December 8, 2011
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Preeclampsia - A condition that is specific for pregnant women. This complication pregnancy disrupts a number of systems and organs in the body of a pregnant woman. This condition disappears a few days after birth. According to research by experts, preeclampsia in varying degrees, typical for one-third of pregnant women. The disease often manifests itself between the sixteenth and twentieth week of pregnancy, but the most characteristic for the occurrence of preeclampsia is the third trimester of pregnancy. Reason manifestations of this disease - the characteristic changes in the body of the future mother, because of which the placenta is formed substances that are doing a mikrosokopicheskie holes in the vessels. It is through these holes in the fabric of the blood protein gets plasma As well as liquid. This promotes the formation of edema . At the beginning of swelling disease can not yet be seen, however, when weighing has been a significant increase in weight.
Similar mikrootvetrstiya formed vessels in the kidneys, the protein falls therethrough into the urine. Urinalysis that a pregnant woman should be held regularly, facilitates the diagnosis and makes it possible to treat preeclampsia start immediately after the onset of the disease.
Types of preeclampsia
To distinguish several kinds of gestosis. Preeclampsia early Arising in the first half of pregnancy, manifested by nausea, vomiting, often indomitable. A woman is strong and salivation. Preeclampsia later It manifested in late pregnancy (third trimester). For this condition characterized by symptoms nephropathy . dropsy . preeclampsia . eclampsia . Diagnosed as a rare form of preeclampsia that occur liver disease . skin . Nervous System et al. also decided to allocate "Clean" gestosis That occur in healthy pregnant women in the absence of background illness. "Combined" gestosis It occurs as a result of the disease, which was preceded by the disease. This can be hypertension . endocrinopathy . kidney disease .
Causes of preeclampsia
To date, there is no single precise opinion about the origin of gestosis. However, there are a number of theories that suggest a certain etiology of preeclampsia. Thus, according to cortico-visceral theory preeclampsia pregnancy is represented as a specific neurosis pregnant women, which is characterized by a violation of the interaction between the cortex and subcortical structures. As a result, there hemodynamic reflex changes. This theory is supported by quite frequent manifestation of gestosis as a consequence of nervous stress.
According to immunological theory preeclampsia occurs due to changes in the mechanisms that are responsible for ensuring trasplatsentarnogo immunity in the body. By genetic theory To have a predisposition to gestosis those women whose mothers observed preeclampsia.
Another theory suggests the relationship of preeclampsia and deficiency in women B vitamins and folic acid . It was in the third trimeste beremennoti body requires much more of said vitamins. If they lack the body is the concentration Homocysteine in the blood becomes higher. Homocysteine - the substance is very toxic to the endothelium. Under the action of this substance in the blood vessels appear pores through which the plasma passes into the tissue. Consequence - swelling, increased pressure in the blood vessels and decrease diuresis .
According to placental theory in patients with preeclampsia, impaired trophoblast migration, so that there is spasm . reduction of intervillous blood flow . hypoxia I . Further, as a result of hypoxia endothelium is affected, there are disorders in hemodynamics, hormonal background, metabolism .
Symptoms of preeclampsia
When preeclampsia changes occur in many organs: impaired functioning of the kidneys and liver, placenta and nervous system. It may be hypoxia chronic nature, fetal growth retardation a .
In early preeclampsia ( toxemia ) Pregnant usually occurs vomiting which may occur many times a day. There is a constant nausea, decreased appetite, desire to eat spicy and salty foods. Constant vomiting does not affect much on the weight of the pregnant: he does not drop significantly. The temperature remains normal. The rest of the described symptoms are characteristic only for the first few months of pregnancy, and later they disappear on their own. In more rare cases, vomiting in women does not stop, and later, at the same time it becomes invincible. In this state vomiting may occur to twenty times a day and it occurs at any time. The patient rapidly loses weight, it produced aversion to food. The pulse becomes more frequent, lowers blood pressure. This analysis indicates the presence in urine acetone and squirrel . In particularly severe cases, it can increase the body temperature, manifest arrhythmia and the state of delirium.
Late gestosis the disease develops gradually. First there dropsy Eventually transient in nephropathy , Later - preeclampsia and eclampsia . In the event of dropsy in pregnant women appear swelling due to constant delays in the body fluid. During this period may appear as the hidden and apparent swelling. Because of the lower urinary excretion from the body weight of pregnant increases very quickly, more intensively urination at night. Swelling, as a rule, initially appearing in the ankles, then they begin to spread up. Sometimes women are observed simultaneous facial swelling. At the end of the day look more swollen legs, abdomen.
