Dropsy of pregnant women is a form of late preeclampsia that develops in the second half of the gestation period. The main manifestation of the syndrome are latent (at the initial stage of pathology), and then obvious edema. The development of such a disease is associated with the inability of the body of the expectant mother to meet the growing needs of the fetus.
The formation of dropsy in pregnant women is based on dysfunctions of the cardiovascular, endocrine and nervous systems, disorders of homeostasis and the principles of antioxidant protection. But with timely detection of the syndrome and proper treatment, the prognosis for the woman and the fetus is favorable.
On estet-portal.com read about the tactics of managing pregnant patients with dropsy.
- Dropsy of pregnancy: main causes
- Clinical presentation and leading symptoms of dropsy
- Diagnosis and treatment of dropsy pregnantх
Dropsy of pregnancy: the main causes of
At the basis of the pathogenesis of dropsy of pregnant women are violations at the level of:
- renin-angiotensin-aldosterone system, which maintains the water-salt balance and resistance of the vascular wall;
- kallikrein-kinin system regulating endothelial tone and blood rheological constancy;
- prostaglandin and prostacyclin-thromboxane synthesis, which affect the activity of microcirculation, normal coagulation and fibrinolytic properties of blood, immune support for the development of pregnancy.
As a result of the deposition of immune complexes on endothelial cells, activation of lipid peroxidation mechanisms, the permeability of the vascular wall increases.
Against the background of dropsy of pregnant women, water and small protein fractions get into the tissues. This is accompanied not only by the occurrence of edema, but also by hypovolemia. The likelihood of developing the disease increases under the influence of the following factors:
- age, the risk of the syndrome is present in underage pregnant women and women over 35 – 40 years;
- hereditary predisposition;
- multiple pregnancy;
- concomitant endocrine, cardiovascular pathologies, lesions of the excretory system, liver;
- propensity to be overweight;
- Rhesus conflict.
In the pathogenesis of dropsy of pregnant women, factors that accelerate lipid peroxidation processes play a role. This is a psycho-emotional overstrain, excessive intake of carbohydrates and fats with food, unfavorable ecology, a decrease in the activity of a number of enzymes.
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Clinical presentation and leading symptoms of dropsy
The development of symptoms of dropsy of pregnancy is preceded by the preclinical stage of the syndrome. At this stage, there are no manifestations of the disease, but dysuric disorders and weight gain without changing the diet are noteworthy.
The woman complains of thirst and copious fluid intake, however, the volume of urine is reduced.
At the next stage of dropsy of pregnant women, slight edema occurs in the lower legs. First, they occur against the background of a long stay in a horizontal position or wearing tight shoes, then they appear at rest.
At the second stage of dropsy of pregnancy swelling appears on the hands. A characteristic symptom is pressure marks after removing rings and other jewelry.
In the later stages of the syndrome, edema spreads to the entire body. In addition, an increase in the heart rate, shortness of breath, and rapid fatigue are noted.
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Diagnosis and treatment of dropsy of pregnancy
A distinctive feature of dropsy of pregnant women, which makes it possible to differentiate the syndrome from other forms of gestosis, is absence of proteinuria. The diagnosis is made on the basis of the following clinical signs:
- decreased total urine volume;
- growth of the woman's body weight in excess of the norm;
- ultrasound data;
- subcutaneous test with isotonic sodium chloride solution;
- CBC results (decrease in serum protein concentration).
Therapy of the syndrome at the preclinical and initial stages is carried out in a day hospital. restriction of salt and liquid in the diet is indicated. It is necessary to regularly measure the level of blood pressure, clinical blood and urine tests, ultrasound monitoring of fetal development parameters.
In the later stages of dropsy of pregnancy, therapy is carried out in a hospital.
The issue of prescribing diuretics is still open. According to some recommendations, they should be included in the treatment regimen, according to others – diuretic drugs can provoke a deterioration in the condition of a pregnant woman. Therefore, the use of these drugs is possible at the discretion of the doctor.
In addition, antispasmodics, herbal sedatives, vitamin therapy are prescribed. Particular attention is paid to prevention of the syndrome in early pregnancy. This will prevent the development of complications and save the woman and the fetus from an excess drug load.
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