of toxicosis of pregnant women and become the cause of an apathetic state.

• Weight loss

With mild toxicosis, weight loss is up to 2 kg per week, which does not cause significant damage to health. With a moderate form of toxicosis, weight loss is from 3 to 5 kg. Severe toxicosis provokes a rapid loss of body weight, 7–15 kg per week, and becomes a threat not only to pregnancy, but also to the health of a woman. nine0005

• Hypotension, tachycardia

Also characteristic to varying degrees of all types of toxicosis. With a mild degree of toxicosis, hypotension is insignificant (100–100/60 mm Hg), and tachycardia does not exceed 90 bpm. With moderate toxicosis, these figures are 100–90/60–50 mm Hg. and tachycardia 90–100 bpm. In severe toxicosis, instead of tachycardia, arrhythmia is observed, and the level of blood pressure reaches 80/40 mm Hg.

• Failed tests

Blood and urine parameters with mild toxicosis remain normal. With moderate toxicosis, acetone is found in the urine. Excessive toxicosis differs from others in extensive deviations in the composition of urine, as well as a high concentration of bilirubin, urea, and creatinine in the blood.

• Dehydration

It develops against the background of excessive toxicosis due to a large loss of body fluid. Dehydration manifests itself as yellowness and dryness of the skin in combination with a decrease in tissue turgor. There are hemorrhages in the conjunctiva and petichia on the skin. Blood clotting is impaired. nine0005

• Dermatoses

They are a rare manifestation of early toxicosis and provoke pruritus, which can be localized in the genital area or spread to the whole body. Usually, the symptoms are limited to this, but it is possible to develop dermatosis in the form of eczema, herpes, herpetiform impetigo. Dermatoses cause insomnia and irritability, as their manifestations are aggravated at night. To confirm dermatosis, it is necessary to exclude diseases with similar symptoms - for example, diabetes mellitus, trichomoniasis, helminths, allergic reactions. nine0005

• Tetanya

This unusual type of early toxicosis is also rare and has no restrictions on the duration of pregnancy. Occurs in the presence of hypoparathyroidism and disorders of calcium metabolism. Tetany makes itself felt with muscle cramps.

Diagnosis

The clinical picture of early toxicosis is compiled in accordance with the patient's complaints and the results of studies that are used in the complex:

• Medical examination

This is the first thing you need to diagnose toxicosis and differentiate its form. An examination on the chair confirms the presence of a fetus in the uterus and indicates to the doctor the direction for further examination.

• Ultrasound

Ultrasound determines the gestational age and the degree of development of the fetus in accordance with it.

• Tests

This is a general blood test, as well as its biochemical studies, which allow to determine the level of total protein, liver enzymes, fibrinogen, electrolytes and CBS. A general urine test is also required. nine0005

• Body measurements

A pregnant woman is able to independently assess the frequency of vomiting and calculate the total diuresis - this will help the doctor to differentiate toxicosis. Measurements of blood pressure and pulse rate, ECG are shown.

All these diagnostic methods allow you to get a complete clinical picture of toxicosis of pregnant women and choose the right treatment.

Treatment of toxicosis of pregnancy

Treatment is prescribed by a doctor and requires strict adherence to his instructions. The approach to treatment is multilateral and depends on the form of pathology:

• Light

It is sufficient to observe this form of pathology on an outpatient basis. A pregnant woman with a mild form of toxicosis is treated in such a way as to ensure that the situation remains under control and improves. To do this, it is enough to provide the pregnant woman with physical and psychological comfort, if necessary, the doctor will prescribe sedatives for this - for example, valerian or motherwort. Antiemetics and fractional meals with easily digestible food will help to avoid the urge to vomit. Take it in small portions and often. Tanning herbal solutions of chamomile, sage and mint help reduce salivation. nine0005

• Moderate

Moderate toxicosis requires hospital conditions, where a pregnant woman is shown parenteral administration of saline solutions, proteins, glucose and other nutrients that the body lacks. To reduce vomiting, antipsychotics are prescribed - for example, droperidol. The positive effect of physiotherapy has been proven. Acupuncture, aromatherapy, herbal medicine, electrosleep, galvanization, endonasal electrophoresis show high efficiency.

