Gravidanza, Malattie

Gestosi in gravidanza: sintomi, cause, cura e prevenzione

gestosi in gravidanza

Gestosi in gravidanza

La preeclampsia, meglio nota come gestosi in gravidanza, è una malattia che può colpire solo le donne incinte e che può essere molto pericolosa sia per il bambino che per la mamma. Quest’ultima può presentare danni agli organi, disturbi alla coagulazione e, se la preeclampsia evolve in eclampsia, convulsioni, emorragie celebrali e morte in gravidanza o durante il parto. Il bambino, invece, rischia di nascere prematuro, perché in caso di gestosi bisogna intervenire con un cesareo d’urgenza. Inoltre, può presentare un ritardo o un arresto della crescita. Di solito la preeclampsia compare all’improvviso dopo la 20esima settimana. Per evitare danni, è necessaria la diagnosi immediata, che è possibile tenendo sempre sotto controllo la pressione arteriosa e i livelli di proteine nelle urine.

Gestosi in gravidanza sintomi

I sintomi della gestosi in gravidanza sono essenzialmente due:

  • presenza di proteine nelle urine a livelli che superano i 290 mg/l,
  • pressione arteriosa che supera i valori di 140 massima e 90 minima.

Non sempre l’aumento delle proteine è sintomo di preeclampsia, anzi, in gravidanza un leggero aumento è da considerarsi normale. Altre cause possono essere anche infezioni delle vie urinarie, come la cistite. In ogni caso, se si riscontrano valori anomali dalle analisi delle urine, è bene consultare subito il medico. Altri sintomi della gestosi, non sempre presenti, sono:

  • mal di testa,
  • forte mal di stomaco,
  • visione di macchie scure o luminose,
  • vista offuscata,
  • oliguria (urine scarse),
  • convulsioni,
  • edema (gonfiore, specialmente alle gambe).

Gestosi in gravidanza cause

Non si sa con esattezza quale sia la causa della gestosi, l’unica cosa certa è che dipenda da un danno alle pareti dei vasi sanguigni della placenta, che funziona male. Di conseguenza essa non trasferisce l’ossigeno e i nutrienti necessari al feto e danneggia la circolazione della gestante. Vi sono, però, alcuni fattori di rischio che rendono una donna particolarmente predisposta a questa patologia, ovvero:

  • ipertensione già prima della gravidanza,
  • diabete,
  • obesità,
  • età superiore ai 40 anni,
  • gravidanza gemellare,
  • sindrome da anticorpi antifosfolipidi (malattia autoimmune)
  • lupus eritematoso sistemico (malattia autoimmune),
  • malattie renali,
  • gravidanza a seguito di procreazione assistita.

gestosi in gravidanza

Gestosi in gravidanza cura e prevenzione

Purtroppo, ad oggi, non esiste una cura per la gestosi, l’unica soluzione è il parto, di solito con cesareo. Rimuovendo la placenta, che non funzionando correttamente è responsabile della malattia, quest’ultima scompare e la salute della mamma migliora progressivamente, tornando alla normalità. Ovviamente, se il parto avviene precocemente, quando lo sviluppo del feto non è completo, il rischio di mortalità neonatale è purtroppo elevato. In questo caso bisogna valutare bene se è il caso di tentare di portare avanti la gravidanza ancora per qualche giorno, con l’aiuto di farmaci che agiscono sui sintomi della malattia. Se però il bambino non riceve più ossigeno e nutrienti, allora è necessario farlo nascere. A volte viene prescritta, in caso di alto rischio di gestosi in gravidanza, l’aspirinetta, ovvero l’aspirina a basso dosaggio. Assunta nelle prime 12-14 settimane di gestazione, ovvero quando la placenta si forma, aiuta a prevenire la preeclampsia. Sempre alle donne a rischio, di solito viene fatto fare qualche controllo in più rispetto alla norma, come la flussimetria doppler delle arterie uterine ed ecografie frequenti, per controllare che la placenta funzioni correttamente e il bambino cresca. Infine, è importante fare l’esame delle urine una volta al mese o più, soprattutto dopo la 20esima settimana.

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