Vomiting in late pregnancy: causes of development, methods of elimination and danger of the phenomenon

Toxicosis of the second half of pregnancy is otherwise called gestosis. This phenomenon is one of the most severe obstetric pathologies and often leads to unfavorable outcomes for the woman and the fetus. It increases the risk of death of the mother or child by 3-4 times.

During gestosis, dangerous changes occur in the pregnant woman’s body:

• decrease in circulating blood volumes,
• spasms of all blood vessels,
• changes in blood clotting and fluidity,
• microcirculation disorders.

As a result of the above processes, a significant decrease in blood supply occurs. Against this background, dystrophic changes occur in tissues, which can provoke their death. The kidneys, liver and brain are most sensitive to these changes. It is these organs that suffer more than others.

The placenta, consisting mainly of vessels, with late toxicosis ceases to cope with its main function. The exchange of oxygen and nutrients between mother and fetus is disrupted. As a result, the child suffers from oxygen starvation and intrauterine developmental delay occurs.

First trimester

Many pregnant women feel sick and feel sick and vomit during early pregnancy. At the very beginning, in the first month, the woman already begins to feel discomfort similar to ARVI. It manifests itself as fatigue, drowsiness, slight runny nose and nausea. These processes are explained by hormonal changes and a general decrease in immunity. This can be considered a normal part of pregnancy. This is often called “morning sickness,” but symptoms can occur at any time—not just in the morning. The feeling of nausea occurs and goes away on its own, lasting from one to four hours. Usually the symptoms are tolerable and do not interfere with normal life.

How to overcome fatigue during pregnancy

From the early months of pregnancy, it is important to slow down and take care of yourself. Useful tips to help cope with unpleasant symptoms and overcome fatigue:

• Get as much rest as possible. Lie down more often, trying to elevate your legs. This reduces the tone of the uterus, helps to relax, and improves venous outflow.
• Ask for help. Don’t try to do everything around the house yourself - involve your husband and relatives in cleaning, cooking, and buying groceries;
• Follow a daily routine. It is logical that if you want to sleep, then you need to do it. Try to take a nap during the day and go to bed early in the evening - do not suffer from extreme drowsiness unless absolutely necessary (if, for example, you are not at work);
• Eat right. Eat more protein foods, complex carbohydrates, vegetables, fruits. minimize sweets and caffeine - after such products the condition only gets worse;
• Don't give up being active. Light exercise and frequent walks in the fresh air will give you energy and help fight lethargy and fatigue;
• Eliminate stress. Nervous shocks are of no use to you. For the sake of your future baby, you should give up communication with people you don’t like and excessive stress at work.

Magnesium supplements and vitamins sometimes help to cope with fatigue. But before taking them, be sure to consult a doctor.

Second trimester

Closer to the second trimester, the condition may worsen and be accompanied by vomiting and diarrhea. At this point, progesterone begins to be actively produced and slow down the functioning of the gastrointestinal tract. And fetal movements, starting from the third month, cause colic and aggravate general malaise.

Vomiting and nausea most often worsen from 9-16 weeks. But for some pregnant women, nausea comes earlier and can last almost the entire pregnancy. Symptoms lasting until the third trimester occur in 15-20% of women.2

Causes of toxicosis

The content of the article

Not all expectant mothers are given the opportunity to experience the symptoms of toxicosis. Young, healthy patients can avoid attacks of nausea and vomiting, since toxicosis occurs due to hormonal changes in the body, the age of the pregnant woman and the presence of chronic diseases.

If your mother suffered from toxicosis, then you may be susceptible to it, as it is inherited.

On the Internet you can find statements that nausea and vomiting in pregnant women are a sign of unpreparedness for motherhood. But these ideas are, of course, wrong, since many older women who have been dreaming of a baby for many years suffer from toxicosis in the same way as those who did not plan a child and became pregnant by accident.

What is uncontrollable vomiting or toxicosis?

A very small number of expectant mothers (1 in 100) develop a serious condition accompanied by constant vomiting and nausea.3 Vomiting can occur every day and more than once. The woman loses about 5% of her body weight and suffers from dehydration. Blood and urine tests easily determine the presence of this condition. Ketones in urine are the main indicator of toxicosis. Vitamin and nutrient deficiencies may develop. Most often, a woman is hospitalized, water-salt balance is maintained and observed for two weeks.

Third trimester of pregnancy

15.07.2021

The third trimester of pregnancy is the time when you watch your belly grow at an incredible rate. This is mainly due to the intensive growth of the child. By the beginning of the third trimester, the fetus looks like a newborn, except that it is very small and thin. However, at the end of the pregnancy he is quite a chubby baby.