• Expressed

Excessive toxicosis requires serious intensive care. Treatment methods are reduced to the introduction of the necessary nutrients into the body of a pregnant woman with the help of enemas and infusions. Drug therapy is used: predominantly antiemetic and neuroleptic drugs are administered. A severe form requires close attention to the condition of the pregnant woman, since untimely or incorrectly chosen treatment threatens to end in coma and even death. In severe cases, a woman may be advised to terminate the pregnancy to save her life. nine0005

Consequences and prevention

Most often, the end of early toxicosis occurs at 12-13 weeks of pregnancy, and the well-being of a pregnant woman improves. But with toxicosis, there is a high risk of developing the following pathologies:

• dehydration: dehydration of the body;
• multiple organ failure: impaired functioning of the heart, liver, kidneys;
• yellow atrophy of the liver: this is a deadly consequence of toxicosis;
• spontaneous abortion. nine0008

If toxicosis is observed for too long, it will be necessary to exclude a number of pathologies: pancreatitis and hepatitis. The cause of prolonged toxicosis is often obstetric pathologies - for example, cystic drift or hepatosis.

Prevention of toxicosis should be carried out well before pregnancy. Women who do not have abortions and lead a healthy lifestyle minimize the risk of developing toxicosis of any severity, up to its complete absence. It is also necessary to take a responsible attitude to the upcoming pregnancy: when planning it, it is necessary to identify and cure diseases that provoke toxicosis. nine0005

Toxicosis during pregnancy at different periods

Valentina

Almetyevsk

Toxicosis is a painful condition that develops during pregnancy. Toxicosis is early (usually occurs in the first trimester) and late (appears in the second or third trimester). In severe cases, toxicosis can pose a danger to the mother and child.

Toxicosis during early pregnancy: symptoms

• Heightened sense of smell. Tobacco smoke, cosmetics, the scent of flowers, or any other odor is irritating. nine0008
• Changing gastronomic tastes. "Classics of the genre" - pickles, herring, oranges. By the way, contrary to the existing misconception, the gender of the unborn child does not affect the food preferences of a woman. Toxicosis during pregnancy as a girl is no different from toxicosis during pregnancy as a boy. A woman's eating habits depend on the needs of the body.
• Nausea, vomiting, salivation. Usually these symptoms make themselves felt in the morning hours, but sometimes they haunt a woman around the clock. nine0006
• A mild form of toxicosis is accompanied by vomiting no more than 5 times a day and does not require the intervention of specialists.
• The average form of toxicosis is characterized by vomiting up to 10 times a day, and it is a reason for mandatory consultation with a doctor.
• Severe toxicosis during pregnancy occurs in 1 out of 500 cases. If a woman vomits more than 10 times a day, suffers from salivation, she needs urgent hospitalization.
• Deficiency of fluid and nutrients can lead to dehydration and metabolic disorders, as a result of which toxins will only accumulate. The expectant mother is waiting for great weight loss and exhaustion. During severe toxicosis, there is a risk of tachycardia, toxic liver dystrophy, arterial hypotension. nine0008

Toxicosis during early pregnancy: causes

There are many hypotheses explaining the causes of early toxicosis. The most famous among them:

1. Immunological theory. A cell, consisting of foreign genes and proteins, is perceived by the body as a foreign body that needs to be disposed of.
2. Hormonal theory. Already on the 6th - 8th day after fertilization, the embryo actively produces the pregnancy hormone - human chorionic gonadotropin (hCG). Its concentration is growing rapidly, but by the 12th week it begins to fall, then toxicosis usually disappears. One of the arguments in favor of this theory is the coincidence of peak hCG values ​​with the onset of vomiting. nine0008
3. Toxic theory. The development of the fetal egg is accompanied by the formation of toxins that poison the mother's body.
4. Neuro-reflex theory. The fetal egg irritates the nerve receptors of the uterus and provokes disturbances in the interaction of the central nervous system, the autonomic nervous system and internal organs. A failure occurs in the work of the subcortical nuclei of the central nervous system, which leads to the appearance of zones of pathological excitation at the most vulnerable points - in the vomiting center and the center of salivation. nine0008
5. Psychogenic theory. Toxicosis develops against the background of experiences associated with pregnancy.

