Coma in Pregnancy

Coma in pregnancy is a pathological condition that is dangerous for the life of the mother and child. Let's look at the causes and symptoms of coma, the methods of diagnosis and treatment, as well as preventive measures to prevent it and predict coma in pregnancy.

Sometimes the normal course of pregnancy can be overshadowed by a condition that threatens the life of the mother and the unborn child. This condition is called a coma in pregnancy. Most of this pathology is affected by pregnant women who are at risk. If you suspect a coma, a gynecologist can perform a caesarean section and prescribe a number of medications for admission during the postpartum period to prevent the development of complications.

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Causes of coma in pregnancy

The causes of coma in pregnancy are very different and completely depend on the condition of the woman, the presence of chronic diseases, age, the general course of pregnancy and much more. On the causes of coma in pregnancy of great importance are the risk factors. Under the risk factors are the state of health, the presence of pathological abnormalities and chronic diseases. To identify the factors that can cause coma in pregnancy, and lead to the death of the mother and child, the doctor conducts a full examination of the woman. The detected risk factors receive certain balls, which allow the doctor to observe the condition of the pregnant woman and provide timely medical assistance.

Let's look at the main risk groups that can cause coma in pregnancy.

1. Dystrophy of the liver is one of the most common causes of coma in pregnancy. The danger of dystrophy is that the condition of a pregnant woman worsens very quickly, and if a coma occurs, it is usually fatal for a child. With this disease, a woman's blood pressure rises sharply and physical activity increases.

After this, there is pain in the pit of stomach and a visual disturbance. As soon as the arterial pressure reaches a critical level, the woman develops a coma and a coma sets in. The main symptoms of liver dystrophy in the predkomatoznom state - a sharp short-term tension of the muscles of the jaw, convulsions. As soon as a woman regains consciousness, she does not remember what happened to her. Coma attacks can occur one after another and lead to a fatal outcome of a pregnant woman.

2. Diabetes mellitus is a pathological condition that is caused by an acute shortage of insulin. This condition disrupts the metabolism, causes glucosuria, hyperglycemia. Dangers are women with any type of diabetes, both insulinosivisimye, and having a hidden form. In pregnancy, the disease causes generalized degenerative lesions of small vessels and vessels of medium caliber. Sometimes there is swelling and diabetic retinopathy, which causes loss of visual acuity and blindness.

Diabetes mellitus during pregnancy causes serious problems with the immune system, which is why a woman is susceptible to various diseases and disorders. This contributes to the development of infectious pathologies, which lead to the appearance of cystitis, pyelonephritis and coma. In order to prevent pathological violations and to whom during pregnancy, a woman should regularly take blood tests and consult a gynecologist about any painful symptoms.

3. Renal failure - pregnancy with kidney disease is problematic, as the kidneys are a heavy load. Even in perfectly healthy women, nephropathy appears during pregnancy, which indicates that the kidneys can not cope with their work. During pregnancy planning, a woman should undergo a full examination and consult with a gynecologist.

Only maintenance therapy and regular examinations will help to prevent renal coma during pregnancy. If a woman has chronic kidney failure, then there is a high probability of not only coma, but also termination of pregnancy. The main symptoms that signal a coma: hyperglycemia, problems with the genitourinary system, a pathological increase in diuresis.

4. Eclampsia - a pathological condition that occurs due to violations of the liver and its acute dystrophy. Pregnant feels anxiety, strong and sharp headaches, there is a tendency to bleeding and pain in the liver. In pre-coma, a woman has seizures and stiff neck muscles. There are twitching of the muscles of the face and gradually convulsions pass to the upper limbs. Convulsions are short-lived and very dangerous for the fetus, since they can lead to the stopping of breathing and the death of the child. After the cramps stop, the pregnant woman regains consciousness, but does not remember anything about the seizure. In very severe cases of eclampsia, a woman does not come out of a coma.

In order to prevent eclampsia, a woman should undergo regular examinations, and monitor her state of health. Of great importance is nutrition, the diet should be high-grade (proteins, carbohydrates, fats). Do not forget about maintaining the water balance in the body, as it is a guarantee of health not only for women, but for her future child.

5. Nephropathy of pregnant women and cerebral stroke

Nephropathy and cerebral stroke most often occur in pregnant women who suffer from atherosclerosis or have hypertension. Because of the disease in the pregnant woman there is swelling and blood circulation is disturbed, changes occur in the urine. Comatose state due to cerebral stroke develops suddenly. A woman does not have cramps or motor troubles.

