Fainting with pregnancy

Fainting during pregnancy is a sharp loss of consciousness in a pregnant woman, it is associated with changes in the organism during this period. This symptom often causes women to worry about their health. This condition is most common in the first trimester, but this pathology is also not excluded on another term. There can be many reasons for this condition, so the approach to diagnosis and treatment should be differentiated.

Causes of the fainting in pregnancy

Very often, poor health, especially fainting, is associated with pregnancy. But do not think about pregnancy, as a pathological condition. Pregnancy is a normal physiological process when a woman's body adapts to a new life within herself. At the same time, all the changes that occur in the body of a pregnant woman are aimed at maintaining the normal functioning of the organs and systems of women, as well as maximizing the sufficient growth and development of the fetal tissues. Therefore, in order to understand the causes and pathogenesis of fainting, it is necessary to know that all processes are physiological, but there is a boundary when syncope can be caused by serious pathology.

Very often syncope is the very sign of pregnancy, rather the first of the symptoms. It happens at the initial terms, when the fetus is just beginning to develop and a woman may not know about pregnancy. At the same time, the body itself is not ready for such changes, and therefore this phenomenon occurs.

The most common cause of syncope in pregnancy is the lack of blood circulation and blood flow to the brain, which causes its hypoxia. This is due to the fact that at the initial stages of pregnancy there is not enough blood circulation of the fetus - there is a formation of a new circulatory system. As a consequence, the woman's organism gradually adapts to this type of blood circulation. At the same time, the number of blood cells, mostly red blood cells, which gradually fulfill the respiratory function, is gradually increasing. Also increases the number of peripheral vessels and small capillaries that provide blood circulation of peripheral organs with relative insufficiency. This is the centralization of blood circulation with the primary supply of blood to the main organs, as well as for normal blood circulation of the fetus. But at the beginning of pregnancy, the mechanisms of regulation of this process are still insufficient and imperfect, so brain stealing can occur, which is accompanied by fainting.

Causes of syncope during pregnancy can be more serious, this applies to cases where this symptom occurs in late pregnancy. One of these etiological factors may be anemia, which develops when iron intake is inadequate and its demand is simultaneously increased. There may be symptoms of circulatory failure due to erythrocyte deficiency.

The third trimester of pregnancy can often be accompanied by late gestosis. The most common cause of this process is high blood pressure. This can be the cause of a woman's fainting late in pregnancy precisely because of a sharp rise in blood pressure. This phenomenon is called pre-eclampsia, which has different degrees of severity, depending on other manifestations.

[1]

Pathogenesis

The pathogenesis of syncope during pregnancy can also be related to the relative insufficiency of the adrenal glands. Under normal conditions, the adrenal glands provide a release of catecholamines in response to a critical situation, which is accompanied by a spasm of the arteries, an increase in pressure. In pregnancy, there may be insufficient adrenal function due to the fact that hormones are necessary for the fetus. Therefore, in a critical situation, when there is an expansion of peripheral vessels, there is not enough concentration of adrenaline and norepinephrine, which leads to atony of blood vessels and drops blood pressure. This can manifest as a faint. But not all women have such problems. It also depends on the risk factors that a woman has. Such risk factors include:

1. low female weight and low body mass index - this increases the chances of developing anemia and circulatory failure due to reduced supplies for nutrition and fetal growth;
2. anemia before pregnancy or inadequate dietary intake of a woman during pregnancy - this increases the likelihood of anemia, and as a consequence and symptoms in the form of fainting;
3. Concomitant chronic diseases that reduce the body's reactivity and resistance to infections;
4. diseases of the circulatory system - arterial hypotension, increased vagal innervation, cardiac pathology with blockades and heart rhythm disturbances;
5. pathology of the thyroid gland in the form of hypothyroidism.

All these conditions can become in the future the cause of the development of changes that will lead to fainting. Pathogenetic mechanisms for the development of syncope in different situations need to be considered, because sometimes there is no need for treatment.

[2], [3], [4], [5]

Symptoms of the fainting in pregnancy

Fainting during pregnancy can be the only symptom that is not so often manifested, then you do not need to think about any pathological processes. But often a syncope is accompanied by other manifestations that need to be considered to identify the cause and possible correction of this condition.

The first signs before fainting can be in the form of some changes that occur a few seconds before the loss of consciousness. Most often there is light dizziness and flickering of midges before your eyes, and only then you faint. Further, the features of syncope symptoms depend on the cause.

If syncope occurs due to anemia, then it is possible to identify the pallor of the skin, a slight blueness of the sclera, as well as nonspecific symptoms in the form of dizziness, headache, weakness, decreased efficiency. Dizziness and fainting in pregnancy are the most frequent symptoms of anemia. Additional symptoms that can be in this case are heartbeat or heartbeat.

