How long is the injection injection for light fetus. Prevention of respiratory distress syndrome newborns. Possible consequences for a woman and baby
The hormonal drug Decasamethasone is based on a number of different diseases, since its pharmacological characteristics are based on improving the state of a person as a whole. Use this medicinal tool with extreme caution and exclusively by the purpose of the specialist.
Indications for the use of dexamethasone for pregnant women
Dexamethasone is widely used in the field of gynecology. He is assigned to women who are planning pregnancy and having a childFeatures of the use of dexamethasone when planning pregnancy
As is known, dexamethasone is a glucocorticoid, which is a synthetically created analogue of adrenal cortex hormones. Since the adrenal glands precisely significantly affect the reproductive function of the female organism, the problems on their part often cause difficulties in conception.Most often, the problem is in hyperandrogenation, that is, in increasing the content of men's sex hormones. Hyperandrode has the following symptomatic manifestations: 
- irregular menstrual cycle;
- lack of ovulation;
- strengthening hair growth on the body.
Practice shows that the efficiency of the drug is very high. Gynecologists recall the mass of cases in their practice when pregnancy after dexamethasone occurred almost instantly. Usually, to restore ovulation is sufficiently minimal dosage of the drug, respectively, its negative impact on the body will be minimal.
Features of reception of dexamethasone during pregnancy
Decimetomone during pregnancy is prescribed only with the condition that the therapeutic effect that it has, remains substantially above the risk of negative impact, which the drug can have on the fruit. As a rule, we are talking about quite serious cases in which the use of other drugs is useless.Answering the question, why appoint dexamethasone during pregnancy, it should be noted that on an early time it is often only this drug is able to avoid miscarriage against the background of hormonal failure. The drug normalizes the content of testosterone in the female organism and the risk of miscarriages disappears.
In some cases, hormonal disorders cause the body's immune system failure. And as a result, the woman's body begins to perceive the pregnancy as something alien. The immune process is activated and a serious threat of miscarriage arises. In this case, also comes to help dexamethasone during pregnancy.
Another reason for which a pregnant woman is prescribed a hormonal drug is a threat to life. This may be swelling or exacerbation of autoimmune diseases.
Dexamethasone during pregnancy for lung child disclosure
Dexamethasone in the third trimester of pregnancy is appointed by a doctor to accelerate the disclosure of light developing fetus. Usually we are talking about situations when there is a serious threat to premature birth. As a rule, there are enough two or three days of receiving the drug by a future mother so that the child born ahead of time can breathe independently. No special negative consequences of a short-term reception of such a drug as dexamethasone for lung disclosure has no. In the rare cases and during a long-term drug intake, the child may begin to develop atrophy of the adrenal cortex, but by special treatment, this state without problems is adjusted.Application of dexamethasone
The drug dexamethane is produced in two versions:- the form of tablets;
- in the form of a solution for injection.
Receiving tablets is made in accordance with the recommendations of the doctor who has made an appointment.
Dosage dexametazone
Since dexamethasone during pregnancy must be prescribed by a doctor who leads pregnancy, the dosage of dexamethasone is appointed individually, and the instructions for the use of dexamethasone should be clearly observed. The amount of the drug in each specifically taken case depends on the following parameters:- features of the disease;
- the duration of therapeutic process;
- the patient's body response on therapy.
During pregnancy, the drug is most often used in the morning or before bedtime at half a pill. Initially, higher doses are assigned, which are gradually decreasing to supporting.
Dexamethasone during pregnancy is used for a long time or high doses, it is better to drink it during meals, and in the intervals between meals to use antacids.
A single case of overdose of the drug does not cause any serious consequences, but it is possible to strengthen those side effects of dexamethasone, which depend on the volume of drugs used inside. In any case, with dosages it is better not to dictate. In the case of dexamethasone, no longer means better. The patient, no matter how well it transfers the medicine, the well-being deteriorates and side effects begin to manifest. Moreover, "get out of the side" begins with an incredible speed. In this regard, the drug is usually prescribed by short courses, the total duration of which does not exceed two weeks. If we talk about dexamethasone during pregnancy, its use remains relatively safe only for several days ..
The main side effects of dexamethasone
Both the development and degree of severity of side effects when taking dexamethasone during pregnancy depends on the dosage of the used drug and the duration of its use. It should be related that in some cases, dexamethasone side effects can be quite serious and tangible. Most often we are talking about a sharp increase in blood pressure, violation of the secretion of testosterone hormone, as well as the risk of developing diabetes and osteoporosis. In addition, the medicine can cause stretch marks, acne rash, serious swelling and muscle weakness.Like any other drugs of a group of glucocorticoster, dexamethasone can reduce the content of thyroid hormones in plasma.
Another unpleasant side effect of reception of dexamethasone during pregnancy is a significant reduction in immunity and wound healing rates. However, the "side faces" designated occur most often when applying the drug intravenously.
