The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty since 2001.
The first trimester of pregnancy is called a period lasting from the moment of fertilization to the full 12 weeks.
List of dangerous conditions
Most often in the first 12 weeks of pregnancy occurs early toxicosis. According to various authors, he observed on 50-60% of all pregnancies up to 90%.
The second state is a threat threatened abortion, which is diagnosed in 2% of all pregnancies, the usual frequency miscarriage It is 5-20%.
And third, a dangerous condition in the first trimester are flu and SARS. The frequency of acute respiratory disease in pregnant women during the first 12 weeks and not defined and dependent on seasonal outbreaks.
Causes
Causes of early toxicity is still not well established, and in this regard there are many theories (hormonal, neurogenic, Reflex, allergic, etc.). The basic mechanism of this condition is due to functional disorders of the central nervous system to the changes of the internal organs. That is in response to hormonal changes in the body during pregnancy lead to abnormalities of the digestive tract. Exacerbate these violations and psycho-emotional state of women. Early toxicosis is designed to protect the fetus from harmful substances contained in the food.
The threat of termination of pregnancy can be caused by numerous factors:
- Genetic diseases of the embryo;
- hormonal disorders in women;
- exposure to harmful environmental factors;
- extragenital exacerbation of chronic diseases;
- some medications;
- gynecological pathology;
- infection, including sex;
- stress;
- immune disorders.
Acute respiratory infections woman most exposed in the first trimester of pregnancy. This is due, firstly, to hormonal changes, and, secondly, with the suppression of immune pregnant, that is intended to prevent the rejection by the body of the embryo.
symptoms
Early toxicosis known to most women. It is manifested in the first place, nausea, usually in the morning, and vomiting. According to the severity of vomiting distinguish 3 degrees of early toxicity:
- light - vomiting 5 or fewer times a day;
- vomiting mid-weight reaches 10 times a day;
- heavy - vomiting is observed up to 20-25 times a day.
In addition to these symptoms in women observed emotional lability (crying, irritability), drowsiness, change of taste and smell, excessive salivation, reduced blood pressure, dry skin, weight loss, and sleep disturbances.
Symptoms of threatened abortion are also well known:
- abdominal pain and / or in the lower back;
- occurrence of bleeding from the genital tract (from minor to heavy);
- fall in rectal temperature up to 37 degrees or below.
Colds are characterized by fever, but not always, the appearance of pain in the throat, nasal nose and rhinitis, cough and symptoms of intoxication (weakness, fatigue, joint and muscle pain, reduced appetite).
Treatment and prevention
Warn the disease is easier than cure, so prevention of threats interrupt catarrhal infections and toxicity must start at the stage of planning of pregnancy.
Not later than 3 months prior to conception a woman should do preventive vaccination against influenza, change the mode of the day, and the power, to start taking multivitamins and folic acid. In addition, the expectant mother should be examined and treated chronic extragenital pathology and infections, sexually transmitted diseases.
toxicosis treatment
toxicosis treatment begins with compliance diet (Split meals in small portions, eliminate spicy, fried and fatty food, to increase the amount of fresh fruits and vegetables), the first snack to prevent nausea should be in bed (crackers, dried fruits). Pregnant women should carry a bottle of water with lemon juice and fruit, crackers or nuts for snacks extraordinary.
Required a full night's sleep at least 8 hours and the afternoon nap, a walk in the forest area, the exclusion of any stress and harmful environmental factors, including industrial hazards.
Of the drugs recommended reception hofitola (made of artichoke extract field), which contains insulin and vitamins and normalizes metabolism. Also shown is the receiving Essentiale (improves liver) enterosgelya (enterosorbent) and Cerucalum (antiemetic, prescribed by the physician).
In severe toxicosis woman is hospitalized, and she appointed infusion therapy (nutrients, multivitamins and brine) to prevent dehydration. According to the testimony used hypnotics and sedatives.
Colds in the first trimester of pregnancy should be treated traditional methods (excessive drinking vitamin and herbal teas, inhalation herbs and aromatic oils, saline nasal lavage and sea brine, vinegar or sponging to reduce vodka temperature).
The pregnant woman should remember that self-treatment of SARS and influenza, especially drugs, dangerous for the condition of the fetus. Of antipyretics allowed only paracetamol.
The threat of interruption is treated only in a hospital, where pregnant women are prescribed bed rest or polupostelny mode, antispasmodics, progesterone preparations (utrozhestan and djufaston), soothing and protective medical mode.
Complications and consequences
All-threatening conditions in the first trimester of pregnancy danger of spontaneous abortion. Besides miscarriage dangerous condition may cause:
- fetal intrauterine infection (subsequently premature rupture of water and preterm labor);
- placental insufficiency fetal development (in the future occurrence of intrauterine fetal hypoxia and developmental delays);
- fetal birth defects of coarse (if mother infections);
- having a baby with low birth weight;
- delay in the neuro-psychological and physical development of the child;
- muscular hypotonia.
In addition, infection and severe early toxicosis contribute to the emergence of maternal complications:
- dehydration and intoxication (ketoacidosis) organism (severe toxemia and severe infection);
- chorioamnionitis (inflammation of the walls of the membranes and infection of the amniotic fluid);
- electrolyte imbalance;
- significant weight loss;
- extragenital exacerbation of chronic diseases;
- development of liver disease, gastro-intestinal tract and of respiratory system;
- problems with teeth, hair and nails (hypo- and beriberi).
forecasts
The favorable outlook in the development of dangerous conditions in the first trimester of pregnancy depends on the reasons that caused them, timely and appropriate treatment, as well as on other factors:
- the woman's age,
- the duration of pregnancy,
- severity of the disease and the presence of concomitant diseases.
So,
- threat of miscarriage in the first trimester is possible to stop more than 60% of cases,
- colds to 80% has no adverse effects on the fetus,
- early toxicosis, even severe, 90% successfully cured.
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.