Fainting in early pregnancy is more common in the morning, on an empty stomach, when there is not enough energy for the brain, and a relative condition of hypoglycemia occurs. Then the symptoms develop quickly, and often it is accompanied by sweating, tremor of the extremities.

Fainting late in pregnancy should alert, because they are symptoms of serious pathological conditions. If syncope is frequent and accompanied by other cardiac manifestations, then you need to think about cardiac pathology. In this case, there may be palpitations, dyspnea, edema - serious symptoms that may indicate the need for immediate care. At the same time, high blood pressure is determined, which is clinically manifested by the sensation of fever of the face, headache, anxiety. Such symptoms are symptoms of late gestosis and therefore require immediate treatment.

Therefore, when talking about faints in the early stages of pregnancy, they can usually be several times and are not specific pathological manifestations, but in later terms it is necessary to pay attention to any such symptoms.

[6], [7], [8]

Complications and consequences

Complications that occur immediately in an acute period of fainting are a severe failure of the fetal circulation. If such faints recur, then chronic fetal hypoxia may develop. This complication leads to dystrophic processes in the placenta, which causes similar disorders.

The consequence of fainting can be a sharp shock and injury to a woman, which in the third trimester can cause premature birth or placental abruption. Therefore, pregnant women should monitor their health twice as much and prevent such conditions.

[9], [10], [11]

Diagnostics of the fainting in pregnancy

Diagnosis of syncope, if it repeats repeatedly for no apparent reason, should be conducted as early as possible and the main purpose of such a survey is to identify the cause of such a condition.

It is necessary to begin with anamnesis of a woman and find out what period of pregnancy and how past pregnancies passed. It is necessary to detail the complaints and find out under what conditions a syncope occurs, whether there are provoking factors, as well as a way of life of the pregnant woman. After all, it is very important in this period to have regular meals and sufficient caloric content, as well as rest and exclusion of stress factors. This is very important, because it is these reasons that can play a priority role in the faint.

When examining a woman, one can see nonspecific manifestations, which may lead to the idea of the cause of fainting. Most often in the first trimester is anemia. Therefore, this pathology is excluded by careful examination and additional methods. On examination, you can see the pallor of a woman, and maybe a slightly yellowish skin tone. With auscultation of the heart, the symptom of anemia is systolic murmur at the apex, which is not carried out anywhere and does not change its character. These clinical signs of syncope in a pregnant woman in case of their combination require confirmation of anemia by additional methods.

Analyzes that must be submitted to determine the etiology of syncope should be most informative and non-invasive. A mandatory method is a detailed blood test, which allows you to exclude or confirm anemia or other pathology. In case of anemia, changes will occur in the form of a decrease in the level of red blood cells and hemoglobin, as well as changes in the color index (reduction of it with iron deficiency anemia), reticulocytes (decrease or increase depends on the type of regeneration in the bone marrow). If the decrease in hemoglobin in pregnant women is less than 110 g / l, it is an anemia. If the anamnestic data of a pregnant woman indicates an insufficient diet, then to confirm, you need to determine the level of iron in the blood. If there is iron deficiency anemia, then the iron level will be less than 12.5 micromolar.

If fainting occurs late in pregnancy, then it is necessary to conduct a general urine test and determine proteinuria (excretion of protein in the urine). This allows you to identify pre-eclampsia, which can be the cause of fainting.

Instrumental diagnosis should be aimed at determining the state of the mother and fetus, including. Therefore, it is necessary to examine the cardiovascular system with the registration of an electrocardiogram and, if necessary, an ultrasound examination of the heart. In the early stages, it is necessary to conduct ultrasound of the fetus to detect blood flow in the placenta and to exclude circulatory insufficiency, which may be secondary to fainting in the mother. In later terms, cardiotocography with the registration of the fetal condition can be performed.

[12], [13], [14], [15],

Differential diagnosis

Differential diagnosis of syncope in pregnancy should exclude primarily extragenital organic pathology. Therefore, it is necessary to differentiate syncope in anemia and in the pathology of the heart - cardiac blockades, arrhythmias, heart failure. The main method is electrocardiography (elongation and prolapse of the ventricular complex during blockade or the appearance of extraordinary cardiac contractions with extrasystole).

