Pregnancy Toxicosis Following Induced Abortion

Successful Treatment of Pregnancy Toxicosis Following Induced Abortion

In spring 2022, a woman presented to the hospital at 7 weeks of pregnancy.
The patient complained of nausea, frequent vomiting throughout the day, loss of appetite, and weight loss. Her symptoms were particularly severe in the mornings but occasionally bothered her throughout the day.

She reported eating only cucumbers the week before seeking medical attention as they were the only food that did not induce nausea. Her symptoms worsened when exposed to cooking smells.

The pregnancy was desired and planned and occurred spontaneously. Symptoms of toxemia began two weeks before seeking medical attention.

She had been pregnant three years ago but had to terminate the pregnancy at 15 weeks due to severe toxemia and high risk to her health.

The patient had a history of childhood infections and acute respiratory viral illnesses. She also had chronic acalculous cholecystitis and chronic gastritis (in remission before pregnancy).

Physical examination revealed mild skin dryness, a coated tongue. There was slight tenderness upon palpation of the upper abdomen.

On gynecological examination, the uterus was enlarged to 7 weeks of pregnancy, and there were mucous discharges without odor.

Blood tests showed a slightly elevated hematocrit level. Urine analysis detected ketones. Biochemical analysis was within normal limits.

Abdominal ultrasound showed no pathological changes. Pelvic ultrasound revealed progressing uterine pregnancy.

Progressing pregnancy at 7 weeks. Severe pregnancy vomiting.

Exacerbation of chronic gastritis. Chronic acalculous cholecystitis.

The patient was hospitalized in the gynecology department and started on intravenous therapy with saline solutions to restore fluid and electrolyte balance.

She was also prescribed:

  • Cerucal – 2 ml twice daily intramuscularly;
  • Diet for gastrointestinal diseases;
  • Preginor (a dietary supplement).

Despite the therapy, morning vomiting persisted, but the patient noted feeling slightly better. On the third day, Cerucal was replaced with Zofran, also 2 ml twice daily. Nausea disappeared on the first day of switching medications, and appetite returned.

The therapy continued for 10 days, after which Zofran was discontinued. The patient continued taking Preginor and adhered to the diet. She was also referred for psychological counseling due to lingering negative memories of her previous pregnancy termination.

She was discharged from the hospital and continued taking Preginor until the 16th week, until the placenta formed. The woman also attended periodic sessions with a psychologist. Her condition gradually improved, and nausea and vomiting ceased.

At 40 weeks, she gave birth to a healthy boy weighing 3750 g. Both the happy patient and her son were discharged on the 4th day.

This clinical case demonstrates that sometimes “ordinary” toxemia can lead to serious consequences, so treatment should always be comprehensive. It’s important to monitor the patient’s emotional state, as constant vomiting, nausea, and loss of appetite adversely affect the pregnant woman’s mood. If necessary, patients should be referred to psychologists and psychotherapists, explaining to them the importance of such assistance.