Pregnancy is not just an exciting and happy moment in the life of any woman, but also an extremely unpleasant stage in terms of sensations. Being pregnant, almost every girl suffers from toxicosis.
The development of such an “illness” is easy to explain. Toxicosis is associated with sudden hormonal changes in the body and is often expressed in nausea, vomiting, and mood swings.
But what to do if manifestations of toxicosis make themselves felt in the late stages of pregnancy? Shouldn't they already disappear by this time? Why is such a condition dangerous? Let's figure it out.
About the phenomenon of toxicosis during pregnancy
Toxicosis during pregnancy is a common occurrence
Toxicosis during pregnancy is a disturbance in the functioning of a woman’s body during the period after the conception of a child and its immediate birth. The development of such a condition is not something unusual or dangerous, since it is extremely simple to explain.
Toxicosis is a natural reaction of the body to sudden changes in its functioning. In particular, the hormonal system and the gastrointestinal tract, which nourishes two people at once throughout pregnancy, switch to a new type of functioning.
The manifestation of toxicosis is truly multidisciplinary and can be observed throughout the entire period of pregnancy. The main symptoms of its onset are considered to be:
- strengthening of the nausea-vomiting reflex;
- dizziness and headaches;
- mood swings;
- loss of appetite;
- profuse drooling;
- taste disorders or changes in taste sensations;
- constant drowsiness and weakness.
Today we’ll talk about nausea and vomiting during pregnancy, which often manifests itself in the early stages of pregnancy. Disorders in the functioning of the gastrointestinal tract are caused by the fact that the body switches to increased secretion of hormones and very often releases them in excess of norms.
What's happening
At 36–37 weeks of pregnancy, the baby’s body produces hormones important for life. One of them, cortisone, is necessary for the full maturation of the lungs. Iron actively accumulates in the liver. Without this microelement, the proper functioning of the body is impossible. In the last trimester of pregnancy, the fetal liver contains five times more iron than adults. This supply will be enough for the baby for the first six months of life.
At the 37th week of pregnancy, the main systems of the body continue to improve. Neurons in the brain begin to be covered with a myelin sheath, which helps nerves transmit signals. This process will continue throughout the first year of the child's life.
The ear and nasal cartilages harden, but the bones of the skull, due to the fontanelles, will remain flexible, so that it is easier for the baby to overcome the obstacles of the birth canal. The fontanel is an area where there is no bone tissue. A newborn baby has as many as six of them, but most close immediately after birth. As the cranial bones grow, the fontanelles will gradually disappear.
Causes of vomiting in pregnant women
Vomiting in late pregnancy is a dangerous symptom
Throughout pregnancy, toxicosis can occur in any woman and is considered a completely natural phenomenon.
Despite this, such a condition in the initial stages of gestation is 100% normal, but in later stages it is normal with a certain pathological context.
Of course, “late” toxicosis itself is not dangerous, but the nature of its manifestation is a little dangerous. The risks of pregnancy complications in women are especially high:
- over 35 years of age;
- previously suffered miscarriages and abortions;
- having pathologies of the heart and blood vessels, liver or endocrine system.
Late toxicosis manifests itself as:
- nausea;
- dizziness;
- tinnitus and headaches;
- weight gain;
- high blood pressure;
- development of edema of the extremities.
To the surprise of many, vomiting in late pregnancy is not a phenomenon of toxicosis. It develops for a different reason.
If at the early stage of fetal growth vomiting was the body’s reaction to increased secretion of hormones and the lack of the need to absorb certain substances from food, then in the later stages of pregnancy, emptying of the gastrointestinal tract in women occurs due to the large size of the child.
By this moment, the fetus has grown significantly and begins to put pressure on the internal organs of the expectant mother. For this reason, the body refuses to take food, especially with a large intake, and “throws it out” in the form of vomiting.
Of course, hormonal problems also have some influence on this phenomenon, but they cannot definitely be considered the main reason for its development. Unlike the same nausea.
Treatment
Nausea at 37 weeks of pregnancy should be treated taking into account the main cause of its occurrence. When it comes to physiological changes during this period, a woman can be advised to eat light foods, which should be taken in small portions and more often.
You also need to drink enough fluids. To reduce discomfort, water with lemon juice helps. A general positive attitude and confidence in a favorable outcome of pregnancy significantly improves the condition.
Conservative treatment
When nausea is a sign of a disease, it is necessary to use those treatment methods that are established by the standards of medical care for a particular pathology.
