Preeclampsia after pregnancy how to treat. Indications for early delivery and caesarean section with preeclampsia

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Gestosis after childbirth

Preeclampsia after delivery: how to deal with it

Preeclampsia after pregnancy and during it has symptoms known to doctors: increased blood pressure, swelling, and in connection with them a quick and large weight gain, as well as protein in the urine. In severe preeclampsia, a woman experiences nausea and vomiting, a severe headache. Since pathology can cause a lot of problems, more than one doctor decides how to treat preeclampsia after childbirth. It all depends on which organs of the mother he hit.

Preeclampsia (late toxicosis) is one of the most severe pathologies in expectant mothers. It is directly related to pregnancy. It begins in the second, and more often the third trimester, and is the main cause of maternal and child mortality. It is not treated with medication, only by delivery. All that doctors can do is to help prepare the child as much as possible for life outside the womb (with the rapid early progression of the pathology, the child is born prematurely) and prevent (though not in all cases) eclampsia, a formidable complication of preeclampsia in the mother.

Preeclampsia that occurs in the mother for a period of weeks, as a rule, leads to an emergency caesarean section due to her serious condition and the child in order to save them. If late toxicosis occurs after weeks, there is a chance that preeclampsia will not have time to harm the body of the mother and child too much. Mild preeclampsia rarely has consequences. Usually, all its symptoms go away in the first 1-2 days after the baby is born.

Childbirth with gestosis can be natural or operative, it depends on many factors. However, this situation is always under the control of doctors and anesthesiologists. Approximately half of the cases of eclampsia (severe seizures) occur in postpartum period, in the first 28 days after birth. And more often eclampsia is diagnosed in women who gave birth at term.

With a period of less than 32 weeks and severe preeclampsia (severe preeclampsia), a woman is given a caesarean section. After 34 weeks, natural childbirth is possible if the baby does not show any health problems and is in the correct position in the uterus.

During childbirth, as a prevention of eclampsia, a woman receives epidural anesthesia, that is, she gives birth only with anesthesia, as well as drugs that reduce blood pressure.

Doctors are required to prevent prolonged labor and severe uterine bleeding after them. Therefore, a uterine contracting drug is used - "Oxytocin".

On the first day after childbirth, a woman suffering from severe preeclampsia is in the intensive care unit, where her condition is closely monitored by resuscitators. At this time, she receives anticonvulsant therapy in the form of "magnesia" familiar to many women. This drug not only relieves the tone of the uterus, but is also a good prophylactic against eclampsia. The condition of the woman is closely monitored. They take urine and blood samples from her, and often measure her blood pressure.

In the first days after childbirth, women physiologically increase the volume of circulating blood, and for those who suffer from preeclampsia, this is an additional risk factor for arterial hypertension. Depending on the level of blood pressure and the severity of preeclampsia, the puerperal is prescribed drugs for pressure. If possible, compatible with lactation. For example, Dopegit, Nifedipine. Treatment of postpartum preeclampsia continues after discharge from the hospital. The increase in pressure can last up to about two months, but normally the condition should gradually return to normal. Withdrawal of the drug occurs by slowly reducing the frequency of administration and dosage.

Edema after childbirth is a common occurrence. And not only in those suffering from gestosis. A sign of preeclampsia is considered a rapid increase in swelling of the hands and face. If the ankles are swollen - it's not so scary. It will pass within a few days or weeks. At the same time, breastfeeding women should not use diuretic (diuretic) drugs, as this will lead to a decrease in lactation - a lack of breast milk.

What to do if preeclampsia does not go away after childbirth

You need to know the symptoms that require urgent health care:

• headache;
• blurred vision, flies in the eyes;
• pain between the ribs or in the right hypochondrium (liver);
• infrequent urination;
• increase in pressure.

If the protein in the urine remains after 6-8 weeks after childbirth, a consultation with a urologist or nephrologist is required.

If there was eclampsia, it is necessary to do a CT scan of the brain. In addition, donate blood for antiphospholipid antibodies, lupus anticoagulant, undergo a test for thrombophilia.

Supervision at least of the gynecologist and the therapist is required.

Consequences of gestosis for the child and mother

The woman is explained that she is at risk for developing arterial hypertension, kidney and liver failure, and diabetes in the future. Preeclampsia after cesarean and childbirth can eventually turn into coronary heart disease, cause a stroke.

As for the new pregnancy, there is a risk of repeating the scenario of the previous one. For prevention, a woman is prescribed aspirin in small doses from 12 weeks of pregnancy until its end. Sometimes together with calcium preparations.

The interval between pregnancies should not be more than 10 years, as this is also a risk factor for the development of eclampsia when carrying a child.

Preeclampsia in pregnant women also has a negative effect on the child's body - after childbirth, preeclampsia in mothers disappears, but problems in the baby may remain. Most often, with the nervous system. Children whose mothers have suffered severe preeclampsia are almost always born small, with signs of intrauterine growth retardation and chronic hypoxia.

Preeclampsia in pregnant women: symptoms, treatment and degree of danger to the fetus and mother

Quite often, pregnancy is accompanied by various pathological conditions. In our article, we will tell you what preeclampsia is, why it occurs, how it develops, describe its signs, talk about the diagnosis, treatment and prevention of this condition.

Preeclampsia during pregnancy is a complication of the gestational period. It develops during childbearing, during childbirth or in the first days after them. Preeclampsia is accompanied by a pronounced disruption of the functioning of vital organs. The basis of this condition is a disturbed adaptation of the woman's body to pregnancy. As a result of a cascade of reactions, vasospasm occurs in all tissues, their blood supply is disturbed, and dystrophy develops. The nervous system, heart and blood vessels, placenta and fetus, kidneys and liver are affected.

Relevance of the problem

Preeclampsia in pregnant women develops in 12-15% of cases. This main reason death of women in the third trimester of pregnancy. With the development of this complication later dates And

up to a third of all children die in childbirth. In women, after a complication, the kidneys suffer, chronic arterial hypertension develops.

What is dangerous preeclampsia for the fetus? It causes intrauterine hypoxia (lack of oxygen) and growth retardation. The consequences of preeclampsia for a child are a lag in physical and mental development.

IN modern conditions increasingly common atypical gestosis. They are characterized by the predominance of one symptom, early start, early formation of placental insufficiency. Underestimation of the severity of the condition in this case leads to delayed diagnosis, untimely treatment and late delivery.

Classification

The classification of preeclampsia is not well developed. In Russia, the most commonly used division of the disease into the following types:

• dropsy of pregnant women (with a predominance of edema);
• nephropathy of mild, moderate and severe degree;
• preeclampsia;
• eclampsia.

The main disadvantage of this classification is the vagueness of the term "preeclampsia", which does not allow clarifying the severity of the condition.

Today, preeclampsia is divided into forms in accordance with the International Classification of Diseases 10th revision:

• O10: hypertension (high blood pressure) that existed before pregnancy and complicated the course of gestation, childbirth, the postpartum period;
• O11: Pre-existing high blood pressure with the addition of proteinuria (protein in the urine);
• O12: the appearance of edema and protein in the urine during pregnancy at normal pressure;
• O13: development of high blood pressure during pregnancy in the absence of protein in the urine;
• O14: Pregnancy-induced hypertension associated with big amount protein in the urine;
• O15: eclampsia;
• O16: Unspecified hypertension.

This classification solves some working aspects of diagnosis and treatment, but does not reflect the processes taking place in the body.

With "pure" gestosis, pathology occurs in a previously healthy woman. This type is observed only in 10-30% of women. Combined forms are difficult. They develop against the background of previously existing diseases: hypertension, kidney and liver pathology, metabolic syndrome (obesity, insulin resistance), endocrine pathology (diabetes mellitus, hypothyroidism, and others).

This condition is typical only for the period of gestation. Preeclampsia after childbirth disappears, with the exception of severe complications. This suggests that the source of the problems is the fetus and the placenta. Gestosis occurs only in humans. This disease does not occur in animals, not even in monkeys, so it cannot be studied experimentally. Related to this a large number of theories and questions about the nature of this state.

Why does gestosis occur

Consider the main modern theories of the development of this state:

1. Cortico-visceral theory. According to her, gestosis is very similar to a neurotic state with disruption of the cerebral cortex and a subsequent increase in vascular tone. Confirmation of this theory is the increase in the frequency of the disease in pregnant women after mental trauma, as well as data obtained using electroencephalography.
2. The endocrine theory considers an improperly proceeding pregnancy as a chronic stress that causes overstrain and exhaustion of all endocrine systems of the body, including those regulating vascular tone.
3. The immunological theory states that the tissue of the trophoblast (the outer membrane of the fetus that forms the placenta) is a weak antigen. The body produces the appropriate antibodies, which also interact with the cells of the woman's kidneys and liver. As a result, the vessels of these organs are affected. However, autoimmune processes are not fixed in all women with preeclampsia.
4. The genetic theory is based on the fact that in women whose mothers suffered preeclampsia, the pathological condition develops 8 times more often than the average. Scientists are actively looking for "eclampsia genes".
5. Placental theory focuses on the violation of the formation of the placenta.
6. thrombophilia and antiphospholipid syndrome can cause damage to the vascular walls throughout the body, and they also lead to disruption of the formation of the placenta.

Scientists believe that a unified theory of the origin of preeclampsia has not yet been developed. The most promising are the immunological and placental versions.

The following factors significantly increase the risk of preeclampsia:

1. Extragenital diseases, namely hypertension, metabolic syndrome, diseases of the kidneys and gastrointestinal tract, frequent colds and endocrine pathology.
2. Multiple pregnancy.
3. Previously transferred gestosis.
4. The age of the woman is under 18 and over 30 years old.
5. Bad social conditions.

