Pregnancy reaction
Introduction
Introduction The first manifestation of early pregnancy, that is, early pregnancy is menopause, reproductive age, regular menstrual cycle rules, once the menstrual period is 10 days or more, the pregnancy should be suspected. If the menstruation has reached 8 weeks, the likelihood of pregnancy is greater. Menopause is the earliest and most important symptom of a woman who may be pregnant. Of course, menopause is not necessarily a pregnancy. Lactating women may still be pregnant again without returning to menstruation.
Cause
Cause
Increased HCG in the body, decreased gastric acid secretion, prolonged gastric emptying, and increased estrogen and progesterone.
In the early pregnancy (about six weeks after menopause), the increase of chorionic gonadotropin (HCG) in pregnant women, decreased gastric acid secretion and prolonged gastric emptying, leading to dizziness, loss of appetite, acid or food, or disgusting greasy nausea, morning vomiting, etc. A series of reactions, collectively referred to as pregnancy reactions. These symptoms generally do not require special treatment. After 12 weeks of gestation, as the level of HCG in the body decreases, the symptoms naturally disappear and the appetite returns to normal. But to remind pregnant women that not all vomiting is an early pregnancy reaction.
Because hormones and HCG work together to cause pregnancy reactions in early pregnancy, each person will have different physical changes in pregnancy response according to differences in physical fitness. Popularly speaking, it is not the same individual, and the degree of reaction is different. Symptoms in the early stages of pregnancy generally occur during the period from 6 weeks of menopause to 3 months of pregnancy.
Examine
an examination
Related inspection
Urine pregnancy test (HCG) cervical mucus examination obstetric B-ultrasound test
According to the history, clinical manifestations and gynecological examination for diagnosis, hCG measurement, can be diagnosed early pregnancy, severe symptoms, test urinary ketone body, can be diagnosed as pregnancy vomiting, pay attention to pregnancy and digestive system disease identification.
According to the medical history and clinical manifestations, it is first clear whether pregnancy, if it is definitely a pregnancy, it is also necessary to exclude vomiting caused by digestive system or other diseases of the nervous system. One case has been pregnant in April, but persistent vomiting, extreme weight loss and atrophy, accompanied by Hypokalemia, after gastrointestinal angiography and gastroscopy confirmed the diagnosis of gastric cancer caused by pyloric obstruction improved after surgery. Therefore, in critically ill patients who cannot be explained by hyperemesis in pregnancy, they must be carefully identified with surgical diseases. Occasionally, vomiting may occur due to meningitis, brain tumor or uremia.
After the diagnosis of pregnancy vomiting, it is necessary to determine the severity according to the clinical manifestations. For severe cases, the following examinations are required:
First, the blood check routine and hematocrit to help understand whether there is blood concentration, if possible, the whole blood viscosity and plasma viscosity can be checked for carbon dioxide binding or blood gas analysis to understand the blood pH, alkali reserve and acid and acid balance. It is also necessary to measure serum bilirubin liver and kidney function.
Second, the urine daily calculation of urine volume, urine specific gravity, ketone body for urine three-biliary test.
Third, ECG examination This test is particularly important to avoid, can help to find out whether there is hypokalemia or hyperkalemia and myocardial condition. According to the clinical manifestations of the medical history and gynecological examination, the hCG measurement can confirm the serious diagnosis of early pregnancy, and the ketone body in the urine can be diagnosed as pregnancy vomiting and pregnancy and digestive system diseases.
Diagnosis
Differential diagnosis
Pre-pregnancy response needs to be identified as follows
The diagnosis of viral hepatitis in pregnancy is characterized by the fact that the initial symptoms of hepatitis are similar to those in pregnancy, and are easily ignored by patients and doctors. When symptoms are severe, they are often found to affect prognosis. In addition, the diagnosis of pregnancy complicated with viral hepatitis can not unilaterally emphasize the importance of elevated transaminase, but gastrointestinal symptoms such as nausea, vomiting, loss of appetite, etc. in pregnancy, must think of the possibility of hepatitis, should be asked in detail, such as close contact, Blood transfusion, injection history, etc., and the determination of various liver functions can be discovered and treated in time.
Viral hepatitis is divided into two types: jaundice and no jaundice. The latter is more common, accounting for about 80%, and there are fatigue, anorexia, pain in the liver area, etc., and the course of disease development is slow. Astragalus-type hepatitis has jaundice, sclera and yellow skin staining, and blood bilirubin is increased about one week after onset. This disease should be differentiated from liver cholestasis during pregnancy. The latter complained of light or no complaints. In addition to jaundice, there is often skin itching, transaminase is generally normal, and blood bilirubin rarely exceeds 5 mg%. The symptoms of jaundice may suddenly increase. After 7 to 10 days after onset, jaundice is progressively deepened, persistent vomiting, high fever, headache, especially severe, acute onset, jaundice may not be heavy and hypoglycemia, etc. Substantially serious necrosis, the patient is restless, stunned and into a coma. This kind of severe jaundice hepatitis during pregnancy is also called acute yellow liver atrophy during pregnancy, and the mortality rate is extremely high. Acute yellow liver atrophy should be differentiated from fatty liver in pregnancy. Fatty liver is a sudden disease during pregnancy. The onset is also urgent, the transaminase is not obvious, the blood bilirubin is high and the urinary bilirubin is negative. Jaundice, coma and dehydration, and finally liver and kidney syndrome. The severity of the two is basically the same as the treatment method, and the prognosis is poor. The correct identification is for liver biopsy. The pathological changes of viral yellow liver atrophy are mainly the extensive necrosis of hepatocytes, which is diffuse steatosis of hepatic lobules.
