Toxicosis of pregnant women. Why does toxicosis develop during pregnancy and how to deal with it? What week can toxicosis occur?

Toxicosis– a pathology in a woman’s body associated with pregnancy. This phenomenon is characterized by nausea and vomiting, which occur against the background of intoxication with harmful substances due to the development of the fetus inside the womb. Pathology, usually does not cause serious harm health, but in some cases exceptions are possible.

When does toxicosis begin and end in pregnant women? Symptoms

Toxicosis manifests itself as nausea and vomiting, which looks like signs of poisoning. These are the main symptoms, but there may be others:

increased salivation;
diarrhea;
skin rashes;
constipation;
swelling;

irritability;
drowsiness or fatigue;
changes in the perception of taste, smell and sounds;
weight change;
decreased or loss of appetite.

At what time does toxicosis begin, from what week? Typically, toxicosis appears during pregnancy in the early stages - in the first trimester, at about 12 months, although there are cases when symptoms appear from the beginning of fetal development. Everything happens purely individually. In other cases, pregnant women may confuse toxicosis with other factors that cause similar symptoms. For example, changes in blood pressure or hormonal imbalance, which depress the body and cause nausea. The state of the body is similar to toxicosis, but it is not it.

How long does toxicosis last in pregnant women? Duration of this pathology depends on the woman’s body and the nature of pregnancy. Usually, symptoms begin to disappear by the second trimester. The intoxication process ends when the fetus’s protective membrane, the placenta, is fully formed. This . Then there is an improvement in well-being until the beginning of the third trimester. At this time it may appear late toxicosis during pregnancy - gestosis. It is more difficult and is characterized by a large number of symptoms and complications associated with pregnancy.

Causes of toxicosis

Main reasons The occurrence of side effects during pregnancy are hormonal changes and metabolic disorders, when the body is rebuilt for the development and gestation of the fetus. As a result, this affects your well-being, leading to nausea. Also, there is a number of factors capable of intensifying the symptoms of toxicosis and leading to complications:

early pregnancy (up to 16 years);
heredity;
presence of chronic diseases;
weak immunity;
gastrointestinal diseases;

smoking and drinking alcohol;
acute diseases of the liver and thyroid gland;
frequent stress and nervous strain;
physical fatigue;
unhealthy diet.

It is believed that increased toxicosis associated with fetal defense reactions, that is, in this way it gives a signal about some kind of violation, primarily this may be related to lifestyle, such as smoking or overwork. Therefore, you should pay attention to the nature of toxicosis and notice changes that increase the severity of symptoms.

Danger depends on the severity of symptoms. If you feel sick 1-2 times a day, then this is normal. But 10-15 times is already a big problem. Excessive vomiting and nausea lead to malnutrition of the fetus and weight loss by the mother herself. As a result, both are in danger.

The fetus does not develop properly due to lack of nutrients, and the mother’s body weakens and becomes vulnerable to any disease. Blood pressure drops, pulse quickens and overload of all internal organs, which poses a threat to life.

Increased salivation may cause fluid loss up to 1-1.5 liters, and this is already dehydration. Together with saliva, minerals and other vital substances are washed out of the body. This directly affects the condition of the fetus, and it may die. Lack of certain substances provokes decreased blood oxygen levels, which causes hypoxia and tissue death in the child’s still unformed body.

Diagnosis and treatment of toxicosis

What to do with toxicosis? To accurately determine the nature of toxicosis, you need to contact a gynecologist. He will appoint everything necessary tests, among which:

general blood analysis;
blood chemistry;

analysis for ketone bodies;
general urine analysis.

The doctor will also ask the patient about all the details of the pregnancy. Based on the information received, treatment will be prescribed, if necessary.

How to treat toxicosis in early pregnancy? If toxicosis is caused by some serious illness, then therapy will be aimed at eliminating the root cause. In ordinary cases, when toxicosis is the norm, The following remedies are used to eliminate unpleasant symptoms:

Immunocytotherapy- introduction of the father's lymphocytes into the mother's body. This will prevent rejection of the fetus, which is sometimes rejected by the mother's body as a foreign body.
Aromatherapy- the use of aromas of essential oils that can overcome the feeling of nausea.
Vitamin therapy- taking vitamin complexes to compensate for the lack of certain substances.
Physiotherapy- a set of exercises to improve physical condition. This helps increase blood circulation and speed up the elimination of toxins.

Each case of toxicosis should be examined by a doctor who will prescribe appropriate treatment. Medications are dangerous for pregnant women, so Regular pills for nausea or other ailments are not suitable, as they pose a threat to the unborn child. You should not self-medicate so as not to aggravate the situation. It is better to follow preventive measures during pregnancy to improve the condition.

How to relieve toxicosis in early pregnancy? What helps against toxicosis? Exists a number of preventive measures available at home. They will help reduce the severity of symptoms and stabilize well-being:

you should eat small portions, but as often as possible;
food must be chewed thoroughly;
should contain as little fried, spicy and fatty foods as possible;
you shouldn’t get out of bed abruptly in the morning;
daily food should be easily digestible, nutritious and healthy (vegetables, fruits, nuts, dried fruits);
if you have a strong urge to vomit, you can chew ginger root;
after eating you need to lie down for a while;
food should not be too hot or cold;
It is recommended to drink a glass of cool water in the morning;
to reduce salivation, decoctions of chamomile, sage or mint will help;
It is prohibited to drink alcohol, smoke or take medications without a doctor’s permission;
You should walk in the fresh air more often, and the premises should be regularly ventilated.

Toxicosis will pass sooner or later, the main thing is to follow all the doctors’ recommendations and take preventive measures. This is a difficult period, so you need to be patient and get through it. It is during toxicosis that the most intensive development of the unborn child occurs, which requires maximum responsibility.

Video about the fight against toxicosis

Pregnancy is a wonderful and long-awaited period for every girl.

But even if the pregnancy proceeds well, it is often associated with toxicosis and other unpleasant manifestations. Therefore, many expectant mothers are interested in when toxicosis begins during pregnancy. You should know that this question cannot be answered unambiguously, since the onset of toxicosis depends on the individual characteristics of each woman.

Many pregnant women have never experienced such an ailment at all. Therefore, in this case, everything is individual. But toxicosis in early pregnancy is observed in more than 80% of women.
How to recognize toxicosis?