How the disease develops

The onset of the disease occurs even in the earliest stages of pregnancy. During implantation (introduction) of the embryo into the wall of the uterus, the arteries located in the muscle layer do not change, but remain in the "pre-pregnancy" state. Their spasm occurs, the inner lining of the vessels, the endothelium, is affected. Endothelial dysfunction is the most important trigger of preeclampsia. It leads to the release of powerful vasoconstrictor substances. At the same time, blood viscosity increases, microthrombi are formed in spasmodic vessels. The syndrome of disseminated intravascular coagulation (DIC) develops.

Vasospasm leads to a decrease in the volume of blood circulating in the body. As a result, the tone of peripheral vessels reflexively increases. The intensity of blood flow in all organs decreases, including the kidneys, liver, heart, brain and placenta. These violations cause a clinical picture of preeclampsia.

Symptoms of preeclampsia

External signs usually manifest gestosis of the second half of pregnancy. However, we found that the disease develops much earlier. Early preeclampsia is considered a preclinical stage, which can be detected using special tests:

• measurement of pressure with an interval of 5 minutes in the position of a woman lying on her side, on her back, again on her side. The test is positive if the diastolic ("lower") pressure changes by more than 20 mm Hg. Art.;
• violation of uteroplacental blood flow according to dopplerography;
• decrease in the number of platelets less than 160×10 9 /l;
• signs of increased blood clotting: increased platelet aggregation, decreased activated partial thromboplastin time, increased fibrinogen concentration in the blood;
• decrease in the concentration of anticoagulants, in particular, own heparin;
• a decrease in the relative number of lymphocytes to 18% and below.

If a woman finds two or three of the listed signs, she needs treatment for preeclampsia.

Classic signs of preeclampsia that appear in the second half of pregnancy and especially in the 3rd trimester:

Gestosis is characterized by a variety of options for its course. The classic triad occurs in only 15% of women, and one of the three symptoms occurs in a third of patients. More than half of patients suffer from protracted forms of the disease.

One of the earliest signs of the disease is excessive weight gain. It usually starts at 22 weeks of gestation. Normally, any woman up to 15 weeks should add no more than 300 g weekly. Then, in patients younger than 30 years old, this increase should be no more than 400 grams per week, in older women, grams.

An increase in blood pressure usually occurs at 29 weeks. For a more accurate diagnosis, you should follow all the measurement rules, register the pressure on both arms, and choose the right cuff size.

Edema in preeclampsia is associated with sodium retention, a decrease in the concentration of proteins in the blood, and the accumulation of incompletely oxidized metabolic products in the tissues. Edema can be only on the legs, spread to the abdominal wall or cover the entire body. Signs of hidden edema:

• excretion of the main volume of urine at night;
• a decrease in the amount of urine excreted compared to the amount of fluid consumed;
• excessive weight gain;
• “a symptom of the ring” - a woman’s wedding or other familiar ring becomes small.

Proteinuria is the excretion of protein in the urine. It is caused by damage to the glomeruli as a result of lack of oxygen and vasospasm. Excretion of more than 1 gram of protein in any portion of urine is a dangerous sign. At the same time, the level of protein in the blood decreases.

Severe forms of the disease

Of particular danger to mother and child is a violation of the function nervous system- preeclampsia and eclampsia.

• headache in the back of the head and temples;
• "shroud", "flies" before the eyes;
• pain in the upper abdomen and in the right hypochondrium;
• nausea and vomiting, fever, itchy skin;
• nasal congestion;
• drowsiness or increased activity;
• redness of the face;
• dry cough and hoarseness;
• tearfulness, inappropriate behavior;
• hearing loss, difficulty speaking;
• chills, shortness of breath, fever.

With the progression of this condition, eclampsia develops - a convulsive seizure, accompanied by hemorrhages and swelling of the brain.

Complications

Late preeclampsia can cause severe complications that can even lead to the death of the mother and child:

• eclampsia and coma after it;
• intracerebral hemorrhage;
• acute renal failure;
• respiratory failure;
• retinal detachment and loss of vision in a pregnant woman;
• premature detachment of the placenta;
• hemorrhagic shock and DIC.

There are more rare forms that complicate preeclampsia. This is the so-called HELLP-syndrome and acute fatty hepatosis of pregnant women.

HELLP syndrome includes hemolysis (breakdown of red blood cells), a decrease in the number of platelets responsible for blood clotting, and abnormal liver function with an increase in its enzymes in the blood. This complication occurs mainly after the 35th week of pregnancy, especially against the background of nephropathy, and often causes the death of a woman and fetus.

Symptoms develop quickly. The woman begins to complain of headache, vomiting, pain in the abdomen or in the right hypochondrium. There is jaundice, bleeding, the patient loses consciousness, she begins to have convulsions. There is a rupture of the liver with bleeding into the abdominal cavity, placental abruption. Even if a woman is urgently operated on, due to blood clotting disorders, she may die in the postoperative period from severe bleeding.

Acute fatty hepatosis of pregnant women develops mainly during the first pregnancy. Within 2-6 weeks, a woman is concerned about weakness, lack of appetite, abdominal pain, nausea and vomiting, weight loss, skin itching. Then liver and kidney failure develops, which is manifested by jaundice, edema, uterine bleeding and fetal death. Often there is a hepatic coma with disruption of the brain.

Assessment of the severity of the condition

According to the Russian classification, the severity of the disease is determined by the condition of the kidneys.

Preeclampsia of the 1st degree is usually accompanied by swelling of the legs, slight proteinuria, and an increase in blood pressure up to 150/90 mm Hg. Art. In this case, the fetus develops normally. This condition usually occurs within a week.

Preeclampsia of the 2nd degree is characterized by the appearance of edema on the abdomen, proteinuria up to 1 g / l, an increase in pressure up to 170/110 mm Hg. Art. Fetal hypotrophy of the 1st degree may be noted. This form occurs a week.

Diagnosis of a severe form is based on the following features:

• increase in blood pressure up to 170/110 mm Hg. Art. and higher;
• protein excretion in an amount of more than 1 gram per liter of urine;
• decrease in urine volume to 400 ml per day;
• widespread edema;
• violation of blood flow in the arteries of the uterus, brain and kidneys;
• delayed fetal development;
• blood clotting disorder;
• increased activity of liver enzymes;
• development up to 30 weeks.

With such a serious condition, treatment in a hospital is necessary.

Treatment of preeclampsia

The main directions of therapy:

• medical and protective regime;
• delivery;
• restoration of functions internal organs.

A woman is prescribed the following drugs:

• sedatives, sedatives (valerian, motherwort), in severe cases - tranquilizers and antipsychotics (Relanium, Droperidol), barbiturates, anesthetics;
• antihypertensive drugs (mainly calcium antagonists - Amlodipine, beta-blockers - Atenolol, as well as Clonidine, Hydralazine and others);
• magnesium sulfate, which has a hypotensive, anticonvulsant, sedative effect;
• replenishment of the volume of circulating blood with the help of intravenous infusions;
• antiplatelet agents (Kurantil) and anticoagulants (Fraksiparin) under strict control of blood coagulation;
• antioxidants (vitamins C, E, Essentiale).

Drug treatment with a mild degree can be carried out within 10 days, with moderate severity - up to 5 days, with a serious condition - up to 6 hours. If treatment fails, urgent delivery is necessary.

Delivery with preeclampsia is carried out through the natural birth canal or with the help of a caesarean section. A woman can give birth herself with a mild degree of illness, a good condition of the fetus, the absence of other diseases, the effect of medications. In more severe cases, a planned operation is used. In severe complications (eclampsia, renal failure, placental abruption, and so on), an emergency caesarean section is performed.

After caesarean section drug treatment continue until full recovery of all body functions. Women are discharged home no earlier than 7-15 days after birth.

Prevention of gestosis during pregnancy

A pregnant woman should avoid nervous and physical overload, have a good rest, and not take medications without a doctor's prescription. Nutrition should be complete, if possible hypoallergenic. Severe fluid restriction and a low-salt diet are not indicated. Only in severe cases of renal failure is the patient recommended to reduce the amount of protein consumed with food.

The key to preventing preeclampsia is regular medical supervision, weight control, blood pressure, blood and urine tests. If necessary, a woman is hospitalized in a day hospital or in a sanatorium, where preventive treatment is carried out.

If the condition worsens, the appearance of edema, headache, pain in the right hypochondrium, the patient should consult a doctor as soon as possible. Self-medication is unacceptable. Untreated acute gestosis is an immediate threat to the life of the mother and child.

Gestosis before and after childbirth. Preeclampsia in pregnant women - symptoms and prevention. Treatment of preeclampsia in pregnant women women's health

Preparing to become a mother, a woman thereby sets herself a very important task - to give birth to a healthy person. And she goes to this goal day after day, experiencing all the joyful moments of pregnancy and steadfastly enduring the unpleasant “surprises” that accompany her. But when most of the path has been passed, and it is not long before the birth of the crumbs, future mom may face another complication of pregnancy - preeclampsia. This disease is very dangerous for both the unborn baby and the health of the pregnant woman herself. Therefore, it is very important not to miss its first signs, to diagnose preeclampsia in time and immediately begin its treatment. And for this you need to know what this disease is, how it manifests itself. And what can a future mother do to minimize the risk of developing preeclampsia in her.

What is gestosis? Preeclampsia of pregnant women or late toxicosis is a complication inherent in the second half of pregnancy, which is associated with disruption of the functioning of vital organs and systems in a woman's body. Only pregnant women can suffer from gestosis, and gestosis disappears after childbirth, after a while. Signs of this disease are detected in 13-16% of women in position. Its seriousness is evidenced by the fact that for quite a long period of time preeclampsia has been called one of the three main causes of maternal mortality in our country.

