Treatment and prevention of acute respiratory infections and influenza in pregnant women - Let's preserve the health of women

The second trimester of pregnancy is a wonderful and at the same time responsible time. Toxicosis and worries were left behind. The expectant mother gets used to her “interesting” position and even enjoys it. The belly is already noticeable, but does not restrict movement yet. Skin and hair become amazingly beautiful, and your health improves.

Yes, and doctors do not particularly restrict either nutrition, lifestyle, or habits. It is believed that almost anything is possible in the 2nd trimester of pregnancy! Is it so? What should an expectant mother pay attention to? And what is actually possible for pregnant women in the second trimester, and what is still not allowed? Obstetrician-gynecologist at the Women's Medical Center, Candidate of Medical Sciences Evgeniy Petreikov these questions from FAN .

Multivitamins

A pregnant woman needs more vitamins, and even a balanced diet during this period cannot fully satisfy the body’s need for vitamins and microelements. It is best to take multivitamin preparations designed specifically for pregnant women. A doctor will help you choose such a drug. However, if various complications occur during pregnancy, your doctor may prescribe you the following medications in addition to the multivitamins you take:

folic acid - vitamin B9, which is recommended to be taken before the 12th week of pregnancy, because its deficiency can lead to anemia, blood clotting disorders, and fetal malnutrition. A sufficient amount of folic acid will ensure the correct formation of the fetal neural tube, from which the baby’s nervous system will then be formed;
Vitamin E performs an important protective function in the body, fighting free radicals - metabolic products that destroy cells; in addition, it helps to relax the muscles of the uterus during pregnancy, thereby preventing its interruption;
During pregnancy, the need for iron , because this microelement is part of hemoglobin, which ensures the delivery of oxygen to the body not only of the mother, but also of the fetus. It is quite difficult to satisfy this need by simply adjusting the diet;
calcium ensures proper growth and formation of fetal bone tissue. If calcium is supplied in insufficient quantities from food, it is “taken” from the mother’s bones, which leads to a disruption of their structure - osteoporosis, deterioration of the condition of the teeth. Therefore, in some cases, pregnant women are recommended to take calcium supplements. Often such preparations also contain vitamin D, which helps improve the absorption of incoming calcium.

Your doctor will determine the right dosage and duration of taking these medications, because they are individual for each woman and depend on the severity of pregnancy complications.

Fetus in the second trimester of pregnancy

The second trimester begins from the 14th week of pregnancy and lasts until the 28th week. At this time, the formation of the child’s internal organs ends. The baby already has all the organs and systems like an adult: the brain, spine, limbs, subcutaneous adipose tissue and even the papillary pattern on the fingertips - future imprints. The child grows and develops daily, and his internal organs develop along with him.

At week 14, the liver produces bile for the first time, and the pancreas begins to produce the hormone insulin. The activity of the endocrine glands increases. If until this time only her hormones were present in a woman’s body, then in the second trimester they are “supplemented” with the child’s hormones. They are produced by the baby’s maturing thyroid gland, pancreas, and adrenal cortex. For this reason, doctors closely monitor the hormonal levels of the expectant mother.

“If a woman’s body produces insufficient amounts of thyroid or pancreatic hormones, the fetus releases its hormones,” comments obstetrician-gynecologist Evgeniy Petreikov. — Disorders of the thyroid gland in the mother increase the risk of developmental delays in the fetus. If a woman has missed diabetes mellitus, it is not corrected with diet and medications, this increases the load on the child’s pancreas. There is a high probability that the baby will develop diabetes mellitus in the first or second year of life.”

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No-shpa

This is an antispasmodic drug that is used during pregnancy to increase the tone of the uterus. The effect of the drug is based on relaxation of the muscle muscles of the uterus. Clinical studies have proven that no-spa does not have an adverse effect on the fetus. Doctors recommend having this drug with you and using it if there are signs of increased uterine tone (painful sensations in the abdominal area, when the uterus becomes hard and dense and does not relax for a long time). It is recommended to take no more than 6 tablets of no-shpa per day. Before you start taking no-shpa, you should consult your doctor, since this drug cannot be taken if you have symptoms of isthmic-cervical insufficiency.