A pregnant woman may not understand when her toxicosis begins. Sometimes it is not accompanied by pronounced symptoms. Most often, the disease manifests itself in the form of morning sickness, a gag reflex to smells, and general weakness. This condition can begin to haunt the expectant mother from the 4th week of pregnancy. It is during this period that the active growth of the fetus begins. The intensity of the manifestations of each woman is different. But there are a number of symptoms that unite the clinical picture of this condition. These include:

loss of appetite;

irritability;

drowsy state;

frequent dizziness;

changing taste preferences and much more.

If you want to know when toxicosis begins in pregnant women in your family, then you can ask your mother, grandmother and close relatives about it. In women of the same family, the symptoms of the disease and the degree of its manifestations are similar.

In addition to nausea and vomiting, a woman may experience constant heartburn. But it can be easily eliminated. The pharmacy has a wide range of medications for pregnant women that help eliminate heartburn. Heartburn is a constant companion of toxicosis, and probably every woman who has carried a baby knows about it.

At what time does toxicosis begin?

If you want to know if toxicosis can begin during the delay period, then the answer will surprise you: this is quite possible. Immediately after the conception of a child, a woman may feel a slight nausea. Very often, a woman realizes that she is pregnant, feeling discomfort in the form of dizziness, vomiting. Already after the appearance of these signs, many girls take a pregnancy test, which shows a positive reaction to hCG.
Early toxicosis may appear at 4-5 weeks. It continues until the end of the first trimester. Most often, its duration is 12 weeks. But there is also late toxicosis, which should cause concern in a pregnant woman. If a woman's toxicosis began in the last trimester, then this is an occasion to consult a gynecologist. In this case, treatment is necessary, since ignoring the symptoms can lead to serious consequences, up to the death of the child.

Late toxicosis, as a disease, has a second medical name - preeclampsia. The course of preeclampsia will be complicated if its symptoms begin to appear in the second trimester. The earlier preeclampsia begins, the worse it is for the expectant mother and baby. The woman begins to swell. This happens due to intoxication of the body. Preeclampsia is a dangerous disease, the causes of which remain a mystery to this day.

If at 24-25 weeks you feel nausea, frequent vomiting, then you should not hesitate to visit the local gynecologist. A pregnant woman who has developed preeclampsia needs urgent treatment. The doctor may suggest that the woman go to the hospital or undergo treatment at home.

Gynecologists explain the phenomenon of toxicosis by the individuality of the body, the presence of various chronic diseases. An important role in the onset of the disease is played by hormonal imbalance, stress and many other factors. But the exact cause of the disease is still not fully understood. You should know that this condition is caused by two main reasons, including changes in the body at the hormonal level and the emotional state of the pregnant woman.

Hormonal changes occur because the fertilized egg attaches to the wall of the uterus at the time of conception. When the embryo begins to develop, the hormone hCG enters the blood of the expectant mother. Increased production of the hormones estrogen and progesterone by a woman’s body can also affect hormonal levels. By week 10, the maximum hCG value in a woman’s blood is reached.

Here lies the answer to the question of what week toxicosis begins. It begins from the moment when fertilization of the egg occurs and the fertilized egg attaches to the uterus. But at this stage, the disease has almost invisible manifestations, and the woman may not be aware of its existence. But due to the individual characteristics of the body, it can occur abruptly and acutely, as there is a rapid release of hormones.

Causes of the disease

The appearance of toxicosis is provoked by a woman’s unstable psycho-emotional state, stress, anxiety, and a sense of fear. If a woman has had an unsuccessful pregnancy, then when a new one occurs, she begins to worry about her child. The woman is waiting for toxicosis to begin to confirm pregnancy and reassure that everything is fine with the baby. And this only leads to nervousness and uncertainty, which negatively affects not only her emotional state, but also her health.

To reduce discomfort and relieve psycho-emotional stress, you need to tune in to the best. Mentally tune in to a favorable outcome and easy childbirth. After that, the woman will certainly feel much better.

An important role in the appearance of the disease is played by the hereditary factor. It is he who determines at what period of pregnancy toxicosis begins. If a woman carried her daughter without toxicosis, then the probability of the absence of toxicosis in her daughter is very high. If a woman during pregnancy began to feel the manifestations of toxicosis at week 5, then her daughter will begin in the same period.

Almost 2/3 of pregnant women experience toxicosis of varying severity. It can significantly worsen a woman’s well-being and even cause her hospitalization. Fortunately, in most cases, toxicosis in pregnant women does not lead to loss of ability to work, although this condition imposes certain restrictions on the diet and diet.

What is considered toxicosis during pregnancy?

Pregnancy without toxicosis is the absolute norm. But in the modern world, this is rare, and the absence of any uncomfortable symptoms in the first days after a missed period is often perceived by a woman as an alarming sign. So what is toxicosis?

This term refers to a group of pathological conditions that arise only during pregnancy, lead to a deterioration in the woman’s well-being and are manifested by extragenital symptoms. They may appear even before a missed period is registered and a positive pregnancy test is received. So many women consider this condition to be the very first and most reliable sign of successful conception.

In fact, toxicosis is one of the dubious signs of pregnancy. After all, its symptoms are nonspecific, sometimes it can be difficult to distinguish them from signs of various somatic diseases. In addition, some complaints that appear in a pregnant woman may be of a psychogenic nature, that is, they may not have a physiological connection with the development of the embryo in the uterus. And sometimes a condition simulating toxicosis even occurs outside of pregnancy. This is possible if a woman really looks forward to its onset and has a tendency to somatize her emotions due to individual psychological characteristics.

The term “toxicosis” was introduced into use at the beginning of the last century. Moreover, initially it designated pathological extragenital conditions that occur at any stage of gestation. Currently, toxicosis is diagnosed only in the 1st trimester. And at later stages the term “preeclampsia” is used. And this is a much more serious and potentially life-threatening condition for the fetus and woman. But even now it is sometimes called late toxicosis, which is not a completely correct term.

Main clinical forms

According to the modern classification, toxicosis includes:

Vomiting during pregnancy is the most common form, accounting for up to 85% of cases. This is what is most often called.
Salivation.
Dermatoses or “pregnancy pruritus”.
Chorea of pregnancy.
Bronchospasm and bronchial asthma.
Hepatosis, acute yellow atrophy of the liver.
Osteomalacia.

