Late gestosis in pregnancy: the more dangerous, the causes, emergency care, prevention

Late gestosis is a form of complicated pregnancy, during which there is a breakdown in metabolism and disruption of normal functioning of the main organs and systems. It is accompanied by severe nausea, vomiting, edema intoxication. Sometimes this disease is called late toxicosis. The main period of development of this pathology is the second half of pregnancy. Progression of the disease occurs right up until delivery.

There are numerous studies, attempts are being made to identify the exact cause of the disease and to select the most effective treatment. But to date, these attempts have not met with the expected success. Most researchers tend to believe that gestosis is a consequence of improper regulation of life processes on the part of the endocrine system. Others believe that gestosis indicates that the fetus and mother are genetically and immunologically incompatible with each other.

The frequency of this pathology is steadily increasing from year to year. This is due to the fact that the number of women who give birth at a later age is significantly increased. An increasing number of women give birth on the execution of 35 years of age, it was considered almost unacceptable and extremely unsafe earlier. This pregnancy is usually complicated by a large number of chronic pathologies, acts as an additional burden on the body.

[1], [2],

Epidemiology

About 10-15% of pregnant women suffer from gestosis. The consequence of this pathology in most cases is maternal mortality, the percentage of which is 40% of all obstetric causes of death.

[3], [4], [5], [6], [7]

Causes of the late gestosis

Despite the fact that there are numerous studies, scientists from around the world are trying to find an answer to the question about the nature of the development of gestosis, the exact causes have not yet been established. It remains only to assume. Various theories are considered, which in general can explain the origin of toxicoses at later stages.

The following theories are recognized and most significant: corticovisceral, endocrine, immunological, genetic, placental.

The corticovisceral theory of gestosis is aimed at treating this pathology as a neurotic frustration of a pregnant woman, which is accompanied by a sharp disruption of the normal functioning of the cerebral cortex and the corresponding subcortical structures. Between these elements, communication is broken, and as a result there are failures in the regulatory processes aimed at controlling the activity of the whole organism. The normal functioning of the circulatory system is disrupted, the hemopoietic process itself is violated, which leads to violations in providing blood to various organs.

If we consider gestosis from the point of view of the endocrine theory, then it can be represented as a violation of the regulation of the cardiovascular system. As a result, the supply of blood to the internal organs is disrupted. Tissues and cells suffer from an excess of waste products and from a lack of nutrients, oxygen. Circulation continues to deteriorate, toxins and metabolic products accumulate in the body, intoxication of the whole organism develops. In addition, the necessary hormones, tissue regulators, biologically active substances cease to be produced. Violated the tone of blood vessels, internal organs, as well as fluidity, coagulability, and the basic properties of blood.

From an immunological point of view, gestosis is a change in the state of protective mechanisms, including mechanisms of nonspecific defense. There is a failure in the work of the organism at all its levels: cellular, tissue, organ. Blood cells and mucous membranes also undergo changes. As a result, the immune system is disoriented and ceases to recognize the cells of its own organism, perceives them as alien. Against them, antigens are being developed, aimed at destroying the latter. This process was called autoimmune. The active struggle between the mother and fetus organism is developing, their survival is being jeopardized. The danger is that the produced antigenic elements act both against the body of the pregnant woman and against the fetus, leaving none of them a chance to survive.

The genetic theory is based on statistically confirmed data. Gestosis is more likely to affect those women whose mothers also suffered gestosis. Some scientists even suggest that there is a "gene of pre-eclampsia", the presence of which is fraught with the development of such an extremely dangerous condition as gestosis.

At the origins of placental theory is the assumption: in the uterus there are no processes peculiar to a pregnant woman. Vessels of the uterus are not subjected to the required changes. They do not develop the ability to feed the placenta. Such vessels begin to be perceived as damaged and foreign and the body triggers the synthesis of biologically active substances, as a result of which the situation is only aggravated. First, the placental vessels are broken, then the vessels that supply the blood supply to the uterus and its mucous layer are transformed. Eventually there is a violation of the common vascular bed, blood and lymph stagnate, intensive swelling develops. The danger consists in the defeat of the vessels of both the cavity and the vessels of the internal organs. This entails a disruption of the activity of the whole organism.

As a result of processing all available data and analyzing existing theories and assumptions, scientists come to the general conclusion that the cause of gestosis is not limited to one factor, but implies the combined effect of several factors. In complex, they disrupt the normal functioning of not only the uterus and placenta, but also the organisms of the mother and fetus.

