How to deal with severe toxicosis in early pregnancy

How common is toxicosis during pregnancy?

This ailment occurs during most pregnancies. It affects 3 out of 4 women, and in only one of them the symptoms are limited to nausea; in the other two, vomiting comes along with it.

Many women who suffered during their first pregnancy are very afraid to meet him again. This is possible, but not at all necessary. The presence or absence of this disease and how severe it was does not help in any way to predict what will happen during the next pregnancy.

What are the causes of toxicosis?

Nobody knows for sure. Some doctors believe that it is a consequence of significant changes in hormonal levels in pregnant women, and list hCG (human chorionic gonadotropin), estradiol, and progesterone as the culprits of toxicosis. Others consider it a psychological condition, something like neurosis, and prove their point of view by the fact that toxicosis during pregnancy often occurs against the background of a woman’s stressful state.

There is a theory that toxicosis is not a disease at all, but, on the contrary, an evolutionary advantage. And really, when does it start? In the early stages, i.e. precisely when the fetus is most vulnerable to toxins. At the same time, the pregnant woman’s body reacts to the most dangerous odors - meat, fish (potential sources of parasites, harmful bacteria), alcohol, cigarette smoke, other sharp-smelling foods, household chemicals, etc. It turns out that with the help of toxicosis, the body tells you that, we hope, you already understand perfectly well: during pregnancy, especially in the first trimester, you need to very carefully monitor your diet and health.

Why do pregnant women feel sick?

The beginning of pregnancy is not only an exciting moment for every family, but also a time of great changes in a woman’s body.

Today, doctors identify the following causes of toxicosis:

1. Serious hormonal changes.
2. Active work of the maternal immune system.
3. Psychological problems: fear and increased anxiety of the expectant mother.

There are several points in the pathogenesis of the disease:

• Firstly , a woman’s nervous system does not have time to rebuild in response to a sharp increase in hormone levels. As a result, there is a disruption in the functioning of the subcortical nuclei of the brain, activation of the vomiting centers and, as a result, the painful symptom of nausea.

Localization of the vomiting center in the central nervous system

• Secondly , the embryo developing in the uterus and its metabolic products are often perceived by the maternal immune system as foreign agents. In this case, toxicosis can be considered as a protective reaction of the body.

This is interesting. That is why in medicine, nausea during pregnancy is called toxicosis: from the word “toxin” - a poison of biological origin. Of course, while carrying a baby, a woman’s poisoning (in the literal sense of the word) does not occur. Rather, toxicosis can be called an individual reaction of the nervous and immune systems to a developing pregnancy.

According to medical research, toxicosis most often develops in women:

• over 35 years old;
• suffering from gynecological diseases;
• with chronic extragenital pathology (especially liver, kidneys);
• with endocrine disorders;
• have undergone surgery;
• with a history of abortion;
• alcohol abusers and smokers.

Bad habits are one of the risk factors

Another interesting theory connects the appearance of toxicosis with a woman’s physique. It is believed that thin, tall patients are more likely to complain of nausea during pregnancy.

What are the symptoms of toxicosis?

Nausea and vomiting, if you're lucky - just nausea. Sometimes attacks of malaise occur for no apparent reason, but most often they are a reaction to pungent smells and tastes. Other symptoms, such as abdominal pain, headache, fever, are not typical for toxicosis and are rare. If you have diarrhea along with vomiting, most likely it is just poisoning.

How severe is toxicosis during pregnancy?

Based on the severity of symptoms, there are two types of toxicosis in early pregnancy. A mild or moderate form is when vomiting occurs no more than 5 times a day, and the woman does not lose or almost does not lose weight. It doesn’t sound very easy, but it’s still just flowers

The severe degree is called Hyperemesis gravidarum in Latin, and in Russian - excessive vomiting of pregnant women. This form is characterized by uncontrolled vomiting, leading to dehydration, weight loss and ketosis (carbohydrate starvation of cells with the formation of acetone and other harmful substances in the liver). Hyperemesis gravidarum is not a very common occurrence, we wish you did not have to become familiar with it. However, you should not completely discount it: excessive vomiting occurs in 0.3–2.0% of pregnant women and causes the following unpleasant consequences:

• Losing more than 5% of weight.
• Dehydration, constipation.
• Nutrient deficiency, primarily vitamins B1, B6, B12.
• Metabolic disorders.
• Physical and psychological stress.
• Significant deterioration in the quality of life during pregnancy, problems at home and at work.

