Coma in pregnancy

Coma during pregnancy is a pathological condition that is life-threatening for the mother and child. Let's look at the causes and symptoms of coma, diagnostic and treatment methods, as well as preventive measures to prevent it and the prognosis of coma during pregnancy.

Sometimes the normal course of pregnancy can be marred by a condition that threatens the life of the mother and the unborn child. This condition is called coma during pregnancy. Pregnant women who are at risk are most susceptible to this pathology. If a comatose state is suspected, the gynecologist can perform a cesarean section and prescribe a number of drugs for use in the postpartum period to prevent the development of complications.

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Causes of coma during pregnancy

The causes of coma during pregnancy are very different and depend entirely on the woman's condition, the presence of chronic diseases, age, the general course of pregnancy, and much more. Risk factors have a huge impact on the causes of coma during pregnancy. Risk factors include health, the presence of pathological abnormalities, and chronic diseases. To identify factors that can cause coma during pregnancy and lead to the death of the mother and child, the doctor conducts a full examination of the woman. The risk factors identified are given certain points, which allow the doctor to monitor the condition of the pregnant woman and provide timely medical care.

Let's look at the main risk groups that can cause coma during pregnancy.

1. Liver dystrophy is one of the most common causes of coma during pregnancy. The danger of dystrophy is that the condition of the pregnant woman deteriorates very quickly, and if a coma occurs, then, as a rule, it is fatal for the child. With this disease, a woman's blood pressure rises sharply and physical activity increases.

After this, there is pain in the pit of the stomach and visual impairment. As soon as the blood pressure reaches a critical level, the woman develops a comatose state and coma sets in. The main symptoms of liver dystrophy in a pre-comatose state are a sharp short-term tension of the jaw muscles, convulsions. As soon as the woman regains consciousness, she does not remember what happened to her. Coma attacks can occur one after another and lead to a fatal outcome for the pregnant woman.

2. Diabetes mellitus is a pathological condition caused by an acute lack of insulin. This condition disrupts metabolism, causes glucosuria and hypoglycemia. Women with any type of diabetes, both insulin-dependent and latent, are at risk. During pregnancy, the disease causes generalized degenerative lesions of small and medium-sized vessels. Sometimes swelling and diabetic retinopathy appear, which causes loss of visual acuity and blindness.

Diabetes mellitus during pregnancy causes serious problems with the immune system, which is why a woman is susceptible to various diseases and disorders. This contributes to the development of infectious pathologies that lead to cystitis, pyelonephritis and coma. In order to prevent pathological disorders and coma during pregnancy, a woman should regularly take blood tests and consult a gynecologist about any painful symptoms.

3. Renal failure – pregnancy with kidney disease is problematic, as the kidneys bear a heavy load. Even in completely healthy women, nephropathy appears during pregnancy, which indicates that the kidneys are not coping with their work. During the period of pregnancy planning, a woman should undergo a full examination and consult a gynecologist.

Only supportive therapy and regular check-ups can help prevent renal coma during pregnancy. If a woman has chronic renal failure, there is a high probability of developing not only a coma, but also a miscarriage. The main symptoms that signal a comatose state are: hyperglycemia, problems with the genitourinary system, pathological increase in diuresis.

4. Eclampsia is a pathological condition that occurs due to liver dysfunction and acute liver dystrophy. The pregnant woman feels anxious, has severe and sharp headaches, and is prone to bleeding and pain in the liver area. In a pre-comatose state, the woman experiences cramps and stiffness of the neck muscles. Twitching of the facial muscles is observed and the cramps gradually spread to the upper limbs. The cramps are short-term and very dangerous for the fetus, as they can lead to respiratory arrest and death of the child. After the cramps stop, the pregnant woman regains consciousness, but does not remember anything about the seizure. In very severe cases of eclampsia, the woman does not come out of the coma.

In order to prevent eclampsia, a woman should undergo regular check-ups and monitor her health. Nutrition is of great importance, the diet should be complete (proteins, carbohydrates, fats). Do not forget about maintaining the water balance in the body, as this is the key to the health of not only the woman, but also her future child.

5. Nephropathy of pregnancy and cerebral stroke

Nephropathy and stroke most often occur in pregnant women who suffer from atherosclerosis or have hypertension. Due to the disease, the pregnant woman experiences swelling and blood circulation problems, and changes occur in the urine. Coma due to stroke develops suddenly. The woman does not experience convulsions or motor restlessness.