In terms of severity, toxicosis can have 3 degrees of severity: mild, moderate, severe. This is decisive when deciding whether to hospitalize a pregnant woman, even if she does not show signs of a threat of miscarriage or deviations in the development of pregnancy.

Why does he appear

For quite a long time, the development of toxicosis was associated with poisoning of a woman’s body with metabolic products (toxins) formed during the development of the embryo. Currently, this theory is recognized as untenable, since it does not explain the disappearance of the main symptoms as pregnancy progresses. Subsequently, many other assumptions were made, and some of them were reflected in the modern understanding of the pathogenesis of pregnancy toxicosis. The study of this condition is still underway, because the mechanisms of development of key symptoms have not yet been fully established.

Today it is believed that the main causes of toxicosis during pregnancy lie in the developing hormonal imbalance in the woman’s body and in changes in the functional state of her central nervous system (especially the diencephalic region and the parasympathetic part). Subsequently, secondary dysmetabolic disorders occur. This aggravates the condition and can contribute to the formation of not functional, but structural changes in some internal organs with the appearance of new symptoms. In severe cases of toxicosis, dystrophic changes develop.

For example, vomiting leads to dehydration and electrolyte imbalance. This can again provoke disruption of the digestive tract, convulsions, and disruption of the functioning of the central nervous system and heart. Accompanying toxicosis, starvation or low absorption of essential nutrients contributes to hypoproteinemia and the accumulation of ketone bodies. If unfavorable, this can cause severe progressive hyperlipemia with subsequent fatty infiltration of the liver.

In some cases, signs of toxicosis can be explained by the pregnant woman’s allergenicity of trophoblast proteins.

Clinically significant hormonal changes

Pathogenetically important dishormonal disorders of early pregnancy:

Relative estrogen deficiency. In itself, this does not lead to toxicosis, but in combination with other disorders it becomes clinically significant and contributes to the development of autonomic reactions.
Increasing concentration of progesterone in the blood. This hormone is produced by the corpus luteum of the ovary, which remains in place and continues to function after implantation of the embryo. Its main task is to prolong pregnancy, prevent spontaneous abortions and ensure adequate growth of uterine tissue. But progesterone's influence is not limited to the reproductive system. It acts on the smooth muscle fibers in the walls of the digestive tract, relaxing them. This can lead to an imbalance in the functioning of the stomach and various parts of the intestines, which causes unpleasant symptoms of toxicosis.
The production of human chorionic gonadotropin progressively increases in the first weeks of pregnancy. There is evidence that peak values of this substance often act as a provoking factor for the development of vomiting. This may explain the predominance of complaints of nausea in the morning, when the concentration of hCG is usually highest.
Decreased secretion of glucocorticosteroids by the adrenal cortex. This leads to a decrease in the response of blood vessels to vasoconstrictor substances and promotes the accumulation of fluid in the intercellular spaces.

Currently, dishormonal changes are considered key in the pathogenesis of toxicosis.

What affects the likelihood of developing toxicosis

Not all pregnant women develop toxicosis. Even for the same woman, the period of bearing the first and subsequent children may differ. And if she has already experienced toxicosis before, during her second pregnancy her symptoms may not bother her. And it is impossible to predict its appearance.

There is also an opinion that there is a relationship between the likelihood of toxicosis and the gender of the conceived child. But it has no scientific evidence. In the very early stages of pregnancy, when toxicosis usually appears, all embryos develop equally. They do not yet have differentiation of the reproductive system; this will occur only from the 8th week of gestation. Therefore, the gender of the child cannot affect the development of early toxicosis.

Predisposing factors include:

. The hormonal “burst” in a pregnant woman is usually higher than when conceiving with one embryo.
Tendency to neurosis-like and somatoform reactions, migraines. Indeed, in these cases, even before pregnancy, there is a change in the interaction between the brain, the autonomic part of the nervous system and target organs.
Infectious diseases and surgical interventions suffered shortly before conception, especially on the reproductive organs.
The presence of chronic diseases of internal organs. The onset and prolongation of pregnancy can become a factor that disrupts the existing balance and leads to decompensation of the existing pathology. This is especially true for diseases of the digestive tract.
Hereditary predisposition.
Age. Pregnant women over 35-40 years of age are more likely to develop toxicosis. This is explained by a decrease in their general compensatory capabilities of the body, a decrease in the functional activity of the endocrine and reproductive systems, and the accumulation of chronic and not always diagnosed pathology of internal organs.

It is important to understand that the presence of predisposing conditions only increases the likelihood of developing toxicosis. And their absence does not guarantee good health in the first months of pregnancy. Absolutely healthy and completely emotionally balanced women often experience toxicosis. This is not an exception to the rule and only indicates the development of their reaction to the changes occurring during pregnancy.

When does toxicosis begin?

How long after conception does toxicosis occur?

The timing of the development of this condition is quite individual, but in any case it appears only after implantation of the fertilized egg into the functional layer of the endometrium of the uterus. And this process occurs no earlier than 5 days after the fusion of the egg and sperm, most often on the 9th day after ovulation.

But in a number of women, for various reasons, the timing of implantation shifts and can be either 7-8 or 11-14 days. At the same time, a long time interval between fertilization and implantation of the fertilized egg is fraught with failure to maintain the pregnancy; the woman’s body simply does not have time to adequately respond and prevent the onset of menstruation.

What explains this period?

Fertilization of the egg most often occurs in the lumen of the fallopian tube. Therefore, for proper implantation, the resulting fertilized egg must reach the endometrium. It also needs to go through certain successive stages of development and transform into a blastocyst through the process of active cell division. Therefore, even if fertilization occurs in the uterine cavity, implantation is still possible only after a strictly defined number of days.

Only after the implantation and consolidation of the fertilized egg in the endometrium, the woman’s body receives a signal about the onset of pregnancy and begins to produce hormones to prolong it. And a pronounced increase in progesterone levels and a progressive increase in hCG synthesis are precisely what can provoke the onset of toxicosis. But this usually does not happen immediately after implantation, and only after reaching a certain concentration of hormones and a secondary change in the functional state of the nervous system. In addition, each pregnant woman has her own sensitivity to the processes occurring in her body.

So at what week does toxicosis begin?

The majority of women begin to experience symptoms within about 1.5 weeks after a missed period. Most often, they are preceded by other signs of an increase in progesterone levels: breast engorgement, increased nipple sensitivity, and others. But in some pregnant women they appear almost simultaneously with nausea, already a week and a half before the expected date of menstruation.

