The article is professionally consulted by an Obstetrician-Gynecologist - Department of Obstetrics and Gynecology - Vinmec International General Hospital Phu Quoc
Toxemia in the first trimester of pregnancy is a pathological condition. If not treated promptly, this condition can adversely affect the health of both the pregnant mother and the fetus.
1. Toxemia
Morning sickness is a common sign indicating that a woman is pregnant. The pregnant woman may experience symptoms such as increased salivation and nausea.
However, when these symptoms become more severe and interfere with the mother's daily activities and health, it is referred to as severe toxemia (hyperemesis gravidarum).
Typically, the symptoms of toxemia will subside by the third month of pregnancy. However, if not detected and treated in time, it can pose serious risks to both the mother and child.
Toxemia not only causes fatigue and irritability in the mother but also leads to complications such as seizures, coma, miscarriage, or preterm birth. Additionally, it may impact the health and development of the fetus, resulting in premature detachment of the placenta, fetal distress, or even stillbirth. Postpartum, the infant may suffer from malnutrition, low birth weight, or developmental delays.
The symptoms of toxemia vary among pregnant women. However, the majority will experience symptoms such as:
- Dizziness and fatigue
- Lightheadedness and vertigo
- Nausea and vomiting
Toxemia is classified into two categories:
- Mild hyperemesis gravidarum, characterized by symptoms such as mouth dryness, discomfort, a desire for certain types of food, aversion to rice, cravings for sour foods, or other unusual food preferences.
- Severe hyperemesis gravidarum: includes vomiting, dehydration, metabolic disturbances, and neurological abnormalities.
2. Signs of Toxemia in the First Trimester of Pregnancy
Vomiting is a symptom of morning sickness. However, if vomiting is excessive and accompanied by other symptoms, it may indicate whether the pregnant woman is suffering from toxemia. These signs may include:
2.1. Edema
Typically, edema occurs in the third trimester due to the enlarging size of the fetus, leading to venous compression.
However, edema caused by toxemia in the first trimester presents with distinct signs and symptoms, such as beginning from the lower extremities and ascending to the face or generalized swelling. The pregnant woman may notice a depression left by a finger when pressing on the ankle.
Rapid weight gain is also an abnormal sign in the first trimester. Therefore, pregnant women should be cautious if they experience rapid weight gain, approximately 500 grams per week, and seek medical consultation.
2.2. Hypertension
Hypertension is also a common symptom of pregnant women with toxemia. For those who have not previously monitored their blood pressure, hypertension is identified when blood pressure rises to 140/90 mmHg.
2.3. Proteinuria
Urinalysis is one of the diagnostic methods for toxemia. If the results indicate a high concentration of protein exceeding 0.3 g/L, the pregnant woman requires monitoring and immediate treatment.
In addition to the symptoms listed above, pregnant women should also be aware of other abnormal signs such as anemia, bradycardia, dyspnea, and blurred vision due to retinal edema.
3. Risk Factors for Toxemia
Generally, the following groups are at a higher risk for developing toxemia:
- Pregnant women with hypertension
- A history of heart disease, obesity
- Multiple gestations (twins or higher-order multiples)
- Gestational diabetes
4. Treatment of Toxemia
The treatment of toxemia in the first trimester depends on the severity of the condition. Pregnant women experiencing the aforementioned symptoms should consult a physician for diagnosis and treatment. Early detection and intervention significantly reduce the risks of serious complications for both the mother and fetus.
- If the pregnant woman is diagnosed with mild toxemia, the physician may prescribe antihypertensive medications. Treatment along with dietary modifications—such as a low-sodium diet, avoiding high-fat foods, and ensuring adequate rest—will help alleviate the symptoms. The mother's sleeping position can also impact the fetus; therefore, mothers are advised to sleep on their left side to avoid compromising nutrient supply to the fetus.
- If the pregnant woman suffers from severe toxemia, hospitalization is required for adequate treatment. In cases where the condition endangers the mother’s life, termination of the pregnancy or preterm delivery may be necessary to protect the mother's health.
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