[8], [9], [10], [11]

Risk factors

Significant risk of getting gestosis is pervading and late-life women, as well as waiting for twins and minors pregnant. More at risk are those suffering from chronic diseases, having genitourinary and venereal infections, giving birth every 2 years. Especially dangerous are such diseases as chlamydia, ureaplasmosis, mycoplasmosis. Any co-morbidities are an additional risk factor.

Postponed catarrhal, viral diseases, stress and nerve stress increase the risk of preeclampsia. Special control is given to women who have preeclampsia in a family history (mother or grandmother had similar problems).

Those at whom polyhydramnios, multiple pregnancies are registered, women with a large fetus, anemia, miscarriage in a history and those with rhesus incompatibility and pronounced early toxicosis are at risk.

[12], [13], [14]

Pathogenesis

Unlike the reasons that are not well understood, the pathogenesis of the disease is known to the fullest. The main pathology is the spasm to which the blood vessels are exposed. Moreover, spasm affects all the blood vessels of the body: vessels of the big and small circle of blood circulation, brain, placenta and even coronary vessels of the brain.

The heart becomes weak, the speed and volume of blood decreases, which circulates through the vessels. As a result, internal organs, let alone cells and tissues, receive less blood. This significantly worsens metabolic processes in the body, contributes to the accumulation of toxins and metabolic products in the blood. Also, cells cease to receive the substances they need. Eventually, dystrophic processes occur in cells and tissues, they are subjected to degenerative processes. It can result in the death of cells and tissues.

The cells of the brain, as well as the kidneys and liver, are the most sensitive to the lack of blood circulation. The placenta, which largely consists of blood vessels, undergoes severe changes, because it is very sensitive.

In gestosis, it does not supply the fetus with the necessary amount of oxygen and nutrients, it does not provide a full exchange between the mother and child, does not completely remove the metabolic products. The consequence is a high intoxication of the body, oxygen starvation.

[15], [16], [17], [18], [19]

Symptoms of the late gestosis

Under the late gestosis, not one disease is meant, but a whole complex of pathologies and critical conditions, the development of which falls on the second half of pregnancy. The signs of gestosis can be very diverse, and sometimes it is difficult to immediately put the right diagnosis. More research is required, systematic observation.

The main symptom is the appearance of nausea and severe swelling in the second and third trimester, heaviness in the legs, severe headache. Gradually, these symptoms increase, the condition worsens. It becomes hard to walk, the load on the heart, legs increases.

The first signs that indicate gestosis, make themselves felt at about 28-29 weeks. Should cause concern in situations in which the swelling of the hands and feet, and also there is a strong swelling of the face. Often this condition is called "dropsy". In this state, the face, the body, as if filled with water and becomes waxy. Pressing leaves a trace, a hollow is formed, which is long smoothed.

Constant control over the situation is important, as the situation progresses rather quickly. If the swelling is insufficient, it is possible not to notice the disease and not to take timely measures, which is fraught with consequences. It is necessary to closely monitor the condition, since if swelling is not enough, a woman may not notice them. Also provide constant weight control, especially in dynamics. On average, a week's weight gain is 350-500 grams. These indicators can significantly exceed the norm, this may indicate that the fluid is trapped in the body, which leads to the development of gestosis.

[20], [21], [22]

Stages

Stage 1 is called dropsy of pregnant women. This is a condition in which the first signs of the disease appear.

The second stage is a nephropathy, in which there is severe damage to the kidneys and other deep lesions of the internals. Damage to the parenchyma, glomerular apparatus. This is manifested by edema. It becomes difficult to breathe, it is difficult to walk. Arterial blood pressure rises sharply. Anxiety is the appearance of protein in the blood and urine. High protein content indicates a serious condition of the body and an unfavorable prognosis. Gradually more and more liquid is retained in the body, and the amount of urine released decreases.

The third stage is an even more severe stage, at which preeclampsia develops. Urgent measures are already required at this stage. Preeclampsia is accompanied by the development of nephropathy, severe kidney damage. To all this, edemas are added. Vision is impaired, various circles appear, which are often called "flies" in the people, a veil appears. If you do not take urgent measures, the final stage begins - eclampsia.

The fourth stage is eclampsia. There is a loss of consciousness, frequent dizziness, convulsions. This stage usually ends in a fatal outcome.  