It is important to conduct differential diagnosis of syncope in a pregnant woman, which is caused by transient insufficiency of the blood circulation of the brain and syncope in hypoglycemic coma with concomitant gestational diabetes. In this case, with hypoglycemia, there is a loss of consciousness, which is accompanied by a sharp sweating, moisture of the skin, as well as tachycardia and an increase in the tone of the eyeballs. Such fainting requires immediate administration of glucose. A faint during pregnancy is transient in nature and passes quickly without interference, as soon as the compensatory protective mechanisms react.

To choose the tactics of treatment you need to know the etiology and correctly carry out differential diagnosis.

Treatment of the fainting in pregnancy

If fainting occurs during pregnancy on the background of fasting or is a single case in the first trimester, then this case does not require targeted treatment. Only after revealing the true cause of syncope can we talk about etiologic treatment. If pregnancy is accompanied by general weakness and a decrease in the reactivity of the body, then in this case the priority is the use of alternative therapies.

It is very important in the treatment of syncope in a pregnant woman to organize the correct mode of work and rest, as well as adequate nutrition. During normal pregnancy moderate physical and mental work is permitted and even recommended. It is necessary to conduct daily walks in the fresh air for at least an hour. Sleep of a pregnant woman should not be less than eight hours a day. It is very useful for a pregnant woman to take sun baths - this activates the synthesis of vitamin D for the normal structure of the bone tissue of the unborn child.

Eating a pregnant woman is of particular importance. The total caloric intake in the first half of pregnancy should be about 2500-3000 kcal. Proteins should be about 100-120 grams per day, carbohydrates about 400-500 grams, and fats should be limited to 100-120 grams. The amount of water is not more than 1.2 liters. You need to eat small meals 3-4 times a day. Such nutrition will reduce episodes of hypoglycemia, which can occur and fainting may stop. It is very important to eat vitamins every day in the form of vegetables and fruits - this improves microcirculation and trophic tissue, which can suffer from oxygen deficiency.

If the cause of syncope is anemia, then it is necessary to treat this disease with the use of iron preparations that form the active substance of hemoglobin. The main drugs that are used for this purpose are the following:

1. Hemoferon is a drug for oral administration, which contains iron, folic acid and vitamin B12. Due to this composition, it is possible to prevent the development of other types of anemia. This drug is available in the form of a pharmacological form of oral solution, which contains four grams of elemental iron. Dosage of the drug is fifteen twenty milliliters of syrup once a day after meals. Precautions - the drug can not be taken with antacids, it may be a violation of the assimilation of the components of the drug, and color changes in the stool are also possible. Side effects are possible in the form of abdominal pain, diarrhea, nausea, an unpleasant aftertaste in the mouth, then you need to reduce the dose and take ten milliliters. Occasionally, allergic reactions are possible.
2. Aktiferrin is an oral iron preparation that contains an amino acid serine, which also has an antioxidant effect on all cells in the body. Actyferrin is available in the pharmacological form of syrup and capsules. Dosage - one capsule of medicine three times a day. The way of application of the drug - should be taken after a meal and washed down with a sufficient amount of liquid. Side effects are possible in the form of dyspepsia, redness of the skin, as well as changes in the nervous system - increased excitability, irritability, weakness. At occurrence of any by-effects it is necessary to correct a dose of a preparation and to pick up as much as possible tolerable doses. Precautions - it is necessary to use the drug with caution in patients with women with peptic ulcer disease, bronchial asthma, and also with gestational diabetes (the glucose in the syrup should be taken into account).
3. Vitrum Prenatal is a complex vitamin preparation that is recommended for pregnant women as a preventive and curative vitamin remedy. Given the rich composition, the drug replenishes stocks of not only vitamins, but it also contains iron and folic acid, which has a very good effect for the treatment of fainting in pregnancy, which are caused by relative circulatory insufficiency. The composition of the drug includes vitamins - A, B1, B2, B6, B9, B12, C, D, E, as well as calcium, zinc. The drug is produced in pharmacological form of tablets and is taken in a dose of one tablet once a day after meals. Side effects are possible in the form of allergic manifestations, as well as dyspepsia in the form of diarrhea, abdominal pain, and a rare stool. Precautions in the case of this drug - you should not take it in combination with other multivitamin complexes and in the treatment of iron.
4. Materna is a vitamin preparation containing a huge amount of vitamin A and E, as well as B vitamins, calcium, magnesium, chromium, zinc. Dosage and method of application of the drug - one tablet once a day after meals. Side effects are possible in the form of allergic reactions, which happens rarely. Precautions - do not use with calcium preparations, since high concentrations can lead to premature overgrowing of fontanelles in the fetus.

Physiotherapeutic treatment of syncope is not used, as many procedures are contraindicated during pregnancy. But it is possible to use non-drug methods that increase the tone of blood vessels and reaction to stress factors. Very good tones the nervous system by hardening and dousing with cold water, but this method can not be started already during pregnancy. Only if the woman used such methods before pregnancy, it is possible to continue during pregnancy.