But if a pregnant woman has a tendency to such a disease, like diabetes mellitus or suffers from this disease, the appointment of dexamethasone is unacceptable to her in principle. This is due to the fact that the drug significantly increases insulin resistance.
With great care, the use of the drug and patients with duodenal ulcer and stomach should be used. When infectious diseases infectious diseases, the use of dexamethasone should also be discontinued.
Analogs of dexamethasone
In its acting substance, the drug has a number of analogues. First of all, we are talking about the following preparations.Structural analogs of dexamethasone on the active substance:
- Decadron;
- Dexaven;
- Dexazone;
- Dexamesed;
- Dexafar;
- Deckon;
- Maxidge;
- Offanta dexamethasone;
- Forthectin.
As for the influence of dexamethasone on the fetus, with non-elong use of any vices from the future child should not develop. But if the treatment continues quite a long time period, some deviations in the development of the fetus may be observed. It is especially dangerous to apply the drug at the very end of pregnancy. If the situation is such that without a medicinal product, it is impossible for no circumstances under any circumstances, it is very important that from the moment of its reception and until the end of pregnancy, everything happened under the control of an experienced and qualified specialist. Only in this case, a pregnant woman accepting dexamethasone can not worry about that its treatment can lead to one or another difficulties.
In anticipation of the birth of a small miracle, any future mother knows how important to follow his health, because a new life inside is still very fragile, therefore the feasibility of admission even ordinary vitamins must be stirred with a doctor, not to mention more serious preparations.
The period of pregnancy is time, during which it is better to refrain from any drugs and medicines at all, since the body of a pregnant woman can react completely unpredictable. However, how to be if the medication takes just a forced measure?
One of the most controversial drugs, the benefits and harm of which gynecologists and obstetrics are constantly arguing, is "dexamethasone". If you look at the instructions for this medicine, you will find that it is contraindicated during pregnancy.
But the paradox is that sometimes it is his reception that helps to prevent the child's life to prevent and save. How does it work?
Very often in the descriptions of the drugs it is indicated that the reception in certain cases is possible, but only if their therapeutic effect is predicted by the doctor, many times will be higher than the potential risk for a woman or baby that can arise during treatment.
Assigning "dexamethasone", the doctors are just trying to assess and compare these categories to make the right decision.
A little about the preparation
Dexamethasone is a fluorinated hydrocortisone homolog, glucocorticoid, intended for local and systemic use, or simply a hormonal agent.
Being a synthetic analogue of the hormones of the adrenal cortex (normally, this substance must maintain the normal operation of the human body), the drug is able to effectively deal with numerous acute and chronic inflammatory processes, autoimmune diseases and even allergic manifestations.
In addition, "dexamethasone" has anti-shift, glucocorticoid and immunosuppressive effect, affecting carbohydrate, protein, water-electrolyte and lipid metabolic processes.
The spectrum of its application is very wide. When almost 100 years ago, American scientists have opened these hormones, they did not suspect how much the region of their effective impact is expanded. However, studies that lasted about half a century did not cost without unpleasant cases and scandals: the extremely negative impact of steroid hormones for pregnancy was proven (children were born with serious pathologies and developmental impairment).
Nevertheless, dexamethasone prescribe women who have a threat to miscarriage or in chronic non-chicken. The main reasons for the adoption of such solutions are the following factors.
- Availability at the future mother hyperandrode.
That is, increased development and increase in the amount of androgens or male hormones in the female body. Hormonal failures are quite frequent phenomenon during pregnancy, because the hormonal background changes very sharply. Therefore, instead of the necessary, ovaries and adrenal glands, testosterone is produced, which does not allow a woman to endure and give birth to a child (and sometimes become pregnant).
To determine whether it really is hyperandrode, the doctor must conduct various studies (as a rule, it will take to make blood test and urine to hormones).
Sometimes, when having tooling a male child, the situation can be aggravated, since its own hormones are added to the material generated by Androgen and even more increase their number.
- Chronic mothers diseases.
The second important factor for prescribing the drug is some diseases of the future mother, as well as the need to maintain the normal state of its health. We are talking about diseases of the kidneys, hepatitis, lupus, arthritis, in which the immune system hyperactivity (or autoimmune state) occurs.
This diagnosis means that in the body there is an active development of special antibodies designed to prevent the development and preservation of pregnancy, that is, the child is perceived as a danger and all the forces are sent to get rid of it. "Dexamethasone" is capable of blocking these antibodies by its action, thereby saving pregnancy from the threat.
In addition, the drug is prescribed to normalize the hormonal background when planning pregnancy, as well as used in some cases premature genera ("dexamethasone" are often used to disclose the lungs in the child).
It should be noted that the medicine is absorbed rather quickly from the gastrointestinal tract, and it is excreted through the intestines and the kidneys. One of the essential drawbacks of the drug is that it can easily penetrate through the placental barrier and fall into breast milk.
