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Gestosis is the state of expectant mothers, which arises up in connection with development of concepts or its separate elements and is characterized by the varied symptoms.

At the removal of concepts or its elements of disease is usually halted.

After the term of origin and clinical displays the noted states are divided into 2 groups. Disorders which show up in the early terms of pregnancy, more frequent in the first trimester, are named as early gestosis. If clinical symptoms are more shown in ІІ and ІІІ trimesters such conditions are named late gestosis.

Gestosis is characterized by disorders and violations of all types of metabolism. Often signs of gestosis of early term are nausea and vomit of pregnant, ptyalism. Rarer such complications of pregnancy appear as a dermopathy (dermatosis), tetania, cholestasia, sharp fatty dystrophy of liver, tetania of pregnant, chorea of pregnant, оsteomalacia, аrtropatia.

Modern view on etiology and pathogenic development of gestosis.

Simply not certain, it is considered that reasons of origin there can be a few, but a leading role belongs to violations of the functional state of CNS. There are reflex, neurogenic, endocrine, allergic theory.

І. Present connection between frequency of vomit of pregnant and biochemical degree of expressed of hyperthyroidism and level of Chorionic gonadotropin (HGT). Y-level of HGT swiftly grows in the first trimester and has the maximal value on 10-12 week. The states which the level of HGT grows at, especially strongly (trophoblastic illness multifetation), are associated with heavy early gestosis  of pregnant. At vomit of pregnant mark the temporal coinciding of beginning of vomit with the peak of maintenance of HGT. Low maintenance of HGT is associated with unmaturing anomalies of development.

ІІ. It is set that postpartum depression arises up rarer at women which had expressed vomit of pregnant, in comparison with women which did not have early gestosis. In addition, due to surplus vomit the use pregnant of food stuffs which can be potentially dangerous for her and embryo is warned.

It is confirmed, that investigation of pregnancy for a mother and fetus  at surplus vomit of pregnant, namely: weight of fetus, term of births, estimation on Аpgar, mortinatality, frequency of anomalies of fetus, does not differ and does not get worse in comparison with general population. But there is intercommunication with possible development of late gestosis and, as a result, by the delay of development of fetus in more late terms.

ІІІ. In behalf of allergic theory testify researches at which the considerable increase of level of histamine is discovered in the whey of blood of women with heavy complications of pregnancy (by surplus vomit,  eclampsia, unmaturing of pregnancy) in comparison with unpregnant and at normal motion of pregnancy.

IV. In pathogenesis of vomit of pregnant violation of the neuroendocrine adjusting of all types of exchange is a leading link as a result of partial (or complete) starvation and dehydration, violation of the functional state of CNS. In the early terms of pregnancy the symptoms of early gestosis (neurosis) show up disorders of function of gastroenteric highway. Food reflexes are the diencephalon areas related to the vegetative focis. Going from periphery afferent signals can have wrong character reason of which is the changes in the receptors of uterus or in leading ways, possible changes in the focis of diencephalon area that can change character of reverse efferent impulses. At the broken sensitiveness of the nervous system quickly there are the changes of reflex reactions violation of food functions: loss of appetite, nausea, salivation, vomit. Neuroendocrine and exchanges violations acts considerable part in development of early gestosis, in connection with what at progress of disease the changes of water-salt, carbohydrate and fatty, and then albuminous metabolism on a background increasing exhaustion and decline of mass of body develop gradually.

V. Connection is set between surplus vomit of pregnant and bacteria. The high level of Іg to Helicobacter pylori at patients with early gestosis when compared to a control group. The maintenance of nausea and vomit in a ІІ trimester can be as a result of other diseases of GIT or it is related to the presence of Helicobacter pylori.

VІ. At research of fetus from women, which suffered heavy early gestosis, found out expressed pathology of chorion, which was characterized by the decline of invasion activity of cytotrofoblast, absence of intravessel component of the first wave of invasion and presence of uterine arteries with incomplete gestational alteration. The indicated factors explain weight of damage of placenta at early gestosis as the inferior angiogenesis of atrophy of trofoblast, edema and fibrosis.

The found out the changes of uterus-placenta  circulation of blood are starting in development of gestosis which in most pregnant does not show up at first, but act considerable part in development of gestosis ІІ and ІІІ trimesters.

The changes in the organs of pregnant at first have functional character, and afterwards at growth of dehydration, catastasis reactions intoxication by products  pass to the dystrophic processes in a liver, buds and other organs.

In 55% pregnant with heavy vomiting there are the expressed par functions livers, which appear with the help of laboratory tests – coagulogram, hepatic enzymes, that in future can result in serious complications of ІІ halves of pregnancy, in that number to the HELLP-syndrome. The synthesis of albumens and antitoxic function of liver, function of buds, is violated at first, and then there are the dystrophic changes in CNS, lights, heart.

Pathogenesis of origin and development of late gestosis.

In etiology of this complication act considerable part neurogenic, hormonal, immunological, placentas, genetic factors.

The above all links of pathogenesis of gestosis are:

  1. Spasm of vessels.
  2. Hypovolemia.
  3. Violation of properties of blood (change of viscidity of blood — haemoconcentration).
  4. Development of endothelium disorders, violation of capillary.
  5. Metabolic disorders.

     6.  Syndrome of functional insufficiency.

The indicated complex of hemodynamic and metabolic changes is a background on which the dystrophic and hemodynamic changes develop in fabrics vital, stipulating their dysfunction.