Any health problem of a pregnant woman should be considered through the prism of future motherhood, namely, the effect of drugs on the fetus should be taken into account. It is very important for the first-timers to be able to competently advise customers on drugs that are acceptable during pregnancy. On the eve of the season of respiratory infections, we answer the most popular questions related to the treatment of SARS in expectant mothers.

Why are colds and flu dangerous in pregnant women?

Respiratory infections pose two threats. First, they may be accompanied by fever, which can lead to defects in the development of the fetus. And secondly, SARS and influenza can lead to the development of complications. During pregnancy, a number of changes occur in the immune response, as well as in the work of the heart and lungs, as a result of which the mother's body becomes especially vulnerable. Therefore, colds and flu in expectant mothers are much more severe than in non-pregnant women and are often complicated by bacterial infections, including bronchitis and pneumonia.

The World Health Organization has included pregnant women at risk for developing severe and/or complicated influenza. It has been proven that pregnant women with influenza require hospitalization 4 times more often than non-pregnant women. Among patients in the third trimester, 8% require hospitalization in intensive care units.

Timely vaccination can prevent infection with the influenza virus during pregnancy. If the infection has already occurred, the woman needs to start treatment as soon as possible.

Is it necessary to bring down the high temperature during pregnancy and what drugs can be used?

Fever in pregnant women is important to stop in a timely manner, because heat may adversely affect pregnancy. It is especially dangerous in the first 12 weeks, when all organs and systems are laid down. Hyperthermia in pregnant women during the first trimester doubles the chance of developing neural tube defects (in the future it will be the brain and spinal cord), and may also be associated with other birth defects and adverse outcomes in the baby.

It is not known for certain which temperature exceeding carries the greatest danger. Thus, data from a cohort study involving more than 77 thousand women showed that the incidence of malformations was approximately the same among those who noted a fever below 39 and above 39 degrees in the first trimester.

Paracetamol is considered the drug of choice for reducing fever, which is approved for use throughout pregnancy. In addition, in the I and II trimesters, ibuprofen is used as an antipyretic and analgesic. Multivitamins containing folic acid can reduce the risk of developmental defects due to hyperthermia.

How to relieve sore throat? What antiseptics can be taken?

During pregnancy, it is allowed to use a number of antiseptics for sore throats, so it is not necessary to endure perspiration and other unpleasant symptoms during this period. Drugs that expectant mothers can take include:

• ambazone, which has an antimicrobial effect against streptococci, a daily dose of 4–5 tablets of 0.04–0.05 g;
• combination lysozyme + pyridoxine, exhibits an antiseptic effect against gram-positive and gram-negative bacteria, fungi and viruses. Vitamin B6 in its composition has a protective effect on the oral mucosa. Assign 2 tablets 3-4 times a day.

In addition, warm drinks, which are indicated in unlimited but reasonable amounts, help relieve sore throats.

Can pregnant women take any expectorants?

Therapists and obstetricians-gynecologists recommend that pregnant women refrain, if possible, from taking expectorant drugs. The vast majority of drugs in this group are prohibited during pregnancy, including herbal remedies, which are often considered “safe” by consumers. In fact, plantain syrup, preparations based on thyme and thyme extract, and other popular herbal remedies are contraindicated for pregnant women.

In the same time ambroxol still approved for use in the II and III trimesters marked "with caution." The same goes for bromhexine- it is prescribed, but only after a thorough assessment of the benefit / risk ratio, and only the attending physician can conduct it. Therefore, first-timers who advise pregnant women with requests for expectorants should limit themselves to strong advice to consult a doctor. And the only recommendation that should be given in such situations is the intake of warm drinks and sufficient humidification of the air in the room.

What can a pregnant woman take with a debilitating dry cough?