Preeclampsia can develop only this week of pregnancy. But most often - in the third trimester, that is, after 28 weeks. This is a very insidious disease - at first, a woman may not have any manifestations of gestosis at all. And even after the discovery of its main symptoms, the well-being of the expectant mother can remain normal. But in no case should preeclampsia be ignored, because the untimely provision of medical care is fraught with serious consequences for the health of the mother and the unborn baby.

What happens in a woman's body with gestosis? Water-salt metabolism is disturbed and water and sodium retention occurs. The permeability of the walls of blood vessels increases, due to which the liquid from them enters the tissues. Blood circulation is disturbed and the supply of tissues with oxygen and nutrients is reduced. The placenta, kidneys and brain are the first to react to insufficient blood supply in the body of the expectant mother. Because of all these changes, the baby also suffers - poor blood supply to the placenta causes placental insufficiency, and it, in turn, delays intrauterine development of the fetus.

How does it manifest itself? Preeclampsia develops in stages. Persistent edema due to fluid retention in the body of the expectant mother is its early symptom. They mean that dropsy has begun, the first stage of gestosis. Depending on the extent of edema, there are different degrees of dropsy. Edema is not only obvious, that is, visible to the eye, but also hidden. They are indicated by uneven or pathological (more than a week) weight gain in the expectant mother. In the morning, swelling is not so noticeable - at night, excess fluid is evenly distributed over the woman's body. But towards the end of the day, swelling begins to appear on the legs and lower abdomen.

If high blood pressure is added to the edema in a pregnant woman, and tests show the presence of protein in the urine, this indicates the development of nephropathy, which usually begins after dropsy, if its treatment was not started on time. The expectant mother's blood pressure is 135/85 mm Hg. Art. and above is a clear sign of nephropathy. However, the starting point is always the baseline blood pressure of the pregnant woman. Complications of preeclampsia in pregnant women no longer arise due to high blood pressure, but due to its sharp fluctuations.

Nephropathy - very dangerous state, because it can flow into eclampsia - a convulsive attack, and also provoke bleeding in the expectant mother, placental abruption, the onset of premature birth, fetal hypoxia, or even his death.

The next stage of preeclampsia is preeclampsia. With it, the pregnant woman experiences a feeling of heaviness in the back of her head, headaches and pains in the stomach, nausea, vomiting, impaired vision, memory. She may be tormented by insomnia or, conversely, drowsiness, lethargy and irritability. The expectant mother feels a veil before her eyes, flashing "flies" and sparks - these are consequences of damage to the retina and circulatory disorders in the occipital part of the cerebral cortex. The blood pressure indicator can reach 160/110 mm Hg. Art. and higher. Here it is important to respond very quickly to the condition of the woman in order to prevent the development of the next stage of preeclampsia, which can take the life of both mother and baby.

At the most severe stage of preeclampsia, eclampsia, seizures lasting 1-2 minutes are added to the symptoms of nephropathy and preeclampsia. In some cases, eclampsia proceeds without convulsions, then the expectant mother complains of a headache, darkening of the eyes and may fall into a coma.

In order to avoid the severe consequences of preeclampsia and to save the life of mother and baby, in some cases, doctors have to resort to an extreme method - premature delivery.

Risk groupWhich of the expectant mothers is most at risk of preeclampsia? - Women who are preparing to become a mother for the first time, pregnant women under the age of 18 and over 35 years (due to aging of the tissues of the reproductive system), with chronic diseases (VVD, diabetes, obesity, hypertension, pyelonephritis) or genital infections, inflammatory diseases of the genital area , endocrine disorders.

The likelihood of developing gestosis is also high with multiple pregnancy, large fetus and polyhydramnios, if the interval between births is less than two years, as well as with previous abortions. If the expectant mother is constantly overtired, is in a state of chronic stress, she is also at risk.

However, preeclampsia can also occur in an absolutely healthy pregnant woman. This usually happens during the week of pregnancy. The reason for this may be the failure of adaptive mechanisms due to the increased load on the body, not proper nutrition pregnant, lack of regimen, and even banal SARS.

About treatment With a mild form of gestosis (dropsy of the first degree), the doctor may limit himself to outpatient treatment. If severe dropsy is found in a pregnant woman, she will be treated in a hospital. With nephropathy, preeclampsia and eclampsia, the expectant mother is hospitalized in a hospital where there is an intensive care unit and a department for premature babies. If the doctor, upon detection of preeclampsia, insists on treating the expectant mother in a hospital, she should not refuse. Because in this way she endangers the health and life of the baby and her own.

While hospitalized, the expectant mother usually undergoes a series of examinations - she takes blood tests (general, for biochemistry, for coagulation), urine tests (general, which determines daily protein loss, Zimnitsky's test). The attending physician will definitely assess the condition of the fetus using ultrasound, cardiotocography and dopplerometry. If necessary, the pregnant woman is examined by an ophthalmologist and a neurologist.

Treatment of gestosis involves several directions:

A diet with fluid restriction (up to 1 liter per day) and salt, enriched with proteins and vitamins;

Intravenous therapy to improve blood circulation in small vessels, including placental vessels;

Therapy aimed at lowering blood pressure;

The introduction of drugs for the prevention of placental insufficiency;

The expectant mother will also be prescribed sedatives, diuretic drugs and will be prescribed bed rest. The duration of treatment in the hospital depends on how severe the form of preeclampsia was found in the pregnant woman. If the treatment of severe forms is ineffective for a certain period of time, the doctor may decide to perform a caesarean section.

To resist preeclampsia, the expectant mother can follow some simple rules, and then there is a chance that the diagnosis "Preeclampsia" will not appear in her medical record. What do we have to do?

1. Watch your weight. Starting from the 28th week, the weekly weight gain of the pregnant woman should not exceed 350 g, maximum.

2. Follow a diet. At the same time, lean on foods rich in protein, limit (or rather refuse) flour and sweets.

3. Limit fluid intake (1-1.5 liters during the day, along with liquid food and juicy fruits) and salty foods.

4. Lead an active lifestyle. Hiking in the fresh air, and if there are no contraindications, yoga, swimming for pregnant women is what you need to keep fit.

5. Engage in self-control. Start, for example, a diary where the expectant mother can record daily weight gain, as well as the number of movements of the crumbs over a certain period of time.

You can consult a doctor about the use of rosehip decoction, cranberry juice, kidney tea, which have a weak diuretic effect and help prevent edema. For the same purpose, the doctor may also prescribe a series of medicines.

Also, one should not forget about the organization of the diet and rest of the pregnant woman, sufficient night sleep, regular walks in the fresh air. The mother-to-be should be in good mood and be in a calm environment.

Preeclampsia in pregnant women - symptoms and treatment

Most women endure pregnancy easily, but there are those for whom bearing a child is associated with the risk of losing health, and sometimes even life. This is observed in about 12 - 27% of expectant mothers.

The functional discrepancy between all systems of a woman's body to the needs of the fetus in late pregnancy is called preeclampsia, i.e. the woman's body cannot cope with the task of providing the fetus with nutrients and oxygen, and this condition is associated precisely with the onset of pregnancy.

Preeclampsia of pregnant women used to be called late toxicosis or dropsy. It is observed after the 20th week of pregnancy and may continue for another 2-3 weeks after delivery.

The mechanism of development of preeclampsia

To date, the causes of preeclampsia in pregnant women have not been fully studied, there are several theories: endocrine (the effect of hormones), immunological (reaction of the mother's body to the fetus), genetic and corticovisceral. None of these theories can 100% explain all the processes that occur during gestosis of pregnant women.

But the changes that occur in the body during gestosis are well studied. Under the influence of toxic substances, damage to the walls of blood vessels is observed, the liquid part of the blood, together with the protein, “leaves” into the tissues, so edema occurs.

The kidneys are an organ where there are a lot of blood vessels, protein through them enters the urine. This phenomenon is called proteinuria.

As a result of a decrease in the amount of circulating blood in the vessels, their narrowing (spasm) occurs, which leads to an increase in blood pressure.

With vasospasm, oxygen starvation of all organs is observed, the kidneys, liver and brain are the most “needed” in it, in a pregnant woman, the placenta should be added to this list. As a result, not only the mother's body suffers, but also the fetus, hypoxia and developmental delay occur.

To date, there are several classifications of preeclampsia in pregnant women, all of them are designed for the convenience of doctors. The tactics of management and treatment depend on the correct diagnosis and determination of the severity of the course of preeclampsia during pregnancy.

There are three main symptoms of preeclampsia: edema, proteinuria and increased blood pressure. Preeclampsia in a pregnant woman can be manifested by one symptom, but their combination is also possible.

The presence of all three symptoms doctors call nephropathy. And in the classifications it is called preeclampsia (divided into 3 degrees of severity).

There are pure gestoses and combined ones, that is, those that have arisen against the background of another disease (pyelonephritis, diabetes mellitus, obesity, hypertension), moreover, combined forms appear up to 20 weeks (early gestosis), proceeding more difficult compared to late gestosis.

The most severe and formidable condition is eclampsia - a convulsive condition, which doctors try to prevent.

Edema is the earliest symptom of preeclampsia that a woman herself can notice. They can be mild, affecting only the legs, or they can be noticeable on the face. Edema is also observed during a normal pregnancy, so do not panic from the very beginning.

It is necessary to weigh yourself regularly, too fast weight gain (more than 0.5 kg per week) should alert you, because edema can be not only obvious, but also hidden (the abdominal wall swells, and the increase in the abdomen is interpreted incorrectly).

