Obstetrics and gynecology. Toxicoses of pregnant women (continued) (most important)

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Obstetrics and gynecology. Toxicoses of pregnant women (continued) (most important)

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30. Toxicosis of pregnant women (continued)

hypersalivation often present with vomiting of pregnant women, but sometimes it can be in the form of an independent form of early toxicosis of pregnant women. With severe salivation, the loss of saliva per day can reach 1 liter or more. Abundant salivation has a depressing effect on the psyche of a pregnant woman, leads to dehydration, hypoproteinemia, sleep disturbance, loss of appetite and body weight. Treatment of hypersalivation is advisable to carry out in the clinic. In this case, atropine and local infusion of astringent and antiseptic herbs (oak bark, chamomile, sage) are used. Severe hypoproteinemia is an indication for plasma transfusion. Hypnosis and acupuncture are used as auxiliary methods.

A special form of early preeclampsia is jaundice due to cholestasis (cholestatic hepatitis). It is characterized by a predominant lesion of the liver, often accompanied by itching of the skin, an increase in cholesterol and alkaline phosphatase activity in the blood with normal alanine aminotransferase activity. This form of gestosis is often complicated by premature termination of pregnancy, bleeding during childbirth, and the formation of fetal malformations. When the pregnancy is terminated, jaundice disappears, but may recur in subsequent pregnancies. Treatment is carried out in accordance with the general principles of hepatitis treatment. A diet, vitamins, glucose, protein preparations, etc. are prescribed. Considering the extremely serious significance of liver damage during pregnancy, primarily for a woman, the question of its premature termination is often raised.

Early toxicosis of pregnant women can also be expressed in some forms of dermatosis. The most common is pruritus. It can appear at the beginning and end of pregnancy, it can be local and limited to the vulva or spread throughout the body. Perhaps the appearance of insomnia, irritability. With this form of toxicosis, it is necessary to exclude diseases accompanied by pruritus. It is necessary to exclude diabetes mellitus, fungal and parasitic skin lesions, trichomoniasis, helminthic invasion, an allergic reaction, etc. Treatment is reduced to the appointment of agents that regulate the functions of the nervous system, desensitizing agents, and UV radiation.

Occasionally, dermatosis manifests itself in the form of eczema, herpes, impetigo herpetiformis. These dermatoses are treated in the same way as in the absence of pregnancy.

Tetany is one of the rare forms of pregnancy toxicosis. Its cause is a violation of calcium metabolism in pregnant women. A manifestation of this form of toxicosis is the occurrence of muscle spasms of the upper and lower extremities, the face. It is also necessary to take into account the possibility of manifestations of hypoparathyroidism in connection with pregnancy. Calcium preparations are used to treat this form of toxicosis. An even rarer form of early toxicosis of pregnant women is bronchial asthma. It should be differentiated from exacerbation of previously existing bronchial asthma. Treatment includes the appointment of calcium preparations, sedatives, a complex of vitamins, general UVI.

Pregnant women who have undergone early toxicosis need careful outpatient monitoring, since they often later develop late toxicosis.

Author: Ivanov A.I.

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