Nephropathy pregnant

Nephropathy pregnant is one form of late toxicosis of pregnancy. The main clinical signs nephropathy pregnant are swelling, hypertension and proteinuria (see).
At first usually occur swelling, then increased blood pressure and protein appears in the urine.
The appearance of any two of these symptoms of toxaemia shows the development of nephropathy.
Swelling is usually initially hidden, then visibly begin to swell legs, face, hands and fingers. Pregnant themselves often say that the ring is hardly removed from the finger, shoes becomes a close. By pressing a finger on the shins remain "dimples". Rapidly increasing body weight.
In the first three months during normal pregnancy, the increase of weight takes place relatively slowly. Intense weight increases during the second half of pregnancy (from 400 to 500 g per week), and at the end of pregnancy weight gain again slightly slowed down, averaging 300 - 350 g per week. With a more rapid increase in body weight pregnant should be examined.
Every pregnant in the first call should be to investigate urine protein. In the early stages of pregnancy urine tests should be done every month, with 20 to 32 weeks every 2 weeks, and with the 32nd week of pregnancy - weekly. If protein in the urine than 0.1%, and it is possible to assume the existence of a toxicosis. Nephropathy can occur in the normal figure blood pressure. Improvement towards the end of pregnancy to 130/80 mm RT. Art. is within the upper limit of normal. In early detection of toxicity the most important are not absolute maximum arterial pressure, but the pressure increase compared to the original. Therefore, the blood pressure should be assessed in the dynamics throughout pregnancy.
For timely diagnosis nephropathy pregnant it is necessary to take into account the pulse pressure. The latter is defined by the difference between the maximum and minimum pressure. Normal pulse pressure is 40-50 mm RT. century; the reduction of pulse pressure (see Blood pressure) in the later stages of pregnancy up to 30 mm RT. Art. and below should be seen as a sign that precedes the appearance of late toxicosis.
If you suspect late toxicosis should refer the patient to an ophthalmologist for the study of the eye.
Nephropathy pregnant women often has an adverse impact on the prenatal development of the fetus. The growth of the uterus when nephropathy pregnant may fall behind in connection with a small amount of water and small weight of the fetus.
Newborn babies can be born geotrupinae (normal length of the body with low weight). Particularly severe nephropathy pregnant result in intrauterine fetal death, so in severe nephropathy and the failure of therapy may have artificially induce premature birth.
Treatment. Every pregnant with signs of late toxicosis necessary assistance obstetrician-gynecologist. Conditions of independent work midwives in rural areas (rural health post, collective maternity hospital) sometimes require preventive and curative interventions on pregnant with nephropathy before arrival of the doctor: bed rest, complete rest, restriction of fluid intake; to appoint a salt-free diet, intramuscular injections 25% solution of magnesium sulfate (10 ml), measured 2 times daily blood pressure. Treatment of this form of toxicity is also the prevention of further, more severe form of it - eclampsia (see).
Of great importance for the prevention of nephropathy pregnant is the timely registration of all pregnant and systematic monitoring of their health and pregnancy. The midwife must follow a systematic visits to pregnant women counselling and, if necessary, to pursue an active patronage. The midwife should advise pregnant women to follow a diet with restriction of salt intake of food and liquid. Special attention should be given to pregnant women, who are most likely to appear late toxicosis: at the first pregnancy in young and older women, in the presence of polyhydramnion, multiple pregnancy, narrow pelvis, obesity. The most severe nephropathy pregnant observed when combined with essential hypertension, chronic nephritis, diabetes mellitus. Cm. also Toxicosis of pregnancy.