All decisions on the dosage, duration and reception mode should receive only your doctor, depending on the testimony and other factors. Under his control and therapeutic or preventive therapy will be carried out.
The medicine can be found in tablet form, as well as in the form of injections (they can be prescribed for intravenous, intramuscular and intra-articular administration). In addition, droplets are used - local or conjunctivally.
The benefits and damage to the drug for the future mother and child
As you could already understand, "dexamethasone" are prescribed during pregnancy, if the medicine is necessary on life indicators, that is, only in cases where the mother or baby's health care treatment threatens a deadly danger.
Also addressed to the drug, if others do not help, more acceptable during pregnancy medication. As a rule, the doctor appoints a woman to a tablet, but intravenous or intramuscular injeces (in the case of an acute rheumatic state can be discharged during a serious or critical condition (in the case of an acute rheumatic state, to help the patient get rid of pain shock, intra-articular injections are used).
The drug is prescribed with the following testimony:
- with some oncology forms (if the patient suffers from leukemia or she has lymphoma);
- with severe neurological states (for example, if there is a brain swelling or a tumor appears);
- with hematological diseases;
- in cases of complex diseases of the gastrointestinal tract (ulcers, etc.);
- with severe respiratory diseases (for those who suffer from pulmonary tuberculosis, bronchospasm or asthma);
- with acute rheumatic states;
- with violations of the endocrine system;
- in cases of sharp (as anaphylactic shock);
- with severe ophthalmological, infectious diseases.
In addition, if a diagnostic study is an analysis of 17 COP (a special analysis that checks the level of seventeen ketosteroids) - shows that the level of men's hormones is raised, "dexamethasone" will be appointed for the entire period of pregnancy to keep the child.
Also, a frequent reason for the purpose of the drug for a long course is the presence of antiphospholipid syndrome (APS), which contributes to the emergence and development of placental insufficiency and its negative consequences. Dexamethasone is usually discharged in suspected of various immune disorders.
At for termination, the fights are also used "dexamethasone", as it is able to suppress the contractile activity of the uterus and not give a premature child to be born.
The baby's body perceives the appearance of the active substance of the drug, as a signal on preparation for the appearance of the light, and its breathing bodies (lungs) ripen faster to be born, he was able to breathe independently.
Pregnant women who are forced to take the drug are given by a natural question as far as he is dangerous for the future child. Studies have shown that the greatest negative impact on the fruit "dexamethasone" can have in the first and third trimesters, especially if a woman takes it in injections.
In the latter case, the newborn will have to carry out substitution therapy, since it also has complications with hormone production.
Contraindications and possible side effects during pregnancy
Reception of "Dexamethasone" is conducted by a doctor in the verified dosage, practiced in gynecology and endocrinology, which allows minimizing all possible risks.
However, the treatment diagram is calculated and adjusted individually, after diagnostics, analysis of the problem and determination of the current state of the woman.
Typically therapy begins with injections (the first few days of treatment). The reception may first be in large doses, and then gradually decrease to the level of minimally efficient. Then pregnant translate into the tablet form of the drug, separating the daily dose for three receptions.
Hormonal treatment is a rather complicated process that requires careful control, analysis and self-discipline. During the therapy, you will have to take tests again and again (every 2-4 weeks) so that the doctor understand what is the effectiveness of treatment, and adjusted it.
In case of any side effects, you should immediately seek medical help. Be sure to consult with your doctor if you feel the following symptoms:
- problems with gastrointestinal tract and digestion (the appetite has decreased, or vomiting appears, the bloating, pancreatitis);
- general deterioration of well-being (, strong migraines, irritability, excessive sweating);
- some violations of the central nervous system (convulsions appear, you can begin to suffer from hallucinations and disorientation, depression);
- pronounced allergic reactions;
- suddenly increased susaks to the use of sugar, you noticed that the weight was abruptly gained, edema appeared (this may be associated with problems in the endocrine system and metabolism violation);
- deviations in the work of the cardiovascular system (the appearance of arrhythmias and acute heart failure, thrombosis).
To reduce the manifestation of some side effects, doctors advise to adjust the diet: it should contain a maximum of products rich in vitamins, useful substances and proteins, but the content of carbon, fats and cooking salts is better limited.
Despite the efficiency and benefit of the drug, unfortunately, it is not suitable for everyone. "Dexamethasone" are not prescribed if the patient has serious contraindications:
Sometimes, if the drug is abruptly canceled, it may develop, the so-called "cancellation" syndrome, when the patient appears weakness, nausea, muscular-skeletal pain and the state is exacerbated, due to which the medicine was appointed.
Is it possible to replace the drug with something?
With the individual intolerance of "dexamethasone" or other factors, due to which it cannot be appointed, doctors turn to its analogues and similar drugs:
- "Prednisone" or "methylpredinone";
- "Decamed";
- "Decadron";
- "DEXAZAZ";
- "Sodium dexamethasone phosphate (and simply phosphate);
- "Maxidge";
- "Dexaven";
- "Forthetortin".