PRE-ECLAMPSIA (nephropathy) is preeclampsia during pregnancy, which combines edema, proteinuria (protein in the urine) and increased blood pressure. There is a mild degree (BP - 150/90 mm Hg, protein in the urine - up to 1.0 g / l, edema is noticeable only on the legs), an average degree (BP - 170/100 mm Hg, protein in urine - 1.0-3.0 g / l, swelling of the legs and abdominal wall occurs), severe (BP - more than 170/100 mm Hg, protein in the urine - more than 3.0 g / l, legs swell, abdominal wall and face) nephropathy.

Objectively, a woman feels a headache, nausea, there may be vomiting, heaviness in the occipital region and a mental disorder.

The level of blood pressure must be measured in dynamics and compared with the initial value, and, moreover, you need to pay attention to diastolic pressure, it is it that displays vasospasm. A small difference between systolic and diastolic blood pressure (less than 30 mmHg) is a poor prognostic sign and requires hospitalization.

Eclampsia is the most severe manifestation of preeclampsia in a pregnant woman, in which convulsions of the whole body are observed. Sharp fluctuations in blood pressure at this moment are dangerous, because this leads to rupture of cerebral vessels (stroke), placental abruption, followed by hypoxia and fetal death. A pregnant woman may experience acute respiratory failure (shortness of breath, shortness of breath, agitation).

The course of preeclampsia can be long with minor symptoms, but sometimes it develops over several days to the state of eclampsia. In both cases, fetal hypoxia occurs.

Symptoms of gestosis In order to make a diagnosis of gestosis in pregnant women, it is necessary to pass general analysis And biochemical analysis urine, determine the protein in the daily urine, check the number of platelets and the state of the entire blood coagulation system.

Control over body weight will help to identify edema, normally, if there is no preeclampsia, in the second half of pregnancy a woman adds 350 grams per week (no more than 500 grams). You can also track the amount of fluid drunk and excreted (in the form of urine).

The level of blood pressure and the state of the vascular system can be judged by the pressure measured on both hands (with gestosis, a difference is possible on two limbs). A valuable diagnostic study will be an examination by an oculist of the fundus and an ultrasound examination of the fetus to detect hypoxia.

Each pregnant woman donates blood and urine, is weighed and regularly measures blood pressure. But women from the risk group for the development of preeclampsia are subject to the closest attention from physicians, these include primiparous women, women with multiple pregnancies, late pregnancy- over 35 years old, women with sexually transmitted infections and chronic diseases (obesity, diabetes, pyelonephritis, arterial hypertension).

Treatment of preeclampsia is to restore the normal state of health of a woman. The most important rules for the development of preeclampsia in the second half of pregnancy is the timely visit to the doctor and the absence of any self-treatment. Only a doctor knows how to treat preeclampsia, because taking certain medications can only aggravate the already difficult condition of a pregnant woman and fetus. For example, to get rid of edema, some begin to drink diuretic pills, but the cause of edema in preeclampsia is pathological vascular permeability, and not excess fluid, so the condition worsens even more.

With mild forms of preeclampsia, you can follow all the prescriptions of the doctor at home. But with a severe course of preeclampsia, it is better to be under the supervision of specialists in a hospital, where they will provide medical assistance in a timely manner (reduce pressure, relieve convulsions).

Timely delivery is also important in the treatment of preeclampsia, because preeclampsia is a condition caused by pregnancy. If the condition of a pregnant woman worsens or severe fetal hypoxia, the absence of the effect of therapy, childbirth is the only right decision. With mild gestosis, the birth of a child is possible naturally, but in this case there is a risk of deterioration during attempts, when the load on the woman's body increases greatly.

Most often, a caesarean section is performed, especially when there is eclampsia, stroke, retinal detachment, kidney or liver failure in a woman in labor.

Prevention of preeclampsia is important point during pregnancy, since it is not possible to cure the disease completely, it remains only to prevent the condition from worsening. The most important thing is to find out in time.

Every responsible woman should regularly be weighed, control blood pressure measurement, and give urine for protein content. Even with a normal pregnancy, proper nutrition is important with a predominance of proteins and fiber, a reduced content of fat and starchy foods, as well as a long stay in the fresh air, walking. And with preeclampsia, these activities are vital not only for the expectant mother, but also for the little man inside her, because this improves the blood supply to the tissues and reduces hypoxia.

Thus, no one is immune from the development of preeclampsia, but you can protect yourself from formidable complications. To do this, it is enough to take care of yourself and feel responsible for your health and the health of the child.

Treatment of preeclampsia in pregnant women

In order to reliably determine whether or not preeclampsia, one visit to the doctor is not enough. Dynamic observation of an obstetrician-gynecologist is necessary.

Blood pressure control - prevention of gestosis At each visit to the doctor of a pregnant woman, blood pressure (BP) in both arms, pulse and body weight must be measured. An increase in blood pressure above 135/85 may indicate preeclampsia. The doctor evaluates the weight gain of the pregnant woman, the presence or absence of edema, asks the pregnant woman if the amount of urine excreted has decreased.

Also, if preeclampsia is suspected, additional tests and studies are prescribed:

Clinical and biochemical analysis of blood;

General urine analysis;

Fetal ultrasound with dopplerometry, CTG (cardiotocography) of the fetus.

If the obtained tests and examination data raise suspicions of preeclampsia (BP above 135/85, pronounced edema and large weight gain, protein in the urine), additionally appoint:

Daily monitoring of blood pressure, ECG;

Urinalysis according to Nechiporenko, according to Zimnitsky, analysis of daily urine for protein;

Consultation of an ophthalmologist, therapist, nephrologist, neurologist.

Treatment of late gestosis

With mild manifestations of gestosis - dropsy, treatment is carried out on an outpatient basis. With nephropathy and more severe manifestations of the disease, hospitalization of the pregnant woman in the obstetric department is indicated.

With minor edema and normal tests, the treatment of preeclampsia is limited to following the recommendations on lifestyle and nutrition.

With dropsy with severe edema and a mild form of nephropathy, the following is prescribed:

Sedatives (tinctures of motherwort, valerian);

Disaggregants (Trental, Curantil) to improve the rheological properties of blood;

Antioxidants (vitamin A and E);

With an increase in blood pressure, antihypertensive drugs with an antispasmodic effect are used (Eufillin, Dibazol);

Phytocollections with a diuretic effect.

In severe nephropathy, preeclampsia and eclampsia, treatment is carried out with the participation of a resuscitator in the intensive care unit. Spend infusion therapy to correct metabolic and electrolyte disorders - injected fresh frozen plasma, reopoliglyukin. In addition to the above groups of drugs, in severe forms of gestosis, anticoagulants (Heparin) are also used. For rapid regulation of water-salt metabolism, diuretics (Furosemide) are used instead of herbal teas.

In all forms of gestosis, in order to prevent the threat of premature birth and fetal hypoxia, selective sympathomimetics (Ginipral) are used.

No less relevant is the question of the method of delivery in preeclampsia.

If the condition of the pregnant woman is satisfactory and the fetus does not suffer, based on the data of ultrasound and CTG, then the birth is carried out through the natural birth canal. In the absence of the effect of therapy, in severe forms of preeclampsia and chronic fetal hypoxia, a caesarean section is indicated.

Treatment of preeclampsia is carried out not only before childbirth, but also during childbirth and in the postpartum period until the woman's condition is completely stabilized.

Nutrition and diet for gestosis

Lifestyle and nutrition in gestosis are very important for successful treatment. In the presence of edema and pathological weight gain, a pregnant woman should follow a special diet. It is necessary to exclude spicy, salty and fried foods from the diet. Consume less salt. Preference should be given to boiled dishes, slightly undersalted. Try to eat foods of both plant and animal origin, as well as dairy products, fruits and vegetables. On average, a pregnant woman with a tendency to edema should consume no more than 3,000 calories per day. It is necessary to limit not only the consumption of food, but also liquids. You need to drink no more than one and a half liters of fluid per day. Attention should be paid to diuresis - the amount of liquid excreted should be greater than that drunk.

Hectic lifestyle, stress also provokes gestosis. In the second half of pregnancy, a woman should sleep at least 8-9 hours a day. If you want to sleep during the day, it is also better to lie down to rest. But at the same time, a sedentary image can also provoke preeclampsia. Therefore, a woman is recommended to take daily walks in the fresh air for at least an hour, to engage in special fitness for pregnant women.

Folk remedies for gestosis

Traditional medicine in the treatment of gestosis is very relevant, especially with dropsy, many medicinal plants have a diuretic effect. With gestosis, kidney tea, cranberry or lingonberry juice, rosehip broth are prescribed. You can use herbal preparations such as Canephron or Cyston. Sedative tinctures from motherwort or valerian can be used starting the week of pregnancy for the prevention and treatment of gestosis. With severe forms of gestosis folk remedies are not effective, so only drugs are used.

Detachment of a normally located placenta, leading to fetal death;

Fetal hypoxia, which also leads to intrauterine death of the fetus;

Hemorrhage and retinal detachment;

Heart failure, pulmonary and cerebral edema, heart attacks and strokes;

Development of renal and hepatic insufficiency, hepatic coma.

Implementation of reproductive function up to 35 years;

Timely treatment of chronic diseases that provoke preeclampsia;

Healthy lifestyle.

Gestosis - what is it?

Preeclampsia is a complication of pregnancy that develops after 20 weeks and can be observed within 2 or 3 days after childbirth. The cause of preeclampsia has not been fully established. Signs of gestosis are the appearance of edema (dropsy of pregnancy), protein in the urine and increased blood pressure. If the disease progresses, preeclampsia occurs, in which the central nervous system is affected.

A woman has a headache, "flies" before her eyes, abdominal pain, nausea or vomiting. This indicates the development of cerebral edema. Without treatment, the disease progresses to the next stage, and eclampsia occurs (convulsions against the background of loss of consciousness).