Antitussive drugs, like mucolytics, are prohibited during pregnancy at all or are allowed under the supervision of a doctor after assessing the risks and benefits. Thus, the popular antitussive agent of central action butamirate it is allowed to take only in the II and III trimesters and only after consulting a doctor. Use with caution during pregnancy and the drug of peripheral action prenoxdiazine. Thus, when counseling a pregnant woman with a dry cough, she should be advised to visit a doctor immediately.

Are homeopathic medicines allowed during pregnancy?

Indeed, homeopathic remedies, including those exhibiting an antiviral effect, as a rule, are not contraindicated for use during pregnancy. However, the first-timer should take into account that there are no clinical studies confirming the safety of these drugs in pregnant women, so manufacturers often indicate in the instructions the need to balance risk and benefit. Sometimes there are notes about the possibility of using the drug after consulting a doctor.

Is it possible to be treated with infusions, decoctions of medicinal herbs or herbal teas during pregnancy?

Despite their natural origin, not all herbal preparations, including herbal teas, are safe during pregnancy. Herbs may contain active substances that adversely affect the development of the fetus or increase the tone of the uterus. Herbs can cause miscarriage or induce premature labor. Medicinal plants unsafe during pregnancy include:

• chamomile - may promote uterine contractions;
• licorice root - may increase the risk of preterm birth;
• laxative herbal teas based on senna and other plants - active intestinal motility can also stimulate the contractile activity of the uterus;
• common prutnyak - stimulates the production of estrogen, may increase the risk of miscarriage;
• echinacea - activates the synthesis of oxytocin; aloe vera - stimulates the contractile activity of the uterus;
• calendula - has an abortive effect and many others.

However, there are medicinal plants that have proven safe during pregnancy. Among them :

• raspberry leaves;
• peppermint leaves;
• shell of psyllium oval seeds;
• garlic.

Since the list of medicinal plants that are unsafe during pregnancy is quite large, it is still better to take herbal remedies during this period after consultation with the doctor.

Are any antiviral drugs allowed during pregnancy?

In the treatment regimen for influenza in pregnant women, antiviral drugs from the group of neuraminidase inhibitors are included. They are active against influenza A and B viruses and have been shown to be effective in numerous clinical studies. Drugs in this group disrupt the ability of viral particles to penetrate into the cell, which leads to the localization of infection in the body, alleviating the condition and reducing the likelihood of complications. According to international and Russian recommendations, neuraminidase inhibitors are the drugs of choice for influenza, including during pregnancy. Their effectiveness is highest when taken within the first 48 hours after the onset of the disease, so when the first symptoms of influenza appear, it is very important to consult a doctor and start treatment. Recall that neuraminidase inhibitors are prescription drugs ( also in this case, you need to make sure that the patient has the flu, and not SARS, - approx. ed.).

How to increase immunity during pregnancy?

To increase the body's defense against respiratory infections during pregnancy, help:

• a balanced diet that compensates for a woman's needs for nutrients, vitamins, microelements;
• healthy sleep;
• laughter - contributes to the activation of the immune response;
• taking probiotics, which normalize the composition of the intestinal flora, which helps reduce the risk of respiratory infections and reduce the severity of cold symptoms;
• taking multivitamin complexes containing vitamin D, which helps to relieve the symptoms of a cold and reduce the frequency of infection.

In addition, to increase the immune response, the doctor may prescribe interferon alfa-2b preparations - intranasal or rectal ( there may be restrictions on the duration of pregnancy, for example, some of them are prescribed only after 14 weeks, - approx. ed.).

How to ease breathing during nasal congestion in a pregnant woman? Can vasoconstrictor drops be used?

Unfortunately, nasal decongestants are contraindicated during pregnancy. The procedure of choice is irrigation of the nasal cavity with solutions of sodium chloride or sea water. They help clear the nasal passages of mucus and even viruses and make breathing easier. These drugs are safe and have no side effects.

Is it possible for a pregnant woman to put mustard plasters, pepper plaster?

