Gestosis, toxaemia of pregnancy

Gestosis refers to pregnancy disorders whose symptoms often include high blood pressure and cloudy urine.

Overview

Gestosis refers to pregnancy disorders whose symptoms often include high blood pressure and cloudy urine. These are presumably caused by pregnancy-related changes combined with various risk factors, such as obesity, smoking or high blood pressure. Pregnancy check-ups are important to ensure early detection of such problems.

Symptoms

In early pregnancy (early gestosis)

  • Nausea and vomiting in the morning (morning sickness)
    • From 2nd to 4th months of pregnancy
    • Common, mostly harmless
    • Disappears on its own
  • Rarely: excessive and dangerous vomiting
    • Dehydration, fever
    • Disturbance of kidney and liver function, disorientation
  • Sometimes, increase in salivation

Gestosis is rare during the second trimester of pregnancy

Gestosis during the third trimester of pregnancy (late gestosis)

  • Main symptom: high blood pressure (hypertension), higher than 140/90 mm Hg
  • Excretion of protein in urine (proteinuria)
    • Indicates disturbance of kidney function
  • Oedema (general swelling)
    • In particular in legs
    • Combined with excessive weight gain
    • Can also happen to pregnant women who are otherwise healthy
  • Other symptoms: nausea and vomiting as well as abdominal pain, anxiety, disorientation
Pre-eclampsia
  • Main symptoms: hypertension and proteinuria
  • Potentially threatening condition for mother and child
  • If not treated, this can lead to eclampsia (see below)
Eclampsia
  • Immediately life-threatening, most severe form of late gestosis
  • Seizures with loss of consciousness
    • Before, during or after the birth
    • Attack is similar to an epileptic seizure (lasts approx. 1 minute)
    • Followed by unconsciousness (hours to days)
HELLP syndrome
  • Comes as a total surprise or as part of eclampsia
    • Can also occur after the birth
  • Acute kidney and liver failure with jaundice, bleeding and thrombosis
  • Loss of placental function is possible
    • Consequence: premature birth or stillborn child

Causes and treatment

Causes

  • The exact causes aren’t known

Various factors are believed to play a role (list is not exhaustive):

  • Pregnancy as a physically and mentally “abnormal situation”
  • First pregnancy (specifically very young or older women)
  • Multiple pregnancy
  • Gestosis during a previous pregnancy
  • Family predisposition
  • Pre-existing disorders
  • Malnutrition or nutritional deficiency
  • Obesity

Further treatment by your doctor / in hospital

Possible tests
  • 24-hour blood pressure monitoring
  • Urine analysis
  • Blood test (liver and kidney function, blood count)
  • Ultrasound (sonography)
  • CTG (cardiotocography ) to assess the foetal heartbeat
Possible therapies
  • Admission to hospital
  • Treatment of blood pressure
  • Magnesium (to prevent eclampsia)
  • Premature delivery
    • Only way to treat the causes
    • Depending on condition of mother and child
    • From induction of labour to emergency Caesarian section

What can I do myself?

  • Go for regular pregnancy check-ups
  • Balanced diet
  • Sufficient vitamin and mineral supplements (in particular calcium and iron)
  • For high blood pressure: low-salt diet, no reduction in fluid intake
  • Avoid stress, take regular rest breaks
  • No alcohol and nicotine (generally during pregnancy)
  • To elevate the legs, raise the foot of the bed
  • Weight control:
    • Weight gain is individual
    • Underweight women gain proportionately more weight than overweight women
    • Generally avoid losing weight during pregnancy

When to see a doctor?

  • For regular pregnancy check-ups (to ensure early detection of complications)
  • In between regular check-ups if problems occur such as:
  • Weight gain of more than 600g/week
    • Primarily visible as oedema (swelling) in the legs

Further information

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch

“Wir eltern” (Parents) magazine
www.wireltern.ch

Synonyms

toxaemia of pregnancy, gestosis, eclampsia and HELLP syndrome, EPH-gestosis, HELLP syndrome, pre-eclampsia

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CSS offers no guarantee for the accuracy and completeness of the information. The information published is no substitute for professional advice from a doctor or pharmacist.

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