[23], [24]

Forms

Types of late gestosis correspond to its stages of development. Accordingly, it is possible to distinguish 4 basic forms of gestosis:

• dropsy of pregnant women;
• nephropathy;
• preeclampsia;
• eclampsia.

There is also a clear gestosis, in which the state of health is satisfactory, pathologies are not detected and pregnancy is normal. With combined gestosis, a large number of accompanying pathologies and diseases are registered, a high level of neuropsychic overstrain.

[25], [26]

Complications and consequences

Consequences are premature birth. This is due to both the natural premature birth of the baby, and the need to cause artificial birth. In many cases, urgent delivery is the only correct option that allows you to save the life and health of the mother and child. In some cases, there is a need to stimulate preterm labor, in others there is a need for urgent cesarean section.

 Also, the effects of placental abruption in its normal location. This results in fetal death and hypoxia, intrauterine death. A frequent consequence is a hemorrhage. Gestosis can end with convulsive seizure, bleeding, development of DIC - syndrome.

[27], [28], [29]

Diagnostics of the late gestosis

Confirmation or refutation of the presence of preeclampsia is not limited to a simple visit to the doctor and inspection. The doctor should prescribe laboratory and instrumental studies. Also systematic observation of the obstetrician-gynecologist is necessary. Observations are recorded in dynamics.

It is necessary to have a picture of the changes in dynamics. You need to know clearly how the blood pressure changes. And the pressure must be measured on both hands. It is important to know how the pulse varies. It is also necessary to monitor changes in body weight in dynamics. A rise in pressure above 135/85 may indicate the presence of preeclampsia. Weight gain should not exceed 500 g per week. A large mass may indicate a fluid retention. It is necessary to know what amount of urine is released per day, whether there has been a change in the direction of a decrease in daily diuresis. You also need to monitor the presence or absence of protein in the urine. In addition, a consultation of such specialists as the oculist, neurologist, nephrologist is needed.

[30], [31], [32], [33], [34], [35],

Analyzes

If a woman is diagnosed with gestosis, a large number of tests will be required. First of all, they donate blood and conduct a general clinical study. Significant information can give the number of red blood cells and platelets in the blood. When biochemical blood test is determined by the amount of protein, which is an important diagnostic feature. Also important is the concentration of electrolytes, which indicates the general state of the body, the state of metabolism. Important indicators of urea and creatinine.

Additionally, the coagulation and flow properties of the blood are examined. One of the main is urine analysis. In this case, a routine clinical analysis of urine, as well as a biochemical and daily urine analysis. Be sure to take into account the amount of protein in the urine. A strict control of diuresis is carried out. If the doctor has an idea of how the liquid is distributed in the body, what is the dynamics of its distribution and elimination, many important conclusions can be drawn and an adequate solution can be found. It is important to know the relationship between the amount of daily drunk fluid and the fluid that is discharged. This information can be obtained in the course of tracking changes in body weight in dynamics.

[36]

Instrumental diagnostics

For additional information, if necessary, carry out such studies as ultrasound of the fetus with dopplerometry, cardiotocography of the fetus. Important information can give daily monitoring of blood pressure and a daily electrocardiogram. If necessary, a haemostasiogram can be performed.

The examination of the fundus is mandatory. This is due to the fact that with gestosis all vessels, including the vessels of the eye, are affected. The state of the vessels of the eye is similar to that of the vessels of the brain and the vascular system as a whole. Also obligatory additional consultation of the oculist, the therapist, the nephrologist, the neuropathologist is appointed.

Differential diagnosis

Late gestosis of pregnant women must be differentiated from hypertension, kidney disease. The closest clinical picture is observed in glomerulonephritis and pyelonephritis. However, these diseases can be distinguished at the onset of the disease and the current anamnesis. Gestosis is manifested for the first time at the 28th week of pregnancy. Other diseases can occur at any time, including pregnancy. A distinctive sign of gestosis is spasm of the eyeball. With other diseases such a pathology is not observed. Edema and decreased diuresis are observed only with gestosis and glomerulonephritis.

In order to deliver an accurate differential diagnosis, the results of the analyzes will be required, as well as the urine test for Nechiporenko. If necessary, a bacteriological study can be conducted, which allows to exclude the development of bacterial infections. Most often this study is subjected to urine. With excessive degree of bacterial contamination, additional antibacterial therapy can be performed.