Conclusion
In general, the reviews about the use of medicines are positive, however, remember that it is categorically prohibited to assign it yourself or be treated without leadership and control.
Although the drug is used in gynecological practice for a long time, each case is individual, therefore, knowing about all properties, benefits and consequences of the drug, the doctor will make a decision that is optimal in your situation. It is not necessary to fear in advance and abandon the treatment that can save the life of the child and will allow you to successfully endure pregnancy.
Not always the pregnancy proceeds smoothly. Often there is a threat of premature births or miscarriage in late terms. The doctor comparing all the facts by weighing all the pros and cons, can prescribe quite strong drugs aimed at prepare the fetus to prematurely appear on the light and increase its chances to survive. One of these drugs is dexamethasone. Why do such a strong hormonal drug appoint, and what consequences to wait for him?
It has already been said above that the main indication for the use of Ukolov decxamethasone is the threat of premature births. If such a problem is detected, this drug will contribute to the accelerated disclosure of the child. After the kid appears on the light, he has every chance to breathe independently, because the respiratory system will be developed and ready. Otherwise, there are risks that the baby will not be able to breathe independently, he can have a stop of breathing, and his death. Dexamethasone injections cause common stress in the body of the mother. It feels a baby, and already in the womb prepares for the fact that he may have to appear early.
Also, the drug is prescribed with increased testosterone production. By the way, if it is known that the woman is waiting for a boy, the drug can be assigned to the end of pregnancy to save it: when carrying a boy can additionally produce testosterone. Sometimes there are situations where the mother's body is trying to turn the fruit. Dexamethasone suppresses a slightly immune system of the mother so that it stops trying to pull the fruit. Thus, it is also possible in many cases to avoid miscarriage, to convey and give birth to a child.
The drug is very strong and in the instructions it is written that it is impossible to apply during pregnancy. Nevertheless, it is often prescribed when there is a serious threat. First of all, the drug is seriously transferred to the woman itself, because the side effects are a huge amount. But, and he also affects the child, because the placenta does not block it. Therefore, no doctor "just so" will not be appointed such a drug. We need serious reasons.
Instructions for applying ampoules intramuscularly
The average daily dose varies within 0.5-0.9 mg. The first day introduces the maximum dose (4-20 mg), and in the following - it gradually decreases. The exact dosage is appointed by the doctor. Injections are made intramuscularly both under medical institution and at home, if a woman can accurately do it.
Detailed instructions for the use of Ukolov, dexamethasone intramuscularly implies self-adequate drug without consulting a doctor and good reason.
Side effects and contraindications
The drug has a lot of contraindications:
Full list of contraindications can be found in the instructions. The doctor when appointing these injections, must take them into account. There are a lot of side effects in dexamethasone. Therefore, it is considered very difficult:
- disorders of the endocrine system;
- violations of exchange processes;
- problems with cardiovascular system;
- problems with the gastrointestinal tract;
- violations of the CNS.
About the side effects must be informed of its doctor, especially if they are pronounced.
How much is dexamethasone in ampoules
The drug is relatively inexpensive. Package price of dexamethasone with 25 ampoules of 4 mg on average 130-200 rubles, depending on the city and pharmacy network, where it is purchased.
Any woman in anticipation of the child would like to completely abandon drugs for all 9 months. With some diseases, you can cope with the help of folk methods, but with serious violations of hormonal background and failures in the work of the immune system without the introduction of drugs, it is not necessary. Dexamethasone during pregnancy is appointed only when there is a risk of abortion or premature birth.
Disputes about the safety of this drug are still underway. Therefore, its reception should be carried out strictly by appointing a doctor and under its control. Dosage and duration are determined by the results of diagnostic surveys, which are conducted every 2-4 weeks.
Dexamethasone is a synthetic analogue of the hormones of the adrenal cortex. It affects the endocrine system, metabolic processes and indirectly on all organs.
After suction to the blood, dexamethasone accelerates the decay of proteins, uses material and energy from these reactions for carbohydrate production. An increase in glucose levels leads to enhanced energy release, which activates the production of adipose tissue.
The proteins in the blood becomes less and the result of the immune system is reduced, since the material does not have enough material for the production of its cells. Increased blood sugar levels can lead to the development of steroid diabetes, and an increase in the production of adipose tissue is to be exhausted.
The decrease in immunity can be as a side effect on the reception of the drug and positive result. This property is successfully used in autoimmune and allergic diseases. Dexamethasone blocks biologically active substances that provoke inflammatory reactions.
Another effect of the drug is the braking process of cell division. It allows you to use dexamethasone at cancer when it is necessary to suspend the tumor growth. But with pathologies where tissue regeneration is required, it is contraindicated.
Among the readings to the use of dexamethasone are present: the lack of adrenal cortex, allergies, autoimmune and oncological diseases congenital androgenital syndrome. The preparation in the form of eye drops is prescribed with ophthalmic inflammatory and allergic diseases.