Colds during pregnancy: how to treat?

Any cold or respiratory disease in the early stages of pregnancy, during the primary formation of the fetus, can lead to unpredictable consequences and complications. The matter is complicated by the fact that most medications are absolutely contraindicated for use during pregnancy.

In this regard, treatment and prevention of colds in pregnant women is an important issue that should be approached especially responsibly! The main message is: be careful with medications and use gentle preventative measures based on alternative medicine methods to avoid respiratory diseases and flu.

"One for two - immunity"

This is a very fragile system; there is no need to interfere with its work, but it is necessary to support and strengthen it. Pregnancy belongs to the category of special, even temporary, conditions during which a woman needs additional protection.

Simple recommendations that are available to everyone will help in this matter:

• During periods of frequent weather changes, it is necessary to dress warmly, paying special attention to shoes. • During an epidemic, it is better for a pregnant woman to refrain from being in crowded places - transport, metro, shops and hospitals. If there is an urgent need, to prevent possible infection, you should wear a protective respiratory mask before leaving the house.

• It is necessary to observe the rules of hygiene especially carefully after visiting the street and public places. When you return home, the first thing you should do is wash your hands thoroughly.

Interesting:

More than 90% of all acute respiratory infections are caused by viruses, about 10% are caused by bacteria and other pathogens.
Accordingly, you can use any soap, not necessarily antibacterial. • Before going outside, you can lubricate the nasal mucosa with oxolinic ointment.
Upon returning home, rinse the upper respiratory tract with soda solution. • Rationalization of nutrition and intake of vitamins will strengthen immune defense. Eating fruits and vegetables that are enriched with vitamins and have not undergone heat treatment is especially beneficial.

Interesting:

Our grandmothers also said: in order not to get sick, you need to drink chicken broth! Strange, but until recently scientists did not attach much importance to this preventive measure. Pulmonologist Stefan Rennard decided to find out whether this is true or not. The professor conducted a study and proved that drinking chicken broth affects the mobility of neutrophils, white blood cells that protect the body from infections and activate the immune system.

Vitamins can be taken using ready-made pharmaceutical multivitamin complexes. Before choosing a drug, you should consult your doctor.
Compliance with sleep schedule and duration - at least 9 hours a day. The possibility of traumatic situations should be minimized.
Maintaining cleanliness in the living area (ventilation, wet cleaning).
Air humidification is an important aspect in preventing flu and respiratory diseases. If a pregnant woman's home uses air conditioners or heaters, it would be best to purchase a mechanical humidifier.

Preventive medications

Grippferon is a drug in the form of nasal drops that prevents and treats influenza and is not contraindicated for pregnant and lactating women. The medicine stimulates increased immunity and has a pronounced antiviral effect that can protect against colds, infections and types of influenza.
Ascorbic acid - can be used as a separate source of vitamin C in a synthetic version, with a reduced daily intake from food. Ascorbic acid not only prevents infection, but also fights viruses that have already entered the woman’s body.
Viferon is a nasal ointment that is prescribed to prevent influenza and respiratory infections during an epidemic. The ointment has protective and immunomodulatory effects, and also allows you to fight disorders that are already occurring in the body at the time of use. Viferon in the form of nasal ointment has no contraindications for use in pregnant women at any stage, including the first trimester.
Aquamaris is a natural medicinal preparation in the form of a nasal spray that allows you to moisturize the nasal mucosa, thereby reducing the risk of influenza viruses entering the nasal cavity.

I would like to say a few words about such a prevention method as vaccination.

Most often, the expectant mother may be at risk of becoming infected due to the annual
flu epidemic
. This disease is dangerous for a pregnant woman precisely because of its complications: pneumonia, bronchitis, otitis media. Flu in a pregnant woman can also affect the health of the fetus. It is most dangerous in the early stages of pregnancy, when the tissues and organs of the human embryo are laid and formed. Viral intoxication or drug exposure can lead to pathology of the child’s organs. In later stages of pregnancy, there is a risk of infection of the fetus.

