EARLY GESTOSIS AS A CAUSE OF SEVERE NEUROLOGICAL DISORDERS IN PREGNANT WOMEN (LITERATURE REVIEW AND CLINICAL CASE)

Abstract

Relevance: Despite the significant advances in modern medical science, some practical cases are still difficult to diagnose and treat since they require awareness in various fields of medicine. Such conditions include vomiting in pregnancy, ICD-10 code O21 (lat. hyperemesis gravidarum) - an early gestosis-related pathological condition of the first half of pregnancy. This complication is a common symptom in pregnancy; however, some cases require inpatient care. Generally, an earlier onset of vomiting in pregnancy predetermines its more severe course. Wernicke’s encephalopathy (WE), a rare neurological syndrome with a severe course, can be a complication of excessive vomiting in pregnancy. An inattentive and unprofessional attitude to these symptoms at the PHC level can have tragic consequences for the woman and the child. The study aimed to increase the clinical awareness of the medical community regarding Wernicke’s encephalopathy, its diagnosis criteria and treatment direction. Methods: The study included the analysis of special literature on WE pathogenesis, diagnosis and treatment, and the analysis of medical documentation on a clinical case of severe early gestosis complicated by WE. Results: WE is manifested by a triad of symptoms: ophthalmoplegia, ataxia, and Korsakov’s syndrome. WE can result in significant complications, including fetal pathologies, namely congenital malformations. WE prognosis depends on timely diagnosis and initiation of treatment. High morbidity (80%) and mortality in pregnant women (10-20%) and fetus (50%) prompts a detailed study of this pathology. Parenteral administration of vitamins (thiamine) in the early stages of the disease contributes to an almost complete recovery of the gravida. Long-term administration of thiamine in large doses is efficient as monotherapy during intensive therapy. Conclusion: Timely administration of thiamine in combination with other means of intensive therapy can safely prevent damage to the subcortical structures of the brain and the disability of mothers and their children.