Forms of release of drug
Dexamethasone is produced in several forms. For each of them there are testimony, contraindications and dosage. During pregnancy, the drug can be appointed in tablets (outpatient and in hospital), in injections (stationary).
Ampoules
Dexamethasone in ampoules is a transparent colorless or yellowish solution for injection. Pricks can be installed intravenously, intramuscularly, intra-shop, periarticular and retrobulbarno. Intravenous administration is sometimes carried out with a dropper. The pharmacies present two volumes of ampoules: 1 and 2 ml (4 and 8 mg of the active substance, respectively). Packaging - 5 or 10 pcs.
Dexamethasone in ampoules during pregnancy is used in severe and critical cases. It is intravenously and intramuscularly administered with disorders from an endocrine system, allergies, oncological diseases. With severe rheumatic pains, the drug is prescribed in the form of intra-articular injections.
Drops
One of the forms of dexamethasone - Eye drops 0.1%. They are a white suspension. Produced in 10 ml dropper bottles. 1 ml contains 1 mg of active substance. Showing at ophthalmic diseases accompanied by inflammatory processes and allergic manifestations, as well as in eye injury.
Drops dexamethasone during pregnancy are prescribed extremely rarely - in case of strong inflammation of the conjunctiva, an allergic reaction, injuries. If possible, doctors replace it with safer drugs.
Pills
Dexamethasone is produced in the form of tablets. Each contains 0.5 mg of the active substance. The pharmacies present packages at 10, 20, 30, 40, 50 and 100 pcs. Tablets are shown in a wide range of diseases, including bronchial asthma, acute eczema, rheumatoid arthritis, brain swelling.
Tablets Dexamethasone during pregnancy are prescribed more often than other forms. They are convenient for use, do not require finding in a hospital. This is especially important when the drug must be taken over all 9 months. Tablets are prescribed to normalize and maintain the required level of hormones, as well as with allergic reactions of weak and moderate severity.
Testimony and contraindications during pregnancy
Dexamethasone refers to glucocorticoids - hormonal drugs. Dexamethasone during pregnancy is often prescribed to disclose the lungs in a child when there is an increased risk of premature starting activities. The drug provides accelerated ripening of surfactant - compounds, due to which the kid's respiratory organs can function normally.
In the instructions for dexamethane it is written that it is contraindicated when entering the child. However, one of the main indications for its purpose is the threat of miscarriage. The drug is effective in cases where the risk of pregnancy interruption occurs due to violations in the endocrine system: the production of a large number of men's sex hormones.
This condition is called hyperagratenia. Dexamethasone oppresses the synthesis of androgen, affecting the adrenal glands and ovaries. Often it is appointed for all 9 months, especially if the fruit is a male. In this case, from a certain period, its sex hormones are added to the maternal and increase the risk of abortion.
And one more important indication for the use of dexamethasone during pregnancy is autoimmune diseases. Their danger is that individual cells of the mother's organism begin to perceive the fruit of both a malicious agent and aggressively react to it, rejected from the womb. The drug is able to affect the immune system, suppressing its activity.
Dexamethasone - a potent means, so the list of contraindications to it is large enough. During pregnancy, the reasons for refusing its purpose are most often overweight and diabetes. This medicine changes metabolic processes: the consumption of carbohydrates increases, the splitting of fats slows down.
With this, an increase in weight during treatment is connected. Due to the influence of dexamethasone on blood clotting, it is contraindicated to women who have a tendency to the formation of thromboms. With a pronounced threat of pregnancy abortion, the drug can be appointed in these cases, but under constant medical inspection.
Dexamethasone during pregnancy in tablets is not prescribed in certain diseases of the gastrointestinal tract. With a more detailed list, you can read the instructions attached to the drug.
The benefits and damage to the drug for pregnant and fetus
Dexamethasone during pregnancy is appointed only in cases where the benefits of its application will be larger than possible risks. The drug effectively copes with its tasks: restores the balance of hormones during hyperandrode, suppresses the production of antibodies during allergic diseases, speeds up the ripening of the lungs in the fetus when premature genera. In other words, he allows a woman to endure a child and reduces the risk of his death with premature pregnancy.
Hurting from reception of dexamethasone for pregnant woman is his side effects. The drug may cause nausea, bloating, decrease in blood pressure, weakening the heart muscle.
In some states, immunity, slowing regenerative processes, is undesirable. Intraocular and intracranial pressure may increase, provoking headaches, coordination disorders, psychopathic reactions. Changes in metabolism increase the risk of developing obesity and diabetes.
Dexamethasone is able to penetrate the placenta. Its influence on the fetus can manifest itself in violation of adrenal functions. In such cases, treatment is carried out with the help of substitution therapy after birth.
Dosage preparation during pregnancy
Dexamethasone during pregnancy is always prescribed with caution, the dosage depends on the results of analyzes for hormones and can change several times in 9 months. Most often, the drug is prescribed in tablet form, per day - from 1 to 3 pcs.
