Again feels sick...
Many consider nausea as obligatory attribute of the beginning of pregnancy. But whether so it actually? And when displays of toxicosis demand the urgent address to the doctor?
What is nausea
Nausea is extremely unpleasant feeling in a throat or in an epigastriya (the top department of a stomach) which often precedes vomiting and can be followed by the feeling sick, a pobledneniye of integuments, lowering of arterial pressure increased by salivation, increase of warm reductions and deepening of breath.
Nausea is a peculiar warning of possibility of vomiting. The emetic act represents difficult sequence of various reflexes and consists of three consecutive phases: nausea, desires to vomiting and the vomiting. But nausea not always comes to an end with vomiting. At nausea normal nature of reductions zheludochno - an intestinal path changes: the tone and vermicular movement (reductions) of a gullet and stomach decreases and the intestines tone therefore contents of a stomach get into a gullet, and then in a mouth raises. Two structures in a medulla are responsible for developing of vomiting: the emetic center and the hemoretseptorny trigger (“starting“) zone. The main role is played by the emetic center: it sends signals and coordinates activity of the muscles participating in vomiting. Allocate two ways of developing of nausea and vomiting. The first is connected with receipt of emetic incentives from bodies zheludochno - an intestinal path of zhelchevyvodyashchy ways, a throat, a vestibular mechanism, a brain, vessels, heart. The second - with stimulation of the emetic center drugs, a lack of oxygen (hypoxia), excess of uric acid at pathology of kidneys, ketone bodies (products of an exchange of carbohydrates at diabetes), toxins of bacteria.to
Proceeding from mechanisms of developing of nausea and vomiting, it becomes clear why there is a set of the reasons of emergence of these symptoms and why nausea is the nonspecific symptom characteristic of many diseases.
Display of toxicosis
during pregnancy nausea is one of symptoms of toxicosis of pregnant women - pregnancy complications which are shown, as a rule, in the first half of pregnancy and are characterized by dispepsichesky frustration (violations of digestion in zheludochno - an intestinal path to which nausea, heartburn, vomiting, an eructation, feeling of weight in the top departments of a stomach, a meteorizm belong) and violations of all types of a metabolism (proteins, fats, carbohydrates and mineral substances). Nausea and vomiting at the beginning of pregnancy occur rather often - at 60 - 80% of women. Most often these symptoms are poorly expressed, do not change the general condition of the woman and do not demand any treatment. The exact reason of nausea during pregnancy still did not manage to be established though there is a set of the theories explaining its origin. The reasons of developing of nausea and vomiting in early terms of pregnancy are considered, in - the first, the expressed change of a hormonal background (the amount of estrogen - female sex hormones increases, there is “a pregnancy hormone“ - a horionichesky gonadotrophin) and, in - the second, violation of interaction between TsNS (the central nervous system - a brain) and zheludochno - an intestinal path. Therefore there is an activation of the emetic center, and also the centers of salivation and sense of smell, and also a vascular tone. These centers are located in a medulla a row with each other for this reason vomiting at “early toxicosis“ is preceded nausea, salivation strengthening, heartbeat increase, pobledneny skin, breath deepening.
the Probability of developing of nausea during pregnancy increases if at future mother:
- the age less than 18 is also more senior than 35 years;
- polycarpous pregnancy (the birth of two and more kids is expected);
- in genetic predisposition (close relatives had an early toxicosis of pregnancy);
- the previous pregnancy proceeded with early toxicosis of pregnancy;
- in diseases of endocrine system (diabetes, a thyrotoxicosis - the increased secretion of hormones of a thyroid gland);
- of a disease of a gastrointestinal tract (for example, chronic gastritis or cholecystitis);
- a “weak“ vestibular mechanism and it rocks to sleep in transport;
- the disease connected with the wrong development of one of covers of fetal egg - puzyrny drift;
- intense schedule of work, frequent stresses, short-term dream;
- the habit to smoke remained.
