But it is precisely this period of pregnancy that is often complicated by early toxicosis. According to statistics, every second expectant mother suffers from this disease. Many people mistakenly consider it the norm, but this is not so: toxicosis is a pathology.
Usually the word “early toxicosis” refers only to nausea, vomiting and drooling. The medical understanding of this word is somewhat different from the everyday one: in textbooks on obstetrics, toxicosis is considered to be all pathological changes in a woman’s body that can appear in the first trimester of pregnancy. These include not only nausea and vomiting, but also some other unpleasant phenomena that are much less common (dermatoses - skin lesions, tetany - muscle cramps, osteomalacia - softening of bones, jaundice, bronchial asthma of pregnant women, etc.).
Causes
Despite numerous studies, the cause of toxicosis has not yet been found. But some hypotheses exist:
The most popular and most substantiated theory of the occurrence of toxicosis is the so-called neuro-reflex theory, according to which disturbances in the relationship between the central nervous system and internal organs play an important role in the development of the disease. Everyone knows that during pregnancy many women become more capricious, irritable, and whiny. This happens because during pregnancy, the historically “older” subcortical structures of the brain begin to work more intensively than usual, whereas usually a person at the highest stage of evolution has a more active cortex. But subcortical structures form the majority of protective reflexes, and wise nature, protecting pregnancy, forces this part of the expectant mother’s brain to work with greater efficiency. The subcortical structures contain the vomiting center, as well as olfactory zones and cells that “control” internal organs, including the stomach, heart, blood vessels, lungs, and salivary glands. Therefore, nausea and vomiting may be preceded by such phenomena as deepening of breathing, increased heart rate, increased amount of saliva, and pallor caused by vasospasm.
Immune theory . From the first days of intrauterine life, the baby is an organism different from the mother in its antigenic composition, to which the pregnant woman produces antibodies that supposedly cause toxicosis.
Hormonal theory . Significant hormonal changes occur in a pregnant woman's body. In particular, a new organ that produces hormones appears - the placenta. The appearance of a new “leader” is not always liked by the nervous system and internal organs of a pregnant woman, and they react to this with symptoms of toxicosis. With vomiting of pregnant women, there is a temporary coincidence of the onset of vomiting with a peak in the content of hCG (placental hormone), and a decrease in corticosteroids in the adrenal cortex is often observed.
Psychogenic theory . It is believed that toxicosis can be the result of negative emotions: fears for the baby, fear of childbirth.
Risk factors
Although no one is immune from toxicosis, it has been noted that most often it occurs in expectant mothers suffering from chronic diseases of the gastrointestinal tract, liver, thyroid gland, as well as in women who have undergone induced abortions, chronic inflammatory diseases of the genital organs. Predisposing factors are frequent nervous stress and poor nutrition, asthenic type of constitution. In addition, severe forms of early toxicosis more often occur during multiple pregnancies.
What causes toxicosis before a missed period?
The reasons that can cause toxicosis, regardless of the duration, on the first day of the delay, even before it, or in several weeks of pregnancy have not yet been sufficiently studied, but it is believed that they could be:
- a change in a woman’s hormonal background, forcing her to accept the fertilized egg, which also contains male cells, and help its further growth;
- chronic infections and other untreated diseases that have weakened the body;
- psychological factor, when self-hypnosis that there may be toxicosis before or immediately after the delay leads to its development;
- genetic predisposition;
- multiple pregnancy.
How does it manifest?
The most common manifestation of toxicosis is vomiting , which can occur with varying frequency, depending on the severity of toxicosis.
In mild cases of toxicosis, vomiting occurs no more than 5 times a day, and may be accompanied by a prolonged or constant feeling of nausea. Vomiting occurs on an empty stomach and can be caused by food intake or unpleasant odors. In this case, the loss of body weight is either absent or small - 1-3 kg (up to 5% of body weight before pregnancy). This condition can be easily treated at home.