Operative treatment of this pathology is not used.

Alternative methods of treatment of syncope in pregnancy

Alternative methods are aimed at improving blood flow in peripheral tissues and organs, as well as reducing vagotonia, which can lead to fainting. Therefore, many methods and broths are used:

1. If there is a frequent fainting condition in a woman, then the root of burdock will help. For reflex action, the burdock root should be mashed, then placed under the rib cage at the point of the ribs and it is easy to massage non-intensively for several minutes. This effect raises the tone of the vessels and removes the amount of nerve impulses.
2. It is necessary to rub the oil in the area of the temples prepared at home. To do this, take five milliliters of milk, and add five drops of violet oil, this should be stirred and rubbed in the morning and evening.
3. To get a woman out of a swoon, you need to let her breathe the aroma of any essential oil - it activates the respiratory center, but not as much as the medication. This should not be done by the usual way of bringing the bottle to the nose, but with light movements of the hand to direct the fragrance to the nose of the woman or to drop on cotton wool and hold under the nose.

Herbs are widely used to correct the work of the nervous system and the state of vascular tone:

1. Well combined in this case, the leaves of chamomile and gentian. For a medical solution, take a liter of hot water and pour five tablespoons of dried chamomile leaves and five spoons of gentian with this water. Such a solution is infused and then it can be taken half a cup in the morning on an empty stomach, which activates the work of all internal oragons.
2. Leave the linden brew like any tea and drink at night on a glass as a therapeutic tea - it will depend on the tone of the vascular bed in the morning.
3. The leaves of St. John's wort, Melissa have a calming effect, but it tones up the nervous system, since there are no sharp shifts in the level of hormones that can cause fainting. Therefore, it is recommended to take a tablespoon of infusion three times a day.

Do not forget about homeopathic medicines, because during pregnancy it is very important that the harm to the fetus is minimal, and the effectiveness of the drug is significant.

1. Bromkampora is a homeopathic remedy, the main component of which is the natural substance of camphor and bromine molecules. The drug has a calming effect, but at the same time and tonic by increasing the tone of the vessels, which increases the pressure and keeps it at a sufficient level. The drug is available in the form of tablets of 150 and 300 milligrams. Dosage - one tablet three times a day. Precautions - patients with bronchospasm and a history of allergic anamnesis are not recommended. Side effects are possible in the form of allergic manifestations and increased heart rate, then you need to reduce the dose of the drug.
2. Nux vomica-Homaccord - a combined homeopathic drug, has efficacy in fainting, which is accompanied by nausea and unpleasant sensations in the throat. The drug is released in drops, dosage - 10 drops per tablespoon of water 3 times a day. Side effects are more often in the form of allergic manifestations. Precautions - not recommended for women prone to constipation.
3. Hyoscyamus is a homeopathic remedy of plant origin, which is effective in repeated fainting in pregnant women. This drug is released in the pharmacological form of homeopathic granules and is dosed on ten granules twice a day. Precautions - when treating pregnant women you need to monitor kidney function. Side effects of the drug are possible in the form of red spots on the face, which is of a reflex and transient nature.
4. Petroleum is a homeopathic remedy that is made from petroleum feedstocks and is available in the form of drops and homeopathic granules, but it is better to use drops to treat fainting. Dosage - seven drops per tablespoon of water, then, it is not recommended to eat another half hour. Side effects are possible in the form of abdominal pain and stomach pathology. Precautions - with caution should be used in combination with caffeine or nicotine.

These are the main alternatives that are used most often and they reveal their effect.

[16], [17], [18],

Prevention

Prevention of syncope only nonspecific:

• the correct mode of the pregnant woman's day;
• Exclusion of stressors and bad habits;
• adequate and balanced nutrition, lack of starvation or malnutrition;
• treatment of chronic pathologies before pregnancy;
• prevention of anemia in pregnancy by timely monitoring of blood tests and other indicators.

[19],

Forecast

The prognosis of fainting during pregnancy for normal gestation is favorable, if these are isolated cases, and if this is repeated, then it is necessary to identify the cause and conduct the treatment.

Fainting in pregnancy is often the first sign of it, but there are times when they are repeated and later on later. In such a case, an etiology is more often anemia, but for an accurate diagnosis it is necessary to thoroughly study. Treatment of syncope should take into account the etiological and pathogenetic principle, but one should not forget about alternative methods. The correct mode of the day is very important for the prevention of fainting, as well as for any other pathological conditions.

[20], [21], [22]