Fetal development in the third trimester of pregnancy

During the last three months of intrauterine development, the child primarily improves the respiratory system and nervous system. At this stage, the fetus already knows the mother and the people around him very well, if they often talk in your environment.

The mother's voice has been shown to have a calming effect on the fetus as it can lower the heart rate. During this period, most children also adopt a head-down position, which is optimal for childbirth .

Considering that during this period the child develops very intensively, you need to carefully monitor what and how much you eat. The fetus's need for nutrients, vitamins and minerals is very high. It takes large amounts of calcium and iron from your blood , which it needs on a regular basis.

Preterm birth in the third trimester

A child born even at the beginning of the third trimester has a chance for proper development. However, if you do give birth before the 37th week of pregnancy , your baby will be premature and may have problems adapting to extrauterine life, especially in the respiratory system.

To reduce the risk of this type of difficulty, the mother should be given a course of steroid therapy of pregnancy and until the end of the 34th week if an increased risk of preterm birth (for example, in women with cervical insufficiency ) .

Steroid therapy is a series of intramuscular injections containing a steroid drug given over two days. These medications are harmless to the baby; on the contrary, their task is to accelerate the maturation of the respiratory tract so that they are ready to begin their functions after childbirth much earlier than expected.

Ultrasound in the third trimester

It is very important to remember the last recommended ultrasound , which is between the thirtieth and thirty-second weeks of pregnancy . In this study, the doctor must first assess the rate of fetal growth. The doctor measures the length of the femur , abdominal , and head circumference, and an ultrasound machine or special computer program estimates the baby's weight based on these measurements.

If the fruit's weight is between the 10th and 90th percentile, it is said to be eutrophic, meaning not too big and not too small.

If the fetal weight is below the 10th percentile, talking about malnutrition, which is too slow growth and you should find out why this is so. It is necessary to determine whether the child is small for genetic reasons (for example, both parents are short and their birth weight is low) or whether the reason for slower growth is an insufficient placenta.

It is also necessary to monitor the well-being of the fetus by performing regular tests : CTG, Doppler ultrasound and checking the child’s weight (usually every 2 weeks) .

If, on the other hand, the baby's estimated weight turns out to be exceptionally high, above the 90th percentile, it is recommended to have another ultrasound scan in a few weeks. If the baby continues to grow so rapidly, the doctor will consider inducing labor to increase the chances of a natural birth .

Wellbeing in the third trimester

While the first trimester was a period of rapid hormonal changes, often leading to malaise, sleepiness and digestive problems, the third trimester is where you'll primarily suffer the effects of your belly at a breakneck pace.

Performing daily activities will become more and more difficult due to the increasing heaviness in movements. Not only the belly , but also the breasts . The uterus puts pressure on the diaphragm, making it difficult to take deeper breaths.

Meanwhile, the need for oxygen will increase as you breathe for yourself and for the rather large person growing inside you. heart beating , which is now working more intensely. Heartburn will reach its peak, as it is now promoted not only by the hormonal changes typical of pregnancy (high levels of progesterone, causing the esophageal sphincter muscles to relax), but also by pressure on the abdomen of the uterus .

Constipation can also become a more serious problem. Many women experience swelling in their legs and arms during the last weeks of pregnancy . They appear especially in the evenings and on hot days. As long as these swellings are not very severe and disappear after resting in a supine position, there is no need to worry about them.

However, if you find that your body is suddenly noticeably swollen not only at the ankle and lower leg , and you have gained several kilograms in a few days, you need to quickly contact your doctor so that he can rule out a serious pregnancy , which is the condition of preeclampsia.

The fetal head, which in most cases is already lowered in the last weeks, puts pressure on the bladder . This means you need to go to the toilet more often and this can lead to uncontrollable urine .

The pressure of a significantly enlarged uterus on the pelvic veins can lead to the development of anal varicose veins, that is, hemorrhoids , which may bleed when passing stool.

Toward the end of your pregnancy , you may experience less burdensome conditions that also affect your well-being, such as hip pain , back pain , or a feeling of painful pressure on the symphysis pubis. You may also notice that your gums bleed from time to time. Don't worry, this is not a pathology, but a normal pregnancy caused by swollen gums due to hormonal changes.

breast milk leaking several weeks before giving birth . If this is causing your underwear to stain, purchase special nursing pads that fit into your bra to absorb the secretions.