The abortion of the pregnancy in the period of 28-37 weeks is called premature childbirth. Abortion of pregnancy on the period from the 22nd week to 28 weeks, according to the rules of the World Health Organization, refer to very early premature births. In our country, the interruption in this period of pregnancy does not belong to premature childbirth, but at the same time they assist in the maternity hospital, and not in the gynecological hospital, take measures to push a deeply premature newborn. A child born as a result of such birth is considered to be a fruit for 7 days, only a week later, such a baby is considered not a fruit, but a child. This feature of terminology is due to the fact that children born to the 28th week of pregnancy are often unable to adapt to environmental conditions outside the womb even with the help of doctors.
Causes of premature birth
The factors leading to premature gods can be divided into social and biological and medical.
It should be noted that in the autumn and spring months the frequency of this complication increases. This is due to the change in weather conditions, in particular, frequent change of atmospheric pressure, which can affect the frequency of premature expulsion of the accumulative water. Heavy colds with high body temperature lifting and a strong cough can increase and cause generic activity prematurely. An unfavorable effect has been noted on the course of pregnancy of a number of production factors: the impact of chemicals, vibrations, radiation, etc. Premature childbirth is more often found in young women who are not married, with a lack of protein and vitamins, as well as women who have bad habits.
Medical factors include severe infectious diseases, including those transferred in childhood, abortion, inflammatory diseases of the genital organs. Chromosomal disorders of the fetus - damage to the hereditary apparatus of the fetus under the action of adverse external and internal factors (ionizing radiation, production harm, adoption of some drugs, smoking, drinking alcohol, drugs, unfavorable ecological situation, etc.) - can lead to premature birth, but more often in Such cases occurring pregnancy in early terms. In most cases, the cause of premature births are diseases of the endocrine system, such as disorders of the function of the thyroid gland, adrenal glands and ovaries, obesity, which changes the operation of all the inner secretion glands. The anatomical changes in the genital organs include genital infantilism (underdevelopment of female genital organs), malformations of uterus, traumatic damage to the uterus during abortion and scraping, uterine tumors. In almost one third of cases, the cause of premature birth is the Effective Cervical Insufficiency, in which as a result of mechanical impact (cervical injury after abortion, previous birth, other gynecological manipulations) or lack of certain cervical hormones does not perform its locking function.
Often, the cause of premature births become cervic-vaginal infections (trichomonosis, mycoplasm, chlamydia, etc.) and viral infections (, cytomegalovirus, herpes, flu, adenoviral infection, vapotitis), especially hidden, the presence of a chronic genital infection contributes to the violation of the local protective barrier and Fruit damage. Heavy forms of extragenital diseases (not related to female genital organs) and pregnancy complications can also lead to pregnancy. Such diseases include, for example, hypertensive disease, cardiovascular diseases, anemia, chronic diseases of the lungs, kidneys, liver, etc.
Symptoms of the beginning of birth
With the early premature birth, regular generic activities and smoothing or disclosure of the cervix appear. The beginning of the generic activity is accompanied by the appearance of regular grapple-shaped pains in the lower stomach departments, which increase in intensity over time, the gaps between the fights are reduced. Quite often, premature genera begin with an influence of spindlewater waters, and their number can be from several drops to several liters, in addition, the appearance of the woman's mucous drugs with streaks or bloody secretions with premature pregnancy testifies to the structural changes in the cervix, t. e. Its smoothing. The emergence of any of the above symptoms requires urgent hospitalization into an obstetric hospital.
With the slightest suspicions of deviation from the normal course of pregnancy, you need to seek qualified help.
If these symptoms appear, it is necessary to immediately cause "ambulance", which will deliver the future mother in the hospital. In some cases, it is possible to extend the pregnancy; If there is no such possibility, then in the hospital the conditions are created for the careful delivery of delivery, during which the smallest loads of possible toddler are attentive.
Features of the flow of birth
With premature childbirth, premature oral influence, weakness and dysfunction of generic activity, quick or, violation of regulation mechanisms, hypoxia of the fetus are observed.
Premature oral influence is more often manifested in exhaustic-cervical insufficiency or the presence of infection. The lower pole is infected, and, as the result of inflammation, the shells are easy to rush. Normally, the fruit bubble breaks closer to the full opening of the cervix, that is, already with a developed generic activity. The sensations of a woman can be different: from a small wet spot on underwear to a large amount of water flowing out of the vagina and the current on the legs. Waters should be blond, but are muddy and dark brown (with infection). Births that occurred ahead of time, often leak quickly or even rapidly. The woman appears rather painful contractions, the frequency is enhanced, the intervals between the fights are less than 5 minutes and quickly decrease to 1 minute, the first period of childbirth (until the cervical disclosure) is reduced to 2-4 hours. Due to the fact that the head in the premature fetus of smaller sizes, the expulsion of the fetus begins with the uterus that does not exceed the cervix. A smaller child passes through the birthway.