In more severe cases, vomiting occurs up to 10-20 times a day and is accompanied by drooling, while the woman’s general condition significantly worsens, weakness and apathy occur. A significant amount of fluid is lost through vomit and saliva, dehydration occurs, and metabolism is disrupted. The skin becomes dry, pale, blood pressure decreases, the pulse quickens, constipation occurs, the amount of urine discharge decreases, and the temperature rises. Loss of body weight can be up to 8-10 kg or more (up to 10% of initial body weight). With the progression of this form of toxicosis, a violation of water-salt, protein, carbohydrate and fat metabolism, acid-base and vitamin balance, and the functions of the endocrine glands gradually develops. In such a situation, the supply of nutrients to the fetus is sharply disrupted, and it is during this period that the laying and formation of all the main organs and systems of the baby takes place.
Drooling (ptyalism) can accompany vomiting during pregnancy; less commonly, it occurs as an independent form of early toxicosis. With severe drooling, a pregnant woman can lose 1 liter of fluid per day. Excessive drooling leads to dehydration of the body, loss of proteins, and negatively affects the mental state of a woman.
By 12 weeks of pregnancy, as a rule, the symptoms of early toxicosis disappear.
Advice from a doctor and women's forum users
If you experience toxicosis before the delay, the forum can help you deal with the main worrying points. Perhaps, after reading the statements of women who have experienced a similar condition, you will understand that even the most difficult trials pass, and the joy of future motherhood will help you survive unpleasant moments.
On women's forums, women often ask whether early toxicosis occurs before the delay, and in most cases they receive a positive answer.
Diagnosis and treatment of toxicosis
Even with mild manifestations of toxicosis, the doctor will refer you for tests. You will need to undergo a urine test for acetone and ketone bodies, biochemical and general blood tests. In case of severe disease, the patient will be admitted to a hospital. For mild, the most common degree of toxicosis, you will be treated at home under the supervision of a antenatal clinic doctor.
To eliminate discomfort, you need to pay attention to diet . With toxicosis, appetite is not always impaired, sometimes it is even increased, but more often than not even the sight of food does not evoke positive emotions, and sometimes you have to make significant efforts to force yourself to swallow even a piece. Therefore, you can satisfy your culinary whims by introducing coveted pickles, sweet buns or exotic fruits into your diet. Food should be taken frequently, 5-6 times a day, but the portions should be small and the menu varied.
It should be borne in mind that very hot or very cold food will more quickly provoke vomiting. Products should be easily digestible and contain sufficient amounts of vitamins. It is better to drink mineral alkaline water and mint tea.
If you notice that the secretion of saliva is significantly increased , rinsing your mouth with tanning solutions that reduce this process, for example, infusions of sage, chamomile, and mint, will help you. If nausea and vomiting occur in the morning, immediately after waking up, try having breakfast in bed, placing a few crackers, lemon slices or mint gum next to the bed. It’s especially nice if in this situation the future dad shows himself to be a gentleman and serves you a light and healthy breakfast.
If nausea begins in the afternoon , then most likely it is due to nervous tension and fatigue. In this case, you can drink a soothing tea, motherwort or valerian.
If these measures do not help, be sure to inform your obstetrician-gynecologist.
Physiological signs
Before your period is missed, you may experience frequent urination. This is explained by an increase in the amount of female hormones. This leads to changes in kidney function. In addition, the uterus enlarges slightly after conception and puts pressure on the bladder. Of course, this symptom manifests itself more pronouncedly in the later stages of pregnancy.
Immediately after conception, progesterone production increases. This hormone causes salt and fluid retention in the body. Because of this, swelling of the legs and arms occurs, but in the early stages of pregnancy, they are practically invisible.
In the early stages, heaviness and weak nagging pain in the lower abdomen may be felt. They resemble premenstrual syndrome and do not cause severe discomfort. This is explained by the fact that when the embryo attaches to the uterus, blood circulation in the pelvic area increases.
