Hypertension during pregnancy - symptoms and treatment

How does a child develop?

This week, the baby actively continues to grow and gain weight, his height is already about 44 cm, and the weight of his tiny body is approximately 1,800-1,900 g. During this period, the baby is no longer so easy to turn around, he takes up more space, which is why his movements. This week the baby sleeps a lot and therefore moves less, and the amplitude of his movements decreases. The muscles become stronger, so the shocks, although rare, are quite strong and more concentrated. For the mother, the baby's movements can be very sensitive and painful, causing internal organs to suffer. The baby’s blood vessels are already expanding and contracting, their walls are becoming thicker and their tone is higher. Brain cells undergo a process of adhesion. The baby’s skin turns pink, and thanks to the increase in subcutaneous fat, all wrinkles on the body are smoothed out. The hairs on the baby's head become darker and thicker, and the hairs covering the body become less and less. This fluffy hair is called lanugo. At week 33, the baby’s skin is covered with a special lubricant that protects it and ensures an easier birth. The lubricant mostly covers the face, back, folds under the arms, groin and neck.

What to do if D-dimer is elevated

If the level is slightly exceeded and the patient is feeling normal, treatment can be carried out in a day hospital. Therapy includes injections and drips of blood thinning drugs.

The following recommendations will also help reduce D-dimer (but they will not replace the main treatment):

• Drink more pure still water;
• Do physical exercise (special classes for pregnant women and water aerobics are especially useful);
• Walk more in the fresh air;
• Don't overwork yourself;
• Pay attention to proper nutrition.

Important! If any of your relatives suffered from blood clotting disorders during pregnancy, you are at increased risk of thrombotic complications. In this case, consultation with a geneticist is recommended, since in some cases these pathologies are inherited. It is advisable to do this at the stage of pregnancy planning.

How does mom feel?

The uterus of the expectant mother rises higher and higher, to a distance of up to 34 cm from the pubis, and the tummy grows significantly. This is due to the large weight of the baby, amniotic fluid and placenta. At the same time, it is harder for mom to squat and make other movements. Strong and sudden kicks from the baby, as well as an enlarged uterus, can cause pain. But the expectant mother can already determine what exactly the baby pushed her with: his knee or his fist. If the kicks are light, this may indicate that the baby is hiccupping. At this time, the woman is recommended to do light physical activity, which allows for frequent breaks. Hiking or fitness is best. Due to the fact that the enlarged uterus puts pressure on many organs, the mother may experience temporary discomfort, which is not related to any diseases. A high load is placed on the spine, causing pain in the sacrum, lower back and pelvis. A pregnant woman has a liter more circulating blood volume, which has a strong effect on the functioning of the kidneys, oppressing the bladder and causing frequent urination. Sometimes mom can get up up to six times a night. The cause of heaviness in the stomach, heartburn and nausea is the pressure of the uterus on the stomach. In this case, frequent meals in small portions will help alleviate the condition.

Symptoms of severe preeclampsia in pregnant women

Preeclampsia and eclampsia are pathological conditions that occur during pregnancy.
Signs of gestosis in late pregnancy are high blood pressure and the presence of protein in the urine. Since preeclampsia can pose a serious threat to the life of the child and mother, at the slightest suspicion it requires the help of a specialist. There are mild preeclampsia, severe preeclampsia and eclampsia. What are the dangers of complications of gestosis during pregnancy? Preeclampsia causes blood vessels to narrow, leading to decreased blood flow and high blood pressure. In this case, the expectant mother’s kidneys, liver, and brain suffer the most. In a child, this condition can cause growth retardation. Oligohydramnios and placental abruption are the main complications of gestosis.

Risk factors:

• multiple pregnancy;
• first pregnancy in women over 35 years of age;
• history of preeclampsia;
• chronic hypertension, kidney disease;
• obesity;
• diabetes;
• presence of gestosis in mother, grandmother, sister.

A high risk of developing eclampsia after childbirth is observed in women over 35 years of age.

How does mom feel?

This week of pregnancy requires conscientious monitoring of the condition of the expectant mother. This is exactly the period when a woman can feel false contractions. Painful sensations appear in the upper part of the uterus and gradually subside. As pregnancy progresses, contractions become more pronounced. They resemble short muscle contractions lasting from a few seconds to five minutes. In this way, the body prepares for the upcoming birth. This process accompanies every woman’s pregnancy with varying intensity. Experts call this Braxton-Hicks contractions. How can an expectant mother distinguish labor pains from warning signs, especially if she is expecting a baby for the first time?