Despite the fact that both mustard plasters and pepper plaster act externally and do not affect the development of the fetus, they are potentially dangerous for the course of pregnancy. Thermal procedures can increase the contractile activity of the uterus, which is associated with an increased risk of miscarriage or premature birth. In addition, the increase in microcirculation, which occurs under the action of mustard plasters or pepper patch, can change the uteroplacental blood flow, which is also undesirable. The greatest danger is thermal procedures in the first and last trimester of pregnancy - in the first they increase the risk of miscarriage, in the last - premature birth.

What should I do if a pregnant woman comes with a prescription for a drug that is contraindicated for use in pregnant women?

Prescribing to a pregnant woman a drug that is contraindicated in pregnancy is not among the grounds for invalidating a prescription. It is known that in practice, some doctors take responsibility by prescribing pregnant women drugs that are contraindicated during pregnancy. In this situation, it is appropriate for the first-timer to contact the doctor and make sure that he really prescribed a specific drug to the pregnant woman, and then release the drug.

Sources

1. Sass L. et al. Fever in pregnancy and the risk of congenital malformations: a cohort study //BMC pregnancy and childbirth. 2017; 17(1):413.
2. Black R. A., Hill D. A. Over-the-counter medications in pregnancy // American family physician. 2003; 67(12): 2517–2524.
3. Lipatov I. S. et al. Influenza infection and pregnancy: the problem of specific prevention // Issues of gynecology, obstetrics and perinatology, 2015. V. 14. no. 1. P. 57–63.
4. Gholami F. et al. Onset of labor in post-term pregnancy by chamomile //Iranian Red Crescent Medical Journal. 2016; 18(11).
5. Ernst E. Herbal medicinal products during pregnancy: are they safe? //BJOG: An International Journal of Obstetrics & Gynaecology. 2002; 109(3): 227–235.
6. Herbs and Pregnancy. American Pregnancy Association. URL: http://americanpregnancy.org/pregnancy-health/herbs-and-pregnancy/ . Accessed 09.09.2018.
7. Kalimatova D. M., Shatunova E. P. Optimization of the management of pregnant women with influenza A H1N1 based on the assessment of levels of markers of endothelial dysfunction // Problems of medicine in modern conditions / Collection of scientific papers following the results, 2010. V. 201. No. 2. P. 15.
8. Guidelines on the diagnosis, treatment and prevention of influenza in pregnant women, 2014
9. Bennett M. P. et al. The effect of mirthful laughter on stress and natural killer cell activity. - 2003.
10. Pregliasco F. et al. A new chance of preventing winter diseases by the administration of synbiotic formulations // Journal of clinical gastroenterology, 2008. V. 42. S. S224‑S233.
11. Martineau A. R. et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data //bmj. 2017; 356:i6583.

It is difficult to name a more important stage in a woman's life than pregnancy. During this period, any expectant mother needs to be more careful, because huge changes are taking place in the body, and the usual antiviral drugs can not always be used in case of illness. This problem is especially relevant during periods of active spread of influenza viruses.

Is the risk justified?

In some cases, if colds not particularly severe, pregnant women can not resort to medication. In this case, there will be enough folk remedies and bed rest. However, the decision on such treatment should be made only by a doctor based on examination, tests, as well as the general condition and course of pregnancy.

But if the expectant mother has caught a more serious illness like the flu and herpes, it is still worth starting medical treatment. Indeed, with serious viral diseases, severe complications can also occur, both in the course of pregnancy and in the development of the fetus. It could be:

• premature termination of pregnancy;
• various lesions of the placenta;
• chorioamnionitis;
• the formation of hydrocephalus (dropsy of the brain);
• congenital pneumonia in a baby;
• the development of a cataract in a baby, retinal atrophy;
• infection of the baby's blood;
• fetal death.

Therefore, antiviral drugs are prescribed by attending physicians for serious diseases. It is not recommended to determine medications on your own and self-medicate.