Preeclampsia is a dangerous condition that can lead to fetal death due to oxygen starvation, since normal blood circulation in the placenta is disrupted. The disease also threatens the life of the mother. Usually, the development of eclampsia is an indication for emergency delivery before the due date in the interests of both the woman and the child.

Preeclampsia occurs in about 13-16% of all pregnancies. The disease develops due to the fact that during pregnancy there are substances that can damage blood vessels. As a result, fluid and plasma protein seep into the tissues, resulting in severe edema. The woman is gaining weight, despite the usual diet. In addition, through the vessels of the kidneys, the protein enters the urine. Due to vasospasm, blood pressure rises.

Preeclampsia is more common in women who are carrying their first child or twins, women over 35 years of age and suffering from chronic diseases. For the timely detection of preeclampsia, it is necessary to regularly weigh the expectant mother, conduct urine tests and measure blood pressure.

Gestosis is divided into two main types. Pure preeclampsia occurs if a woman has no other background diseases. The disease appears after 35 weeks of pregnancy and lasts 1-2 weeks. Combined preeclampsia develops in women with other chronic diseases. It starts at the week of pregnancy and lasts up to 6 weeks.

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Often during pregnancy there are various pathological conditions. Gestosis is one of them. The disease at an early stage of pregnancy is called toxicosis. It is accompanied by intolerance to certain odors, nausea, vomiting, drowsiness and weakness, but does not pose a danger to the fetus and mother. Late preeclampsia can develop in the third trimester, during delivery or after. With this disease, vital organs are affected: the heart, blood vessels, liver and kidneys, as well as the placenta and fetus.

Reasons for the development of gestosis

Until now, doctors do not know the exact causes of gestosis. However, there is an opinion that the disease occurs against the background of high blood pressure, disorders in the liver and kidneys, and other somatic diseases in pregnant women. There are several theories explaining the formation of gestosis:

1. Endocrine - during pregnancy, the work of the heart and blood vessels is disturbed due to poor metabolism and insufficient blood supply to organs with nutrients. Such failures are the result of a change in the functioning of the endocrine system, which is responsible for the composition of the blood and vascular tone.
2. Cortico-visceral - explains the disease by the development of neurosis in a pregnant woman. The cerebral cortex, due to conditioned reflexes, affects the state of internal organs, and this upsets the balance of inhibition and excitation in it.
3. Placental - most likely, the uterine arteries, due to genetic and immunological characteristics, do not change their structure, as in the normal development of pregnancy, and the muscle layer is not transformed in them. As the fetus grows, vasospasm occurs, leading to a decrease in blood flow and the occurrence of hypoxia.
4. Immunological - there is an immunological discrepancy between the tissues of the fetus and mother. As a result of this, the female body does not accept a foreign body or there is an insufficient production of antibodies, which disrupts blood circulation and preeclampsia occurs after childbirth.
5. Genetic - the disease is often inherited. Studies have confirmed that fetal genes play a role in the development of preeclampsia.

With the disease, the work of the heart worsens, which means that blood circulation worsens, its coagulability increases. Organs and tissues are no longer supplied with enough oxygen and nutrition. The brain, liver, kidneys and placenta suffer most from lack of blood circulation. The fetus has oxygen starvation and its development is suspended, which gives rise to very serious consequences after preeclampsia.

Symptoms of preeclampsia

The disease can be asymptomatic for a long time. The clinical picture is characterized by special signs at each stage of the disease:

• Edema, or dropsy - swelling of soft tissues is observed in different places. There are four degrees: the first - the feet; the second is the legs and stomach; the third - lower and upper limbs, stomach, face; the fourth is the whole body.
• The appearance of protein in urine - there is a violation of the functioning of the kidneys, decreases daily rate urine. During the study, a protein is found in it, its rapid increase is a sign of the rapid progression of the disease.
• Increased blood pressure - failure of the kidneys and swelling cause an increase in pressure. In severe cases, high blood pressure leads to loss of consciousness, hemorrhages, and the occurrence of postpartum preeclampsia is also possible.
• Preeclampsia - headaches occur, vision deteriorates, inadequate reactions appear, irritability (or indifference sets in), the condition may be drowsy or, conversely, insomnia torments.
• Eclampsia is the most severe and dangerous stage of the disease, which can develop both before and after childbirth. The condition is accompanied by seizures, convulsions. During this period, the functions of all organs and systems of the body are disrupted: severe renal failure, possible liver rupture, pulmonary edema, stroke or heart attack, placental abruption, fetal hypoxia and premature birth. Preeclampsia after childbirth can cause the death of the mother and child.

Who is at risk?

No one is safe from the disease of preeclampsia, but its manifestation is most likely in the following female category:

• women in labor under 18 and over 30;
• having given birth many times;
• with multiple pregnancy;
• having a short break between pregnancies, when the body is weakened, gestosis may occur in the child after birth;
• often interrupting pregnancy artificially;
• with hereditary predisposition;
• with diseases of the kidneys, liver, cardiovascular and endocrine systems.

The well-being of a woman bearing a child does not always indicate her health. The test results may show malfunctions in the body with external well-being. Experts strongly recommend regular visits to the gynecologist throughout pregnancy, so as not to miss serious complications.

Diagnosis of the disease

If gestosis is suspected, the doctor takes the following measures:

• History taking - during a conversation with a pregnant woman or a woman who has already given birth, the doctor listens to complaints, finds out all the ailments that the woman feels, specifies the time when the symptoms of the disease began, asks if close relatives had preeclampsia.
• Visual examination - it turns out if there is swelling on the legs and body, blood pressure is measured, the pulse is felt, the heart sounds of the mother and fetus are heard.
• A general analysis and biochemistry of blood is prescribed.
• Urine is being studied - a clinical, daily and biochemical analysis is taken.
• The fundus is checked.
• The pressure is constantly monitored.
• Body weight is determined.
• Ultrasound and dopplerometry of the fetus is done.

Additional consultations of a therapist, neurologist, nephrologist, ophthalmologist are prescribed. Based on the data obtained, a diagnosis is made, and a course of treatment for preeclampsia is prescribed after or before childbirth.

Development of the disease

According to the severity of the course and the severity of the manifestations, late preeclampsia is divided into three degrees:

• First, it is called dropsy. Light initial manifestations in the form of edema spread throughout the body. They significantly increase the body weight of a woman in position, and often remain after childbirth. Edema appears on the limbs, gradually spreading to the stomach and face. They progress rapidly, increasing in the evening, and are poorly corrected. Nephropathy joins dropsy. The kidneys stop functioning normally.
• The second - an increase in edema, the appearance of protein in urine, the further development of nephropathy, an increase in pressure are manifestations of severe preeclampsia. The body of a pregnant woman ceases to cope with stress and begins to malfunction.
• Third - all processes gradually progress and an extremely serious condition sets in. The nervous system is damaged, which threatens the life of the fetus and woman. A severe form of the disease is diagnosed according to the following signs: protein excretion in the urine of more than 1 g / l, a decrease in the daily volume of urine to 400 ml, pressure reaches 170/110 and above, severe swelling of the whole body, blood flow is disturbed, blood clotting and fetal development, increases activity of liver enzymes. Urgent resuscitation and the birth of a baby are required, often with the help of an operation. In this condition, the child may develop preeclampsia after cesarean.

Treatment of preeclampsia

The main areas of therapy include:

• childbirth;
• medical and protective regime;
• treatment of postpartum preeclampsia;
• restoration of the activity of internal organs.

For pharmacotherapy, the following medicines are used:

• tincture of "Valerian", "Motherwort", in severe conditions, antipsychotics and tranquilizers are indicated - "Droperidol", "Relanium".
• Medications to relieve pressure - Amlodipine, Atenolol, Hydralazine.
• Magnesium sulfate is used as an anticonvulsant drug.
• Intravenous infusions are carried out to replenish blood volume.
• Anticoagulants and antiplatelet agents - Fraxiparin, Curantil.
• Antioxidants - "Essentiale", vitamins E and C.

A mild degree of the disease is treated for no more than ten days, an average one - five, and a serious condition - six hours. If there is no effect, urgent delivery is prescribed, which is carried out naturally with a mild degree of the disease. The consequences of preeclampsia after childbirth in this case are minimal for both the fetus and the mother. In severe cases, a planned operation is prescribed. The occurrence of eclampsia and placental abruption requires emergency delivery by caesarean section. Further, pharmacotherapy lasts until the normal functioning of all body systems. The woman in labor is discharged from the hospital in one to two weeks.

Gestosis after childbirth

The disease during and after pregnancy is marked by three well-known symptoms: edema, protein in the urine, and increased blood pressure. Late toxicosis is always associated with pregnancy. It can be in the second trimester, and most often in the third. Gestoses are pathological changes during pregnancy associated with hormonal disruptions and various pathologies. The disease in a mild form, as a rule, has no consequences, and preeclampsia after childbirth disappears in the first two days. The onset of the disease at 24-28 weeks requires an emergency caesarean section to save the life of the baby and mother. If late toxicosis occurs at 30-32 weeks of gestation, the mother and baby suffer slightly.

A woman can give birth herself or by surgery. After 34 weeks, in the absence of health problems for the baby, childbirth can be natural. To prevent eclampsia, a woman is given drugs that reduce blood pressure and anesthetize childbirth. Doctors keep track labor activity and uterine bleeding, using the drug "Oxytocin", which contributes to the woman is placed - under the supervision of resuscitators - in the intensive care unit. For the prevention of eclampsia, "Magnesium sulfate" is prescribed and blood and urine are constantly taken for analysis, blood pressure readings are monitored.