Unfortunately, an enlarged belly inevitably causes increased tension in the skin, which in women who are predisposed to it begins to crack at some point. This produces an image of red streaks resembling a scar. Stretch marks will become lighter and less noticeable over time, but they cannot be completely removed.

It is worth lubricating your stomach , buttocks, thighs and breasts with an anti-stretch mark cream intended for pregnant women from the very beginning of pregnancy , but you should know that if you are prone to them, stretch marks will definitely appear, only there will be fewer of them than if you were nothing did.

All of these ailments and ailments that appear in the third trimester, along with high levels of certain hormones , can make you feel worse. However, don't worry because in a few weeks you will see wonderful rewards for your endurance and most problems will disappear very quickly after giving birth . In the third trimester, you will feel your baby's movements more and more intensely.

Monitoring fetal movements is very important when it comes to monitoring fetal well-being. You should pay close attention to your movements, especially during the last few weeks of pregnancy . OB / GYN emergency department .

Uterine contractions in the third trimester

During the last dozen weeks of pregnancy uterine contractions may occur . After the twentieth week of pregnancy , the uterus begins the “exercise” for childbirth . These are called Braxton Hicks contractions.

Braxton Hicks contractions are irregular and painless, unlike contractions that occur at least once every 10 minutes, they are painful (pain in the lower abdomen , lower back , or painful tightness in the entire abdomen ) and can only be assessed by a gynecologist .

Gradually, as the weeks of pregnancy , Braxton Hicks contractions will appear more and more frequently. Don't worry about them. Once you know what they are, you can easily distinguish them from the action of birth at the right moment.

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What causes nausea and vomiting during pregnancy?

The exact cause of the malaise is still not known. The most common and likely causes are hormonal changes, slower peristalsis and genetic predisposition.4

There are many risk factors that make you more susceptible to nausea and illness:

• first pregnancy and young age;
• presence of migraine;
• history of estrogen use and reaction to it;
• disturbances in the functioning of the vestibular apparatus or seasickness;
• the presence of these symptoms in other women in the family;
• GERD or stomach ulcer;
• twins or more embryos;
• overweight.

Causes

The main reason for toxicosis in the second half of pregnancy is the presence of various diseases in the mother. The disease can be caused by:

• diseases of the endocrine system,
• obesity,
• hypertension,
• disorders of fat metabolism,
• pathologies of the liver and kidneys,
• some sexually transmitted infections.

Gestosis can occur against the background of influenza or ARVI. In rare cases, it can even develop due to improper nutrition of the expectant mother. The risk group includes women who have chronic illnesses, are often exposed to stress, and give birth to a second child less than 2 years apart.

When to ask for help

If you have moderate nausea and slight vomiting, no additional tests are needed. But if your symptoms worsen, you are unable to eat, or you experience weight loss, you should consult a doctor. A urine test, especially for ketones, a blood test, and sometimes an ultrasound should be performed.

Other warning signs:

• repeated vomiting, especially with blood;
• diarrhea and abdominal pain;
• pelvic pain and muscle spasm;
• signs of dehydration, infrequent urination and dark urine;
• temperature.

How does late toxicosis (preeclampsia) manifest during pregnancy?

Russian medicine classifies the following conditions as gestosis, or “late toxicosis of pregnancy”:

• Dropsy. It is characterized by the appearance of edema, not only of the arms and legs, but of the entire body. Dropsy does not necessarily indicate gestosis, but very often it is its first stage. Therefore, the appearance of edema should be discussed with your doctor.
• Nephropathy. Kidney damage begins, and high blood pressure is added to the swelling. Since it easily transforms into other forms, at the first signs (lower back pain, cloudy urine, nausea) you should immediately consult a doctor.
• Preeclampsia. Pressure increases, protein appears in the urine, the amount of urine excreted becomes less and less, and there is more and more edema. Symptoms: headache, nausea, vomiting, blurred vision. This indicates a deterioration in blood circulation in the cerebral cortex.
• Eclampsia. The most serious condition of gestosis is characterized by seizures that can lead to coma, stroke or brain swelling.

These conditions can easily flow into one another, gradually increasing in severity. This is why in the third trimester a woman needs to take urine samples so often - this will help determine the onset of gestosis in time.

Nausea relief

Until the third trimester and symptoms stop, you can relieve them on your own without seeking medical help. The main task is to prevent dehydration of the body and establish normal nutrition. Any anti-nausea medications should be recommended by your doctor. It should be understood that dietary supplements and herbal supplements are also not recommended for use without consultation.