In this case, it is necessary to consider the relationship between the benefit for the woman and the risk to the fetus, choosing the safest means.
Taking into account all contraindications and depending on the identified disease, the following groups of drugs can be used:
- Antiemetics.
- Antispasmodics.
- Antisecretory.
- Enzymes.
- Choleretic.
- Antibiotics.
- Antipyretic.
Treatment of severe pathology should be carried out only in a hospital. Some cases require intensive care (eg, preeclampsia, shock, or dehydration).
Taking any medications must be agreed with your doctor. Medicines should not be taken independently, especially during pregnancy.
Surgical treatment
In certain situations it is impossible to do without surgical intervention. First of all, this concerns surgical pathology – appendicitis or acute pancreatitis. And if in the first case surgery becomes the only solution to the problem even during pregnancy, then in the second it is a necessary measure when conservative measures are ineffective.
In this case, intervention is performed according to vital indications on the part of the mother without harm to the fetus. For severe preeclampsia that does not respond to intensive care, a cesarean section must be performed.
Nausea at 37 weeks requires a differentiated approach, when everything depends on the cause. Timely detected pathology will be effectively treated, and the child will be born healthy.
Is exacerbation of the nausea-vomiting reflex dangerous?
Vomiting in late pregnancy is a reason to consult a doctor
Nausea is a very unpleasant phenomenon, but its development takes place at the level of feelings and even with a constant flow does not cause harm to the body.
Vomiting is significantly different from nausea, so its appearance in many expectant mothers causes anxiety. The latter, by the way, has some basis, but only partly.
Let’s immediately agree that nausea and even vomiting at any stage of pregnancy are the norm. They are due to what has already been noted:
- Hormonal changes in the body.
- Fetal growth.
However, the normal manifestation of the nausea-vomiting reflex has certain limits, if violated, the pregnant woman needs to be wary and seek help from a specialist observing her. You should resort to similar actions if you vomit during pregnancy:
- appears more than 4-6 times a day;
- very often develops with an “empty” stomach;
- provokes severe pain in the abdomen, mouth, sternum and any other part of the body;
- accompanied by abnormal manifestations such as the presence of blood in the vomit, excessive amounts of bile, diarrhea, or increased body temperature.
This manifestation of toxicosis is abnormal and requires monitoring by a doctor. It is important to immediately consult a specialist for those pregnant women who have begun to lose weight for no reason or show signs of dehydration and intoxication.
It is important to understand that such serious reactions of the body can lead to pregnancy complications. Unfortunately, the lack of response to exacerbation of “late” toxicosis often leads to miscarriages. There is no need to be afraid of vomiting, but leaving it unattended when the manifestations are noted is unacceptable.
Nausea and vomiting during pregnancy
There are many women’s topics, but one of the frequently discussed ones is the topic of suffering during pregnancy, “difficult” childbirth and the suffering of the postpartum period. And more than once we hear stories about “terrible toxicosis.” The word “toxicosis” has become an attribute of our woman’s life, and it seems that without toxicosis there can be no pregnancy. At a time when Western doctors abandoned this diagnosis and the term itself, in post-Soviet obstetrics this diagnosis is used to describe many pregnancy complications when the doctor cannot make another, more accurate diagnosis.
What is toxicosis? The word “toxicosis” itself comes from the word “toxin”, that is, “poison”, and it turns out that toxicosis is a state of poisoning. But by what or by whom? The ovum, embryo, and fetus are foreign bodies for the female body, and in order to accept and tolerate this foreign biological body, a whole series of biochemical processes occur in the woman’s body with the production of varying amounts of active organic substances. The reaction to such substances, and therefore to the pregnancy itself, is individual for each woman, and largely depends on the psychological factor - how the woman herself perceives her pregnancy. The fetus does not poison the female body, so calling some unpleasant sensations during pregnancy toxicosis is not entirely correct. But isn’t a woman who drinks alcohol, stale food, smokes, breathes air polluted with exhaust fumes, and takes mountains of all kinds of medications “just in case” poisoning her unborn child? But don’t some diseases of a woman affect the development of the fetus? So why doesn’t anyone call deviations in the development of the fetus its toxicosis?