The most dangerous consequence of the flu in a pregnant woman is a threatened miscarriage or premature birth!

It is quite natural that expectant mothers often wonder whether or not to get vaccinated.

According to the conclusion of the studies, the use of inactivated (“killed”) influenza vaccines does not have a teratogenic effect on the fetus and does not harm the health of a pregnant woman. After consulting with your doctor about such a vaccination, you can come to the optimal decision.

If a flu epidemic is inevitable and a pregnant woman has no contraindications, then the vaccine should be given. If a pregnant woman has a negligible risk of infection, she does not come into contact with a large number of people, or is opposed to vaccination, then you don’t have to do it. According to research results, it is known that vaccinating a mother reduces the risk of influenza infection in a newborn child by 63%. Seasonal prevention of influenza is carried out in September and October. Vaccinations for pregnant women are recommended from the second trimester of pregnancy.

During the period of planned pregnancy, the flu vaccine is given 1 month before it: the formation of immunity occurs in 2–4 weeks. Protection after vaccination lasts about a year.

If infection does occur, action must be taken immediately if at least one symptom of the disease is detected. The health of a pregnant woman and her unborn child depends entirely on her responsibility and careful attitude towards her own body.

Proven folk remedies will be the first to be used. Since pregnant women should not steam their legs, steam your arms and this will make nasal breathing easier. Wrap yourself up, put on woolen socks and crawl under the blanket: warmth, peace and sleep are good for colds. Don't forget to drink plenty of fluids - hot green tea with lemon and honey, tea with linden blossom, cranberry juice, rosehip infusion, dried fruit compote. Ginger in the form of tea also helps, not only with catarrhal symptoms, but with nausea in the morning.

Various hot milk drinks are also suitable. You can add honey to milk, and it is best to cook it on onions. It should be emphasized right away that not all herbs can be used for colds during pregnancy. Here is a list of medicinal plants that are contraindicated: aloe, anise, barberry, elecampane (herb and root), sweet clover, oregano, St. John's wort, strawberries (leaves), viburnum (berries), raspberries (leaves), lemon balm, lovage, wormwood, licorice ( root), celandine, sage. Accordingly, you should not take medications containing these plants.

The use of medications for colds during pregnancy must be treated with great caution!

The following drugs are contraindicated

: Pertussin, Tussin plus, Joset, Glycodin, Ascoril, Travisil, Broncholitin, ACC, Grippex, Codelac, Terpincode. You should not use lozenges and lozenges for a sore throat or cough; they are also undesirable due to the likelihood of developing allergic reactions.

Pinosol spray, judging by the components indicated in the instructions, is not dangerous during pregnancy. However, the essential oils contained in the drug - Scots pine, peppermint, eucalyptus, thymol, guaiazulen (citvarum wormwood oil) - can lead to an allergic reaction with swelling of the nasal mucosa.

Viferon suppositories can be used only after 14 weeks from the start of conception. This drug contains recombinant human interferon alpha-2, ascorbic acid and alpha-tocopherol acetate and has antiviral, immunomodulatory and antiproliferative effects. It is used in the treatment of various infectious and inflammatory diseases of adults and children (including newborns). In the form of an ointment, Viferon is used to treat herpetic lesions of the skin and mucous membranes. The ointment is applied in a thin layer to the affected areas of the skin 3-4 times a day for 5-7 days.

The homeopathic drug Stodal, which includes mainly herbal ingredients, affects various types of cough and has an expectorant and bronchodilator effect.

Viburkol - homeopathic suppositories - have analgesic, anti-inflammatory, sedative, antispasmodic effects. They are prescribed in the complex therapy of acute respiratory viral infections and other uncomplicated infections (including in newborns), as well as in inflammatory processes of the ENT organs and inflammatory diseases of the genitourinary system.