Premature baby
A child born as a result of premature births has signs of prematurity, which are determined immediately after delivery. The body weight of such a newborn is less than 2500 g, height is less than 45 cm, on the skin a lot of raw-like lubricant, subcutaneous fiber is not developed enough, ears and nasal cartilage soft. Nails do not enter the tips of the fingers, the umbilical ring is located closer to the lane. The boys the testicles are not omitted in the scrotum (it is determined to the touch), the girls have a clitoris and small sex lips are not covered with large sexual lips, the cry is squeaky. It should be noted that the presence of one sign is not an indisputable evidence of the child's prematurity, the presence of the fetus is determined by the set of signs.Unlike timely delivery, with premature births there are more complications, firstly, the child's head does not have time to adapt to the mother's pelvic bones and configure. The configuration of the head is the possibility of displacement of the bones of the fetus skull during childbirth to reduce its volume when passing through the generic paths. This mechanism allows you to reduce the pressure on the head and the cervical spine of a born baby. The bones of the skull prematurely are rather soft and cannot provide protection for the brain, the risk of traumatization, hemorrhages under the shell in the fruit brain tissue during childbirth. As a result, the child may have hemorrhages, it does not have time to adapt to environmental changes, it is disturbed by the regulation system. Secondly, often the woman receives the trips of the tributes (cervix, vagina and outdoor genital organs), as the fabrics do not have time to adapt to stretching.
With threatening and beginning childbirth, a woman urgently hospitalized.
Much less often with premature births there is a weakness of generic activity. Weakness can manifest itself weak, rare or short fights. The birth's time increases significantly, the woman gets tired, the child also begins to suffer. Other generic anomalies are possible, such as the strength and frequency of shattering, and the disclosure of the cervix does not occur. All this is due to violation of regulation systems for premature births, there is no sufficient hormonal preparation for childbirth. Infectious complications in childbirth and postpartum period are an order of magnitude more often than the mother and the fetus. Among such complications - the suppuration of the seams (if available), the postpartum metroendometrite (inflammation of the mucous membrane and the muscular layer of the uterus), peritonitis (peritoneum inflammation) and the maximum distribution of infection (sepsis). This is due to the presence of a hidden or explicit infection, which was used before childbirth in a pregnant woman, which often is the cause of pregnancy. The infection can be joined during childbirth, due to their duration (with weakness), for example, chorioamnionitis (inflammation of the embryo shells). Premature children have reduced immunity and, accordingly, are more susceptible to infections.
Forecast for the child
In connection with the peculiarities of the obstetric tactics and the different outcome of labor for the fetus, it is considered advisable to separate the separation of premature births for three periods, taking into account the deadlines of gestation (pregnancy): premature births in 22-27 weeks, premature births in 28-33 weeks, premature births in 34- 37 weeks of gestation.
Premature births in 22-27 weeks (a lot of fruit from 500 to 1000 g) is most often due to erect-cervical insufficiency (due to injury in previous births), infection with the lower pole of the fetus bubble and the premature rupture of the fruit bubble. Therefore, in this group of women, as a rule, few primaries. The presence of infection in the sex tract eliminates the possibility of pregnancy prolongation in most pregnant women. The light fetus is immature, and to achieve accelerate their ripening by the appointment of medical means of the mother in a short period of time fails. Such children refer to a high-risk group are more often subject to urgent resuscitation. They are in Küweza, under the strict control of a neonatologist and qualified medical sisters. Children are almost always needed in the further phase of sticking and long stand on in perinatal centers or polyclinics at the place of residence.
Premature genera under the period of gestation 28-33 weeks (the mass of the fetus 1000-1800 g) is due to more diverse reasons than earlier premature genera. Varberogenic women in this category of birth more than 30%.
More than half of women spend expectant tactics and pregnancy pregnancy. In such children, the lungs do not have time to "mature", the production of surfactant is disturbed. The surfactant is a mixture of fats and proteins, which is synthesized in large alveoli (composite unit of lungs), covering them, contributing to their disclosure and preventing decay when inhaling. In the absence or lack of this substance, the child is disturbed. The preparation of surfactant can be introduced newborns if necessary, it greatly facilitates breathing, but this drug is very expensive and is not always available. Therefore, with the aim of preventing respiratory impairment, women prescribe glucocorticoids. They stimulate the production of surfactant and the "maturation" of the fetus of the fetus within 2-3 days in the threat of premature labor. With the beginning of the generic activity of glucocorticoids administered intravenously with an interval of 3-4 hours.
Premature genera under the period of gestacin 34-37 weeks (the mass of the fruit of 1900-2500 g or more) is due to even more diverse reasons, the percentage of infected women is much less than in the preceding groups, and primaries - more than 50%. However, due to the fact that the light fetus is practically mature, no funds are required to stimulate the ripening of the surfactant.