Nephropathy of pregnancy and cerebral stroke cause persistent unilateral paralysis, which progresses rapidly. Pre-comatose condition causes hyperemia of the face, i.e. sharp redness due to overfilling of blood vessels. The left ventricle of the heart is hypertrophied; the pregnant woman develops paresis (a neurological syndrome that causes weakening of voluntary movements due to damage to the motor centers of the brain or spinal cord).

6. Hypoglycemic coma

Hypoglycemic coma is a dangerous condition for a pregnant woman, which occurs due to a critical decrease in blood glucose levels. In the initial stages of the disease, a woman often experiences headaches, hunger, and dizziness. In diabetics, hypoglycemia causes convulsions, spots before the eyes, and loss of consciousness. Hypoglycemic coma during pregnancy occurs due to incorrect insulin dosage or failure to comply with the rules for using the drug. Irregular meals, increased physical activity, severe stress, and alcohol consumption are the main causes of hypoglycemic coma during pregnancy.

A comatose state may occur in early pregnancy, with liver failure, surgery, and infectious diseases. Hypoglycemic coma develops very quickly, causing pale skin, loss of consciousness, profuse sweating, convulsions, and vomiting. In a comatose state, the pregnant woman maintains normal breathing and blood circulation, while blood pressure is elevated. The danger of such a coma for a woman is that the pre-comatose state is poorly diagnosed and can cause a miscarriage; less often, a coma causes the death of a woman.

7. Hyperglycemic coma

Hyperglycemic coma is a pathological condition that occurs in pregnant women with diabetes. Coma is caused by a lack of insulin. The concentration of glucose and toxic metabolic products in the woman's blood increases. In a pre-comatose state, a woman feels weak, thirsty, sleepy, and has rapid breathing and a rapid pulse. After this, the pregnant woman loses consciousness and falls into a coma. In a comatose state, blood pressure is very low, and the limbs twitch.

The main causes of hyperglycemic coma are failure to comply with the insulin dosage, the woman does not adhere to the diet or has an infectious disease. In pregnant women who have a latent form of diabetes, that is, do not suspect their pathology, coma can lead to death, both the child and the mother.

In addition to the above-described reasons, coma during pregnancy can occur due to anemia, cardiovascular diseases and circulatory system disorders, varicose veins and thrombosis, brain injuries and damage, allergic reactions, infectious diseases, use of antibiotics and medications, tumors and other pathologies of the body.

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Symptoms of Coma During Pregnancy

Symptoms of coma during pregnancy manifest as a growing pathological condition of a woman, which is related to the risk group. Growing symptoms lead to suppression of brain functions and development of seizures and fainting, i.e. pre-comatose condition. Eclampsia can occur both in the first weeks of pregnancy and in the last trimester. Let's consider the main stages and symptoms of coma during pregnancy.

• Short-term muscle spasms of the body, face, eyelids, trembling. Sometimes breathing stops.
• Strong muscle tension, rigid jaw clenching. Pupils dilate sharply, then eyes roll back.
• Rapid muscle contractions that are followed by heavy, deep breathing of the pregnant woman.

After the above symptoms, a state of coma sets in. The woman is unconscious, breathing noisily. With liver dystrophy, foam with blood flows from the mouth, such a condition is observed in coma due to cardiovascular insufficiency. After a while, the heartbeat normalizes, the skin acquires a normal color.

When the woman comes to, she cannot remember the attack. In some cases, the pregnant woman does not come out of the coma or the attacks are repeated many times, this may be a direct indication for termination of pregnancy or cesarean section (depending on the term of pregnancy). Without timely medical care, the comatose state ends in a fatal outcome for the woman and death for the child.

Diagnosis of coma during pregnancy

Diagnosis of coma during pregnancy is based on the symptoms that appear. It is by the symptoms that the causes of coma can be determined. Diagnosis of coma during pregnancy is based on instrumental and laboratory studies. As soon as the gynecologist has identified a woman as a risk group, the pregnant woman should regularly take tests and undergo diagnostics. This is necessary so that the doctor can react to the pre-comatose state in time and provide timely medical care.

If a pregnant woman falls into a coma without any apparent reason, the doctor's job is to examine the woman and identify the cause. To do this, the pregnant woman takes a blood and urine sample, conducts a biochemical blood test and an analysis of glucose, bilirubin, creatine, and liver enzymes. The doctor conducts an examination of the thyroid gland and a tomography of the brain. In extreme cases, the doctor takes cerebrospinal fluid and an electroencephalogram. An ultrasound examination is mandatory to diagnose the condition of the fetus.

