Introduction
Pregnancy poisoning, also known as gestosis, is a generic term for all diseases associated with elevated blood pressure levels during pregnancy. It is one of the most common pregnancy complications, besides bleeding, and leads to 20% of perinatal deaths. Although the term pregnancy poisoning is widespread, it is now outdated and somewhat misleading, as this clinical picture is not poisoning in that sense.
Therefore, the term gestosis is more commonly used nowadays. Pregnancy poisoning occurs mainly in the last third of pregnancy and is accompanied by water retention in the legs, hands, and face, high blood pressure and increased protein excretion in the urine. Values above 140/90 mmHg are referred to as high blood pressure.
Blood pressure values below 130/80 mmHg are normal. Pregnancy poisoning can under certain circumstances be life-threatening for mother and child, but can usually be detected in time and treated well. Only in rare, severe cases is an early delivery of the child necessary, but usually not before the 28th week of pregnancy, from which the child is already viable.
Definition
Pregnancy intoxication (gestosis) is a collective term for all pregnancy diseases that are associated with high blood pressure. It manifests itself primarily in generalized water retention in the body (edema), blood pressure values above 140/90 mmHg (hypertension) and increased protein excretion via the urine (proteinuria). Pregnancy poisoning is further subdivided into five subforms:
- Pregnancy-related high blood pressure (SIH)
- Preeclampsia
- Eclampsia
- HELLP syndrome
- Grafts
Pregnancy-related hypertension (SIH) is the first time that elevated blood pressure values are seen after the 20th week of pregnancy, without protein excretion.
Pre-eclampsia is defined as blood pressure values above 160/110 mmHg, which first appear after the 20th week of pregnancy and are associated with increased protein excretion in the urine, kidney and liver damage, as well as neurological complaints such as headaches and visual disturbances. Pre-eclampsia can also lead to growth and developmental disorders of the child. Eclampsia is characterized by the same symptoms as pre-eclampsia, plus additional seizures.
Eclampsia is a life-threatening emergency that can sometimes lead to coma and multiple organ failure. The maternal mortality rate is between 8-27%. HELLP syndrome is characterized by severe upper abdominal pain, nausea, vomiting, visual disturbances and headaches, and is associated with severe liver damage and impaired blood clotting, which can be life-threatening.
HELLP syndrome is considered a very important and very dangerous complication of pregnancy poisoning. The term graft gestosis is used if the woman suffers from chronic high blood pressure or kidney disease before pregnancy begins and then develops symptoms of pregnancy poisoning during pregnancy. Women with a graft have a high risk of pre-eclampsia.