Even in the first trimester, which is considered the most dangerous, and the disease threatens the development of serious pathologies, the doctor, based on an examination of the general condition and the course of pregnancy, may prescribe antiviral drugs.

What drugs can be used?

Mom should not only monitor her health, but also carefully choose medications for treatment, especially on early dates. Unfortunately, even with the most careful precautions, sometimes the disease cannot be avoided, and you already have to think not about the choice of means for prevention, but about which antiviral drugs you can drink.

Of course, the final decision on which antiviral drugs are best to drink is made by the attending physician. However, it is worth knowing which of them are the most harmless to mom and baby.

List of the safest means:

• Viferon is the most popular for the treatment of pregnant women. This medicine is not only effective in fighting viruses and bacteria, but also promotes healing and stimulates the production of immune cells. This remedy is also prescribed for the treatment of rubella, herpes and as a prophylaxis during epidemics of viruses. The main component of this medication is interferon, which begins to act even before the mother's body recognizes viruses.
• Anaferon is a rather controversial remedy, because if you read the instructions, you can see the phrase about the prohibition of taking during pregnancy. However, doctors are increasingly prescribing it for the treatment of expectant mothers, as well as during breastfeeding, from influenza, SARS, acute respiratory infections. This is a multifunctional drug that actively fights viruses, bacteria and colds. It should be noted that the drug may cause allergic reaction, because during the bearing of the baby, the body is more sensitive.
• Oscillococcinum is a remedy based on natural ingredients. It is often prescribed to pregnant women in order to alleviate the condition of the disease and reduce its period to a minimum. It also relieves the symptoms of the disease and has antipyretic properties. This remedy is homeopathic and is based on extracts of the liver and heart of the Barbary duck, which is one of the carriers of influenza viruses.

If the expectant mother suffers from a runny nose, you can use Aquamaris, which basically contains sea water that is safe for the baby. Also effective means is Mukaltin, Bromhexine (not possible in the first trimester), Pinosol.

The first trimester is the most dangerous period when the foundations of all the organs of the unborn baby are laid. Use any medications in the early stages is strictly contraindicated. After all, their impact can lead to the formation of various defects and pathologies in the development of the baby.

It is worth considering that even those antiviral drugs that are approved for the treatment of expectant mothers (Anaferon, Viferon and Grippferon) are not recommended for treatment in the first trimester of pregnancy. They are prescribed only in the most extreme situations.

Drugs prohibited for use

When it's hot, pregnant women should not use Aspirin, because it negatively affects the blood. future mother and baby. In addition, tetracycline-based medicines are prohibited, since its components can disrupt the formation of the child's skeleton.

For the treatment of a runny nose, expectant mothers should absolutely not use those remedies that have a vasoconstrictive property (Nazivin, Sanorin and others). After all, they are based on chemicals that act not locally, but systemically. Relieving nasal congestion, the drops will also affect the blood flow to the baby, as a result of which oxygen starvation. It is especially not recommended to use such drops in the first trimester.

For the treatment of cough in the early stages, it is recommended to use homeopathic medicines. Means based on ambroxol (Lazolvan, Ambroxol and others) are not recommended for use in the first trimester of gestation. In other cases, they are prescribed only if the benefits of treatment with these drugs outweigh the possible risk to the baby.

There is no single answer from experts about which antiviral medications are safe to use during the first trimester of pregnancy. One can only single out the most harmless, which include the antiviral agent Oscillococcinum. However, according to statistics and observations, it is not always effective.

After the 14th week, you can take Viferon and Anaferon. If the cold is not serious, it is better to resort to folk methods, bed rest and as little as possible to visit places with a large crowd of people, where there is an increased risk of catching some kind of virus.

During pregnancy, all women experience a decrease in immunity. This is necessary for the normal course of development of the fetal egg. Immediately after fertilization, the woman's body perceives the embryo as a foreign body and tries to reject it. It is for this that nature has conceived a deliberate decrease in the body's immune defenses.