Pregnancy that follows can also occur with toxicosis. In this case, it is necessary to take into account the later implantation of the fertilized egg due to the technical features and timing of the procedure for transferring embryos into the uterine cavity. Therefore, symptoms of toxicosis usually occur after confirmation of pregnancy using a laboratory test for hCG and ultrasound.

It is important to understand that toxicosis cannot be ruled out. After all, the site of implantation does not affect the functioning of the corpus luteum; the synthesis of hormones is supported by signals emanating from the developing fertilized egg. Therefore, it is impossible to assume an ectopic pregnancy only by the severity of toxicosis; other symptoms indicate this pathology.

Main manifestations

The most common form of toxicosis is nausea and vomiting during pregnancy. They are usually combined with increased salivation, increased sensitivity to odors (both food and household), the emergence of taste preferences, and changes in appetite.

Nausea is an uncomfortable, but not at all dangerous symptom for a woman’s health and for the development of the embryo. It can be almost constant, bother you in influxes in response to external taste and aromatic stimuli, or appear mainly in the first hours after waking up in the morning. But evening toxicosis is also possible, which is not a gross pathology. The deterioration of the condition at the end of the day is explained by the fatigue of the pregnant woman with depletion of the functional reserves of the nervous system.

Vomiting most often accompanies nausea and develops at its peak. In the first half of pregnancy, morning urges usually occur on an empty stomach. But vomiting can also occur after eating. Its frequency and abundance depend on the severity of toxicosis and the presence of concomitant chronic diseases of the gastrointestinal tract. The diet of a pregnant woman is also of certain importance. Rich, irritating, fatty foods usually aggravate the situation and more often provoke vomiting.

In addition, gastric emptying may not be spontaneous. Wanting to alleviate the condition, reduce the severity of nausea and the feeling of heaviness and fullness in the stomach, some pregnant women deliberately induce vomiting. This is fraught with the appearance of traumatic linear tears in the mucous membrane of the esophagus at the point of its transition to the stomach, which causes some discomfort and can even cause the appearance of individual streaks of fresh blood in the vomit.

Early toxicosis may also be accompanied by heartburn - a burning sensation behind the sternum with a sour taste in the mouth, and sometimes with a feeling of irritation in the throat. The appearance of this symptom is explained by relaxation of the cardiac sphincter between the esophagus and stomach with the reflux of acidic contents into the upper sections and even into the oral cavity. The likelihood of heartburn increases when you intentionally induce vomiting. But in general, heartburn usually appears at more advanced stages of gestation.

Changes in the general condition, the nature and severity of metabolic changes during toxicosis in the first half of pregnancy depend on the severity of its course. With repeated, debilitating vomiting, other symptoms appear and increase. They are associated with dehydration, electrolyte imbalance, protein deficiency and deterioration in the functioning of internal organs. Severe toxicosis is actually multiple organ failure.

Main criteria of severity

There are 3 degrees of severity of vomiting during pregnancy:

Light. Vomiting occurs 2-4 times a day, while the discharge is not abundant and without pathological impurities. The pregnant woman does not experience weight loss and there are no abnormalities in biochemical or general blood tests. Her general condition is assessed as satisfactory.
Medium-heavy. The frequency of vomiting is 10 or more times a day. The pregnant woman loses weight, she exhibits obvious autonomic disorders and signs of dehydration (dry skin, decreased volume of urine excreted with acetonuria, severe asthenia, tachycardia and a tendency to lower blood pressure). But there are no critical changes in the general and biochemical blood tests yet; the existing hypochloremia and mild anemia can be corrected. The temperature is usually low-grade. With inadequate treatment, the condition progresses, and disorders of carbohydrate and fat metabolism develop.
Heavy. Indomitable vomiting (more than 20 times a day) is one of the many polymorphic symptoms caused by multiple organ failure. Body temperature may be low-grade or febrile. There is a progressive decrease in body weight with signs of degeneration of internal organs and tissues. The functioning of the kidneys is impaired, persistent oliguria, proteinuria, acetonemia and acetonuria develop. Liver damage causes jaundice due to bilirubinemia. The balance of minerals is grossly disturbed, and there are obvious disturbances of all types of metabolism. As symptoms increase, the level of consciousness is disrupted, and coma subsequently develops.

Fortunately, uncontrollable vomiting of pregnancy with progressive deterioration of the condition is now rarely diagnosed. After all, such a severe form of toxicosis develops through a gradual worsening of symptoms, so that there is the possibility of timely correction of emerging disorders.

When to worry

Most pregnant women experience a mild form of toxicosis, manifested by nausea and mild morning vomiting. This condition does not pose any threat and does not even require special treatment. However, symptoms may develop that require immediate medical attention.

These include:

vomiting more than 10 times a day;
severe adynamia and asthenia, significantly interfering with the daily functioning of a pregnant woman;
disturbance of the depth of consciousness (in the form of stupor and even stupor), the main symptom of this condition is motor and mental retardation with a violation of the level of contact with the outside world;
weight loss;
dryness and decreased skin turgor;
the appearance of the smell of acetone in the exhaled air;
a clear decrease in the amount of urine excreted per day;
the appearance of yellowness of the sclera, visible mucous membranes and skin;
sudden disappearance of complaints, which may be a sign of a progressive drop in hCG levels due to.

Intensification of existing symptoms, the appearance of new disorders - all this also requires consultation with a doctor.

What is included in the examination

Examination of pregnant women with complaints of symptoms of toxicosis is aimed at assessing their physical condition and excluding diseases that may lead to similar complaints.

Diagnostics includes laboratory and instrumental studies:

general blood test to detect anemia and signs of inflammation;
biochemical blood test with mandatory assessment of the functional state of the kidneys and liver, total protein and protein fractions, the ratio of key ions;
urine analysis, determination of daily diuresis and daily protein loss in urine;
Ultrasound of the hepatobiliary system, pancreas and kidneys, which allows not only to identify existing chronic diseases, but also pregnancy-related hepatosis;
consultation with a neurologist (if a neuroinfection is suspected, or if consciousness disorders develop);
according to indications - smears and, if necessary, serological testing to exclude foodborne infections.

Pregnant women with toxicosis must regularly monitor their blood pressure levels. After all, nausea and weakness can be caused by its significant fluctuations both in the direction of increase and in the direction of obvious decrease.

