Medical blog

There are three principal views of treatment illnesses: conservative, surgical, .
Considering, that with the pregnancy termination — the factor which has provoked illness occurrence, — expansion of veins decreases or disappears, to pregnant women recommend to accept periodically position with the raised feet for 10—15 minutes and to apply so-called a compression (use special bandage, and stockings). The Elastichesky compression promotes squeezing of hypodermic veins, reduction of developments of stagnation and increase in speed of a blood-groove. To use a compression it is possible not only as a medical measure, but also as occurrence preventive maintenance expansions of veins.
Applying a compression, it is necessary to adhere to certain rules: to put on stockings, or to bandage feet bandage follows laying. It is better to do it in the morning, not lowering feet from bed, or after half-hour rest laying. To start to bandage feet it is necessary from fingers. Each subsequent coil of bandage should block the previous. The heel and a knee should be bandaged, as well as other part of a foot.
Besides to pregnant women the physiotherapy exercises and self-massage in a combination to a correct mode of work and rest, a diet directed on preventive maintenance of locks is necessary for a compression. Reception of vitamins, especially ascorbic acid and vitamin PP which strengthen a vascular wall is necessary also.

For increase of a tone of vessels appoint , , , , forte, . These preparations normalise permeability of vessels, interfere with formation of blood clots, reduce a pain. In the first trimester do not apply and , and in feeding by a breast reception is not recommended.

therapy is an introduction in vessels special the substance closing a gleam of a vessel. Such kind of therapy during pregnancy do not apply.
Only at the expressed expansion of veins during pregnancy bring an attention to the question concerning surgical intervention.
illness is not the indication to interruption of pregnancy or by operation sections.

During pregnancy it is necessary to carry out preventive maintenance possible disease complications.
Preference at give to sorts through natural patrimonial ways. For lying-in women necessarily bandaging of both feet bandage for the prevention blood in veins during attempts.

During pregnancy of the woman hand over analyses for an estimation of system of coagulability of blood. At the raised coagulability of blood spend special preventive treatment (, , , , ) and (Aspirin, , ) preparations which continue usually and in postnatal (postoperative) the periods.

In early terms of pregnancy (till 10 weeks) it is necessary to pass full inspection for diagnosis specification to find out, is how much compensated a condition of system of blood circulation, to solve a question concerning possibility pregnancy or its interruption.
During the second hospitalisation (27—32 weeks) corresponding correction of infringements of cardiovascular system is spent.
On 37-38th week (the third hospitalisation) the pregnant woman is hospitalised in a hospital for preparation for sorts, a choice of the plan of conducting sorts and carrying out of preventive maintenance and therapy of possible complications.
Important not only to carry out certain medical appointments, but also to observe a corresponding mode of work and rest, eutrophy and hygiene during pregnancy.

Among illnesses of cardiovascular system at pregnant women heart diseases win first place. Whether they influence a current of pregnancy and a fruit condition? Certainly.
Increase in weight of a body, volume of circulating blood, change of position of heart, increase of intrabelly pressure in connection with the uterus increase, the strengthened metabolism at pregnancy lead to certain changes of cardiovascular system even at healthy women. Therefore at some not compensated heart diseases to pregnancy it is strictly counter-indicative.
Depending on expressiveness of changes during pregnancy distinguish some periods during which time the highest loading on system is marked and diseases of cardiovascular system are to the greatest degree shown.

In the first period — from the beginning of pregnancy till 16 weeks — most often becomes aggravated , especially at development of an early toxicosis of pregnant women.

The second period — from 26 till 32—34 weeks — is characterised by the greatest loadings on heart and vessels, increase in volume of blood.

In the third period — from 35 till 36 weeks prior to the beginning of patrimonial activity — the basic role play: increase in weight of a body, difficulty of pulmonary blood circulation in connection with high standing of a bottom of a uterus, change of the form of a thorax, decrease in function of a diaphragm.

Infringement of indemnification of this or that heart disease is the most frequent occurs on 24-32nd week of pregnancy, during sorts and in the first days after them.

In this connection each pregnant woman with a heart disease should be hospitalised it is desirable in specialised a hospital three times.

I degree — the actual weight of a body exceeds "ideal" no more than on 29 %;
II degree — surplus of weight of a body makes 30-49 %;
III degree — the actual weight of a body exceeds "ideal" on 50—99,9 %;
IV degree — the actual weight of a body surpasses "ideal" more than on 100 %.
There is a set of formulas, for calculation of "ideal" weight of a body.

The pyelonephritis is an infekpionno-inflammatory disease of a fabric of kidneys and nephritic . During pregnancy this most frequent disease from among diseases ways. It is marked at 2—5 % of pregnant women. The pyelonephritis can arise as to (sharp or chronic), and during pregnancy — a pyelonephritis. The aggravation of already available chronic pyelonephritis or occurrence a pyelonephritis are promoted by following factors: "weakening" influence of a progesterone, a growing uterus, expansion nephritic and . Besides, the big role the centres of a chronic infection play a-chronic tonsillitis, cholecystitises, caries of a teeth and others. At easing of immunity during pregnancy pathogenic microorganisms in the centres of a chronic infection (, fungi, , streptococci and others) become more active and through blood get to kidneys that promotes pyelonephritis development.
For a sharp pyelonephritis the sudden beginning is characteristic: the temperature with a fever, pains in a waist, infringements sharply raises, there can be a vomiting. In urine the maintenance of leukocytes, bacteria is raised, can be .
Treatment consists in a confinement to bed (for a heat), plentiful drink (in the absence of hypostases), taking into account the infection activator (the preparations resolved during pregnancy). Treatment both sharp, and an aggravation of a chronic pyelonephritis spend strictly in a hospital.
At an aggravation of a chronic pyelonephritis (and it becomes aggravated at 30—50 % of the pregnant women, suffering this disease), symptoms are expressed a little bit more poorly. However the chronic pyelonephritis is often accompanied by increase of arterial pressure, that negatively influences a current of pregnancy and sorts. The pyelonephritis is especially dangerous at a unique kidney.
At pyelonephritises often joins (40—50 %), threat of interruption of pregnancy (25—30 %), premature birth, pre-natal a fruit, placentary insufficiency, pre-natal and a fruit.