Nausea in early terms of pregnancy arises most often in the mornings and passes independently (without reception of any medicines) in the second half of day though it can proceed throughout the day. As a rule, nausea arises in the term of 4 - 6 weeks of pregnancy and passes by the beginning of the second trimester. Often nausea is followed by vomiting. Nausea and vomiting to 2 - 3 times a day do not demand drug treatment. The vomiting arising more often than 2 - 3 times a day, irrespective of meal and combined with loss of appetite, change of flavoring and olfactory feelings, reduction of weight, feeling of constant weakness, is considered display of toxicosis of the first half of pregnancy and demands the immediate address to the doctor and carrying out treatment.
Gravity of a situation
Distinguish nausea and vomiting of pregnant women easy, moderate severity and excessive.the constant feeling of nausea, vomiting of 3 - 5 times a day, insignificant reduction of body weight to 1 - 3 kg, decrease in working capacity is characteristic
Of toxicosis of easy degree, emergence of easy apathy - the indifferent relation to surrounding is possible. At the same time the general state remains satisfactory, pulse and arterial pressure do not change. At inspection all analyses (the general blood test and urine, biochemical blood test) within norm. Treatment of toxicosis of easy degree is carried out on an outpatient basis under supervision of the doctor of the obstetrician - the gynecologist. However, despite the carried-out treatment, in 10 - 15% of cases deterioration in a state and development of toxicosis of average degree is possible.
Toxicosis of moderate severity is characterized by the constant nausea, vomiting to 10 and more times a day which is followed by the expressed salivation. In this case the general condition of the pregnant woman is broken, reduction of body weight to 3 - 5 kg quickly progresses up to exhaustion, there is a considerable weakness and apathy, skin becomes dry and pale, sometimes with a subtle icteric shade, pulse to 100 beats per minute becomes frequent, the arterial pressure (AP), perhaps slight increase of temperature to 37,5 º decreases; With, the amount of the emitted urine to 900 ml a day decreases, there can be locks. At inspection the following changes come to light: in the general blood test - small decrease in hemoglobin (the substance transferring oxygen), in the general analysis of urine - increases relative density, urine becomes more concentrated from - for dehydration, and ketone bodies (substances which are formed as a result of violation of an exchange of carbohydrates) appear; in biochemical blood test increase in the general bilirubin (the pigment developed in a liver) comes to light that demonstrates violation of work of a liver. Treatment of toxicosis of average degree is carried out only in a hospital. At timely treatment the forecast, as a rule, favorable.by
Toxicosis of heavy degree (excessive vomiting) meets seldom. Constant nausea, vomiting to 20 times a day with the raised salivation is characteristic of this state. The general condition of the woman heavy, is broken function of all important bodies and systems. Loss of weight more than 5 kg, there are headaches and dizzinesses, skin becomes dry and flabby, language and lips dry, temperature increases to 38 º With, pulse is more often than 100 beats per minute, systolic HELL is lower than 100 mm of mercury., in days less than 700 ml of urine are allocated. In the general blood test the quantity of leukocytes and a gematokrit (the volume of elements of blood in relation to plasma) at the expense of dehydration increases and a condensation of blood, in the general analysis of urine a large number of ketone bodies, and also protein (it is normal of protein in urine is not present) is defined, in biochemical blood test reduction of protein, cholesterol, potassium, chlorides and increase in the general bilirubin, urea, residual nitrogen is noted (that demonstrates violation of work of kidneys and a liver). In this case treatment is carried out only in a hospital.
As nausea is not the specific symptom characteristic only of pregnancy, consultation of the doctor is often necessary for an exception of other pathology.Treatment Treatment of nausea and vomiting of pregnant women of easy degree should begin
with change of nature of food and observance of a work-rest schedule.should be begun Every day with
- slowly: not to jump from a bed on a call of an alarm clock and to try not to make since morning of sharp movements. To refuse morning exercises (as inclinations, squats and other movements can cause activation of the emetic center). In order that there was in the morning an opportunity to lie down in a bed, it is necessary to set an alarm clock for 10 - 15 minutes before usual. Having woken up, it is necessary to lie down in a bed of 5 - 10 minutes and to stretch slowly. Without getting up, in a prone position it is necessary to eat the beds which are in advance prepared and lying near crackers, ship`s biscuits, nutlets or dried fruits.