So, you can try to eliminate a slight ailment on your own, but there are conditions under which you need to call a doctor at home:

Prolonged increase in body temperature;
Myalgia, feeling of tiredness, increased fatigue, general broken state;
Difficulty breathing, the appearance of lumps in the nasopharynx and a dry or wet barking cough;
A pregnant woman is worried about a severe pressing headache.

In conclusion, I would like to emphasize the importance of treating chronic diseases before pregnancy, a healthy lifestyle while carrying a child, and following all doctor’s orders.

I wish expectant mothers and their loved ones to try to maintain a good mood: optimists live longer and happier, they are more productive. Remember your victories and pleasant moments more often and everything will be fine!

Drugs for the treatment of hemorrhoids

Constipation that often occurs during pregnancy can provoke the development of hemorrhoids - varicose veins of the anus and rectum in the form of painful nodes and lumps that begin to bleed during bowel movements. You can use rectal suppositories and Gepatrombin , suppositories with novocaine after 12 weeks of pregnancy. While taking these medications, the hemorrhoids will become smaller and the pain will go away. In addition, hepatrombin will also have a preventive effect: its use sharply reduces the risk of relapse of the disease.

2nd trimester screening

Health control is extremely important for the expectant mother. Regular examinations and tests prescribed by the doctor are necessary to ensure that the pregnancy is proceeding normally and the child is developing correctly.

This is the purpose of the second screening during pregnancy. The optimal time for its completion is in the 18th week, the recommended time interval is from the 17th to the 20th week. During screening, a woman will need to undergo blood and urine tests and an ultrasound. Doctors focus on:

hormonal examinations;
monitoring the function and condition of the kidneys;
hemoglobin level in the blood to eliminate the risk of iron deficiency anemia;
anatomical ultrasound examination of the fetal anatomy.

“In the first trimester, we do an analysis of the level of glucocorticoid hormones,” explains Evgeniy Petreikov. — In the second, we take this hormone again and look at the dynamics. If abnormal glucocorticoid levels are detected, replacement therapy should be prescribed as early as possible to reduce the risk of developmental delays, late miscarriage and premature birth.”

To exclude the risk of developing diabetes mellitus in pregnant women, a glucose tolerance test is performed from the 24th to the 28th week. Even if a woman has no prerequisites for developing the disease, she still needs to be examined. The expectant mother is asked to drink a glucose solution and blood is taken after an hour and two hours. Based on the obtained blood glucose levels, a “sugar curve” is constructed. If it passes above normal values, gestational diabetes mellitus is diagnosed. It requires mandatory monitoring by doctors and the woman herself.

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7.Oxolinic ointment

To prevent ARVI and influenza**, especially during epidemics, you can use a product such as Oxolinic ointment . It is placed in a small amount into the nose, lubricating its mucous membrane. The action of oxolinic ointment is based on the fact that it prevents the introduction of the virus. It is recommended to use oxolinic ointment before planning to visit crowded places, as well as in the autumn-winter period. You can use Vitaon .

Medications in the second trimester

Medicines during pregnancy should be used only as prescribed by a doctor. Despite the fact that there are products approved for use by expectant mothers, it is important to remember their side effects and the characteristics of your body.

“20% of the liver cells of a healthy pregnant woman work for the fetus,” says Evgeniy Petreikin. “This means that any drug must be used in the lowest possible dosage. You shouldn’t drink handfuls of pills, as this can cause liver cell damage and intoxication.”

Temperature during pregnancy in the 2nd trimester, which occurs against the background of a cold or viral disease, can be reduced with drugs based on paracetamol and anti-inflammatory, non-steroidal drugs (Ibuprofen, Nurofen). They should be used if the temperature exceeds 38.3 degrees. If it is lower, there is no need to bring it down, since the body fights infection by increasing the temperature.

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These same medications will help with headaches. But they should be taken with caution. Do not use tablets marked "Forte". The amount of active substance in them is increased, and the liver may not be able to cope with the load.