Nephropathy of pregnant women and cerebral stroke cause persistent unilateral paralysis, which rapidly progress. The predkokatoznoe state causes hyperemia of the face, that is, a sharp redness due to overflow of blood vessels. The left ventricle of the heart is hypertrophied in the pregnant woman, paresis occurs (neurological syndrome, which causes the weakening of voluntary movements due to damage to the motor centers of the brain or spinal cord).

6. Hypoglycemic coma

Hypoglycemic coma is a dangerous condition for a pregnant woman, which occurs because of a critical drop in blood glucose. At the initial stages of the disease, a woman often feels headache, hunger, dizziness. In diabetics, hypoglycemia causes seizures, flies in the eyes, loss of consciousness. There is a hypoglycemic coma in pregnancy due to an incorrect dosage of insulin or non-compliance with the rules of drug use. Irregular nutrition, increased physical activity, severe stress, alcohol consumption are the main causes of hypoglycemic coma in pregnancy.

A coma can occur in the early stages of pregnancy, with liver failure, surgical intervention and infectious diseases. Hypoglycemic coma develops very quickly, causes blanching of the skin, loss of consciousness, profuse sweating, seizures and vomiting. In a comatose state, the pregnant woman has normal breathing and blood circulation, while the arterial pressure is increased. The danger of such a coma for a woman is that the predkomatoznoe condition is poorly diagnosed and can cause a miscarriage, less often a coma causes the death of a woman.

7. Hyperglycaemic coma

Hyperglycemic coma is a pathological condition that occurs in pregnant women with diabetes mellitus. Coma is caused by a lack of insulin. In the blood of a woman, the concentration of glucose and toxic metabolic products increases. In pre-coma, a woman feels weak, thirsty, sleepy, there is a rapid breathing and a pulse. After that, the pregnant woman loses consciousness and falls into a coma. In coma, blood pressure is very low, limbs twitch.

The main causes of hyperglycemic coma is the failure to comply with the dosage of insulin administration, a woman does not follow a diet or has an infectious disease. In pregnant women who have a latent form of diabetes mellitus, that is, they do not suspect their pathology, a coma can lead to a fatal outcome, both for the child and for the mother.

In addition to the above reasons, coma during pregnancy can occur with anemia, cardiovascular diseases and circulatory system disorders, with varicose veins and thrombosis, with injuries and brain damage, allergic reactions, infectious diseases, the use of antibiotics and medications, tumors and other pathologies of the body.

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Symptoms of coma in pregnancy

Symptoms of coma during pregnancy are manifested in the form of an increasing pathological condition of a woman who is at risk. Increasing symptoms lead to suppression of brain functions and development of seizures and fainting, that is, pre-coma. The condition of eclampsia can occur both in the first weeks of pregnancy, and in the last trimester. Let's look at the main stages and symptoms of coma during pregnancy.

• Short-term cramps of the muscles of the body, face, eyelids, trembling. Sometimes there is a stop of breathing.
• Heavy muscle tension, rigid jaw clutch. Pupils sharply expand, after which the eyes roll.
• Rapid muscle contractions, which are followed by severe and deep breathing of the pregnant.

After the above described symptoms, coma sets in. The woman is unconscious, noisy breathing. With liver dystrophy, a foam with blood flows out of the mouth, this condition is observed in coma due to cardiovascular insufficiency. After a while, the palpitation normalizes, the skin acquires a normal color.

When a woman comes to, she can not remember the seizure. In some cases, the pregnant woman does not go out of the state of coma or the seizures are repeated many times, this may be a direct indication for abortion or caesarean section (depending on the period of pregnancy). Without timely medical assistance, a coma follows with a fatal outcome for a woman and death for a child.

Diagnosis of coma in pregnancy

Diagnosis of coma during pregnancy is based on the manifested symptoms. It is by symptoms that you can determine the causes of coma. Diagnosis of coma during pregnancy is based on instrumental and laboratory studies. Once a gynecologist has identified a woman at risk, the pregnant woman should regularly take tests and undergo a diagnosis. This is necessary for the doctor to react in time to the pre-coma and to provide timely medical assistance.