When nephropathy in the presence of a woman in three main symptoms of preeclampsia: severe swelling, presence of protein in the urine, occasionally exhibit high blood pressure. There may be a combination of any two symptoms. Nephropathy is shown against a background of dropsy. When this condition is particularly dangerous is the high rate diastolic pressure, which affects the decrease of placental blood. Accordingly, the fetus gets less oxygen. Later nephropathy may go into eclampsia, which is a very dangerous condition for a pregnant woman. When preeclampsia is disturbed microcirculation in the central nervous system. Besides the three main symptoms of preeclampsia during this condition can manifest a feeling of heaviness in the head, stomach pain, headache, vomiting, nausea. The woman may get worse eyesight and memory, disrupt sleep. As a result of impaired blood flow in the occipital cortex can stand the sight of "veil" or seen flickering "spark." Signs of preeclampsia is high systolic Blood pressure (160 mm Hg. V) and diastolic blood pressure (110 mm Hg. Art.). Significantly decreased urine output, reducing the number of blood platelets, reduces blood clotting, liver disrupted.
If eclampsia, the most severe stage of preeclampsia, there are convulsive seizures, with all the functions of organs and systems are broken. Seizures, which provokes pain, bright light, sharp sound, and so on, last a few minutes. After the attack the woman faints. Also, after such seizures can develop deep coma . It can provoke placental abruption . bleeding . fetal hypoxia and miscarriage . This condition threatens the life of the fetus.
It is important to note that when preeclampsia certain period of time a woman can feel quite well, complaining only slight swelling, significant weight gain. However, the swelling are not specific to the limbs, but also for the placenta, resulting in insufficient oxygen supply of the fetus. Therefore, the symptoms described are an occasion to visit a doctor without delay.
Diagnosis of preeclampsia
The reason for the assumption of such a diagnosis is the presence of a pregnant woman described symptoms. The doctor conducts regular inspection and weighing the patient to rule out the presence of edema. Diagnosis of preeclampsia is conducted in the light of the general urine and blood. Continuous blood pressure measurement to determine the existence of problems in this area. Also for the correct diagnosis is determined daily diuresis For what you need to know the ratio of the fluid, which was drained, and the one that stands out. Usually, the diagnosis of "preeclampsia" is placed in the presence of three symptoms - edema . Protein in the urine and high blood pressure .
If a woman has no visible swelling, but the weight grows too rapidly, the doctor may perform sample McClure-Aldrich . To do this, saline is injected under the skin and is determined, for what period will resolve papule. If this occurred in less than thirty-five minutes in the body are hidden edema.
Treatment of preeclampsia
If the expert determines a pregnant woman only minor swelling of the feet, then the treatment can be performed on an outpatient basis. If there is significant swelling and protein in the urine is required hospitalization and inpatient treatment. In severe preeclampsia there is a threat to the life of mother and fetus. Therefore, treatment is carried out in the intensive care unit or ICU.
It is mandatory in the hospital before prescribing the treatment is carried out survey of women, including blood and urine tests, a study of the condition of the fetus by US . CTG and Doppler .
In the treatment of fluid therapy is used to recover the desired quantity of fluid in the bloodstream and removal of fluid from body tissues. It is also important to make up for lost protein. If you have high blood pressure is applied antihypertensive therapy . The duration of treatment depends on the condition of the woman. If the treatment does not give the desired effect for three days with severe preeclampsia, the operation is conducted caesarean section .
Prevention of preeclampsia
Typically, preeclampsia occurs more often in women pregnant with twins, those whose age exceeds 35 years, women with a variety of chronic diseases ( kidney disease . hypertension . disorders of fat metabolism ) genital infections . To prevent the development of preeclampsia for pregnant women is extremely important to constantly monitor their own weight. To do this, should not overeat, eat food costs, which has a high protein content, significantly limit the menu sweet and flour. It is important to consume adequate amounts of fiber, which is found in vegetables, bran, fruit, green. Women who notice that significantly gained weight, should limit the use of sharp, salty liquid. Thus, should not drink more than 1-1, 5 liters per day. An important factor in the prevention of preeclampsia is a restful sleep (at least eight hours per day), a positive emotional background.
Another method of preventing preeclampsia is considered to be an active lifestyle. Pregnant women are recommended daily walking, swimming, yoga classes, as well as the implementation of specially designed exercises for a certain period.
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