The Soviet obstetric school divided all toxicoses into early ones, which included nausea and vomiting during pregnancy, and late ones, which included eclampsia (little was said about preeclampsia), edema of pregnant women, and other complications of pregnancy, the exact name of which was not known. Analyzing many cases of late pregnancy terminations and stillbirths, I tried to clarify the diagnoses of those women who lost a pregnancy and turned to me for advice, and in many cases there was only one diagnosis - toxicosis. And the treatment in most cases was the same. But, studying the medical history of these women, it turned out that many of them had completely different problems that required different diagnostic methods, and even more so different treatment and observation regimens. This is the danger of the diagnosis of “toxicosis”, that many complications of pregnancy can be “attributed” to it. And often these complications are repeated in subsequent pregnancies, and the woman is told that since you had toxicosis during the first pregnancy, you will have it in subsequent ones, which is completely false. Therefore, let's forget such a concept as “toxicosis” and forever exclude it from our vocabulary. Most often, pregnant women complain of nausea and vomiting, and sometimes these complaints are described as almost tragic. Many people cannot simply say “I feel sick,” but “I have toxicosis!” It already sounds like a disease, a diagnosis, something serious. It is interesting that for many husbands who are far from medicine, the word “toxicosis” evokes fear. Because if their wives simply complained of nausea, then who doesn’t have it? And so “toxicosis” immediately causes fear. “Isn’t it dangerous, honey?” - “Oh, who knows! The doctor says that toxicosis can be very dangerous. And I can’t move or have sex, I can only lie down. Maybe you’ll even have to lie in bed for the entire pregnancy!” Sounds familiar? Nausea and vomiting in pregnant women is a normal physiological phenomenon in early pregnancy. It is extremely rare that vomiting can become “uncontrollable” when any introduction of food ends in its evacuation - vomiting.
Nausea and vomiting occur in 70-85% of pregnant women, that is, almost everyone, especially during their first pregnancy. Therefore, calling this state of pregnancy a disease and diagnosing “toxicosis” is somehow not respectable from the point of view of modern medicine. Nausea and vomiting usually begins at 5-6 weeks, reaches a peak at 8-12 weeks, and in 90% of women completely disappears before 20 weeks. Only 10% of women experience nausea and vomiting until the end of pregnancy, but this often happens due to diseases of the gastrointestinal tract. In 0.5-2% of pregnant women, vomiting may progress to a serious condition called hyperemesis gravidarum, or hyperemesis gravidarum. In this case, vomiting is observed more than 5-6 times a day, after any meal or liquid, the woman loses weight, and her salt metabolism is disrupted. Such a pregnant woman should be in the hospital under the supervision of doctors.
Although the occurrence of nausea and vomiting in pregnant women can theoretically be explained by the woman's reaction to pregnancy hormones, the cause of this condition in pregnant women is unknown. There are a lot of theories, and hence many treatment regimens have been tried, but the effect of all types of treatment was insignificant or absent altogether. Nausea and vomiting in pregnancy occurs more often in women who have a genetic predisposition (mother, sisters, and other maternal relatives have had cases of nausea and vomiting), although many doctors deny the presence of a genetic link. More often, cases of nausea and vomiting occur in mothers who smoke, women of advanced childbearing age (after 30-35 years), during multiple pregnancies, and pregnancies with fetal malformations. A woman’s condition can also influence the incidence of nausea and vomiting: migraine, high blood pressure, diabetes mellitus, gastritis, colitis, peptic ulcers, mental illness, low body weight, thyroid disease, trophoblastic disease, poor nutrition and lack of nutrients.
If you experience nausea and vomiting, it is important to understand that this is a temporary, unpleasant pregnancy condition that is difficult to prevent for most women, as there is no preventative treatment. During such periods, women can eat food at any time of the day, preferably in small portions, cold, in a reclining position. There should be no restrictions on the types of food, with the exception of alcohol-containing products. This period is very short-lived and takes only 2-3 weeks, sometimes even less, so an unbalanced diet will not cause much harm, but will help the woman quickly adapt to the state of pregnancy. It is desirable that the food be balanced in nutrients, however, if a woman wants to take a limited amount of food during this period, this is quite acceptable.