If the pregnant woman has fallen into a coma for no apparent reason, then the doctor's task is to examine the woman and identify the cause. To do this, a pregnant woman takes a blood test, urine, conducts a biochemical blood test and an analysis for glucose, bilirubin, creatine, liver enzymes. The doctor performs a thyroid examination and a brain imaging. In extreme cases, the doctor takes spinal fluid and electroencephalography. Obligatory is the ultrasound for the diagnosis of the fetus.

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Treatment of coma in pregnancy

Treatment of coma during pregnancy begins with the provision of prompt medical attention. Treatment takes place in a hospital and depends on the causes that caused a coma. Mandatory is the provision of urgent measures that are aimed at stopping vomiting, maintaining blood circulation and breathing.

• If a diabetic coma occurs during pregnancy due to high blood sugar, the woman is injected intravenously with insulin. If a coma has arisen because of a low sugar level, then a glucose solution is administered for treatment. At a coma, which is caused by intoxication, pregnant, carry out forced diuresis.
• With uremic coma, that is, coma on the background of renal insufficiency, a woman is hemodialysis, purifies the blood with the use of an artificial kidney apparatus. As a rule, after such a coma in a pregnant woman, the child does not survive.
• If a coma during pregnancy has arisen from an injury that involves surgery, the doctor's task is to monitor the normal blood supply to the mother and baby. With severe convulsions during coma, pregnant intravenously injected phenytoin (anticonvulsant). But the use of the drug is possible only in the case when the therapeutic effect for the mother is much more important than the life of the child.
• With eclampsia, the method of treatment of Stroganov is used. The technique assumes complete protection of the woman from any stimuli. Pregnant intravenously injected drugs to reduce blood pressure, if necessary, conduct bloodletting. Pay attention, for treatment use narcotic preparations, therefore, if the coma has arisen in last trimester of pregnancy, to the woman do or make cesarean section to rescue the child. When comatose in the early stages, the doctor aborts the pregnant woman. If, after therapy, the precomatosis state is repeated, the woman is given a puncture of the spinal canal to stabilize the condition.
• When hypoglycemic coma, you should immediately call an ambulance. If the coma is not deep, the woman is given water or tea with sugar to ease the condition. If swallowing is difficult, under the tongue of the pregnant woman, you need to put some honey or jam. But this must be done very carefully, because in an unconscious state a woman can easily choke. It is strictly forbidden to introduce insulin before the arrival of physicians, since this can worsen the condition of the pregnant woman.
• In hyperglycemic coma, you need to call an ambulance, put the woman on its side and ensure a normal airflow. Treatment is carried out in a hospital, in intensive care. Doctors restore the level of insulin in the blood and electrolyte balance.

Prevention of coma in pregnancy

Preventing coma during pregnancy depends on the potential risks of its occurrence. If the coma is caused by circulatory disorders, then the doctor's task is to prevent the pathological condition, and if necessary, restore the blood flow as quickly as possible. With the risk of developing diabetic coma, the task of the pregnant woman is not to skip meals and inject insulin.

In the prevention of hyperglycemic coma, the pregnant woman should monitor blood glucose levels, administer insulin and maintain a diet. The timely treatment of infectious diseases is mandatory. A woman should limit physical activity to prevent trauma. Similar preventive measures should also be in case of suspected hypoglycemic coma. Prevention of eclampsia involves limiting physical activity, adherence to dietary intake, with the regular intake of vitamins and proteins. A woman should often be in the fresh air.

Prevention of coma during pregnancy is the passage of regular examinations and the delivery of tests. This will allow doctors to monitor the health and body of the pregnant woman and respond in a timely manner to potentially dangerous conditions that can cause someone.

Prognosis of coma in pregnancy

The prognosis of coma during pregnancy depends on the gestational age, the age of the woman, the cause that caused the coma, and the past time from the onset of the attack to the provision of medical care. Especially dangerous for the life of a woman and a baby are the symptoms of a fall in the work of the cardiovascular system and a weakened pulse, a high temperature, a critical high or vice versa, low blood pressure, sugar and glucose in the blood.

Such symptoms cause the development of collapse, which is accompanied by a drop in blood pressure, a decrease in diuresis and increased skin pallor. A positive coma prognosis during pregnancy helps to save the life of the baby and the woman. With a negative prognosis of coma during pregnancy, a woman is c-sectioned or interrupted pregnancy, in the worst possible predictions, coma causes death of the most pregnant woman.

Coma in pregnancy is a dangerous condition that threatens the life of the child and mother. To prevent coma, a woman should monitor her health, undergo regular examinations, take tests and conduct preventive procedures prescribed by a doctor.