All these hypotheses complement each other, but the most convincing, according to experts, is the neuro-reflex theory.

Factors contributing to the development of toxicosis

In most women, toxicosis lasts from 6 to 12-13 weeks. But this is not an axiom. Someone has a pregnancy without toxicosis, and someone is sick all 9 months. It is very difficult to predict the reaction of the body. However, factors are known that increase the risk of development and severity of toxicosis during pregnancy. Among them: nine0005

• multiple pregnancy,
• heredity,
• too young or, on the contrary, mature age,
• underweight,
• chronic diseases of the gastrointestinal tract and liver,
• termination of pregnancy,
• malnutrition,
• bad habits,
• stress.

Early toxicosis: what to do?

There is no universal remedy for toxicosis: everything is very individual. However, in any case, in order to alleviate the symptoms of malaise, it is necessary to reconsider the usual lifestyle and diet. nine0005

• Get more rest. Sleep at least 8 hours a day and walk outdoors for at least 1.5 hours.
• Eat small meals 6 to 7 times a day.
• Eliminate hot, spicy and fatty foods from your diet.
• Introduce foods rich in pyridoxine (vitamin B6) into your diet. Its lack can exacerbate toxicosis during pregnancy. There is not so much vitamin B6 in animal food, so focus on plant products: rice, barley and buckwheat, millet, beans, soy. nine0008
• Include foods rich in complex carbohydrates in the evening menu. Cereals, potatoes, pasta made from durum wheat will help maintain a stable level of glucose in the blood and avoid its sharp drop in the morning.
• Before going to bed, leave a glass of water, a lemon, some biscuits or crackers on your bedside table. After waking up, without getting up, add lemon to the water, drink it and eat cookies or crackers.
• Stay in bed after breakfast. Lie down for a bit and only then slowly get up. nine0008
• If gagging occurs while brushing teeth, change toothpaste or limit mouthwash.
• Consult your doctor about herbal teas. Chamomile, calendula, lemon balm and valerian can alleviate your condition.
• Ask your doctor about taking ginger. In American literature, it is known as one of the most effective remedies for toxicosis.

Toxicosis in late pregnancy: causes

Late toxicosis during pregnancy is better known as "preeclampsia". This is a serious complication, which is accompanied by disruption of the functioning of vital organs. Most often, toxicosis in late pregnancy occurs in women younger than 19 and older than 30. Risk factors:

• multiple pregnancy,
• early toxicosis,
• fetal malnutrition,
• Rhesus conflict,
• heredity,
nine0007 anemia,
• obesity,
• hypertension,
• kidney disease,
• endocrine diseases,
• malnutrition,
• preeclampsia during previous pregnancies.

The cause of late toxicosis is a violation of blood microcirculation and water-salt metabolism. Spasm of small vessels provokes a decrease in blood flow velocity and the formation of blood clots. The volume of circulating blood decreases, and the permeability of the walls of blood vessels increases. As a result, blood circulation is disturbed, and tissue nutrition deteriorates. Changes occur in organs that can lead to necrosis (death of cells and tissues). nine0005

Toxicosis in late pregnancy: stages and symptoms

There are 4 stages of late toxicosis: dropsy, nephropathy, preeclampsia and eclampsia.

• dropsy. This is the mildest form of gestosis. It is characterized by a sharp increase in weight and swelling.
• Nephropathy. In addition to edema, other symptoms of late toxicosis appear: protein in the urine and high blood pressure. Its sudden changes are especially dangerous for the fetus. Possible premature detachment of the placenta, bleeding, premature birth. nine0008
• Preeclampsia. The woman's condition is deteriorating. Against the background of high pressure, headaches occur, rippling in the eyes, nausea, vomiting, sometimes drowsiness, lethargy, forgetfulness.

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