illness can be accompanied by following complications (the so-called complicated form):
— Bleedings;
— Thromboses and thrombophlebitises;
— an ulcer;
— An erysipelatous inflammation;
— and allergic .
Diagnostics usually is not represented to illness difficult. It is based on survey of area of the expanded veins, the functional tests, allowing to define, what veins (superficial or deep) are amazed, and additional tool researches: ultrasonic and researches of veins.

Some incorrectly consider, that during pregnancy at women with heart diseases in connection with loading on cardiovascular system physical exercises are counter-indicative. Yes, of course, the general complex of exercises for pregnant women can lead to considerable shifts in health of the pregnant woman with a heart disease. However there are special "sparing" complexes of exercises for such future mums who promote the best maintenance with oxygen both its organism, and an organism of the kid, train muscles and in general improve the general state of health. Such exercises are necessary for beginning with the skilled instructor. The essence of a complex of exercises is reduced to the following.
In the beginning loading on an organism minimum — exercises are carried out "laying", then gradually (in 1 week) the complex joins exercises with small loading — exercises "sitting". In one more week the complex is included already by exercises "standing". Gymnastics courses are usually calculated for 4—5 weeks.

Huge value at a combination of pregnancy and heart diseases has eutrophy. It should be high-grade, that is contain necessary quantity of carbohydrates, fibers and fats, vitamins and mineral substances. It is necessary to exclude strong meat broths, sharp and salty dishes, strong tea, coffee and cocoa, any fat meat, fried and smoked dishes from a diet. (Including soups, milk and kefir) about 1 litre a day, and quantity of table salt — to 1—3 as the liquid considerable quantity promotes still to an overload of all departments of heart is desirable to limit volume of the drunk liquid, and salt — is capable to detain this liquid.
What then it is possible? Necessary for your organism and growth of your child of substance contain in a considerable quantity in vegetables and fruit, seafood, dairy products, juice.
In the rest a food at heart diseases a little than differs from a food during pregnancy at healthy women which is in detail described in section a Food during pregnancy.

During pregnancy the appendicitis quite often develops. The appendix inflammation ( a shoot of a blind gut) is promoted by growth of a pregnant uterus therefore there is an appendix displacement upwards and , its excess and infringement of its blood supply. Important value in appendicitis development has propensity to locks, and also hormonal changes during pregnancy.
To thicket the appendicitis arises in first half of pregnancy. There are pains, a nausea, vomiting, temperature slight increase. At occurrence of these signs it is necessary to address immediately to the doctor.
Development of an appendicitis during pregnancy without dependence from term is the indication to operation as very often has the serious complications dangerous to a life (for example, an inflammation ).

Pregnancy in a combination with illness meets in 3—4 % of cases ( means above or increase, over). At the majority of pregnant women hypertensive illness develops to pregnancy, but can arise and during it.
Recently hypertensive illness began to be marked often at young men. Nevertheless the increase in frequency of hypertensive illness is marked in parallel increase to age. So, at women frequency of hypertensive illness is more senior 30 years makes 3 4 %, is more senior 35 years — 5—8 %, and is more senior 40 years - 13,5 %.
It is considered, that normal arterial pressure is equal 110—140 mm Hg — (or top); 70—90 mm Hg — (or bottom).
Increase of arterial pressure testifies to presence of an arterial hypertensia above 140/90 mm hg

At hypertensive illness mark some severity levels of illness on which the forecast of an outcome of pregnancy and sorts for the woman depends.

For I stage (it still name functional) it is characteristic changeable , that is increase of arterial pressure is replaced by the periods of normal pressure. For stages of the PAS and WILLOWS proof increase of arterial pressure is observed, and III stage of hypertensive illness is characterised already by defeat of bodies and fabrics (a brain, heart, kidneys, vessels).

Only at easy degree (I degree) hypertensive illness when increase of arterial pressure is unsharply expressed and it is changeable, in the absence of changes in heart pregnancy and childbirth can proceed normally. At proof and substantial increase of arterial pressure pregnancy worsens a current of hypertensive illness. At patients with III stage of hypertensive illness ability to conception is sharply lowered, and if pregnancy nevertheless comes, as a rule, comes to an end with an abortion or pre-natal  destruction of a fruit.
Can arise and other heavy complications during pregnancy. The heaviest complication is the encephalopathy which can lead to a hemorrhage in a brain (stroke), to a clod and even death. Therefore to pregnancy at this stage of disease it is counter-indicative.
The current of hypertensive illness during pregnancy has the features.

At many patients in initial stages of disease on 15-16th week of pregnancy arterial pressure decreases (often to normal indicators), that speaks changes in an organism at pregnancy, in particular increase in synthesis of a progesterone a placenta which reduces a tone of vessels. At II—III stages of such decrease it is not marked.

After 24 weeks arterial pressure raises at all patients irrespective of a disease stage. On this background such complication of pregnancy, as (32—55 %) which has an adverse current often joins.
In connection with a spasm of matochno-platsentar th vessels delivery to a fruit of nutrients and oxygen that conducts to oxygen starvation and a fruit growth inhibition is broken. Placentary insufficiency develops, there is a threat of interruption of pregnancy.

In 20—25 % of cases the child is born with the lowered weight of a body . Often there is premature birth, in 4 % there can come pre-natal  destruction of a fruit.