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Principles of treatment of late toxicosis
Last reviewed: 08.07.2025
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It is recommended to observe the following provisions:
- possible elimination of any irritations;
- systematic, planned administration of narcotic drugs, preventing seizures rather than waiting for them to appear; in doing so, one should never lose sight of the basic principle of the method - seizures must be interrupted, and if they recur, the administration of narcotic drugs must be intensified and even increased in frequency;
- a quick, but usually not forced delivery is possible - forceps, rotation, extraction in breech presentations;
- maintaining all the most important functions of the body in the best condition - breathing, heart activity, kidneys and skin;
- if the attacks continue despite adequate use of medication, bloodletting of about 400 ml of blood is indicated;
- if, despite the use of the indicated measures, the seizures still continue and the sick pregnant woman or woman in labor is at the beginning of labor, forced delivery is indicated;
- In addition to bloodletting, the improved prophylactic method involves more vigorous administration of narcotic drugs during the first 2-3 hours of treatment.
Childbirth with nephropathy can proceed normally, but complications such as fetal hypoxia, prolonged labor, premature detachment of a normally located placenta, and the transition of nephropathy to preeclampsia and eclampsia often arise.
During labor, the mother's condition should be carefully monitored, complex treatment of nephropathy should be carried out together with the anesthesiologist, adequate pain relief during labor should be provided, fetal hypoxia should be prevented and treated, and pushing should be stopped if indicated.
All vaginal manipulations, blood pressure measurements, and injections must be performed under a nitrous oxide mixture (anesthesia).
In modern conditions, cesarean section for eclampsia is indicated for:
- persistent attacks of eclampsia despite treatment;
- comatose state;
- hemorrhage in the fundus, retinitis, retinal detachment;
- anuria and severe oliguria.
In the third stage of labor, it is necessary to prevent bleeding.
In the early and late postpartum periods, women suffering from late toxicosis are subject to examination and treatment with the involvement of a therapist. After discharge from the hospital, they should be under the supervision of an obstetrician-gynecologist and other specialists (therapist, nephrologist). This contingent of patients should undergo rehabilitation measures.
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