How should the mothers use the medicine when they met in pregnancy and vaginitis?

Author: Shi Haoqiang, Affiliated to Shanghai Jiaotong University Medical College, Ruijin Hospital

It is a common reproductive system infectious diseases for women. It mainly focuses on bacterial vaginitis, vulvar vulva, and vulvar vulvar infections, and trichomonas vaginitis. This disease has been delayed and patients are very painful.

For pregnant women, due to changes in hormone levels, the environment in the vagina has also changed accordingly. The growth and reproduction of bacteria become active, which also increases the possibility of vaginitis.Once you are sick during pregnancy, if you do not actively treat, a high probability event will have adverse effects on pregnancy, such as premature birth, premature fetal membrane, low weight, and so on.

The most tangled is that the treatment of vaginitis during pregnancy also takes into account the effects of the drugs used on the fetus. Therefore, when pregnancy and vaginitis are unexpectedly encountered, reasonable drugs are particularly important.

Bacterial vaginitis is caused by the decrease in lactobacillus in the vaginal, and the anaerobic bacteria such as Gednezali and Prodorm caused the imbalance of vaginal flora.There is fishy smell, the secretions are mostly gray -white, and pH> 4.5.For women with bacterial vaginitis during pregnancy, it is generally recommended to use metronidazole, clinithromycin, lactobacillus alone or combined with medication. There are also reports of traditional Chinese medicine smoking treatment.

Both metronidazole and clinomycin are drugs for pregnancy safety level B (pregnancy medication is generally defined as A, B, C, D, X level 5, and the safety decreases step by step.It is still safer.

The treatment of symptoms of bacterial vaginitis is as follows:

1. Oral metronidazole 500mg, twice a day, the course of treatment lasts for 7 days;

2, or vaginal tinidazole embolism, once a night, lasts for 7-10 days;

3, or 0.75%metronidazole gel in the vagina, once a night, lasts for 5 days;

4. Or 2%of Klinomycin milk cream vaginal application, once a night, last 7 days;

5. Nitrite Taier 200mg is taken three times a day, 7 days in a row, or 250mg vaginal plug, for 10 days.

For pregnant women with asymptomatic bacterial vaginitis, whether it is necessary to treat some controversy in the treatment of clinical clinicals. Preventive medical groups recommend that pregnant women with low -risk premature risks do not need to screen and treat them.The effective evidence of screening and treatment is not sufficient.

Studies have shown that oral patients with oral metharomycin are used to treat pregnant women who are asymptomatic without bacterial vaginitis, which can reduce the risk of premature birth at about 10%, and reduce the risk of abortion of pregnant women in advanced pregnancy.

Candida infectious vaginitis is second only to bacterial vaginitis. The main symptoms are severe vulvar itching, accompanied by burning pain, increased leucorrhea and often white bean slag -shaped or condensed.The problem.

Pregnant women during pregnancy are high in estrogen and progesterone, the vaginal epithelium has increased sugar content, and Candida grows a lot of growth and reproduction, so it is easy to suffer from this disease.

In the middle and late pregnancy, if you suffer from Candida vaginitis and not treated in time, it may lead to complications such as premature birth, premature fetal membrane breakfast, and chorionic amnioceitis.

During pregnancy, pearl Candida vaginitis is mainly local therapy:

1. Using 2 to 4%sodium bicarbonate solution can be washed to create an alkaline environment that is not conducive to the survival of Candida;

2. Kercimazole suppositories or tablets, vaginal plugs, one capsule per night, 7 days of treatment;

3. Nitrifidiopidazole suppository vaginal plug, one capsule per night, 7 days of treatment;

4. Micromycin embolism, one capsule per night, 7-10 days in a row;

5. Nitrite Taier 200mg is taken three times a day, 7 days in a row, or 250mg vaginal plug, for 10 days.

6. In addition to western medicine, there are also combination of traditional Chinese and western medicine for treatment. For example, in addition to local treatment, it is supplemented by cinniations, snake beds, yellow cypress, rhubarb, hundreds, and white sturgeon.Effect.

Trichomonas vaginitis is a common vaginitis caused by vaginal tricia.For women during pregnancy, changes in vaginal micro -environment are prone to trichomonal vaginitis.

Trichomonas vaginitis can produce adverse consequences such as miscarriage, intrauterine infection, and low birth weight.

The disease is mainly treated with metronidazole:

1. You can take 400 mg metronidazole orally, 2 to 3 times, a total of 7 days;

2. Or 2g metronidazole once; or 200 mg metronidazole vaginal placement;

3. Nitrite Taier 200mg three times a day, 7 days, or vaginal plugs, and 10 days in a row.

After careful reading of metronidazole’s drug manual carefully, readers can find that there is an explanation of "prohibited for pregnant women", which can not help but worry about people.In fact, as mentioned earlier, metronidazole is a level B drug for pregnancy medicine, which is still relatively safe. Some random control tests abroad also show that taking metronidazole does not increase the probability of fetal malformations.

In fact, although metronidazole’s instructions suggest that pregnant women are banned, it is generally believed that metronidazole does not necessarily cause fetal malformations, and on the contrary, there is also a report that reducing the risk of premature birth.

Therefore, the author believes that when vaginitis is onset during pregnancy, it is still possible to use metronidazole preparations due to the consideration of greater prosperity. However, while actively treatingThe possibility of eliminating abnormal tires throughout pregnancy is essential for ordinary pregnant women. It is more important for pregnant women with vaginitis, because in some sense, the health of the pregnant woman’s own physical health is for the fetus for the fetus.The impact will greatly exceed the drug itself.

Of course, taking metronidazole may cause gastrointestinal discomfort, such as nausea, vomiting, abdominal pain, diarrhea, etc., so it is best to take food with food.In addition, patients should avoid alcohol in the use of metronidazole within at least 3 days to avoid "sulfurite -like" toxic reactions.

In summary, when the pregnancy and vaginitis are encountered in an unexpected, the mother of Baoshi should go to the doctor in time to confirm which type of vaginitis belongs to it as soon as possible, and under the guidance of a doctor, use appropriate drugs for active treatment.

In fact, if pregnant women blindly worry about the adverse effects of the drug on the fetus, they may have a lot of bad pregnancy results, leaving regret.

The above is the original work of the "Drug Safety Cooperation Alliance" volunteer. If you reprint, please indicate the author and source!

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