Diseases In Pregnancy

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Diseases In Pregnancy
Diseases In Pregnancy

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Diseases in pregnancy

Physical changes during pregnancy are normal and necessary for the development of the unborn child. Slight symptoms as an accompanying symptom are frequent and generally not a cause for concern. In some cases, however, clinical pictures develop during pregnancy. These must be treated in good time, as otherwise they can pose a serious risk to the health of mother and child.

The examinations in the mother-child pass help to identify incipient illnesses at an early stage.

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  • Severe vomiting (hyperemesis gravidarum)
  • Pregnancy-related high blood pressure
  • pre-eclampsia
  • Eclampsia
  • HELLP syndrome
  • Gestational diabetes

Severe vomiting (hyperemesis gravidarum)

Many women suffer from nausea, nausea and vomiting, especially at the beginning of pregnancy. The cause of pregnancy sickness is not fully understood, but it has been linked to increased sex hormone levels and the rise in the hormone hCG. Psychological and social factors (e.g. stress, fears, conflict situations) can also have an influence on the development of vomiting.

If the tendency to vomit persists beyond the first trimester of pregnancy or if the woman vomits several times a day, there is a risk that the body will be undersupplied. This can lead to severe disorders of metabolism, electrolyte balance and liver function. In pronounced cases, drug treatment and, under certain circumstances, hospitalization is necessary in order to compensate for the loss of fluids, minerals and vitamins with infusions.

Pregnancy-related high blood pressure

Due to the adaptations of the cardiovascular system to the pregnancy, the blood pressure usually decreases slightly in the first few weeks before it reaches normal values ​​again towards the end of the pregnancy.

From the second half of pregnancy onwards, some women experience an excessive increase in blood pressure; From a value of 140/90 mmHg one speaks of pregnancy hypertension. The cause is often unknown; genetic factors, lifestyle (diet, exercise, etc.) and changes during pregnancy all play a role. A new high blood pressure that occurred during pregnancy usually returns to normal shortly after the birth.

Chronic hypertension that existed before pregnancy can normalize in the course of physical adjustments in the first half of pregnancy and only reappear in the second half.

A slight increase in blood pressure without any other concomitant illnesses usually does not interfere with the course of pregnancy. However, high blood pressure can lead to changes in the blood vessels of the organs and placenta, and the risk of premature placenta detachment or growth disorders in the child increases. In severe cases, drug treatment is therefore necessary. High blood pressure can also be the first sign of the onset of preeclampsia, which is a dangerous disease for both mother and child.

pre-eclampsia

Preeclampsia is characterized by the combination of high blood pressure with increased protein excretion in the urine (proteinuria). Edema can also occur, particularly on the legs, hands and face. Preeclampsia is one of the so-called gestoses, which is colloquially referred to as pregnancy poisoning (the term is outdated, however). It can occur from the second half of pregnancy.

The cause of preeclampsia is not clearly understood. Various messenger substances that control the formation of blood vessels, as well as metabolic processes seem to play a role in the development. The increased blood pressure is the result of vascular constrictions, which also lead to a reduced blood flow to the affected tissue (e.g. the placenta). The increased excretion of protein in the urine and the edema are signs of further organ damage (e.g. impaired kidney function). An increase in the liver values ​​in the blood is also possible. The disease regresses after birth.

Are risk factors

  • preeclampsia in a previous pregnancy,
  • existing kidney disease,
  • chronic high blood pressure,
  • Diabetes,
  • high BMI in pregnancy as well
  • Multiple pregnancy.

Preeclampsia is associated with a high health risk for both mother and child. There is a risk of multiple organ damage, undersupply of the unborn child and premature placenta detachment. The symptoms of preeclampsia can vary widely. Affected women complain of headache, dizziness, sensitivity to light, nausea, vomiting, upper abdominal pain, visual disturbances or sudden weight gain. The symptoms can appear within a very short time and worsen quickly; within hours, eclampsia or HELLP syndrome (see below) can develop.

In the case of a mild form of the disease, possible therapeutic measures are physical rest or bed rest, as well as lowering blood pressure with medication. In general, however, it is not possible to treat the cause of the disease. If it is severe, the pregnancy must be terminated. Depending on the gestational age, the risks of the disease itself must be weighed against the risks of a premature birth.

Eclampsia

Eclampsia can follow severe preeclampsia, but it can also come on suddenly, with no previous high blood pressure or proteinuria. Eclampsia results in neurological disorders, in particular there is a risk of seizures. The seizures are similar to an epileptic seizure and can be accompanied by loss of consciousness and respiratory failure. Complications such as thrombosis, cerebral haemorrhage, retinal damage or cerebral edema are possible.

Eclampsia is a life-threatening situation for both mother and child, and immediate emergency care and inpatient treatment are important. The pregnancy may need to be terminated immediately.

HELLP syndrome

HELLP syndrome is a rare, dangerous variant of preeclampsia, but it can also occur suddenly without any sign. With the disease it comes to

  • in destruction of the red blood cells (H ämolyse)
  • a disease of the liver with abnormal liver function tests (E levated L iver Enzymes), and to
  • a sharp drop in the number of blood platelets (L ow P latelets).

As in preeclampsia, the exact cause is not fully understood. Symptoms include general malaise, severe pain in the upper right abdomen, sudden headache, visual disturbances and nausea. Due to the changes in the blood count, there is an increased tendency to bleed. There is a risk of severe organ damage and placental insufficiency or detachment within a short time.

A rapid delivery is usually used as therapy. HELLP syndrome can also occur after the birth; intensive monitoring is necessary.

Gestational diabetes

If diabetes mellitus (diabetes) occurs for the first time during pregnancy, it is called gestational diabetes. The disturbance in the carbohydrate metabolism can be triggered by the increase in pregnancy hormones. However, hidden diabetes mellitus (type I or type II) may have existed before pregnancy.

In pregnant women, a permanently high blood sugar level can lead to frequent urinary tract infections or fungal infections of the vagina, among other things. In addition, the risk of high blood pressure, preeclampsia or premature birth is significantly increased. With the appropriate therapeutic measures, however, pregnancy is uncomplicated in most cases.

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