Pregnant women with sudden disappearance or sharp weakening of the main symptoms require special attention. They are shown an unscheduled ultrasound to confirm the viability of the embryo. The fact is that during a frozen pregnancy, toxicosis often quickly decreases due to the cessation of the synthesis of supporting hormones.

How to deal with toxicosis during pregnancy

Mild toxicosis is usually not treated. Only with the development of neurosis-like reactions and a decrease in working ability can a woman be offered therapy in a day or 24-hour hospital setting. Moderate forms of toxicosis are the basis for deciding whether hospitalization is advisable. And severe variants require the pregnant woman to be admitted to a hospital or even to the intensive care unit as soon as possible.

It is important to understand that all prescribed medications are not able to completely eliminate the main symptoms, since it is impossible to get rid of toxicosis while its only cause (pregnancy) remains. The drugs used help relieve potentially life-threatening complications, mitigate some manifestations and thereby alleviate the woman’s condition. Moreover, each prescribed remedy for toxicosis has its own point of application and specific indications. Therefore, only a doctor should select the optimal therapeutic regimen.

Possible areas of therapeutic treatment for toxicosis:

Elimination of existing dehydration, the choice of technique depends on the severity of dehydration and the patient’s condition. Feeding with the use of special saline solutions, infusion therapy based on rheopolyglucin, Ringer-Lock and others are practiced.
Correction of electrolyte disturbances and metabolic acidosis. In cases of severe vomiting during pregnancy, the administration of a glucose-insulin-potassium mixture and sodium bicarbonate is often required. The selection of solutions to replenish electrolyte deficiency is based on a dynamic assessment of their level in the blood plasma.
Replenishment of obvious nutrient deficiencies. In severe cases, special nutritional mixtures are prescribed; plasma, albumin, and serotransfusin can be administered intravenously.
Reducing endogenous intoxication caused by multiple organ failure. Intravenous administration of hemodesis is indicated, and sometimes extracorporeal blood purification procedures are performed.
Maintaining the function of the hepatobiliary system. For mild to moderate cases, Hofitol and Essentiale are often prescribed for hepatoprotective purposes and to improve the functioning of the biliary system. For severe disorders, treatment regimens for non-infectious hepatitis are used.
Fighting kidney failure.
Fighting vomiting. Cerucal is most often used for this. Pyridoxine (vitamin B6) preparations, such as Navidoxin, also have an antiemetic effect. Injections of antipsychotic and antihistamines can be used to relieve severe vomiting attacks.
Stabilization of the neurovegetative background, regulation of the activity of the central nervous system. In case of indomitable vomiting in the first days of treatment, potent substances (tranquilizers, some neuroleptics, anesthetics) can be used to quickly reduce the excitability of the main structures of the brain. Subsequently, it is recommended to take herbal-based medications, magnesium. The very fact of hospitalization often has a stabilizing effect, making it possible to create a protective regime for a pregnant woman. Psychotherapeutic and some physiotherapeutic techniques are actively used (electrosleep, color and light therapy, aromatherapy, acupuncture, massage of the cervical-collar area and hands, darsonvalization, etc.).

In case of severe toxicosis with the development of life-threatening conditions that cannot be at least partially corrected within 24 hours, the issue of terminating the pregnancy for medical reasons is decided. This measure is also necessary in the development of acute yellow atrophy of the liver.

How to relieve toxicosis without drugs

Drug therapy for toxicosis is by no means an everyday measure. For mild (and sometimes moderate) vomiting during pregnancy, non-drug measures are sufficient. These include diet, work and rest schedule, and various folk remedies for toxicosis. Some women during this period resort to the help of homeopaths.

Herbal infusions based on mint, chamomile, lemon balm, valerian, sage, rose hips, oregano, and ginger are widely used. Some of them have a mild sedative effect, others help reduce the severity of the gag reflex. But do not forget that herbal medicine is potentially allergenic. In addition, without consulting your doctor, you should avoid plants that can affect blood clotting.

Aromatherapy also helps against toxicosis during pregnancy, despite the woman’s increased sensitivity to odors. You can reduce the severity of nausea by inhaling a small amount of essential oils of peppermint, lemon, anise, and ginger oil. They are usually used not in pure (concentrated) form, but in a mixture with base neutral oil. For such inhalations, you can use aroma lamps, aroma pendants, or simply apply a few fragrant drops to a handkerchief.

How to eat

Nutrition during toxicosis is a very important aspect. Food should be taken in small portions, which will avoid overeating and long periods of hunger. Many women manage morning sickness with a light snack immediately after waking up, right in bed. Such a meal will increase the level of glucose in the blood, because natural morning subhypoglycemia for a pregnant woman can become a factor provoking vomiting.

During the day, to reduce the symptoms of toxicosis, you can use crackers, a slice of lemon, a teaspoon of honey, a small amount of sunflower seeds, and cranberry juice. The composition of such a snack is selected individually, experimentally.

Food during toxicosis should be easily digestible, appetizing-looking, freshly prepared, with a minimum of artificial flavoring and preservative additives. At the same time, it must provide essential nutrients and have adequate caloric content. It is advisable to avoid frying and deep-frying, using fatty sauces, smoked meats and factory-made sausages. Preference should be given to baked, boiled and stewed dishes, as well as fresh vegetables and fruits. Marinades and pickles can be used to a limited extent, subject to appropriate taste preferences.

It is recommended to include in the menu foods high in digestible protein, vitamin B6, and polyunsaturated fatty acids. But freshly baked bread, products made from yeast dough and premium flour, legumes should be avoided - they can increase gas formation in the intestines, which will negatively affect the well-being of the pregnant woman.

When can you expect relief?

How long does toxicosis last in pregnant women and at what stage of gestation should its symptoms disappear? This question is one of the most frequently asked questions at an appointment with an obstetrician-gynecologist. After all, nausea and other symptoms are very uncomfortable and can even disrupt the social life of a pregnant woman.

Toxicosis is typical for the first trimester of pregnancy, in most cases it begins to fade at 12-14 weeks of gestation. But sometimes its symptoms persist for some time (up to about 20 weeks), which is quite acceptable. Therefore, to refer to this condition, it is more correct to use the term “toxicosis of the first half of pregnancy.”