Treatment of the late gestosis

With mild manifestations, in the early stages of the disease, outpatient treatment is provided. In severe cases, it is necessary to hospitalize a pregnant woman. This is necessary in order to conduct daily monitoring, monitor the change in key indicators in dynamics, and also provides the opportunity to apply full and complex treatment. In addition, the patient will be under the constant supervision of medical personnel, which will avoid complications and, if necessary, take urgent measures. Hospitalize the patient in the obstetric ward.

Treatment of the initial stages includes mainly medical therapy. Prescribe sedatives, antioxidants, drugs to control blood pressure. With pronounced swelling, you may need antihistamines, or antispasmodics that help relax the muscles, relieve tension. Desaggregants may be required, which make it possible to improve the rheological properties of the blood. With severe edema, diuretics are prescribed. It is better to use phytopreparations and homeopathic remedies.

In severe nephropathy, especially at the stage of pre-eclampsia and eclampsia, treatment is performed in the intensive care unit with the participation of the resuscitator. Infusion therapy is performed, which allows to correct metabolic and electrolyte disturbances. Introduced fresh frozen plasma, reopoliglyukin. In addition to these drugs, anticoagulants may be required. To control the daily amount of urine, diuretics may be prescribed. In order to quickly restore the water-salt balance, it is possible to use phytogens.

With any form of gestosis, selective sympathomimetics are used, which make it possible to prevent the threat of premature birth and fetal hypoxia. Also, any form of gestosis implies the need to address the issue of delivery. With a satisfactory condition, the births pass through the natural birth canal. If the condition is difficult, it is necessary to think through alternative ways. When the therapy is ineffective, a caesarean section is performed. Sometimes planned, sometimes - emergency.

The peculiarity of gestosis is that its treatment is carried out both before and during childbirth. In most cases, treatment continues even after delivery, until the woman's condition is fully stabilized.

Treatment regimens for late gestosis

The main principles of gestosis treatment are the need for a woman to be treated for a medical and protective regimen. Depending on the severity of the disease, any treatment regimen should include sedatives. The choice of funds depends on the specific treatment scheme and severity of the disease. For example, at the initial stage there may be enough calming agents of plant origin. While at the stage of eclampsia, strong remedies are needed.

Any scheme involves drug restoration of the function of vital organs, depending on which organ is affected. An important stage in determining the treatment regimen is the choice of the method of delivery: natural delivery or cesarean section, timely or emergency, premature delivery.

There is no universal treatment for gestosis. In each case, it will be strictly individual. Depends on many factors. In no case should you engage in self-medication, as this can be dangerous for both the mother and the child and have serious consequences. It is necessary to strictly follow the recommendations of the doctor.

Medications

Magnesia therapy is often prescribed, which is a course of magnesium sulfate. This technique has proved itself well, has been used in many countries for a long time. To do this, take 24 ml of 25% magnesium sulfate and inject it parenterally. The drug is administered 4 times a day, approximately every 4-5 hours.

With strong edema, high blood pressure, euphyllin is used. Introduce 10 ml of a 2.4% solution of euphyllin diluted in 10 ml of saline. Has hypotensive, diuretic action, improves microcirculation of blood and improves coagulation properties of blood. The drug is administered slowly, because with rapid administration, there can be numerous side effects, including nausea, dizziness.

For spasms and high blood pressure, 2-4 ml of 1% dibasol and 2 ml of 2% papaverine solution are administered. Also these drugs have an additional immunostimulating effect.

If the pressure is at a stable high level and does not get knocked out by dibazolum, and by other easy means, pentamine is used. Introduce 0, 5-1 ml of a 5% solution of the drug. 

Vitamins

With gestosis, as with any other condition, the body of a pregnant woman needs vitamins. It is recommended to take vitamins in the following daily concentration:

• Vitamin PP - 60 mg
• vitamin H - 150 mcg
• vitamin C - 500 mg
• vitamin D - 45 mcg.

Physiotherapeutic treatment

Physiotherapeutic treatment is used for obstetric pathology, during exacerbation of diseases, in infectious and inflammatory processes. When gestosis can be used to reduce nausea, to prevent the threat of miscarriage or premature birth. In some cases, on the contrary, to stimulate labor and prepare the body for childbirth. It is used to relieve symptoms of gestosis, to accelerate the healing of postoperative wounds after caesarean section, crotch injuries, to enhance crack repair on the nipples, to stimulate contractions of the uterus with its subinvolution after childbirth. Can help keep the developing fetus or accelerate its development when lagging behind.