Some tips that can help you feel better on your own:

• Diet. Overeating or hunger makes the problem worse. Therefore, you need to eat in small portions and often, preferably at a certain time. Before eating, you can suck on a piece of ginger.
• Elimination of provoking odors and tastes. For example, you may react to your usual toothpaste, perfume, the smell of food, or detergents. Try replacing them with others or eliminating them. The smell of fresh lemon or orange can help with nausea.
• Ventilate the apartment and avoid stuffiness.
• Drink clean water often and little by little. You can add a little lemon or ginger to the water if you are not allergic. You need to drink at least two liters of clean water.
• Avoid foods and drinks with lots of sugar, fats and spices.
• Loud noise, driving a car, and lying down after eating can also be triggers for nausea.
• Walk and sleep more.
• Buy an acupuncture bracelet.

Nausea and vomiting can be a problem and disrupt your normal routine, but in most cases they are not dangerous for you or your baby. Even if you skip meals due to nausea, your baby gets nutrients from your body's reserves, and the effort of vomiting does not harm him in any way. Some studies suggest that early morning “morning sickness” is a normal and even a good sign of a healthy pregnancy.5

The only danger can be posed by uncontrollable vomiting or toxicosis due to dehydration of the body, but this condition cannot be missed and you should immediately seek medical help.

Treatment

In case of toxicosis in the second half of pregnancy, the woman is hospitalized. To normalize her condition, special medications and droppers are prescribed. Their task is to reduce protein levels and replenish the lack of fluid in the blood vessels.

Natural delivery is possible if the condition of the patient and the fetus is satisfactory. The development of the latter is assessed using ultrasound and CTG. Severe forms of gestosis and deterioration of the woman’s condition are indications for cesarean section.

Our clinic’s specialists use effective methods for treating gestosis. The doctor will select medications that will help quickly alleviate the patient’s condition. Also, gynecologists at our clinic monitor pregnant women. For more information about services, please call.

Causes of vomiting in pregnant women

Dyspeptic symptoms, including vomiting, occur in the first half of gestation in the vast majority of women. They are mainly associated with natural changes in the hormonal and nervous regulation of the digestive tract, but can be caused by gastrointestinal pathologies that worsen during pregnancy. Pregnant women are characterized by the absence of foreign impurities in their vomit. The presence of bile or blood in the gastric secretions indicates a serious illness that requires consultation with a specialist.

Early toxicosis

With a mild degree of the disorder, the symptom is observed up to 5 times a day; vomiting is provoked by strong chemical odors and aromas during cooking. In some pregnant women, regurgitation of gastric contents occurs immediately after waking up. Before vomiting, you feel severe nausea, a “lump in the throat,” and possibly profuse salivation. Regurgitation of chyme brings slight relief, but nausea persists almost constantly. Pregnant women try to eat less so as not to induce vomiting, so weight loss of up to 2 kg per week is typical.

Vomiting 8-10 times throughout the day is observed with moderate toxicosis. Women complain of constant nausea, lack of appetite, and discomfort when eating. The vomit is scanty and sometimes contains bile. The deterioration of the condition is indicated by an increase in regurgitation up to 20 times a day, accompanied by painful nausea and sleep disorders. In this case, the intake of both food and liquid is disrupted, and pregnant women rapidly lose weight. The appearance of such symptoms indicates a severe degree of toxicosis, in which hospitalization in a hospital is indicated for the expectant mother.

GERD during pregnancy

With gastroesophageal reflux disease, vomiting occurs in the second and third trimesters, when the growth of the uterus increases intra-abdominal pressure. Regurgitation of acidic gastric contents usually occurs in a horizontal position and when the body is tilted forward. Before vomiting, the expectant mother feels a burning sensation in the throat, behind the sternum, and nausea. After vomiting, pregnant women notice a sour taste in the mouth. Regurgitation of chyme with gastric juice is often accompanied by severe chest pain, which indicates the development of acute esophagitis or esophageal ulcer.

Specific pathology of pregnancy

During the period of bearing a child, changes in neurohumoral regulation and restructuring of internal organs occur in the female body, which provokes the development of various pathological conditions. Some of these diseases are manifested by vomiting, which occurs both as a reflex when the receptors in the wall of the digestive tract are irritated, and as a result of damage to the nervous system. The symptom is usually detected in the second half of pregnancy and is combined with other dyspeptic disorders. The most common causes of vomiting during pregnancy are:

• Cholestasis
  . Regurgitation of the contents of the stomach and duodenum is observed in the third trimester, especially from the 36th week of gestation. Before the onset of vomiting, discomfort and heaviness in the epigastrium and right hypochondrium, nausea, are disturbing. After vomiting, a strong bitter taste is felt in the mouth. Symptoms increase as labor approaches; in most cases, dyspeptic disorders disappear on their own in the postpartum period.
• Hypothyroidism
  . When the concentration of thyroid hormones decreases, periodic vomiting with the release of eaten foods without pathological impurities occurs 1-2 times a day. The symptom can occur at any stage of gestation. As hormonal deficiency progresses, pregnant women complain of repeated regurgitation up to 15 times a day, accompanied by painful urges, constant nausea, and dehydration.
• Polyneuropathy of pregnancy
  . The symptom is provoked by damage to the vagus nerve. Repeated vomiting occurs at any time of the day and is not associated with exposure to provoking factors. Typically regurgitation of food followed by the appearance of a sour taste in the mouth due to increased secretion of gastric juice. Vomiting is preceded by nausea and a feeling of heaviness in the stomach.

Appendicitis during pregnancy

Acute inflammation of the appendix is ​​characterized by the appearance of two or three times of vomiting of gastric contents without inclusions of bile or streaks of blood. The symptom is preceded by sharp abdominal pain localized in the right iliac region or near the navel. Repeated discharge of yellow-green vomit with a foul odor indicates the generalization of the process and the onset of peritonitis, a life-threatening condition in which a pregnant woman requires emergency medical care.

Digestive system diseases

Chronic gastrointestinal diseases, which are manifested by regurgitation of gastric chyme and other dyspeptic disorders, often worsen in the 2nd half of gestation. This is due to dysregulation of the digestive tract and the negative effects of high concentrations of sex hormones. According to statistics, if a woman had gastrointestinal pathologies before pregnancy, they worsen in 50-60% of cases. Most often, vomiting in pregnant women is caused by:

• Esophageal hernia
  . The symptom occurs in the 2-3 trimesters, which is associated with an exacerbation of the disease due to increased intra-abdominal pressure. Pregnant women notice that vomiting is preceded by severe pain in the area of ​​the xiphoid process, radiating to the arm and shoulder blade. The contents of the vomit may contain streaks of red or dark blood. Regurgitation is provoked by overeating, physical activity, and bending of the body.
• Gastritis
  . Copious regurgitation of gastric contents with a rotten odor develops with atrophic or hypoacid inflammation of the stomach. The symptom is accompanied by heaviness and distension in the abdomen. Scanty vomiting with impurities of mucus and bile, which is combined with sharp pain in the epigastrium, is observed in pregnant women with hyperacid gastritis. Detection of vomit with streaks of blood is characteristic of hemorrhagic gastritis.
• Functional stomach disorders
  . Regurgitation in pregnant women is possible in the absence of an organic basis. In such cases, severe emotional shocks become a prerequisite for vomiting gastric contents 2-3 times a day. The symptom is preceded by moderate nausea, increased salivation, and abdominal discomfort. Pregnant women note variability and inconstancy of painful sensations, worsening of the condition under stress.
• Duodenitis
  . Vomiting with inflammation of the duodenum usually occurs 1-1.5 hours after eating, which is due to irritation of the receptors in the wall of the upper gastrointestinal tract. Before gagging, a woman feels a gradually increasing pain in the epigastrium, and sometimes there is bloating. Yellow-green streaks of bile are visible in the vomit. At the end of belching, pregnant women feel bitterness in the mouth and a burning sensation along the esophagus.
• Chronic pancreatitis.
  One of the common causes of vomiting during pregnancy is pancreatic enzyme deficiency. Regurgitation occurs during exacerbations of the inflammatory process; the symptom is disturbing after eating, especially when overeating fatty “heavy” foods. The vomit is copious and contains partially digested food and bile. Regurgitation of gastrointestinal contents usually improves overall health.

Symptomatic therapy

Vomiting of pregnancy, which occurs in the first trimester with a frequency of up to five times during the day, does not require drug treatment. A woman is advised to avoid odors or foods that provoke vomiting. To relieve painful sensations, expectant mothers use mint candies, lemon slices, and herbal teas. It is important to follow a diet and avoid overeating. After eating, it is advisable to walk around for a short time - you should not immediately take a horizontal position. In some cases, psychotherapy methods and mild sedative herbal remedies are effective.

Repeated vomiting disrupts the normal diet of a pregnant woman and indicates decompensation of the condition, so the patient needs urgent medical attention. Therapy is selected individually, taking into account the root cause of the symptom. Before verification of the clinical diagnosis, prokinetics and antacids are allowed to reduce the frequency of regurgitation. During pregnancy, it is prohibited to use strong antiemetics without a doctor's prescription, as this may harm the baby.