The disappearance of symptoms is explained by physiological changes that occur starting from the 12th week of gestation. We are talking about the formation of the placenta. It not only forms a semi-permeable selective barrier between the blood of the mother and the fetus, but also performs an endocrine function. At the beginning of the first trimester, it begins to actively synthesize hCG and other hormones that were previously produced by the corpus luteum in the ovary. And at 14-16 weeks this function completely passes to the placenta. At the same time, the concentration of hCG in the woman’s blood gradually decreases, which explains the improvement in her well-being.

Therefore, toxicosis usually goes away at the beginning of the second trimester. Of course, this happens gradually, with a gradual depletion of symptoms and an improvement in the general well-being and activity of the pregnant woman.

Morning sickness is a fairly common occurrence in early gestation. And in many cases this does not require the use of any drugs. As pregnancy progresses, its symptoms disappear, which usually allows the woman to fully enjoy the period of bearing a child.

Toxicosis of pregnant women is a pathological condition that occurs only during pregnancy, complicates its course and, as a rule, disappears with its interruption or independently during treatment.

Causes of toxicosis

To date cause of toxicosis insufficiently studied. There is no exact data on the origin of this pathological condition. The International Association of Obstetricians and Gynecologists has identified the most likely causes of toxicosis:

Hormonal changes. From the first days after conception, great changes occur in a woman’s body due to changes in the amount of hormones released. Against this background, the pregnant woman’s well-being may worsen;
Presence of chronic diseases. It is noted that toxicosis occurs more often in women with weakened immunity and diseases of various organs (especially diseases of the digestive, respiratory and endocrine systems). Therefore, women planning a pregnancy are advised to undergo a full medical examination in advance;
Psycho-emotional state of a woman. , lack of sleep, heavy mental stress contribute to the development of toxicosis and aggravate the severity of their manifestation;
: , drug use;
Woman's age. It has been noted that early pregnancy (mother's age up to 20 years) and late pregnancy (over 35 years) more often occur with various forms of toxicosis;
Heredity. Genetic predisposition plays a significant role here: if a woman’s mother, aunt or grandmother suffered from toxicosis, then there is a high probability of developing preeclampsia in this woman.

There are three forms of toxicosis:

Early (develops in the first trimester of pregnancy);
Late (occurs in the second and third trimester, more often in the last two to three months);
Rare (usually begins in the first trimester, but can occur at any stage of pregnancy).

Early toxicoses: types, timing, treatment

Early toxicoses occur at the beginning of pregnancy and end by the end of the first trimester. Most often, symptoms begin at 5-6 weeks of pregnancy, less often at an earlier date (some women feel a deterioration in their health almost immediately after conception, even before the start of delayed menstruation). Allocate two forms early gestosis:

Vomiting pregnant

Lightweight;
Moderate;
Excessive.

Drooling (salivation).

Vomiting pregnant– the most common form of early toxicosis. In the first weeks of pregnancy, many women experience nausea and vomiting, which occurs in the morning, not every day, and does not in any way affect the condition of the pregnant woman. Such vomiting is not classified as toxicosis and does not require treatment.

Information Gestosis includes vomiting, which is repeated several times during the day, accompanied by severe nausea, a sharp decrease or absence of appetite, changes in taste preferences and olfactory sensations.

According to severity they are distinguished:

Light form. Vomiting repeats up to 5 times a day, more often after meals, slightly worsens the woman’s well-being, is easily treatable or goes away on its own by 10-12 weeks of pregnancy;
Moderate form. Vomiting occurs up to 10 times a day, is not associated with food intake, and is accompanied by a significant deterioration in the woman’s condition and general weakness. With proper treatment, this form of toxicosis gradually stops. Subsequently, pregnancy develops normally.
Excessive form. Vomiting occurs up to 20 times or more per day and contributes to the development of a woman’s serious condition. Fasting and dehydration lead to decreased body weight, exhaustion, and increased temperature and pulse. Emergency treatment is required, failure to do so can result in death.

Drooling (ptialism) is increased salivation and loss of more fluid (up to 1 liter or more per day). Ptyalism can occur as an independent form of toxicosis or accompany vomiting of pregnant women. With severe drooling, a woman’s well-being worsens, sleep is disturbed, weight loss and dehydration of the body due to fluid loss are possible. Due to the constant secretion of saliva, maceration of the skin and mucous membranes occurs.

Treatment ptyalism and mild vomiting are carried out on an outpatient basis. If there is no effect, the woman must be hospitalized and further examination and treatment is carried out in a hospital setting. For moderate and excessive vomiting, hospitalization should be immediate.

Special treatment of early toxicosis consists of the following measures:

Ensuring complete physical and emotional peace;
Proper diet (eating high-calorie foods in fractional portions every 2-3 hours);
Taking sedatives (,);
Antiemetic therapy;
Vitamin therapy;
Hepatoprotectors;
Intravenous drip infusions of solutions to combat dehydration.

Important If the treatment does not give the desired effect and the pregnant woman’s condition worsens, then emergency termination of pregnancy is indicated.

Late toxicosis: types, timing of occurrence, treatment

Late toxicosis develops most often after 30 weeks of pregnancy. In rare cases, it appears already in the second trimester and then becomes more malignant and less treatable. The following are distinguished: forms of gestosis:

Dropsy of pregnancy(fluid retention in the body and the appearance of persistent edema);
Nephropathy(clinically manifested by three symptoms: swelling, high blood pressure);
Preeclampsia(transitional stage from nephropathy, characterized by dysfunction of the nervous system);
Eclampsia(the final stage of late gestosis with the occurrence of convulsions and loss of consciousness).

Dropsy of pregnancy occurs when fluid is retained in the tissues. Its main clinical manifestation is edema, which progresses with the development of the disease. Allocate three degrees of severity of dropsy:

First degree. Swelling appears on the legs; when pressure is applied to the tissue in the area of the tibia, visible impressions remain;
Second degree. The swelling spreads further to the torso, but water does not stagnate in the abdominal cavity. Indentations remain when pressing on the abdomen;
Third degree. Swelling appears on the torso and face. The general condition of the pregnant woman worsens: increased fatigue, shortness of breath, and rapid heartbeat appear.

Treatment this stage of toxicosis includes:

Limiting liquid (no more than 1 liter per day) and table salt when preparing food;
Exclusion from the diet of all foods that can retain water in the body: smoked, fatty, spicy, salty;
(furosemide, hypothiazide, etc.).