Also, physiotherapy can be used to treat colds and inflammatory diseases of the upper respiratory tract, to stimulate the bowel, improve peristalsis, with various concomitant diseases.

Despite the numerous positive effects of physiotherapy, it should be treated with caution in pregnancy. Not all kinds of physiotherapy can be useful. Incorrect dosage or incorrect choice of the procedure can harm both the mother and the future child. Some types of exposure are prohibited for pregnant women. For example, magnetic influence is contraindicated at any time of pregnancy. Even local exposure to restricted areas of the body is forbidden.

Microwave therapy is also harmful to the body of a pregnant woman. With this type of therapy, the body is exposed to microwaves that penetrate into the deep layers of internal tissues, can even affect the developing fetus. The consequences of such influence to science are not known to the end.

Cryotherapy refers to those types of exposure that are contraindicated in pregnant women. The body is not recommended to be exposed to extremely low temperatures.

The most effective effect of physiotherapy in the complex therapy. Any method can be used only on the advice of a doctor.

Alternative treatment

Alternative treatment should be used as part of complex therapy. Before the beginning of treatment it is better to consult a doctor.

For the treatment of gestosis, aromatic medicinal baths have proved themselves well. To prepare such a bath it is recommended to make a decoction of herbs and add essential oils. Positively impact on the condition is sushenitsa and chamomile. To make a bath, make a decoction. For this, a small amount of grass is poured with boiling water. Prepare a rich broth in a container with a capacity of 1-2 liters. After that, the broth is filtered and hot poured into a bath filled with water. The temperature is comfortable. The bath is taken 15-20 minutes, several times a week. Decoctions penetrate through the pores into the skin, promote relaxation, removal of the main symptoms of gestosis. You can add a few drops of essential oil, picking up the fragrance that will be most pleasing to the woman.

Aromatherapy is an effective way to combat swelling, signs of gestosis. Promotes relaxation, tranquility, helps a woman to gain a sense of harmony, balance. To conduct an aromatherapy session at home, you need to create a favorable atmosphere, choose a secluded room, pre-ventilate it.

It is recommended to use the aroma lamp. It will distribute the fragrance throughout the room, will contribute to its even distribution and admission. For this purpose, a candle is lit in the lamp, which heats up the upper container with water. Several drops of essential oil are added to this water. The water begins to boil, evaporate and the room is filled with a delicate aroma. After the lamp is lit, you need to sit in a comfortable pose, or lie down, relax as much as possible. We must try not to stir, not think about anything, drive away all thoughts away. It is important to feel only the harmony, tranquility and subtle aroma of essential oil that fills the room. It is better to cover your eyes, listen to your inner sensations.

This helps to relax the muscles, nervous system, relieve edema and eliminate the underlying symptoms. The procedure lasts as long as it delivers comfort and pleasure. But it is recommended to spend at least 30 minutes, because less time will be ineffective. The person begins to relax at least 20 minutes later, and complete relaxation usually comes only after 30 minutes. It is necessary to observe the precautionary measure - to control the amount of water in the aroma lamp. The water evaporates constantly, and the aromatic oil should not remain empty. Firstly, in the absence of evaporation, the fragrance will cease to emerge. Secondly, from below the lamp is heated all the time with a candle. In the absence of water, a red-hot lamp may crack. Therefore, it is better to put it side by side, and periodically, without losing the state of harmony and relaxation, pour in a small amount of water as it evaporates. It is recommended to take an aromatherapy course, every day or every other day for 21-28 days, with a noticeable positive effect, you can have a longer period.

An effective alternative is the treatment of magnolia vine juice. Applied as a part of tea or water. To a glass of tea, add about 15 ml of juice, mix and drink. To taste, you can add honey or sugar. Has a positive effect on the body, has antioxidant properties, helps relax the muscles, relieve tension. Especially effective is the juice of magnolia vine after an aromatherapy session, as it enhances relaxation.

[37], [38], [39], [40]

Herbal Treatment

The root of ginseng has a positive effect in the treatment of gestosis. Stimulates immunity, eliminates the feeling of nausea. It is used as a tincture. It can be used in pure form, but can be added to tea or water. The daily dose is 60 drops, they need to be divided into several receptions.

Ellekuterokokk also has an immunostimulating effect, normalizes the hormonal background. It is recommended for early and late toxicosis. Helps to eliminate edema and stagnant phenomena. The extract of the plant is taken 2 ml several times a day before each meal.

