Gestational toxicosis, or preeclampsia, includes several pathological conditions that occur during pregnancy, complicating its course. Gestoses divided into raniie arising in the first trimester, and later developing in the second half of pregnancy.

Early gestosis includes: vomiting (mild), excessive vomiting, excessive salivation. The cause of toxicity, many authors consider the body's inability to adapt to pregnancy. Congenital or acquired deficiency of neuroendocrine regulation of adaptive responses (hypoxia, infection, intoxication, hereditary factors) contribute to the development of preeclampsia as well as other pathologies (from the cardiovascular system - hypertension, hypotension, heart disease, endocrine diseases - diabetes Diabetes - threatening and incurable disease , Hyper or hypothyroidism, urinary tract disease - pyelonephritis Pyelonephritis - kidney disease Glomerulonephritis).

Forms toxicity

Early preeclampsia include vomiting, repeated several times a day, accompanied by nausea, loss of appetite, changes in the perception of taste and smell. In accordance with the intensity of release:

• Mild forms
• Moderate form
• Uncontrollable vomiting (severe).

Mild corresponds to functional changes of the nervous system (phase neuroses), a mild form - the phase of intoxication, severe phase corresponds to dystrophy.

Late toxicosis pregnant women often appear in the third tremestre and are characterized by disturbances in the operation of many organs.

Late gestosis have three main simtomov - edema, proteinuria, hypertension, at least - more severe symptoms (convulsions, coma). There are many classifications of late gestosis, practical obstetrics are 4 main clinical forms:

• Dropsy pregnant
• Nephropathy (mild, moderate, severe)
• Preeclampsia
• Eclampsia

It should also be noted preclinical stage of preeclampsia - pregestoz. All clinical forms of late gestosis are the successive stages of the pathological process.

Excessive weight gain during pregnancy - one of the early signs of preeclampsia, first hidden, then clear dropsy.

Hidden dropsy can be found regularly weighing the patient and determining the diuresis. Set a weight of 300-400 grams per week, and a negative urine output - Symptoms hidden dropsy.

Obvious swelling is divided into three stages:

• swelling of the hands and feet
• edema of the lower extremities and the anterior abdominal wall
• total up to subcutaneous edema (anasarca).

Nephropathy in pregnancy is divided into three levels:

• Lightweight (no more than 150/100 pressure, swelling of the legs Swelling of the legs - do not leave without attention   not higher tibia, proteinuria of less than 1 g / l)
• Medium (pressure not higher than 175/115, swelling of the legs and the entire abdominal wall, proteinuria of 1 to 3 g / l)
• Severe (pressure higher than 175/115, anasarca, proteinuria greater than 3 g / l)

Pre-eclampsia - a serious but reversible condition, which develops against the backdrop of severe preeclampsia. In addition to the triad of symptoms of preeclampsia, the patient develops a headache, nasal congestion, blurred vision. These signs indicate poor circulation of the brain.

Eclampsia - the most severe form of preeclampsia. It is characterized by convulsions with loss of consciousness. The duration and number of attacks may be different. During an attack occur cerebrovascular accidents, bleeding in the brain. Often it happens hemorrhage in the internal organs. Hypoxia and metabolic disorders Metabolism: The basis of life of all living things . Rapidly deteriorating renal function, oliguria develops. Suffer and other internal organs. Eclampsia - a serious threat to the life of both the mother and the fetus.

If during pregnancy you suffer permanent and severe itching, it could be the cause cholestasis - a very common disease of the liver, occurring only during pregnancy. Cholestasis of pregnancy - a condition in which there is a violation of promoting bile caused by increased levels of pregnancy hormones. In particular, often cholestasis is observed in the third trimester of pregnancy, when hormone levels peak, and just a few days after the birth usually disappears.

Causes of cholestasis

Hormones, the level of which rises in women during pregnancy, affect the normal functioning of the gallbladder Gall bladder: structure and function , Thereby promoting bile slows or stops, the bile stasis, stasis and, in turn, can cause accumulation of bile acids in the liver and their penetration into the blood.

Cholestasis of pregnancy accompanied by a number of characteristic symptoms, including:

• Intense itching, especially the arms and legs (often itchy - one clear sign of cholestasis, which sees a woman)
• Changes in urine color to a darker
• Fatigue, tiredness, exhaustion
• Loss of appetite
• Depression

Much less in cholestasis the following symptoms:

• Jaundice (yellowing of the skin, eyes, mucous membranes)
• Sickness

According to statistics, only one or two cases of the thousands during pregnancy observed cholestasis. Factors that increase the risk of cholestasis of pregnancy include:

• Polycyesis
• History of liver disease or damage
• Family history (presence of cholestasis in the immediate family)

Harmful if cholestasis for a pregnant woman and child

Cholestasis may increase the risk of birth defects, premature birth or stillbirth. The function of excretion of bile acids from the blood of the fetus up to the birth of a child carries the mother liver, so bile stasis in women can have an additional burden on the child's liver and cause damage. In severe forms of cholestasis during pregnancy, your doctor may recommend an artificial call delivery immediately after fetal lung development is completed.

Diagnosis and treatment

For the diagnosis of cholestasis of pregnancy carried out a series of blood tests Blood tests: a mirror of health , To assess liver function, the level of bile acids and bilirubin Bilirubin - a great tool for the diagnosis . The main goal of treatment - relief of unbearable itching sensations, the main symptom of cholestasis, and means to combat the stagnation of bile. To do this, fit the following treatments:

• Protivozudnoe for external use (ointments, creams) or preparations with corticosteroids (suppress itching antihistamines to relieve the symptoms of cholestasis of pregnancy is not recommended)
• Drugs that reduce the concentration of bile acids - such as ursodeoxycholic acid
• , Strengthens liver health, including traditional medicines (for example, a decoction of the root of the dandelion)
• If severe form of cholestasis made it necessary to call delivery before the due date, can be assigned to pre-dexamethasone Dexamethasone - one of the most effective glucocorticosteroids   - A steroid that accelerates the development of fetal lung - and vitamin K before birth and after birth, preventing the risk of intracranial outpouring.

Of course, the optimal treatment of cholestasis of pregnancy is able to identify only a doctor. Of great importance in the selection of treatment is played by the following factors:

• Current and gestational age, overall health, history of previous diseases
• The severity of cholestasis
• Reaction to certain medications and procedures
• Forecast of development of cholestasis

Even a completely successful treatment of cholestasis during pregnancy reduces the risk of pregnancy after repeated. According to some estimates, the probability of relapse in the case of the next pregnancy can be up to ninety percent.