In most cases, the treatment is effective and takes no more than 6-8 days for mild to moderate toxicosis and 10-12 days for severe toxicosis.

Nephropathy most often develops against the background of undiagnosed or improperly treated hydrocele in pregnant women. This form of late toxicosis is characterized by triad of symptoms:

Edema;
Hypertension (increased blood pressure);
Proteinuria (increased protein in the urine).

Nephropathy can be monosymptomatic (only one symptom is observed - hypertension or albuminuria) or polysymptomatic (two or three signs appear simultaneously).

Treatment nephropathy should be carried out only in a hospital setting. Therapy consists of the following activities:

Complete bed rest, a state of physical and emotional peace;
Normalization of nutrition. A pregnant woman is prescribed a predominantly dairy-vegetable diet, with strict restriction of fluid, salt and fat intake. Once a week, fasting days are carried out (fruit or);
Normalization of sleep by taking sedatives;
Taking diuretics to reduce swelling;
Consultation with a therapist and taking antihypertensive drugs to lower blood pressure.

If treatment is unsuccessful, it is necessary to carry out early delivery, because further prolongation of pregnancy can threaten the health and life of the woman.

The final stages of development of gestosis are preeclampsia And eclampsia. At preeclampsia headaches, blurred vision, drowsiness, and increased fatigue appear. Some patients experience abdominal pain, nausea, vomiting,... These symptoms are associated with profound changes in cerebral circulation and increased intracranial pressure.

Treatment preeclampsia is the same as for nephropathy, but all injections and intravenous infusions should be carried out only under anesthesia (inhalation of nitrous oxide and oxygen) so as not to provoke an attack of eclampsia.

Eclampsia manifested by the sudden appearance of convulsions and complete loss of consciousness. A seizure occurs in three stages:

First stage. Small contractions of the facial muscles appear, which move to the muscles of the upper limbs. This period lasts 20-30 seconds;
Second phase. Severe cramps of all muscles occur, breathing is disrupted until it stops completely, and the woman loses consciousness. The stage lasts no more than 25 seconds.
Third stage. The convulsions stop, and the pregnant woman falls into a coma. Upon returning to consciousness, the patient does not remember anything and complains of severe fatigue and muscle pain. The duration of the third stage is up to 1.5 minutes.

Therapeutic measures in case of eclampsia, they must be urgent and take place with the obligatory presence of resuscitators. Therapy includes:

Relief of seizures by inhalation of oxygen, nitrous oxide and ether;
Reducing blood pressure by intravenous administration of antihypertensive drugs (the woman must be under anesthesia at this time);
Sleeping pills (the pregnant woman is put into a state of medicated sleep for 1-2 days).

Intensive care in the intensive care unit should last about 10 days. If attacks recur during treatment, the woman is prescribed emergency delivery.

Rare forms of toxicosis: types, timing, treatment

Rare forms of toxicosis most often begin in the first trimester, but can occur at any stage of pregnancy. This type of toxicosis includes:

Dermatoses (various skin diseases);
Jaundice of pregnancy (jaundiced discoloration of the skin and visible mucous membranes);
Yellow liver atrophy (acute liver disease with degeneration of liver cells);
(a disease of the respiratory tract, manifested by difficulty breathing, shortness of breath and periodic attacks of suffocation);
Tetany (convulsive attacks caused by impaired calcium metabolism in the body);
Osteomalacia (a disease characterized by softening and deformation of the skeletal system due to disruption of phosphorus-calcium metabolism in the body).

Dermatoses pregnant women include a group of skin diseases that occur only during pregnancy. The most common pregnancy itch is pregnancy itch, which can spread throughout the body. The woman’s general health deteriorates, irritability appears, and sleep is disturbed. Less common is eczema (an inflammatory skin disease manifested by a profuse rash, itching and burning). Treatment is carried out in a hospital. A pregnant woman is recommended to follow a gentle diet with the exception of spicy and smoked foods. To reduce itching and burning, vitamin therapy and calcium supplements are prescribed. Locally, lotions with a solution of potassium permanganate are applied to the affected areas.

Jaundice It is quite rare in pregnant women. Its main clinical manifestations are liver damage, icteric discoloration of the skin, and itching. When a diagnosis is made, the pregnant woman is urgently hospitalized and the pregnancy is terminated at any stage.

Yellow liver dystrophy– an extremely dangerous form of rare toxicosis. It is very difficult and often leads to death. Liver damage occurs, jaundice increases, a sudden onset of convulsions and a coma occur. Immediate termination of pregnancy is indicated, which can help save the woman’s life.

Bronchial asthma as a manifestation of toxicosis occurs in isolated cases. It responds well to treatment, and pregnancy can be maintained. Pregnant women are prescribed vitamin therapy, sedatives and calcium supplements.

Tetany of pregnant women occurs when the parathyroid glands malfunction, which leads to a significant disruption of calcium metabolism in the body. Clinically, the disease manifests itself in the form of muscle spasms of the upper and lower extremities, and less commonly of the muscles of the face and torso. For treatment, parathyroidin (a hormone produced by the parathyroid glands) and calcium supplements are taken. In most cases, treatment is successful and the pregnancy continues.

Osteomalacia occurs as a result of a violation of the metabolism of phosphorus and calcium in the body. Clinically manifested by decalcification and softening of bones (usually the spine and pelvis), which leads to severe pain and deformation of the skeleton. Treatment includes vitamins D and E, physiotherapy (ultraviolet irradiation). If there is no effect of therapy, termination of pregnancy is indicated.

No matter how desired pregnancy may be, it can be overshadowed by toxicosis (preeclampsia). This condition is characterized by attacks of nausea and vomiting, weakness, darkening of the eyes and sometimes loss of consciousness. It may go away in a couple of weeks, or it may last for months.

Sometimes nausea can be so frequent and severe that it becomes problematic for the expectant mother to even take pills, for example, Duphaston or Magne B6, which are prescribed to many pregnant women.

During Soviet times, there was a practice of terminating a pregnancy if a woman vomited continuously for a long period of time. Nowadays, such methods of getting rid of toxicosis, fortunately, are no longer used, and studying the issue of the origin of gestosis and inventing new methods of combating it helps many expectant mothers survive this period more easily.