Modern medicine can combat this condition, but previously it led to serious consequences, including the death of the expectant mother. For example, all the facts indicate that the famous British writer of the 19th century, Charlotte Bronte, author of the famous novel “Jane Eyre,” died in the fourth month of pregnancy precisely from complications of severe toxicosis. At the same time, the Duchess of Cambridge Catherine Middleton, although she suffered from Hyperemesis gravidarum in the early stages during all three pregnancies, successfully went through it and pleases us with photographs with the princess and two princes.

Sources

• Kapickis M., Beinarovica I. Fascial Epicondylar Augmentation in Cases of Cubital Tunnel Syndrome With Ulnar Nerve Instability. // Tech Hand Up Extrem Surg - 2021 - 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 - 2021 - Vol - NNULL - p.; PMID:33891155
• Levina Y., Dantuluri PK. Radial Tunnel Syndrome. // Curr Rev Musculoskelet Med - 2021 - 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 - 2021 - 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) - 2021 - 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 - 2021 - 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 - 2021 - Vol - NNULL - p.; PMID:33847604
• Wee TC., Simon NG. Asymptomatic common extensor tendon pathology in patients with carpal tunnel syndrome. // Muscle Nerve - 2021 - 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 - 2021 - Vol - NNULL - p.14034948211002729; PMID:33845698

Is toxicosis dangerous for the baby?

Usually it does not have the slightest effect on the development of the fetus. Quite the contrary: some studies show a connection between toxicosis and the likelihood of miscarriage: in pregnant women suffering from nausea and vomiting, it is lower than in women who avoided this disease in the early stages. As you can see, everything has its positive sides

Only very severe cases can become a problem, when toxicosis leads a woman’s body to severe exhaustion. But, let us repeat, modern medicine has in its arsenal therapeutic methods that make it possible to cope with this condition.

Complications and prevention

Complications of toxicosis include gestosis and multiple organ failure. Late toxicosis (preeclampsia) is dangerous due to placental abruption.

Good prevention would be a healthy lifestyle, timely treatment of inflammatory diseases, psychological balance, moderate physical activity and strict adherence to doctor’s recommendations. Let us remind you that there is no clear answer to the question “when does toxicosis begin and end in pregnant women”. Everything is individual and depends on many factors.

If you have any questions, please contact our center specialists. You can make an appointment directly on the website. The doctor will answer your questions, including “at what week does toxicosis go away” and recommend additional examination methods if necessary.

Related services: Ultrasound examination Consultation with an obstetrician-gynecologist during pregnancy

How to make life easier for an expectant mother during pregnancy with toxicosis?

There are several simple methods that can relieve toxicosis symptoms. Here are some of them:

• Full sleep. Lack of sleep can be an aggravating factor. During this period, pregnant women need to sleep at least 8 hours a day.
• The right diet. Toxicosis “reacts” to strong smells and tastes, so in the early stages the expectant mother needs to exclude fatty, smoked, and spicy foods from her diet, and limit the consumption of fried meat and fish. Simply put, remove everything that poses a serious challenge to digestion even without pregnancy.
• Special diet. For toxicosis, it is recommended to eat little, but often - about 5-6 times a day. Food should not be heated too much: all dishes should be at room temperature or only slightly warm.
• Drink plenty of fluids. Vomiting causes dehydration and lost fluid must be replaced. During toxicosis during pregnancy, you need to drink at least 2 liters of water per day. But not carbonated!
• Walks. Taking leisurely walks in the fresh air can also help. If in everyday life you rarely walk further than a parked car, reconsider your habits.
• Yoga. Active sports are poorly compatible with toxicosis. But yoga is very good, and it can bring relief.
• Ginger. It is not clear what the reason is, but ginger helps. Some mothers also note the beneficial effects of decoctions of mint and chamomile, water with honey or lemon in the early stages. Here is a simple recipe for an “anti-toxic” drink: grate fresh ginger on a fine grater or grind it in a blender, mix with lemon juice, and add boiled water. Start drinking in small sips when it cools down.
• Vitamins. Vitamin and mineral complexes can also contribute to the fight against the disease. Doctors note that it is easier in expectant mothers who took vitamins in preparation for pregnancy.

What to do if you can’t cope with toxicosis?

In severe cases, toxicosis can cause serious consequences for the expectant mother, and in order to prevent them, doctors often decide on hospitalization. At the hospital, specialists take a number of therapeutic measures, mainly aimed at stopping vomiting and restoring the balance of nutrients in the pregnant woman's body.

A combination of pyridoxine (vitamin B6) and doxylamine is considered a reliable drug treatment. Numerous studies confirm the highest safety of these drugs for a pregnant woman and fetus.

And most importantly, if you have any concerns about morning sickness, don't hesitate to contact your doctor!

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