It is important to understand that severe and unexpected pain may indicate an ectopic pregnancy or be a harbinger of spontaneous miscarriage. This is a dangerous condition that requires emergency medical attention.
Hospitalization
If the doctor discovers changes in the tests, the scale arrow stubbornly deviates to the left every day, and your health worsens, most likely you will have to go to the hospital . The doctors' first task will be to restore lost fluid, protein, and salts. You will be given an IV to ensure that nutrients and vitamins go directly into your blood. To suppress vomiting and nausea, drugs that block the gag reflex are used. Since, as already mentioned, the state of the nervous system has a significant impact on the severity of toxicosis, a protective treatment regime will be created in the hospital for your peace of mind. In addition, you will be prescribed medications that have a calming effect, and if there is increased salivation, medications that inhibit the action of the salivary glands. It is possible that non-drug methods will also be used: acupuncture, hypnotherapy and psychotherapy, herbal and aromatherapy. This will help reduce the number of drugs that can have undesirable effects on the developing embryo.
When, as a result of treatment, weight gain becomes obvious, daily diuresis (the amount of urine excreted), as well as pulse, blood pressure and temperature are normalized, vomiting stops or becomes less frequent, and you can return to your usual home environment. In rare cases, complex treatment over several days turns out to be completely ineffective, and then the pregnancy has to be terminated.
Based on materials from the magazine “9 months” No. 3, 2003
Sources
- Kapickis M., Beinarovica I. Fascial Epicondylar Augmentation in Cases of Cubital Tunnel Syndrome With Ulnar Nerve Instability. // Tech Hand Up Extrem Surg - 2022 - Vol - NNULL - p.; PMID:33900059
- Leow JM., Clement ND., McQueen MM., Duckworth AD. The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius. // Eur J Orthop Surg Traumatol - 2022 - Vol - NNULL - p.; PMID:33891155
- Levina Y., Dantuluri PK. Radial Tunnel Syndrome. // Curr Rev Musculoskelet Med - 2022 - Vol - NNULL - p.; PMID:33890229
- Billig JI., Lu YT., Hayward RA., Sears ED. Surgical Timing for Carpal Tunnel Syndrome: A Comparison of Health Care Delivery in the Veterans Administration and Private Sector. // J Hand Surg Am - 2021 - Vol - NNULL - p.; PMID:33867201
- Low J., Kong A., Castro G., Rodriguez de la Vega P., Lozano J., Varella M. Association Between Diabetes Mellitus and Carpal Tunnel Syndrome: Results From the United States National Ambulatory Medical Care Survey. // Cureus - 2022 - Vol13 - N3 - p.e13844; PMID:33859898
- Abdolrazaghi HA., Khansari M., Mirshahi M., Ahmadi Pishkuhi M. Effectiveness of Tendon and Nerve Gliding Exercises in the Treatment of Patients With Mild Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial. // Hand (NY) - 2022 - Vol - NNULL - p.15589447211006857; PMID:33855879
- Ho TY., Chen SR., Li TY., Li CY., Lam KHS., Chen LC., Md YW. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. // Int J Med Sci - 2022 - Vol18 - N9 - p.1960-1965; PMID:33850465
- Goyal R., Mercado A.E., Ring D., Crijns TJ. Most YouTube Videos About Carpal Tunnel Syndrome Have the Potential to Reinforce Misconceptions. // Clin Orthop Relat Res - 2022 - Vol - NNULL - p.; PMID:33847604
- Wee TC., Simon NG. Asymptomatic common extensor tendon pathology in patients with carpal tunnel syndrome. // Muscle Nerve - 2022 - Vol - NNULL - p.; PMID:33847378
- Lallukka T., Shiri R., Alexanderson K., Ervasti J., Mittendorfer-Rutz E., Virtanen M. Sickness absence and disability pension after carpal tunnel syndrome diagnosis: A register-based study of patients and matched references in Sweden. // Scand J Public Health - 2022 - Vol - NNULL - p.14034948211002729; PMID:33845698