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Causes of toxicosis during pregnancy

The question of the reasons for the development of toxicosis has not yet been fully studied. But doctors have every reason to believe that its manifestation and intensity directly depend on the amount of toxins in a woman’s body.

However, there are other versions of the appearance of nausea and vomiting in the first weeks of pregnancy, so it makes sense to list them as possible culprits of preeclampsia:

The mother's body's reaction to hormonal imbalance. However, this theory cannot answer two questions: 1) why does the reaction occur only in the first weeks, if hormonal changes occur in the female body throughout pregnancy? 2) Why don’t all women undergo such a reaction, because everyone experiences hormonal disruption to the same extent?
Psychological rejection of the new position, subconscious reluctance to become a mother. But this version also has contradictions, because then it is completely unclear why severe toxicosis occurs in women who consciously planned pregnancy and in whom conception occurred only after serious efforts.

There is a popular belief that by the presence and intensity of toxicosis during pregnancy, one can determine who will be: a boy or a girl. But doctors are skeptical about this theory of the occurrence of nausea in the early stages.

When does toxicity start?

There are women who say that nausea and vomiting began from the first days of conception. This is, of course, impossible. In the first week after fertilization, the level of hCG is still so low that it cannot cause such severe intoxication in the body.

Usually, expectant mothers begin to feel the first signs of gestosis at 3–4 weeks from conception. It starts differently for everyone. Some people experience a feeling of nausea, which after a few days develops into vomiting.

For some, intoxication of the body is immediately expressed in the appearance of vomiting, which becomes more intense over time. No matter what week early toxicosis begins during pregnancy, should alert, if from the first day it manifested itself in the form of frequent uncontrollable vomiting.

When does it end?

The end of gestosis, even in the same woman during different pregnancies, can occur at different times. The most common pattern observed is: the more intense the manifestations of vomiting, the longer the toxicosis lasts.

So, in women who only experienced a feeling of nausea and could eat more or less normally, gestosis lasts about 3 to 4 weeks and disappears without a trace. The situation is different for those expectant mothers who were forced to spend whole days in the toilet and did not have the opportunity to eat normally.

In such cases, toxicosis is prolonged and begins to gradually recede only by 12 weeks. In severe cases, toxicosis can completely end only at 15–16 weeks.

Signs of toxicosis:

Nausea, which is more intense in the morning and subsides in the evening.
Vomiting that begins immediately upon waking and disappears almost completely during sleep.
Reaction to odors.
Dizziness and weakness. Often this condition occurs when a woman is in a stuffy room or remains in a stationary position for a long time.
Aversion to certain types of food.

Severity of toxicosis

Each body can react differently to pregnancy. Some people experience only mild nausea in the morning, while others are admitted to the hospital due to incessant vomiting. Gynecologists distinguish three degrees of severity of toxicosis:

I degree

Preeclampsia is mild, with nausea, a reaction to certain odors and vomiting, which occurs no more than 5 times a day. The general condition of the pregnant woman can be assessed as satisfactory. The woman can eat food and drink water.

II degree

A woman has an aversion to many types of food; a large number of smells invariably make her feel nauseous. Traveling in transport is complicated by vomiting, but vomiting itself, on average, occurs no more than 10 times per day. A pregnant woman can consume food and water with some difficulty.

III degree

The woman's condition begins to cause concern among doctors. The patient experiences attacks of nausea even at the mere sight of any food. Vomiting occurs up to 25 times a day. A pregnant woman cannot eat; breaks in food can last up to two days.

It becomes impossible to even drink water, which can lead to a life-threatening condition - dehydration. The patient experiences relief only when she lies down.

If toxicosis becomes protracted, then after 4–5 weeks it becomes difficult for a woman to move long distances on her own.

Why is severe gestosis dangerous?

If toxicosis in the first trimester becomes painful and deprives the expectant mother of the opportunity to eat and drink enough water, then doctors must take emergency measures to stabilize her condition. Severe gestosis leads to the following negative consequences:

Weight loss. With grade III toxicosis, a woman can lose up to 10 kg of weight in 3 months.
Decreased hemoglobin levels in the blood.
Increased uterine tone. Frequent gagging causes excessive tension in the abdominal muscles. The result is an effect similar to an abdominal pump. This tones the uterus and creates a threat of miscarriage.
Danger of dehydration. The water is odorless and its appearance does not disgust a pregnant woman. However, liquid entering the stomach still provokes vomiting.
The appearance of vitamin deficiency. Due to the impossibility of normal food consumption, the body cannot replenish its reserves of vitamins and minerals.

How to deal with toxicosis in the early stages, what to do?

When signs of toxicosis appear during early pregnancy, the question invariably arises: how to deal with it? The gynecologist can give recommendations to consume certain foods, prescribe treatment, or place the woman in a hospital.

Changing your daily diet

If gestosis manifests itself only in attacks of nausea and rare cases of vomiting, then the doctor will recommend including in the daily diet foods that will be easily digested by the intestines: yoghurt, kefir, vegetables, fruits.

Sometimes the pregnant woman herself determines what type of food helps her cope with the feeling of nausea. So, many people save themselves with mints, lemons, oranges, apple juice, pickled cucumbers, and sauerkraut.

Taking medications

In this case, medications are designed to cleanse the woman’s body of waste and toxins, as well as replenish the water-salt balance, which undergoes significant changes with constant vomiting.

For this purpose, the gynecologist prescribes Enterosgel and Regidron (less commonly, Cerucal). Within a few days of taking these drugs, grade II toxicosis disappears.

True, the taste of both Enterosgel and Regidron is such that their use can provoke a gag reflex.

Hospital treatment

In case of severe toxicosis, when dehydration becomes life-threatening for a pregnant woman, it is important to be admitted to a hospital, where the patient will be prescribed intravenous drips with glucose and other drugs that replenish the lack of fluid and nutrients in the body.

Typically, such measures do not help stop vomiting. A woman can still not leave the toilet for hours, it’s just that now her body is forced to feed and be saturated with enough fluid.

Prevention

Since the causes of toxicosis are not reliably known, it is difficult to judge measures to prevent it. It is also difficult to predict whether carrying a child will be accompanied by nausea and vomiting, or whether the expectant mother will be lucky enough to have a pregnancy without toxicosis.

Until now, scientists have not been able to prove that morning sickness is guaranteed to be cured by preliminary vitamin therapy or a visit to a psychologist, so today gestosis is treated symptomatically and is not prevented in any way.

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