What is a gesture?

Synonyms

Preeclampsia, eclampsia, HELLP syndrome, pregnancy poisoning

Definition

Gestoses are pregnancy-associated diseases, which are based on a general cramping of small arteries. Psychological factors such as a disturbed relationship with one’s mother and magnesium deficiency are also discussed as causes. The symptoms manifest themselves in the form of high blood pressure (hypertension), water retention in the tissue (edema), excessive reflexes and excretion of proteins in the urine (proteinuria).

Depending on the severity of the symptoms, sedatives, antihypertensives, a diet and relaxation techniques can be used. Sometimes, however, childbirth remains unavoidable. After the birth there is usually a complete healing.

However, the probability of falling ill again during pregnancy is higher than in the normal population. High blood pressure (hypertension) in the context of gestation is defined by the double measurement of a blood pressure of over 140/90 mmHg at intervals of several hours. If protein excretion also occurs in the urine, this is called pre-eclampsia.

What are the signs?

Signs of a gestosis can be of different nature, since a gestosis does not have to be limited to a certain organ, but can generally have effects on different organs. For example, a gesture can have effects on the kidney. Symptoms of this are characterized by a reduction in the total amount of urine produced daily (oligouria).

Signs of this are less frequent urination or reduced amounts of urine when going to the toilet. Another symptom of kidney involvement is water retention in various parts of the body (edema), often the legs. Protein can also be detected in the urine using a special test strip (proteinuria).

If the lungs are involved, shortness of breath can be a further symptom. This is often caused by water retention in the lungs (pulmonary edema). Special attention should be paid to the involvement of the liver and the central nervous system.

A possible involvement of the liver may be right-sided pain in the upper abdomen (pain below the right costal arch). Seizures, sensitivity to light and sound, headaches, nausea and vomiting may be symptoms of central nervous system involvement. Edema is fluid retention in tissue.

In a gesture, edema can occur in various parts of the body (often feet, legs). On the one hand, edema can be caused by reduced fluid excretion of the kidney. This increases the fluid in the blood vessels.

This fluid accumulates and is pressed into the tissue by the dust-related pressure. If you press on the swollen tissue and a dent remains, which only disappears slowly (after several seconds to minutes), this is a relatively sure sign of edema. Fluid retention in the lungs can also occur in rare cases and lead to breathing difficulties.

In this case, the heart is no longer able to pump the increased volume of fluid into the body’s circulation. This causes the fluid to back up in the lungs and is pressed into the lung tissue due to pressure. A distinction is made here between pregnancy-induced blood pressure increase (hypertension).

This refers to a blood pressure increase of more than 140/90 mmHg (or severe hypertension with a 2nd value (diastolic) of more than 110 mmHg), which occurs after the 20th week of pregnancy (SSW). Before and during pregnancy (up to the 20th week of gestation), normal blood pressures (less than 140/90 mmHg) should have been measured. A distinction must be made between this and the pregnancy-independent blood pressure increase.

This refers to an already known, long-standing increase in blood pressure, as well as the increase in blood pressure before the 20th week of pregnancy (for limits see above). Since elevated blood pressure increases the risk of so-called pre-eclampsia, special attention should be paid to protein excretion in urine when blood pressure is elevated. This can prevent or detect complications such as eclampsia or HELLP syndrome at an early stage.

The kidneys can only cope with elevated blood pressure to a limited extent. Over time, the increased pressure causes substances such as proteins to enter the urine, which are normally held in the blood by a filter (blood-urine barrier). In medical terminology, increased protein excretion in the urine is referred to as proteinuria.This can be determined using test strips in any doctor’s office. Alternatively, a more precise urine diagnosis can be carried out. For this purpose, medium jet urine or, in some cases, collective urine (urine collected over 24 hours) is used.