Due to the fact that in the early stages of pregnancy the laying of the baby’s organs occurs, doctors abroad try to adhere to the rule: medicines only when strictly necessary! Let me remind you that most existing drugs have not been tested on pregnant women. Therefore, doctors' recommendations are based on the use of non-pharmacological drugs and auxiliary measures, which include changing the diet and selecting foods that will not provoke vomiting. Supplementing with 10 mg of vitamin B6 (pyridoxine) has been shown in new clinical studies to reduce the incidence of nausea and vomiting by 70% in pregnant women. This vitamin is very safe, which is why many doctors now recommend taking it to pregnant women. There is controversy among doctors regarding the dose - it is not entirely clear what the dose of vitamin B6 should be, but most agree that 10 mg is quite enough. In some countries, a preparation of pyridoxine in combination with doxylamine (diclectin) is commercially available. The history of the use of this combination is very interesting and instructive. The drug, consisting of a combination of doxylamine and vitamin B6, went on sale in many countries around the world under the names Debendox, Bendectin, Lenotan in the late 80s and gained great popularity - it was used worldwide by more than 30 million pregnant women. However, in 1983, the drug was banned for sale and discontinued due to a lawsuit in which it was proven that Debendox was guilty of causing fetal malformations. Theoretically, if we follow the conclusion of the trial, this drug should have increased the birth rate of children with developmental defects, but practically, against the backdrop of the huge number of users of the drug, the number of newborns with defects has not increased. Later, 19 serious scientific studies were conducted that refuted the existing connection between debenox and developmental defects. Nevertheless, both doctors and women began to treat the combination of vitamin B6 and doxylamine very carefully.
Another group of medications that are prescribed to pregnant women for nausea and vomiting is a group of antihistamines , because, as a number of studies have shown, they are very safe. Antihistamines are also used to relieve heartburn in pregnant women. All other therapeutic antiemetic drugs are prescribed less frequently because they have a number of side effects. Cases of indomitable vomiting require a serious approach to treatment in the form of intravenous administration of essential nutrients (amino acids, glucose, vitamins, minerals), and very rarely, in the interests of a woman’s life, pregnancy has to be terminated.
Acupuncture (acupuncture) or squeezing the Neiguan point (P6), which is located behind the wrist (more precisely, on the inside of the forearm in the “bracelet” area), showed good results Usually, people who get motion sickness on the road - travelers - are advised to periodically press this point.
During periods of nausea and vomiting, it is advisable to lead a moderate lifestyle, limiting physical activity, but bed rest is not recommended. It is important to spend more time outdoors, take in more fresh vegetables and fruits, and enough fluids. So, nausea and vomiting are very common during pregnancy, and in most cases they are not complications of pregnancy.
About nausea and vomiting during pregnancy - Dr. Elena Berezovskaya -
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Recommendations
From the 37th week of pregnancy, the baby can be born at any time. Check if everything is prepared for the maternity hospital. At the last moment you will not have time for this. When packing your bags, don't forget to include sanitary pads (not tampons!) and two or three bras.
If you are troubled by insomnia, be more active during the day. At 36 - 37 weeks of pregnancy, you can do simple housework, walk in the fresh air, attend courses for expectant mothers and do gymnastics for pregnant women. And before going to bed, thoroughly ventilate the bedroom.
Constantly monitor your diet. At 37 weeks of pregnancy, you should consume as much fermented milk products as possible. Let your daily menu include: kefir, cottage cheese, natural yogurt, yogurt, sour cream and cheese. In addition, you really need foods rich in iron and vitamin C.
At 37 weeks of pregnancy, many couples refuse intimate relationships. If you are in good physical condition and there are no medical contraindications, sex is not prohibited at this stage.
Medical observation
At the appointment, the gynecologist will examine you in the chair to see if your cervix is ready for childbirth, because starting from the 36th – 37th week of pregnancy, the baby can ask to be born at any minute. During a vaginal examination, the doctor pays attention to the location, density and length of the cervix.
While the baby lives in the mother’s tummy, the lower segment of the uterus has thick walls, which during childbirth begin to stretch, becoming softer and thinner. This is called "smoothing". Before the onset of labor, it is zero; during active labor, the walls of the cervix are smoothed by 50%, and just before the birth of the baby - by 100%.
Also, at 37 weeks of pregnancy, the doctor checks the degree of dilatation (stretching) of the cervix. This indicator is determined in centimeters. When fully dilated, the width of the pharynx reaches 10 cm. If during the examination it is discovered that the cervix is not ready for childbirth, the doctor prescribes medicinal or non-medicinal means to increase its maturity.
When examined at 37 weeks of pregnancy, the gynecologist takes a smear. The test results will allow us to judge the presence or absence of infection in the birth canal. If necessary, treatment is prescribed, because at the moment of birth the child should be maximally protected from possible infection. Also during this visit, the doctor will listen to the baby's heartbeat, measure your weight and blood pressure, and assess the width of the pelvis and the presentation of the fetus.
Ultrasound is usually not done at this stage. It may be needed only if any abnormalities were identified during pregnancy.