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Treatment of coma during pregnancy

Treatment of coma during pregnancy begins with immediate medical care. Treatment takes place in a hospital setting and depends on the causes that caused the comatose state. It is mandatory to provide emergency measures aimed at stopping vomiting, maintaining blood circulation and breathing.

• If a diabetic coma occurs during pregnancy due to high blood sugar levels, the woman is given insulin intravenously. If the coma occurs due to low blood sugar levels, a glucose solution is administered for treatment. In case of a coma caused by intoxication, the pregnant woman undergoes forced diuresis.
• In case of uremic coma, i.e. coma against the background of renal failure, the woman undergoes hemodialysis, the blood is purified using an artificial kidney apparatus. As a rule, after such a coma in a pregnant woman, the child does not survive.
• If a coma during pregnancy is caused by an injury that requires surgical intervention, the doctor's task is to monitor the normal blood supply to the mother and baby. In case of severe convulsions during a coma, the pregnant woman is given Phenytoin (anticonvulsant) intravenously. But the use of the drug is possible only if the therapeutic effect for the mother is much more important than the life of the child.
• In case of eclampsia, the Stroganov method of treatment is used. The method involves completely isolating the woman from any irritants. The pregnant woman is given intravenous medications to lower blood pressure, and bloodletting is performed if necessary. Please note that narcotic drugs are used for treatment, so if a coma occurs in the last trimester of pregnancy, the woman undergoes a cesarean section to save the child. In case of a comatose state in the early stages, the doctor aborts the pregnant woman. If the pre-comatose state recurs after treatment, the woman undergoes a spinal canal puncture to stabilize the condition.
• In case of hypoglycemic coma, it is necessary to call an ambulance immediately. If the comatose state is not deep, the woman is given water or tea with sugar to ease the condition. If swallowing is difficult, a little honey or jam should be placed under the pregnant woman's tongue. But this should be done very carefully, since in an unconscious state a woman can easily choke. It is strictly forbidden to administer insulin before the arrival of doctors, since this can worsen the condition of the pregnant woman.
• In case of hyperglycemic coma, it is necessary to call an ambulance, lay the woman on her side and ensure normal air flow. Treatment is carried out in a hospital setting, in intensive care. Doctors restore the level of insulin in the blood and electrolyte balance.

Prevention of coma during pregnancy

Prevention of coma during pregnancy depends on the potential risks of its occurrence. If the coma is caused by circulatory disorders, the doctor's task is to prevent the pathological condition and, if necessary, restore blood flow as quickly as possible. If there is a risk of developing a diabetic coma, the pregnant woman's task is not to skip meals and administer insulin.

In the prevention of hyperglycemic coma, a pregnant woman should monitor blood glucose levels, administer insulin, and follow a diet. Timely treatment of infectious diseases is mandatory. A woman should limit physical activity to prevent injury. Similar preventive measures should be taken if hypoglycemic coma is suspected. Prevention of eclampsia involves limiting physical activity, following a dietary diet, and regularly consuming vitamins and proteins. A woman should often be outdoors.

Preventing coma during pregnancy involves regular check-ups and tests. This will allow doctors to monitor the health and body of the pregnant woman and promptly respond to potentially dangerous conditions that can cause coma.

Pregnancy Coma Prognosis

The prognosis of coma during pregnancy depends on the gestational age, the woman's age, the cause of the comatose state, and the time elapsed from the onset of the attack to the provision of medical care. Particularly dangerous to the life of the woman and the baby are symptoms of a decline in the work of the cardiovascular system and a weakened pulse, high temperature, critically high or, conversely, low blood pressure, sugar and glucose levels in the blood.

Such symptoms cause the development of collapse, which is accompanied by a drop in blood pressure, a decrease in diuresis and increased pallor of the skin. A positive prognosis for coma during pregnancy allows you to save the life of the baby and the woman. With a negative prognosis for coma during pregnancy, the woman undergoes a cesarean section or terminates the pregnancy; in the worst prognosis, coma causes the death of the pregnant woman herself.

Coma during pregnancy is a dangerous condition that threatens the life of the child and mother. To prevent a comatose state, a woman should monitor her health, undergo regular examinations, take tests and undergo preventive procedures prescribed by a doctor.