Cold during pregnancy

Surely everyone knows that pregnancy can be dangerous. That is why you should not neglect your well-being and self-medicate. This is exactly what most non-pregnant women do.

A woman who is in an interesting position, if a cold occurs, should undergo a medical examination as soon as possible. At the same time, not only the therapist, but also the gynecologist should give an assessment of the state of health.

Cold treatment during pregnancy

The disease should never be left to chance. You always need to make appropriate adjustments. In most cases, doctors recommend using folk remedies for treatment. However, in some cases, antiviral drugs are simply needed. During pregnancy, not all remedies are allowed. The age of the fetus must always be taken into account.

during pregnancy: 1 trimester

At this stage, the future baby is especially susceptible to the influence of extraneous factors. The placenta has not yet formed to protect the baby. That is why you should be very careful when taking various medications. You can use tablets or medicine only on the recommendation of a doctor. Self-treatment can cause irreparable harm to the unborn baby.

Antiviral drugs during pregnancy should be taken in compliance with the prescribed dosage. Quite often, doctors reduce the dose indicated in the annotation, thereby they want to reduce Negative influence to the fruit. In the first trimester, you may be prescribed Arbidol tablets, but only in a prophylactic dosage. In this case, you can never independently increase the number of tablets. Also, the doctor may recommend drinking the medicine "Paracetamol", but this should be done only when the body temperature rises.

With the development of infection in the sinuses of the nose, antiviral drops are prescribed: "Pinosol" or "Lazolvan". They are safe for the baby, as they are not absorbed into the blood, but have only a local effect. Also, for irrigation of the throat, it is recommended to use the Lugol solution, Chlorophyllipt oil or the Tantum Verde spray.

In the first trimester of pregnancy, if possible, use only folk ways treatment, but should not be taken a large number of vitamin C. That is why you need to be very careful when choosing grandmother's recipes.

Antiviral drugs during pregnancy: 2nd trimester

At this stage, the treatment is somewhat easier, but it is worth noting that in the second trimester, expectant mothers rarely get sick. Antiviral drugs during pregnancy (they do not have any effect on the fetus, since the formed placenta reliably protects it. However, this does not mean that the medicine can be taken independently and thoughtlessly from now on. At this stage, all the same drugs that the doctor recommended earlier.

Antiviral drugs during pregnancy that can be used after 14 weeks may be as follows: Interferon drops, Viferon suppositories, Oscilococcinum or Ergoferon tablets.

All these substances contain the main active ingredient: interferon. Once in the body, it binds to proteins and destroys viruses, increasing its own immunity. The method of administration of the substance is chosen by the doctor and depends only on what kind of virus has entered your body.

With a common cold, preference should be given to tablets and drops. At the same time, the latter are prepared independently (from a dry powder, which can be purchased at the pharmacy network).

If the virus has affected your intestines, then you should choose candles. They are administered rectally and act on the body more quickly.

Third trimester and treatment of viral diseases

Allowed antiviral drugs make up a slightly larger list. During this period, you can be assigned all the same funds that can be used in the second trimester. In this case, the dosage can be increased from prophylactic to normal.

Also at this time, you can treat with antibacterial agents. This becomes necessary when antiviral drugs become powerless. Of the following, the following can be recommended: Flemoxin tablets, Fmoxicilin capsules, Vilprofen and others. Before starting such treatment, it is necessary to pass a bacterial culture for sensitivity to certain drugs. Simultaneously with such treatment, it is worth taking funds that restore the internal microflora of the intestines and vagina.

Antivirals before childbirth

If you get sick just before the birth of the baby, then you should start treatment as soon as possible. during childbirth can lead to unexpected consequences. In this case, you need to remember about the time of removal of antiviral drugs from the body. If you took antimicrobials a few hours before your baby was born, you may not be allowed to feed your baby right away. breast milk. All drugs must be removed from the body before breastfeeding. That is why treatment before childbirth should be approached especially responsibly.

