To the Etiopathogenes Gestosa Pregnant
The author examines the current problem of modern medicine related to toxicosis
in pregnancy. The fact is that this pathological process is still a mystery to doctors.
Several theories have been proposed, but they cannot explain the cause of toxicosis in
the early and late stages of pregnancy. According to WHO statistics, up to 90 per cent of
all pregnant women suffer from toxicity in the first trimester of pregnancy and about 40
per cent in the third trimester. The author of the article has formed the opinion that in
the development of gestosis (toxicosis in the third trimester) it is important to actively
include in the metabolic process of the embryo’s urinary system. His urine does not
have time to suck from the bladder and on the urethra begins to periodically flow into
the uterine cavity of the mother, causing poisoning of her body. This is the reason for
the sharp deterioration of her condition. Vomiting urges increase up to 10-25 times a
day, and they are not associated with eating. There is a weight loss of up to 10kg. There
is weakness. The heart rate increases and blood pressure decreases. The temperature
rises, there is bad breath, and the woman becomes inhibited. Some of them may have
impaired kidney function, and an artificial termination of pregnancy is already required.
All these symptoms immediately pass after childbirth, which only confirms the fairness
of the proposed version of the cause of pathology and dictates the need to develop an
adequate and effective treatment for this pathological process.
The Aim of the Study: Reflect the importance
of the fetal urinary system in the development
of gestosis in the mother.
Keywords: Pregnancy; Hestosis; Embryo;
Fetal Urinary System
Why a pregnant woman’s physiological process of embryo
development is very often complicated by toxicosis, i.e. the
pathological process, remains a mystery to modern medicine.
There are early and late toxicosis of pregnancy, with early may
begin either from the first days after conception of a new life, or at
5-6 weeks of pregnancy, and ends by 13-14 weeks. It is observed in
almost all pregnant women [1,4]. This complication is explained by
the toxic effects of the embryo on the mother’s homeostasis, when
she has not yet formed the placenta - it is formed only by 12-14
weeks. Late toxicosis (hestosis) usually begins 30 weeks from the
beginning of pregnancy - in the last (third) of her trimester, and
sometimes even in the middle of the second, and then it proceeds
heavier. It is observed in almost half of pregnant women. There are
4 forms of gestosis - water of pregnant women, nephropathy, preeclampsia,
eclampsia. When waterside, water lingers in the body
with the development of swelling. In nephropathy there is swelling,
high blood pressure, protein in the urine. In pre-eclampsia there
is a violation of the function of the nervous system. In eclampsia
there are convulsions and loss of consciousness. The cause of
gestosis has not yet been determined [2-4]. If early toxicosis, with
a certain degree of doubt, the authors explained, or neuroreflex
reactions from the effects of the embryo on the endometrial of the
uterus, or poisoning by toxins coming from fetal tissue, or chorionic
gonadotropic hormone, or they could not explain the late toxicosis.
It was not clear why the fetus suddenly began to pose a mortal
danger to the mother in the last 2-3 months of life in her body.
At this time, she had pronounced symptoms of inflammation in
the abdominal cavity - constant abdominal pain, increased body
temperature, tachycardia, drop in blood pressure, excruciating
multiple vomiting, leukocytosis, increase in fertilized water, rotten
breath [5,6]. Careful analysis of this clinical picture of the disease
suggested that this is not an accidental negative phenomenon, but a
certain pathological process associated with the impending birth of
a child. At this time, his mother begins to feel his movements, which
inevitably should have led to the strengthening of his metabolic
processes. This is accompanied by increased kidney and rectal function. However, if the opening has a reliable locking mechanism
- in the form of internal and external sphincters, the urethra is
deprived of it. Not only has that, the preponderability in the inertia
of the parasympathetic nervous system, over the sympathetic,
made it unstable to stretch. As a result, the fetus does not have time
to suck urine from the bladder cavity and begins to flow through
the urethra into the uterine cavity. This was accompanied by the
development of the inflammatory process. Determining the cause
of gestosis allowed to revise the algorithm of treatment.
Working as a district homeowner for 16 years, I had to
constantly do an examination of patients in the department
of pathology of pregnant women. The main reason for their
hospitalization was toxicosis. At a young age it was particularly
difficult. Attempting to combat swelling only led to increased
intoxication, although diuretics were part of the standard algorithm
for treating these patients. This discomfort from treatment forced
not only to reconsider the tactics of treatment of these pregnant
women, but also to take a fresh look at the etiopathogeny of this
pathological process. These observations formed the basis of the
new theory of gestosis, as was reported above. To combat swelling,
instead of diuretic began to limit the intake of fluid, and intoxication
was reduced due to the normalization of the stool - making it daily
and voluminous. This was achieved by taking bran, vegetables and
fruits. Diet therapy was purely individual, but it was forbidden to
take salty and irritating food. At the same time prescribed corrective
infusion therapy, fat emulsion, vitamins and sedatives.
The treatment was meaningful. His main task was to bring the
pregnancy to delivery. After that, all the suffering of the woman
ceased. No fatalities were observed. Completely to rid a patient of
the painful symptom complex was not possible, which testified to
the resilience of the pathological process, and the need to correct
homeostasis before delivery.
Despite the simplicity of the treatment, it allowed to reduce the
phenomenon of gestosis after 2-3 days. This was mainly due to the
normalization of the chair - severe intoxication caused by prolonged
constipation (3-4 days or more) was eliminated. Restricting the
intake of fluids reduced the fruit’s urine production. Both of these
activities were more of an organizational than a therapeutic one.
The development of late toxicosis in pregnant women is
associated with the flow of urine from the fetal bladder into the
uterine cavity of the mother. This occurs during the increased
movement of the fetus and is natural. At this time it is necessary
to achieve the normalization of the chair in a woman - it should
be voluminous and daily. This effectively reduces her intoxication
and reduces the water load. As a result, the plov decreases urine
production and it is absorbed in his bladder. These activities are
more of an organizational nature than a therapeutic one.
- Bryn VB (2016) Normal Physiology. (3rd edn) In Tkachenko BI (Eds.). Geotar Media, Russia, pp. 688s.
- Degtyarev VP, Sorokina ND (2016) Normal Physiology. Geotar Media, Russia, pp. 480c.
- Kamkin AG, Kisilova IS (2013) Atlas in Physiology in Two Volumes. Geotar Media, Russia, pp. 408s.
- Svirskaya ES (2010) Pregnancy from conception to childbirth (1st edn). Peter pp. 272s.
- Tela LS, Aghajanyan NA (2015) Normal Physiology. Lit Terra pp. 768s.
- Yuan Y, Ren J, He Y (2013) Current status of the open abdomen treatment for intra-abdominal infection. Gastroenterology Res Pract 2013: 532013.