How to treat preeclampsia after childbirth?

Therapy of preeclampsia continues at home. High blood pressure can be observed for up to two months, so a woman should systematically monitor it and take drugs to reduce it. During the period of breastfeeding, it is recommended to take Dopegit and Nifedipine. Over time, the pressure returns to normal. Cancellation of drugs should be done gradually, by reducing the dosage and frequency of administration. In addition to high blood pressure, edema appears in women after childbirth. First of all, they form at the ankles. Over time, they pass. Worse, if there is an increasing swelling of the hands and face - these are signs of preeclampsia. It is urgent to visit a doctor who will prescribe the necessary treatment for preeclampsia after childbirth. It should be noted that about half of the cases of severe convulsive seizures (eclampsia) occur in the first four weeks after childbirth. Often the disease occurs in women who gave birth at term. In this case, urgent medical attention is needed.

How is childbirth going?

The severity of the disease, the condition of the mother and child affect the method of choosing childbirth and the time of their delivery. The most favorable births are those that occur naturally. For them, it is necessary: ​​the absence of diseases in the mother, the correct diligence of the fetus and the proportions of the fetal head, pelvis, normal cervix, and the age of the woman in labor is not more than 30 years. Childbirth for a woman is a stressful condition, and with gestosis, women in labor are especially sensitive to painful sensations, fatigue, so doctors use painkillers and antispasmodics. Otherwise, a sharp jump in pressure may occur at any time, which will lead to disruption of brain activity and the occurrence of eclampsia. The disease occurs both during natural childbirth and after surgery. In this case, the following complications are possible:

• fetal asphyxia;
• bleeding in the postpartum period;
• placental abruption.

Childbirth helps a woman get rid of preeclampsia. Sometimes for premature baby birth - the most the best option. Sometimes the birth of a baby before term gives him a better chance of surviving than staying in the womb. In this case, doctors decide to conduct early delivery operational or natural.

What to do if the disease does not go away after childbirth?

Will late preeclampsia go away after childbirth? This question worries women who have been discharged from the hospital, and they have the following symptoms:

• visual impairment;
• pain in the right hypochondrium;
• high blood pressure;
• headache;
• infrequent urination.

In this case, you should immediately consult a doctor. After eclampsia, a gynecologist or therapist will prescribe a CT scan of the brain, blood biochemistry. If the protein content in the urine is up to two months after childbirth, you should seek advice from a urologist and nephrologist. Preeclampsia will pass, but serious complications may remain after it if the treatment and strict adherence to all the recommendations of doctors are neglected.

The consequences of the disease for women

The consequences of preeclampsia for the mother after childbirth can manifest itself in the following:

• renal and liver failure;
• headache;
• hypertension;
• stroke development;
• visual impairment;
• brain damage;
• ischemia of the heart;
• severe postpartum bleeding.

With a new pregnancy, a repetition of the situation is possible.

Consequences for the child

The severe condition of the mother negatively affects the health of the baby. The most dangerous consequence is intrauterine fetal death due to nutritional deficiencies and lack of oxygen as a result of placental damage. But even after childbirth, the consequences of preeclampsia for the child are very serious. Children are very weak, have a small weight, often and for a long time get sick, lag behind in development and growth. Because of the illness of the mother, they are born prematurely, are not adapted to independent living, require special care and assistance in development. Health problems in a baby can remain for life.

Indications for preterm birth, regardless of the gestational age

These include:

• seizures and eclampsia;
• premature detachment of the placenta;
• rapid progression of the disease;
• retinal disinsertion;
• malfunction of the liver and kidneys.

Doctors try to conduct a quick and gentle birth using painkillers and sedatives. With preeclampsia after childbirth or caesarean section, the necessary treatment and careful monitoring of the state of health are prescribed for the woman and the baby. The treatment regimen is selected individually.

Caesarean section with gestosis

With a threat to life for the fetus or woman and the inability to give birth on their own, a caesarean section is used. This method is used for complicated gestosis, when the condition of the woman in labor begins to deteriorate rapidly, and the child experiences oxygen starvation. The operation is performed using endotracheal combined anesthesia. The uterus is opened and the baby is released if he has problems with breathing or circulation, and resuscitation is carried out. The woman is sutured and after the operation is transferred to the ICU (intensive care unit), where she is injected during the day sedatives and constantly monitor pressure, edema, liver and kidney function. It is believed that the first two days with preeclampsia after cesarean are the most critical. During this period, severe complications can occur that threaten the health and life of the woman in labor. The child and mother are under the supervision of doctors until the full normalization of health. After examination and satisfactory condition, they are discharged from the hospital. When a child is born on time and there is no oxygen starvation, he will develop normally and keep up with his peers. Otherwise, various complications and disorders of mental and physical health. Some symptoms last for two months, so the treatment of preeclampsia after cesarean continues at home under the supervision of a medical professional.

Complications

Late preeclampsia is dangerous with severe consequences that can begin both during pregnancy and after the birth of a child. The most common of them:

• stroke;
• placental abruption;
• insufficiency of respiratory activity;
• retinal detachment;
• eclampsia and coma;
• hemorrhagic shock;
• acute renal failure;
• oxygen starvation of the fetus can occur with preeclampsia after cesarean section.

More rare forms complicating gestosis is:

• HELP-syndrome - red blood cells decay, the number of platelets decreases, which affect blood clotting, in addition, liver function is disrupted. The disease is transient. The woman has headaches and liver pain, jaundice, vomiting. She loses consciousness, convulsions are possible. There is a rupture of the liver, the abdominal cavity is filled with blood, the placenta exfoliates. The death of the fetus and mother occurs.
• Acute fatty hepatosis - often occurs during the first pregnancy. First, a woman is tormented by severe weakness, abdominal pain, nausea, weight loss, vomiting, itching of the skin. Subsequently, liver and kidney failure appears, jaundice develops, severe edema, uterine bleeding and fetal death occurs. A woman may have a coma and a malfunction in the brain.

About contraception

After suffering preeclampsia, a woman is advised not to become pregnant for at least two years, since time is needed for the body to recover. Young parents should remember that even breastfeeding does not provide a full guarantee of protection against pregnancy. Menstruation may well occur after childbirth in four weeks. But the cycle is still unstable, so it is not recommended to use the calendar method of contraception after severe preeclampsia. Hormonal tablets during lactation enter the milk, which is undesirable for a weakened baby. It turns out that barrier contraception in this case is the most optimal method. It must be remembered that until the bleeding stops, until the uterus is completely contracted, vaginal contraceptives should not be used. The ointment and fatty base of the funds can enter the uterus. Gynecologists recommend using a condom during this period.

Recovery period

Effective recovery after preeclampsia is influenced by proper nutrition, the help of relatives and friends, normal rest, intimate hygiene. The main task of the recovery period is to eliminate the malfunction of the kidneys and water-salt metabolism. These reasons reduce the ability of patients to work and are considered contraindications for subsequent pregnancy. Recovery is carried out in stages, depending on the severity of preeclampsia:

The first one is galvanization, ultrasonic treatment, microwave therapy. Physiotherapy improves renal hemodynamics, enhance their excretory ability.

How to treat preeclampsia after childbirth with the second degree of severity? Drug therapy is carried out with the use of sedatives: tincture of "Valerian", "Motherwort", "Corvalol"; antihypertensive drugs: "Dibazol", "Papaverin", "Eufillin"; drugs with a diuretic effect: Triampur, Hypothiazid. To increase the absorption of drugs, collar galvanization is used.

The third - a complex of drugs used in the second degree of severity, is supplemented by the introduction of "Albumin" and "Rausedil".

Weakened by preeclampsia after childbirth, a woman's body is prone to various infections, so a woman needs to restore her immune system and return to normal life faster. Gynecologists advise:

• observe the hygiene of the genitals: wash yourself after using the toilet with clean hands from front to back;
• do not use sponges and washcloths;
• use for washing baby soap;
• use individual towels for the chest and perineum;
• use disposable pads;
• underwear should be made of simple fabrics, well breathable;
• it is recommended to sleep on the stomach to improve the outflow of secretions from the uterus;
• it is recommended to visit a gynecologist two weeks after discharge from the hospital;
• in the absence of spotting, you can return to intimate life.

Prevention of preeclampsia

It is impossible to cure preeclampsia, so measures must be taken to prevent it. To do this, you need to visit a gynecologist in a timely manner, measure blood pressure, monitor weight gain, and take tests. A pregnant woman needs to find time for daily walks in the fresh air. In food, eat more animal proteins, cottage cheese, vegetables, fruits, greens. With a predisposition to edema, drink herbal teas, cranberry juice. The diagnosis of "preeclampsia" obliges a woman to monitor her well-being with a vengeance. Experts advise women to give birth before the age of 35 to reduce the risk of complications.

Usually, early gestosis is called toxicosis of pregnant women, these are its classic signs with nausea and vomiting, intolerance to strong odors, weakness and severe drowsiness. However, doctors consider toxicosis not as dangerous for the fetus as the development of so-called late gestosis.

Gestoses of pregnancy or toxicosis are painful changes during pregnancy caused by hormonal fluctuations, various pathologies and diseases. According to the time when a problem may arise, early gestosis during pregnancy and late are distinguished.

Causes of gestosis in pregnant women

Although the manifestations of gestosis have been studied for a long time, but until today it has not been possible to identify the exact causes of this pathology. Often, pregnant women with disorders of the nervous system and brain, with problems with the heart and pressure suffer from gestosis. Relationships with kidney pathologies and the development of preeclampsia, with the presence of allergies, endocrine and metabolic failures, as well as the presence of bad habits before conception.

Very young future mothers or age-related ones often suffer from gestosis - this is explained either by immaturity or age-related changes in the body, as well as those who carry twins, who have excess weight and pressure, or who in the female line also had gestosis in the genus.