Let's look at the main differences:

• Preparatory contractions are characterized by a high interval between them, which varies in duration. And prenatal contractions are regular, with a gradually decreasing interval.
• Preparatory contractions may stop immediately after resting or changing the body position of the expectant mother, and labor contractions gradually intensify regardless of the change in position.
• The pain sensations are also different. Labor pains are accompanied by severe pain, which becomes more and more noticeable. Preparatory contractions are characterized by either sharp pain or can be completely painless.
• False contractions can stop with the use of antispasmodics approved by doctors. While such drugs will not have any effect on labor contractions or will be minimized.
• A woman can feel false contractions in various places. This could be the lower abdomen, the side walls of the uterus, or the entire abdomen. Pain during labor may resemble premenstrual pain. Also, pain may begin in the lower back, gradually covering the front of the abdomen.

It is very important for a woman with such symptoms to provide a sense of security; in case of any contractions, the pregnant gynecologist must be informed.

What is D-dimer

D-dimers are small protein fragments. They are formed during the breakdown of fibrin, a substance whose synthesis occurs in the liver during the breakdown of a blood clot.

Why do you need a D-dimer test?

During pregnancy, a number of hormonal changes occur in a woman’s body, which affect many organs and systems, including the hemostasis (blood clotting) system. Therefore, an elevated level of D-dimer is a physiological norm. Nevertheless, it is advisable to constantly monitor its level and, if it increases significantly, take immediate measures to prevent thrombosis. With varicose veins (and this is observed in at least a third of pregnant women), blood clotting disorders can lead to serious, sometimes life-threatening consequences for the mother and child.

How does mom feel?

During this period, the mother has difficulty breathing. This is caused by the growing uterus, which pushes aside the lungs first. The lungs cannot fully expand, making breathing difficult. Also, the enlarged uterus pushes aside the bladder and intestines. This week, almost every pregnant woman feels short of air, has shallow and rapid breathing and a constant desire to take a deep breath. The cause of shortness of breath during this period may be a long walk or climbing stairs, as well as prolonged lying down. A competent alternation of rest and physical activity will help alleviate the condition. The fundus of the uterus rises 35 cm from the pubis and 15 cm from the navel, this is the highest point during the entire period of bearing a baby. This feels like one of the most difficult weeks of pregnancy. The body of the expectant mother is actively preparing for the upcoming birth, all ligaments become more extensible and elastic. It can also lead to an increased risk of injury and falls. During this period, doctors do not recommend flying or long trips. If you need to go somewhere, it is important to have a loved one present and to change your position approximately every 15 minutes. This week, mom needs to rest more often. Special physical exercises will be useful to help reduce back pain.

How does the fetus behave at 35 weeks?

At this stage of pregnancy, the baby is a unique person, with his own facial features, patterns on his fingertips and even character. He gains weight very quickly - up to 2.5 kg, and height - up to 47 cm. Your baby is already big! He is already cramped in the hitherto familiar space of the uterus, so mother feels every movement very clearly. The child moves less, but only because he does not have enough space.

Important! If the baby moves too often or the mother does not feel his movements, then the child is experiencing difficulties. This is a reason to see a doctor.

The following signs are characteristic of fetal development at the 35th week:

• The systems are formed: the liver and kidneys function, the adrenal glands produce hormones, the pancreas produces insulin, the endocrine and immune systems work.
• Fatty tissue accumulates, muscles and bones become stronger.
• The small heart works actively in conjunction with the vascular system.
• The toenails are formed, the ears take on shape and do not fit tightly to the skull.
• The skin becomes denser and more elastic, acquiring a natural shade. The vessels are no longer visible through it as before.
• Mineral and water-salt balance is regulated.

Some babies may develop hair. At this stage, the baby already looks quite plump, his shoulders and cheeks are rounded. He can distinguish sounds, smells and tastes well, and knows when it is dark or light outside. The baby perfectly senses the mother’s mood and her well-being.

Interesting! Enough surfactant has accumulated in the fetus's lungs and it is able to breathe on its own. Sometimes the baby is so cramped in the womb that he prefers to be born earlier. Nothing wrong with that. As practice shows, such children are born safely and subsequently do not lag behind their peers in development.