Consult with an experienced specialist and find out all the subtleties and nuances of such a correction.

Conclusion

Now you know which antiviral drugs can be taken at different stages of pregnancy. Do not think that expectant mothers are prohibited from any treatment. Antiviral therapy can and should be carried out, but only after examination and doctor's appointments.

Pathogenic microorganisms are able to pass from sick people to healthy people through the air.

Therefore, the common cold spreads with such speed: after all, everyone breathes everywhere.

What should a future mother do if a sick person has already appeared in her family?

And if the virus still overtakes her, then what antiviral drugs for pregnant women can women take, if they are allowed to use pills in this position at all?

When not to

Yes, there are situations when, being in a position, you have to resort to medication, although the doctor recognizes their harm, which can affect the health of the unborn baby and potential mother.

The greatest danger to the body of the mother and child occurs when antiviral drugs are taken in the early stages.

Because at this time the systems and organs of the embryo are formed. That is why drugs can have a negative effect on the development of the fetus.

In the 2nd trimester, some pills and medicines are already much less able to negatively affect the baby's body.

But the expectant mother can still drink them only with the consent of the doctor.

What can

• Paracetamol

Pregnant women are allowed to take only "pure" Paracetamol, without any additives.

Medications for colds include a small percentage of those that can be given to pregnant women when needed.

• Panadol

It will help to reduce the temperature without much harm to the baby.

• Doctor Mom

Soothes the throat and relieves cough

• Aquamaris, Mukaltin, Bromhexine

Permitted for the treatment of the common cold.

• Allowed to fight viruses Grippferon, homeopathic , Viferon(they only apply after ).
• ointment and drops

Helps in the treatment of a runny nose in a pregnant woman. Also other sprays with sea water.

All these drugs are used only with the permission and under the supervision of a physician.

After all, only a doctor can determine what caused a cold - viruses or bacteria. Antibiotics are used to treat bacterial infections.

Yes, despite the reluctance of the expectant mother to swallow antibiotics, sometimes this is a necessity.

Failure to treat bronchitis, tonsillitis or sinusitis can be fraught with serious complications.

What medicines and remedies are not allowed

At early and later dates not recommended for pregnant women tetracycline and its derivatives streptomycin And chloramphenicol.

Patients often escape from fever aspirin, but doctors know what side effects this medicine has, and insist that women in position do not need to take it.

It can adversely affect the blood of the future mother and baby.

In no case should you put mustard plasters and soar legs, and physiotherapy procedures are categorically contraindicated.

If the treatment of the expectant mother does not help and the temperature rises above 39 ° C, it is urgent to call an ambulance.

And what proven medicines from the “people's first aid kit” will help women cope with viruses during pregnancy?

• The first target in the attack of a cold is the nasopharynx.

So let's not forget about medicinal rinses.

You can use sage infusion:

A handful of its leaves is poured into 0.5 liters of boiling water,

Close tightly and infuse for at least 20 minutes.

The infusion will be even more effective if you add half a teaspoon of sea salt to the glass.

• Any medications will replace radish, this amazingly healthy root crop deserves a place of honor on the table of a pregnant woman.

Radish is rich in antimicrobial substances.

It is very useful to rub it and add honey, it will turn out better. The main thing is that the expectant mother should not be allergic to honey.

• Cranberry- the real natural antibiotic.

It is more useful than any medicine, and will help defeat the flu, acute respiratory infections.

Cranberry juice should not be boiled, because then vitamins are destroyed.

The berries are just poured over hot water, crush with a crush, and then dilute the resulting mixture with slightly cooled boiling water to the desired volume.

The berry mixture is then filtered and sugar or honey is added to taste.

• You can also drink folk antiviral agents - teas with lemon balm and mint, lingonberry juice.

The doctor must decide which teas and fruit drinks you can drink so as not to cause.