For colds, sore throat, runny nose and nasal congestion in the 2nd trimester you can use:

saline solutions for rinsing the nose - they make breathing easier, help remove mucus and germs from the nasal cavity;
solutions for gargling - any, both pharmacy and homemade;
tablets and lozenges for resorption, sprays for local treatment of the throat.

Plenty of warm fluids and rest are recommended. But nasal drops should not be used in the 2nd trimester. Vasoconstrictor drugs cause temporary spasm of blood vessels, which leads to their subsequent dilation and even greater nasal congestion. In large dosages they can provoke uterine tone.

Antiviral drugs are also not recommended in the 2nd trimester.

“There are no drugs that kill the virus,” says doctor Evgeniy Petreikin. “We just boost our immunity with them.” But now you can’t do this. Due to the way the immune system works during pregnancy, we can provoke the threat of miscarriage and premature birth.”

The specialist advises to increase immunity in a safe way - by taking vitamins. In the 2nd trimester, a woman must take multivitamin complexes. Even with a nutritious diet, rich in fresh vegetables and fruits, there are not enough vitamins in the diet, since they are destroyed during transportation and storage of food. And after heat treatment, there are no vitamins left in the food at all.

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8. Soothing agent

In the first half of pregnancy, given the peculiarities of changes in the excitability of the nervous system, for example, increased tearfulness, irritability, and in the second half of pregnancy, given frequent insomnia, you may need a sedative . In this capacity, we can recommend Valerian and Motherwort (they can be used in the form of tablets, extracts, decoctions of dry herbs). You can use the drug Novopassit , which is based on herbs and does not contain alcohol.

Well-being of the expectant mother and illnesses of the 2nd trimester

As the belly grows, the woman’s body also changes. The uterus increases in size, and after the 12-14th week it emerges from the pelvis. At the same time, the ligaments have not yet stretched, which is why abdominal pain may occur in the second trimester.

Ligamentous pains that seem to pull the uterus down are not dangerous. They do not threaten the healthy course of pregnancy. However, if your stomach feels tight and you experience discomfort and, even more so, painful sensations, you should definitely visit a doctor, even if the date of your next visit has not yet arrived.

Pain in the lower abdomen can have many explanations. In addition to sprains, they can be caused by harmless and natural Braxton Hicks contractions, which usually indicate a woman is overtired, needs rest or changes in body position.

Dangerous conditions can also manifest themselves as pain. For example, uterine tone in the 2nd trimester, in which there is a threat of premature birth. Or inflammatory processes in the kidneys or bladder, which requires specialist consultation and treatment.

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If you experience pain in the lower abdomen, it would be a good idea to visit a doctor. This must be done when:

copious or unusual in color and consistency discharge in the 2nd trimester (white, greenish, cheesy);
increased body temperature without signs of a cold or viral disease;
bloody discharge;
acute pain.

An enlarged uterus puts pressure on internal organs, which can lead to exacerbation of chronic diseases or the development of specific pregnancy conditions. The symptoms of hemorrhoids may increase, so to prevent constipation in the 2nd trimester, it is extremely important to follow a healthy diet rich in vegetables and fruits. And don’t forget about physical activity - it also stimulates intestinal motility.

10.Headache remedies

The question often arises: can a pregnant woman take medications for headaches ? It should be remembered: enduring a headache is much more harmful than taking painkillers (of course, if the headache is not regular, but occasional). If you are experiencing frequent, painful headaches, they may indicate the development of some disease, and you should consult your doctor.

If a similar reason is excluded, you can take a painkiller . The most studied effects on a pregnant woman and fetus are paracetamol and drugs based on it (for example, Panadol ). In small doses or for a short period of treatment, it does not have a negative effect on the fetus.

Non-drug methods

Given the small choice of medications for relieving headaches during pregnancy, it is worth giving preference to alternative methods.

Massage

It has been proven that running your fingers from the frontal part of the head to the back of the head (in one direction only) helps eliminate stagnation of venous blood in the sinuses of the brain. This is explained by the presence of perforating veins on the surface of the head, which are connected to the venous sinuses.