Echinacea is useful, both for the mother's body and for the fetus. Reduces intoxication, helps to remove toxins from the body, reduces swelling. Apply 2-3 ml before meals. Can be used in a mixture with an extract of Eleutherococcus. Together, these two tools enhance each other's action, have a more powerful effect.

Homeopathy

Homeopathic remedies are effective in the treatment of gestosis. But take them carefully and after a preliminary consultation with a doctor. Not all homeopathic remedies are shown to pregnant women. Some of them may have a negative effect on the mother's body, others - on the fetus. In addition, homeopathic remedies may not be combined with other drugs and their components. Dosage is determined strictly individually. It should be remembered that homeopathic remedies can have a cumulative effect, so their effect may not appear immediately. Some substances begin to act only after the entire course of treatment has been completed. Therefore, in spite of the relative safety of these agents and the small number of side effects, precautions are recommended. The best precautionary measure will be a preliminary consultation with the doctor.

• Tea "Bouquet of Altai"

For the preparation of tea, you need to take the balan, the rhodiola rosea root, the root of the penny-tree and the leaves of the cowberry in the ratio 2: 1: 1: 1. These herbs are mixed and taken to prepare a decoction of about 30-45 g of the mixture. Pour boiling water, insist about 30 minutes. After that, filter and drink 2-3 glasses a day in a warm form. You can add honey or sugar to your taste.

• Hibiscus tea"

Ordinary karkade tea, which is sold in stores, can be an excellent homeopathic remedy having a positive effect on the condition of a pregnant woman suffering from gestosis. Tea has a calming effect, helps to relax the nervous system, muscles. At the same time, it is a rich source of vitamins and trace elements. Tea is brewed in the brew and drunk during the day. If desired, sugar can be added to the tea, honey to taste. When strong swelling to tea it is recommended to add leaves of nettle. An approximately equal proportion is made. You can also add berries of viburnum or lemon to taste.

• Elixir "Siberian herbalist"

Elixir promotes harmonization of the internal organs, stabilizes the nervous and vascular system. Has a positive impact, both on the mother's body and on the baby's body.

Elixir can be bought in pharmacies in the finished form. Take in accordance with the instructions. You can also prepare the elixir yourself. To do this, take the fruits of cranberries, Siberian oleoresin, seeds of milk thistle, honey or pergue, mix and pour alcohol or vodka. The solid content should fill the container by about a quarter. The agent should be allowed to infuse for 3-7 days. Then you can drink it in its pure form or add it to the tea. The daily dose is 40-50 ml.

• Collection medicinal. With hypotension and edema

It is recommended to take in the form of a decoction. To do this, take the hips and hawthorn fruits in a ratio of approximately 2: 1.5. Make a decoction. To do this, the mixture is poured with boiling water in an amount of approximately 1 liter, brought to a light boil, set aside, allowed to brew. They drink like tea. You can add sugar, honey. It is recommended to drink all the broth during the day, the next day to make a new decoction. Drink in a warm form.

• Collection of herbal. With late gestoses

To prepare the broth, take leaves of cranberries, leaves of blueberries and willow-tea approximately in equal quantities. Mix, from this mixture take 2-3 tablespoons, pour boiling water. Allow to brew for about 30 minutes, then drink like tea. You can add honey, sugar. If desired, you can add the fruits of blueberries or cranberries, or cook them.

Surgery

If the treatment is ineffective for 3 days with severe gestosis and for 3 hours at the stage of pre-eclampsia, a mandatory cesarean section

Prevention

Prevention is reduced to the implementation of reproductive function at the age of 35 years. It is also necessary to diagnose and treat concomitant diseases in a timely manner, not to allow the transition of diseases into a chronic form. It is also important to lead a healthy lifestyle, eat fully, exercise, and avoid stress.

[41], [42], [43], [44], [45], [46]

Forecast

At the first stages, with the necessary treatment and strict observance of all prescriptions of the doctor, the prognosis may be favorable. It is possible to save pregnancy, on time and in a natural way to give birth to a baby.

Late toxicosis in severe form is a life-threatening condition, and the prognosis can be extremely unfavorable. The only and the main method of treatment in this case is delivery, since late gestosis leads to damage to the placenta and the further preservation of pregnancy becomes dangerous both for the life of the mother and for the life of the fetus. If treatment is not effective within 3 days, an emergency cesarean section is performed. When the first symptoms of pre-eclampsia appear, the cesarean section is also urgently performed.

[47], [48]