- Is at early toxicosis it is necessary often (not less than 5 - 6 times a day), but in the small portions. It is not necessary to overeat and starve, you should not refuse food at all even if does not getting hungry at all. At itself it is always necessary to have something, than it is possible to have a bite, for example a bag of crackers or a small bottle of drinking yogurt. At the same time it is necessary to refuse greasy, spicy and fried food completely. Also it is necessary to exclude hot and very cold food as it irritates a stomach and can strengthen nausea. It is necessary to give preference to dishes, protein-rich and carbohydrates (porridges, boiled meat, cottage cheese, potatoes), and it is obligatory to include vegetables and fruit dishes in the diet. It is impossible to drink much (more than 200 ml) liquids at one time. It is the best of all to use alkaline not carbonated mineral water, kissels.
- Should refuse smoking as it not only can exert negative impact on pregnancy development, but also provokes nausea and vomiting.
- needs to avoid pungent and strong smells, it is possible even to refuse temporarily otdukh, deodorants, the flavored cosmetics and means of household chemicals with a pungent smell. At intolerance of smells of powders and cleaners it is the best of all to ask the family to help you about the house. And also it is necessary to replace toothpaste if it causes unpleasant feelings. As a rule, toothpaste with easy mint taste is well transferred. Whenever possible it is necessary to avoid the close, stuffy, smoked rooms and not to use public transport in rush hours. Do not hesitate to ask to give way to you. >
- it is obligatory for li to observe a work-rest schedule, not to overtire. It is necessary to sleep not less than 8 - 10 hours a day. If necessary to have a rest in the afternoon. Weakness and fatigue promote development of nausea.
- Try to avoid stressful and conflict situations at work and at home, distract from disturbing, unpleasant thoughts - walk, go to the cinema or on a visit, call the best friend. by
- When developing nausea make a slow deep breath and an exhalation. Deep breath promotes easing or disappearance of nausea. Use an aromatherapy: apply several drops of ginger, bazilikovy or lemon oil on clothes or add to shower gel. The substances which are contained in these oils promote reduction of nausea.
- Make ginger tea. To prepare ginger tea, it is necessary to fill in 1 h a spoon of the crushed ginger of 200 ml of boiled water and to insist within 20 - 30 minutes. It is necessary to drink such tea not to a thicket than once at four o`clock as the high dose of ginger can raise a uterus tone.
From medicines 6 vitamin B (Pyridoxine) and preparations, containing magnesium (Magne - In 6 , Magnerot), an antivomitive Metoklopramid (Tserukal). So, if toxicosis of the first half of pregnancy of average and heavy severity at which the general condition of the pregnant woman is broken develops, hospitalization in a hospital and carrying out parenteral therapy (intravenous and intramuscular administration of drugs) for the purpose of suppression of nausea and vomiting, normalization of the general state and restoration vodno - mineral structure and all types of a metabolism is obligatory. The preparations normalizing function of the central nervous system and the blocking emetic reflex (Tserukal), infusional therapy are for this purpose applied (intravenous slow administration of 1 - 3 l of solutions of glucose, amino acids, salt solutions, such as Trisol. Hlosol, etc.) and the preparations normalizing a metabolism (vitamins. Aktovegin, Hofitol). Improvement of a condition of the pregnant woman, normalization of results of analyses of urine and blood are considered as criteria of efficiency of treatment.
Nausea - the unpleasant feeling in the waiting time of the kid giving a lot of trouble, but, nevertheless, if it is caused by pregnancy, then in most cases does not make any negative impact neither on health of mother, nor on development of the child and most often independently passes by the beginning of the second trimester.