Such a massage for 15 minutes can significantly reduce pain, even eliminating it completely.

For more information on how to get rid of headaches with massage, watch the video:

Neck massage

It is especially effective if your head hurts due to osteochondrosis of the cervical spine. After all, the vertebral arteries pass through the cervical region, compression of which can cause excruciating pain in the head.

Reflexology

Impact on certain points of our body leads to the activation of certain physiological processes. So, for headaches, light pressure on the temporal areas on both sides is effective; you can use light massaging movements in a clockwise direction.

Doctor's advice

Neck massage can only be done in the form of light pressure on the muscles, stroking, and in no case too much. Firstly, movements with intense pressure will cause muscle pain. Secondly, there is always the possibility of a hernia, massage in which is done very carefully.

Victoria Druzhikina Neurologist, Therapist

Pressing on the following points will help relieve headaches: at the base of the inner edge of both eyebrows, the center of the superciliary arches (the exit point of the supraorbital nerve), the middle of the bridge of the nose, the point between the base of the 1st and 2nd fingers of both hands. You need to gently press on each point for 2-3 minutes.

Drinking strong tea with sugar

It is effective to drink a cup of strong tea for headaches associated with low blood pressure. Coffee drinks should not be consumed during pregnancy, as caffeine can cause increased heart rate. Use caution in case of diabetes mellitus and gestational diabetes mellitus, which is common among pregnant women.

Normalization of the daily routine

If a pregnant woman often has headaches, she needs to adjust her daily routine. Normalizing sleep and rest is very important. For example, walking for 15 minutes before bed is very beneficial. Pain will become much less of a problem if you pay due attention to rest.

Taking a warm shower

Promotes relaxation and improves blood circulation in the body.

You should not get carried away with aromatherapy, as some essential oils can cause an allergic reaction.

There are currently at least 50 known reasons why a headache may occur. During pregnancy, the most common are tension headaches, as well as headaches that occur when pressure rises (for example, with severe gestosis).

Despite such a wide range of drugs available on the pharmacological market, during pregnancy their choice is extremely limited. Therefore, during the period of bearing a child, before taking this or that medicine, it is necessary to find out the cause of the headache.

Unsystematic use of pills can negatively affect the baby's development. We must not forget about the serious causes of headaches (vascular aneurysm, pathological tortuosity, space-occupying brain formations). A consultation with a gynecologist and therapist will help you understand the mechanisms of pain, as well as prescribe the necessary medication.

This article has been verified by a current qualified physician, Victoria Druzhikina, and can be considered a reliable source of information for site users.

Bibliography

1. https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-ss-korsakova/2015/11/downloads/ru/591997-729820151118 2. https://journals.eco-vector .com/RFD/article/viewFile/1431/1051
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Antihistamines

During pregnancy, due to changes in immune status, there is a high probability of experiencing certain allergic reactions, even if you have never encountered this disease before. In this case, such well-known drugs as Suprastin, Claritin .

In conclusion, let us remind you: you can use any medications only after consulting a doctor and with extreme caution - up to 12 weeks of pregnancy.

Nadezhda Zaretskaya

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

Magazine “9 months” No. 7 2003

Ultrasound during pregnancy 2nd trimester

Ultrasound examination is carried out at 20-24 weeks. Its task is to clarify the anatomy of the fetus and its healthy development. During the study, the specialist records “anatomical elements”: structural features of the body, the development of arms and legs, the number of fingers. Looks at the condition of the brain, heart, and circulatory system.

During this period, a heart defect can be identified if it has not been diagnosed previously. As well as dilatation of the ventricles of the brain - hydrocephalus.

“Using ultrasound, we can see hemorrhages in the brain, brain cysts,” comments Evgeniy Petreikov. “These conditions will not necessarily lead to severe pathologies of fetal development. During pregnancy, they may go away, but it is important for the doctor to monitor this process and monitor the dynamics of the identified disorders.”

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