According to the severity of manifestations and the severity of the course, it is customary to distinguish three degrees in late gestosis.

Preeclampsia 1 degree during pregnancy

Usually, mild gestosis during pregnancy is called dropsy of pregnant women. These are the initial, relatively mild manifestations. At the same time, pronounced, rather serious edemas are formed throughout the body; they give a large increase in body weight. Edema is visible on the limbs, on the body and even on the face, they increase in the evening, progress and are difficult to correct. Against the background of dropsy, the phenomena of nephropathy can join - kidney damage when they do not cope with their tasks.

Preeclampsia of the 2nd degree during pregnancy

It is the development of nephropathy (kidney damage) with the progression of edema and increased blood pressure, the manifestation of protein in the urine that is already referred to as severe preeclampsia. Such changes indicate that the body cannot cope with the loads that pregnancy imposes on it, and it malfunctions. Gradually, with the progression of the process, extremely severe manifestations of gestosis can occur - preeclampsia and eclampsia. These are serious lesions of the nervous system against the background of all the ongoing changes - swelling, pressure, loss of protein by the kidneys. These changes give the most severe and life-threatening consequences of preeclampsia during pregnancy.

What is dangerous gestosis in late pregnancy

Gestoses develop exclusively in pregnant women - they are directly related to the bearing of the fetus. After childbirth, gestosis usually disappears, but often, in severe cases, the consequences of gestosis remain even after childbirth. However, gestosis is dangerous during pregnancy, especially in the third trimester. They can lead to eclampsia, severe seizures that are life-threatening. With them, the pressure goes off scale, the kidneys fail, the whole body swells. This condition requires immediate resuscitation and the birth of a baby to save both lives.

The consequences of preeclampsia for the mother

But often, even after delivery, as a result of severe complications of pregnancy, there are serious consequences of preeclampsia for the mother after childbirth. These can be severe postpartum hemorrhage leading to anemia, as well as complications such as the development of strokes or brain damage due to seizures, irreversible kidney damage with the development of their failure, visual impairment, persistent headaches due to high blood pressure, and much more.

The consequences of gestosis for a child

Naturally, in a serious condition of the mother developing baby will suffer with her. The development of preeclampsia during pregnancy is no less dangerous and the consequences for the child. Naturally, the most dangerous complication will be intrauterine death of the fetus as a result of hypoxia and nutritional deficiency. This is due to severe placental edema or placental abruption, bleeding and premature birth.

The influence of preeclampsia in the mother on the development of the fetus is expressed. Such children are weakened, they suffer from chronic hypoxia, lag behind in growth and development, and can often and for a long time get sick after birth.

Given the need for the development of pathology to give birth ahead of time, you can add another answer here - what is the danger of gestosis for the fetus. When a child is born much earlier than the due date, he is completely unprepared for an independent life and requires special care, may have deviations in health and developmental delay.

Table of contents of the subject "Treatment of a preeclampsia. Treatment of an eclampsia. Premature birth.":
1. Treatment of preeclampsia. Prevention of attacks of eclampsia. Relief of attacks of eclampsia.
2. Treatment of eclampsia. Relief of attacks of eclampsia.
3. Indications for caesarean section in preeclampsia. Tactics of conducting childbirth in women with preeclampsia. Postpartum period with gestosis.
4. Premature birth. Definition, classification of preterm birth.
5. Frequency (epidemiology) of preterm birth. Causes (etiology) of premature birth.
6. Pathogenesis (development) of preterm labor. The mechanism of action of bacteria in inducing preterm labor.
7. Clinical picture (clinic) of premature birth. Threatening premature birth. Beginning, beginning premature birth. course of preterm birth.
8. Diagnosis of threatening and incipient preterm labor. Tocolysis index according to Baumgarten.
9. Transvaginal ultrasound in preterm labor. biochemical markers of infection. Fruit fibronectin.
10. Management of preterm labor. Conservative-waiting tactics.

Indications for caesarean section with preeclampsia. Tactics of conducting childbirth in women with preeclampsia. Postpartum period with gestosis.

Indication for caesarean section with gestosis is:
1) eclampsia during pregnancy and childbirth in the absence of conditions for delivery through the natural birth canal;
2)severe complications of preeclampsia(suspicion or presence of hemorrhages in the brain, detachment or hemorrhage in the retina, coma, acute renal and hepatic failure, premature detachment of the placenta);
3) no effect of treatment severe forms of nephropathy and preeclampsia with unprepared birth canals;
4) no effect from labor induction or rhodostimulation;
5) combination of gestosis with obstetric pathology (breech presentation, large fetus, etc.);
6) fetal weight less than 1500 g and an immature cervix;
7) worsening condition of the mother(increase in blood pressure, tachycardia, shortness of breath, the appearance of neurological symptoms) or the fetus during childbirth in the absence of conditions for rapid delivery through the natural birth canal.

Of considerable interest is practice of childbirth in women with preeclampsia. Complex intensive care in childbirth with gestosis has a number of features. The main task of treatment during childbirth is adequate pain relief and effective antihypertensive therapy. Anesthesia during childbirth is carried out due to long-term phased analgesia, the combined use of neurotropic drugs for various purposes. It is based on acid-oxygen analgesia (2:1 ratio), promedol (20 mg) intravenously. In the absence of effect on the background of antihypertensive therapy, prolonged superficial anesthesia is used using intravenous administration of sodium oxybutyrate at a rate of 40-50 mg/kg against the background of preliminary intramuscular administration of seduxen (sibazon) at a dose of 0.1 mg/kg under the control of blood pressure.

Effective potentiation of oxygen-oxygen analgesia intramuscular or intravenous administration of 5-10 mg (2-4 ml) of droperidol or 5-10 mg (1-2 ml) of seduxen in combination with antihypstaminic drugs (suprastin, diphenhydramine, tavegil, diprazine intramuscularly).

Very effective in childbirth epidural anesthesia lidocaine, which, in addition to analgesic action, has a hypotensive effect.

In the first stage of childbirth should be conducted in a noise-isolated room. In the opening period, an early opening of the fetal bladder is shown (with the opening of the cervix by 3-4 cm) in order to reduce intrauterine pressure and stimulate labor, as well as the widespread use of antispasmodic drugs (no-shpa, etc.).

In the first and second stages of childbirth are carried out under cardiomonitoring control over the condition of the fetus and the nature of the contractile activity of the uterus. Prevention of intrauterine fetal hypoxia is shown. It is necessary to limit infusion therapy to 500-800 ml.

Antihypertensive therapy during delivery is carried out under the control of blood pressure. High blood pressure and the threat of transition of nephropathy to preeclampsia and eclampsia may be an indication for an anesthetist to conduct controlled relative normotension with gangliolytic drugs, which is usually carried out in the second and third stages of labor. If it is impossible to use this method in severe nephropathy, it is necessary to turn off the attempts by applying obstetric forceps (with cephalic presentation) or removing the fetus by the pelvic end (with breech presentation). The operation of vacuum extraction of the fetus with preeclampsia is contraindicated. A child born to a woman with preeclampsia is at risk and needs special monitoring.

In the third stage of labor in order to prevent bleeding, drip intravenous administration of methylergometrine or oxytocin is indicated. Pathological blood loss in puerperas with gestosis should be completely replenished. Immediately after delivery, adequate infusion therapy is indicated. As the main symptoms of gestosis regress, the volume of therapy is gradually reduced.

Used in caesarean section combined endotracheal anesthesia, which allows to control the patient's respiratory function, exclude hypoxia and minimize the amount of anesthetics used. Patients with eclampsia in the presence of inadequate breathing in the initial state or with often following one after another eclamptic seizures, endotracheal anesthesia may also be necessary for "small" obstetric operations (imposition of forceps, etc.), since mask and intravenous anesthesia does not allow adequate breathing. ALV is used in this case not only as a component of anesthesia, but also as a therapeutic and resuscitation aid. You should not rush to extubate the trachea, spontaneous breathing is carried out through an endotracheal tube for 30 minutes - 1 hour. After extubation of the trachea, a therapeutic and protective regimen is created with the introduction of sedative, ataractic and other drugs in reduced doses. In the early postoperative period, complex therapy is continued until the function of vital organs is restored.

In the postpartum period, continue gestosis therapy until the disappearance of edema, normalization of blood pressure, the disappearance of protein in the urine. Women in childbirth who have undergone severe forms of gestosis, complex therapy in a hospital is carried out for 2 weeks. After discharge from the hospital, women in this group are observed not only by an obstetrician-gynecologist; they should be registered with the therapist, nephrologist and, according to indications, with other specialists.

Almost every second expectant mother faces one or another manifestation of toxicosis (preeclampsia) at different stages of pregnancy. For many, it is morning sickness that becomes the first news that life has arisen under their hearts. But preeclampsia can take on a more sinister guise. We are talking about this with Irina Nikolaevna BUZAEVA, head of the department of pathology of pregnant women of the Perinatal Center (Kaliningrad)

- What is gestosis? What are the symptoms of this diagnosis?

Gestosis (toxicosis) is a complication of pregnancy associated directly with the pregnancy itself. They are early and late. Everyone knows about the early ones: this is nausea, vomiting in the first weeks or months of bearing a child. They are extremely rarely aggressive and lead to changes in the mother's body, but they are visible, tangible, and both the woman and the people around her pay attention to them. Late toxicosis is much more insidious. They can lead to the most serious complications during pregnancy, and, unfortunately, late gestosis is still one of the leading causes of maternal death in the world.