How does mom feel?

During this period, a pregnant woman feels very tired. The tummy becomes heavier, making it difficult to choose a body position. The baby begins to sink lower, preparing for birth, and the mother begins to breathe easier. But this increases pressure on the bladder, causing more frequent urination. The uterus is located at a distance of 36 cm from the pubis. This is the highest point during the entire pregnancy. The body of the expectant mother is being rebuilt, making intensive preparations for childbirth. Hormonal changes cause an increase in hormone levels. The pelvic bones soften under the influence of hormones, trying to make it as easy as possible for the baby to pass through the birth canal. At the same time, contractions intensify and more abundant vaginal discharge appears. A pregnant woman this week needs to listen more to her body and carefully monitor it. If you have nagging pain in the lower abdomen, as well as pain in the lower back, you should pay attention to its duration and frequency. If all indicators are present, you should immediately contact a gynecologist: premature birth is not uncommon this week, so it is important to respond to the body’s signals in a timely manner. Mom should be very careful: do not make sudden movements, control her posture, moderate walks and sitting time. During this period, sleep is disturbed, thus the body also prepares for the baby’s night feedings. This week, mom can fully feel what swelling is. It is necessary to control swelling, which can cause organ dysfunction.

Causes of preeclampsia and methods of its treatment

Evgeniy Rafailovich explains that it is not entirely correct to ask the question of how preeclampsia is treated without understanding the mechanisms of its occurrence. The choice of treatment tactics depends on both the degree of gestosis and the pathogenesis, that is, in simple words, the general principles of the course and outcome of the disease.

Doctor Petreykov:

“It all depends on the degree and on the background against which the pathology arose. The etiology, that is, the conditions for its occurrence, is not known for certain. There are 20 different theories of the causes of preeclampsia, and all of them are not part of the coherent system of our knowledge. These are mainly, of course, immune and autoimmune mechanisms. Immune, of course, is associated with immunity, which suffers during pregnancy. Autoimmune diseases are caused by the fact that the immune system, roughly speaking, goes in the wrong direction and the body begins to eat itself.”

Today, medical science does not find an exact answer to the question of what to prioritize: either spasm of very small vessels - capillaries, arterioles and venules, or primary damage to the internal walls of blood vessels.

Evgeniy Petreikov says that if we examine the vessels of preeclampsia through a microscope, we will see signs of damage to the internal lining of the vessel walls. When blood vessels are damaged and spasm occurs, urine filtration in the kidneys is impaired; protein comes out along with the urine, because, let’s put it this way, there is no filter that could restrain this process. At the same time, the protein content in the blood drops, and a forced spasm of blood vessels occurs, aimed at maintaining pressure. In this case, edema of pregnant women immediately appears, associated with a drop in oncotic pressure, spasms and release of the liquid part of the blood. This is how the mechanism of edema occurs.

However, Evgeniy Rafailovich explains that for an obstetrician-gynecologist who sees the development of a pathological process, it is not even so important what comes first. The doctor needs to act immediately. The woman must be hospitalized and continue to be monitored in a hospital setting, while the medical institution must be equipped with everything necessary for obstetric care.

Preeclampsia rarely responds to any treatment, but doctors may try to treat the patient if the disease is in a mild stage. A pregnant woman is prescribed antispasmodics, anticonvulsants, drugs to lower blood pressure, as well as infusion therapy with medicinal solutions to correct the development of pathological processes.

Attention! WHO standards allow monitoring of a pregnant woman suffering from preeclampsia for 48 hours. If during this time there are no visible improvements, a decision is made on immediate delivery, regardless of the duration and degree of physical development of the fetus! Moreover, these improvements should be objective, not subjective.

Evgeny Petreikov:

“A woman can talk to us and smile, but if tests and hemostasis show that fatal changes are about to begin, which will be difficult or impossible to correct later, then we must end the pregnancy in any way possible. The most important treatment for preeclampsia is childbirth. Since this is an immune or autoimmune disease, then this chain needs to be interrupted, and it is interrupted by childbirth.”

Unfortunately, it is almost impossible to say for sure in advance whether a woman will have to face gestosis in the second half of her term, however, some clinics now offer to undergo additional examination as part of the first pregnancy screening, which allows you to calculate the risks of developing the disease based on ultrasound data and urine test results and blood and blood pressure measurements.

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