Children are less likely to be transferred to the intensive care unit, but 24-hour care and observation are necessary in all cases until the child's status is fully stabilized.
Features of naughty
After inspection, the neonatologist is most often translated into the separation of intensive therapy, and if necessary, then in the resuscitation department. They are carried out round-the-clock control, care and treatment, and the prevention of possible complications is carried out. The premature children are imperfect thermoregulation, they may be in a cuvez, where the temperature regime, the level of humidity, oxygen, etc. is strictly controlled. They have a tendency to respiratory disorders, reduced resilience to the effects of environmental factors, so it is necessary round-the-clock duty not only of the middle medical personnel, but also neonatologist. In most cases, premature children after certain efforts of a group of neonatologists doctors are translated into a second phase of sticking in a specialized hospital. In the presence of a perinatal center in the city, the second stage of sticking is carried out in the same hospital in which childbirth was carried out, and children are not transported. It should be noted that often premature children stabilize pretty quickly, and in the second stage, no need is needed.Tactics of conducting premature birth
With threatening and starting birth - when there is no disclosure of the cervix or it is a slight - tactics are directed to prolongation of pregnancy. A woman is urgently hospitalized, create a strict bed mode, prescribe sedatives, eliminate the reasons for premature childbirth (if possible). For example, the seams are carried out on the cervix in the exhaustic-cervical insufficiency, the treatment of vaginal infections, the restoration of the natural microflora of the vagina or the purpose of antibiotics in the presence of an infectious process, treatment is carried out in conjunction with the therapist or endocrinologist (if necessary). The obligatory component are drugs that reduce the tone of the uterus (toecolatics), which improve the work of placenta, increasing immunity, vitaminotherapy, as well as drugs that improve the child's intrauterine nutrition and accelerating the "maturation" of light fetus.
In each case, an individual approach is needed, but not always the efforts of doctors lead to the desired results, and the process goes into the early premature genera.
24-hour care and observation are needed in all cases until complete stabilization of the child's condition.
Premature births require a qualified doctor of an obstetrician-gynecologist, a medical sister and neonatologist. It is necessary to monitor the woman and the state of the fetus. A woman is regularly inspecting, measured pressure, body temperature, control urine and blood tests. In addition to the data of cardiomonitorial observation, control the development of generic activities, listened to the palpitations of the fetus, determine the position of the fetus. Fetal cardiomonitoring is a study of cardiac rhythm. It is carried out on a special apparatus at rest, in a pregnant position on the side for 30-60 minutes. On the front abdominal wall of the pregnant woman with the help of an elastic ribbon, registering sensors are located, which fix cardiac abbreviations of the fetus, as well as the frequency and strength of the bumps.
Most complications in childbirth, both from the mother and from the fetus, are due to violation of the contractile activities of the uterus. To identify the features of the contractile activity of the uterus at premature births, the partograph is recommended (graphic image of the frequency and strength of the bouts) and record the contractile activity of the uterus. The partograph can be carried out without any technique, to the touch, with a stopwatch to fix the frequency, strength and duration of the bumps, and then depict them on the chart. However, all specialized centers have a cardiomonitorial observation, which clearly displays the condition of the child during the generic process, as well as the tone of the uterus and the effectiveness of the fights in the dynamics, which allows you to adjust and provide qualified medical care in time.
To determine the degree of revelation of the cervix, the doctor examines a woman on a gynecological chair. Due to the possible negative impact on the state of the fetus, relatives or braking of generic activity is carefully considered, and it is often necessary to solve the issue for a short time, while the decision is made by several doctors. Conduct the prevention of hypoxia (lack of oxygen) of the fetus, from narcotic anesthesia in most cases refuse (as they adversely affect the respiratory center of the fetus). Births lead in the position lying on the side, because it is easier to control the childbirth in this position, the head moves to the generic paths not quickly, the well-being of a woman and the fetus remains satisfactory, in contrast to the position lying on the back, in which the pregnant uterus squeezes large venous vessels, worsen The blood circulation of mother and fetus. The anesthesia and epidural anesthesia accelerate the process of opening the cervix, which is so often too fast, the fetal head does not have time to adapt to the generic paths, and often poorly stretching crotch aggravates the situation, so it is suitable individually.
In the power of the woman itself, reduce the likelihood of premature birth. There is no need to hide previous abortions and inflammatory processes in the past from the doctor who has a woman consists. It is necessary to immediately inform the doctor about all changes in its body, go to special classes in preparing for childbirth. When identifying pathology should not be abandoned from the treatment appointed by the doctor. It is necessary to limit physical exertion, follow the diet, which should be diverse and well balanced. Excessive consumption of acute, salty or fatty food leads to exacerbations of chronic diseases of the digestive system, which can cause premature birth. With the appearance of pregnancy symptoms, sexual life should be abandoned over the past two months of pregnancy. With the appearance of the slightest suspicions of deviation from the normal course of pregnancy, it is necessary to seek qualified help.