Late gestosis is less noticeable for a woman and is usually manifested by three symptoms: the appearance of edema, protein in the urine, and an increase in blood pressure. Late gestosis may contain all three symptoms, or may contain only one. In this case, only swelling is visible to the eye. Rise in blood pressure by pregnant women are less felt, and changes in urine tests are not felt at all. That is why, at the end of pregnancy, all expectant mothers are forced to regularly weigh themselves, measure blood pressure and take urine tests.

Late gestosis is extremely insidious, because they can have an unpredictable course. This toxicosis, I repeat, can manifest itself in the form of edema, and only edema remains until the end of pregnancy. Or toxicosis can make itself felt only by such a symptom as a moderate increase in blood pressure. And such a scenario is also possible, when toxicosis begins to progress very quickly, and then the deterioration of the woman's health goes on by the day and even by the hour. Therefore, this pathology should be treated only in stationary conditions.

- Is gestosis a common problem?

In the pregnancy pathology department of our maternity hospital, about 25-30% of women are treated with gestosis, about 30-50 people per month.

- What are the causes of gestosis?

There are many theories here, but scientists have not yet made a final conclusion about the causes of toxicosis. There are versions, but I would not scare expectant mothers with medical terms.

- But is it possible to talk about risk groups for the development of preeclampsia?

Yes. Toxicosis rarely develops in absolutely healthy women. Most often, we have combined gestosis, which develop against the background of maternal diseases. These include kidney disease, high blood pressure, liver dysfunction and many other somatic diseases.

- Is there a connection between toxicosis of the first third of pregnancy and preeclampsia of the third trimester?

If at the beginning of pregnancy a woman is sick in the morning, it does not mean that at the end she will develop preeclampsia. But there is another relationship: in a woman who has health problems before pregnancy, we often expect the development of late preeclampsia. And there are situations when we offer women with the second stage of hypertension to terminate the pregnancy, because the bearing of a child threatens her life.

- Why are gestoses dangerous?

Gestosis can lead to very serious complications: these are severe violations of kidney function, and visual impairment, and hemorrhages in the brain, and disorders of the blood coagulation system. The latter is one of the most formidable complications: with the developed DIC, thrombosis of the uterine vessels may begin first, and after a short-term increase in the blood coagulation system, a decrease occurs until the blood loses its ability to coagulate. This leads to the development of severe obstetric bleeding, which requires serious resuscitation, blood transfusion, and which, unfortunately, for a woman, can result in the removal of the uterus if everything is started and help is not provided on time.

In a medical institution, of course, they never bring it to this extreme stage, they try to raise the issue of delivery, because it is almost impossible to cure toxicosis during pregnancy. You can stop the severity of its course, but the final cure of this pathology occurs only after delivery. Therefore, late toxicosis is often the cause of premature termination of pregnancy. If this is done in a hospital and on time, the risk negative consequences for mother and fetus is minimal.

Eclampsia is a severe form of manifestation of late gestosis, its extreme stage, when a woman develops convulsions, very reminiscent of an epileptic seizure, pressure rises sharply, protein appears in the urine. An attack of eclampsia is a life-threatening situation that can lead to impaired or loss of vision, hemorrhage in the brain, and irreversible changes in the kidneys.

Is it necessary and possible to treat early preeclampsia? And is it possible that he becomes the reason for the hospitalization of the expectant mother?

If a woman is only concerned about nausea and vomiting no more than once a day, this does not lead to weight loss, such preeclampsia does not need treatment. Of course, there are also severe forms of early gestosis, but they are very rare in comparison with severe forms of late gestosis. In this case, the woman is hospitalized, she is given a dropper, if necessary, physiotherapy is carried out, an immunological method of treatment is used, etc. As a rule, by 12 weeks with the most severe gestosis, the symptoms gradually disappear, and by 16 weeks there is no nausea and vomiting and trace.

- What pressure during pregnancy is considered pathological? Or is its sharp increase more important here?

Here there is such a rule: we look at the initial level of pressure in a woman and compare it with the pressure in the second half of pregnancy. If a woman has her normal pressure - 90/60, then already 120/90 is a serious problem. In overweight women, the pressure is always a little higher, and for them, the norm may be, say, 140/80. Then we again evaluate how much this pressure has increased. A particular problem is hypertensive patients, who have early term pressure was 150-160. Such women are under especially close medical supervision.

- Is it possible to say only by the presence of edema that a woman has gestosis?

Yes, edema is definitely preeclampsia, and such a woman is at risk for developing a more severe form of preeclampsia. And we begin to fight this preeclampsia at the stage of edema. What happens next depends on when the treatment was started, and on the woman’s body itself, how healthy it is and how much it resists the problem that has arisen.

How are edema diagnosed? Is it only because white marks remain on the arms and legs after pressing for a long time?

No, the weight gain for the entire pregnancy and weekly, monthly is necessarily estimated. During each visit to the antenatal clinic, the expectant mother must be weighed. The norm is an increase of 300-400 grams per week. If a pathological weight gain begins in the second half, this indicates that there are hidden edema in the body, which means that a correction of water-salt metabolism is necessary. Treatment begins with dietary adjustments. The doctor of the antenatal clinic appoints a fasting day. If this does not lead to any effect, medications are used.

- And as for the fluid intake, should a woman reduce its amount?

Considering the peculiarities of the course of pregnancy, it is necessary to reduce the amount of fluid you drink in the second half of it, otherwise serious violations of the water-salt metabolism will lead to the development of edema, that is, you can provoke the development of edema in yourself if you consume fluid uncontrollably. After all, do not forget that pregnancy itself causes a moderate tendency to fluid retention in the body.

- How much liquid per day can or should the expectant mother drink in the last months of bearing a baby?

No more than 1-1.5 liters per day.

- Does physical activity affect the appearance or reduction of edema?

Fitness will not remove swelling and, sitting in the position of the legs above the head, only redistribute them. Edema is fluid retention in the intercellular spaces, and it must be removed.

- Is it possible to do it only in a hospital?

Edema is the easiest stage of late gestosis, and they always begin to treat it in antenatal clinics. If within 7-10 days the treatment does not give any effect, then the woman is sent to the hospital. Unfortunately, sometimes mothers come to us who have neglected the advice of obstetrician-gynecologists of antenatal clinics, and all because many simply do not realize the danger of edema.

How appropriate is the use of drugs for the treatment of preeclampsia? If the metabolism is disturbed, will the situation be aggravated by chemicals that put an additional burden on the body?

The use of drugs for gestosis, I think, is mandatory. The question rests only on what to apply, in what quantities and for what symptoms. No diets, herbs can cure a serious stage of late gestosis. And to use diuretic herbs, if swelling has just begun, it is necessary under the strict supervision of a doctor: the symptoms that can follow swelling - increased pressure and impaired filtration function of the kidneys - the woman herself will not notice, only the doctor sees this during the examination.

- Is preeclampsia an indication for caesarean section? Is natural childbirth possible with gestosis?

With gestosis of mild and moderate severity, women, as a rule, give birth themselves. Indications for caesarean section are only severe forms of gestosis, when it is necessary to deliver very quickly and there are no conditions for childbirth through the natural birth canal.

How does preeclampsia in a mother during pregnancy affect the condition of the newborn? Is there a relationship here?

It is believed that there are no long-term consequences, no special threats to children. But we must keep in mind that gestosis itself often makes us terminate a pregnancy prematurely, and premature birth is a certain risk to the health of the child and its further development. That is why, when a woman comes to us with a gestosis clinic at 37-38 weeks, we breathe easier: we have a mature child and we know that the mother's condition will not affect the condition of the fetus.

- Do the symptoms of preeclampsia disappear after childbirth?

Symptoms of gestosis can last up to two months after delivery, and eclampsia can develop in the early postpartum period. But we believe that if no complications developed within two weeks, then we avoided the risk.

If you have some kind of somatic disease, you need to undergo serious preparation for pregnancy, be examined by a specialist according to the profile of the disease, and find out if pregnancy is possible in this situation. And I advise expectant mothers to listen to the advice of specialists. Yes, our women have become more literate, they read a lot, they strive to get as much information as possible, but there are things that only a doctor knows.

Interviewed by Irina Shelygina
Regional Fund for Support of Motherhood and Childhood "Creation"

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COMMENTS

Natalia / 2012-02-24

I gave birth 5 years ago, I was not diagnosed with preeclampsia, but I had very high blood pressure, severe swelling, and over the past 2 months I gained about 20 kg, this did not bother the gynecologist. I gave birth to a premature baby (8 months), there were very difficult births (high blood pressure, increased protein in the urine) I think it was preeclampsia, can preeclampsia affect my health in some way now? After giving birth, I started having problems with my kidneys (although my kidneys were always healthy), my eyesight worsened and my blood pressure often jumps (this caused headaches) Thank you in advance

Tatiana / 2012-04-14

I was diagnosed with o-preeclampsia during pregnancy, the ratio of fluid drunk and excreted was 100 to 5-10%. I have gained 19 kg in the last few months. The new gynecologist did not advise me anything except to drink less liquid. the protein in my urine went through the roof. 7 years have passed since the birth, but my swelling has not gone away. all the liquid drunk enters the tissues - arms, legs and face. the nephrologist did not find anything, the endocrinologist too, the gynecologist and the therapist also say that I do not have their diseases, they checked both the heart and hormones, the liver and the thyroid gland. how many examinations and analyzes I have not passed over these 7 years and no one can tell me anything how to stop it all. Before pregnancy, I did not suffer from edema and kidney disease either. I am now gaining up to 1 kg in a day, in a week I can gain up to 5-6 kg, then I drink a diuretic, tk. I can’t feel normal at the same time, my health is deteriorating greatly. tell me, can this be the consequences of gestosis and which doctor would you advise me to contact or what tests do I need to pass so that they show specific results?