Antibiotics during pregnancy: why not and when to

Main indicators of urine analysis during pregnancy

• Color Yellow and its shades are considered normal. But some color changes are also possible, which are not always a sign of abnormalities. There are a number of foods (for example, cherries, beets, blackberries) that can color your urine. But if they were absent from the diet, then it is worth finding out what is causing the color change.
• Transparency Urine should only be transparent and a slight cloudiness is already a deviation from the norm. If the urine is not clear, most likely it contains salts, red blood cells, white blood cells, bacteria, drops of fat or pus. The causes of cloudiness may be the presence of infection, kidney stones and other problems.

These are indicators of a general urine test during pregnancy that are “visible to the naked eye.” The further research process is quite complicated and therefore takes some time. But laboratory tests will allow doctors to study other parameters.

Briefly about antibiotics

In a few words, we will consider the benefits and harms of antibiotics for any organism. After all, we all know that we shouldn’t just go into using them. This is a very aggressive category of pharmaceuticals. And at the same time very diverse. In any case, antibiotics require a special order of administration - as prescribed by a physician and in accordance with a strict course. In other words, antibiotics can not only be useless, but also cause harm if you prescribe them to yourself at your own discretion. And that's why.

The main effect of any antibiotic is to destroy bacteria. Only bacteria, which means they are useless against viruses and fungi. Is the average person able to “by eye” understand why he is coughing or snotty - because of a virus or because of a bacterium? Hardly. And it’s not so bad if the medicine simply does not act on the causative agent of the disease, but it can affect other aspects of the body’s life!

Most (but not all!) antibiotics are very toxic, some of them have less drastic effects, and only a few are practically harmless. Side effects of antibiotics include stress on the liver, destruction of beneficial microflora (for example, in the intestines or vagina), dysbiosis and disruption of digestive processes, and the development of fungal diseases (candidiasis). Some of them (in particular from the gentamicin group) even affect the functioning of the kidneys and... the inner ear.

Another feature of antibiotics is that to destroy a specific bacterium, a complex of several drugs or a course of a certain duration may be needed. Mismatch and resistance develops! This mysterious word means that the bacteria remains in the body, its activity may have subsided, but the next time (during an exacerbation or relapse) the group of medications used for the first time will be useless. This kind of immunity to a substance is developed by bacteria.

The imperfection of antibiotics lies in the fact that most of them do not particularly understand what bacteria they act against. But beneficial microflora also lives in the human body. And very often it is more sensitive to antibiotics, that is, it dies before pathogens. The use of antibiotics is almost always stressful for the body. Here you need to weigh the pros and cons: is it possible to do without antibiotics, and it’s good if so. If antibiotics are simply necessary (and this is determined exclusively by a specialized physician), then an attentive doctor will certainly prescribe his patient a course of hepatoprotectors and probiotics. Taking antibiotics from time to time is normal, but regularly is harmful. If a person again and again becomes a victim of bacterial infections, the doctor should think about changing the treatment strategy and rather restoring the immune system. Frequent use of antibiotics only undermines it.

Decoding a urine test during pregnancy: normal and bad analysis

• The protein content in the urine, even insignificantly (for example, 0.033 g/l), indicates the presence of diseases. A healthy person should not have any protein in their urine, so the more protein there is, the worse it is. Protein in a urine test during pregnancy may be caused by kidney disease. Also, a normal urine test during pregnancy should not contain glucose. Its appearance may be a signal from the body about the presence of diabetes or prolonged fasting.
• The acidity of a urine test during pregnancy (pH) should normally be from 4.5 to 8. An increase in the value indicates a possible pathology of the parathyroid glands or kidneys. A decrease indicates the presence of a high temperature, a lack of potassium or dehydration of the body (as, for example, with such a complication of early pregnancy as toxicosis).
• The presence of blood elements in the urine is a sign of various pathologies (infections, kidney stones, etc.).
• Urine density is normal values ​​from 1010 g/l to 1025 g/l. Exceeding the norm of this parameter is called hypersthenuria. The presence of protein, glucose in the urine, and a small amount of excretion are the main reasons for its appearance. On the contrary, a decrease in urine density below 1010 g/l (hyposthenuria) indicates kidney damage, hormonal disorders and a large amount of discharge.

A bad urine test during pregnancy (with an increased content of protein or leukocytes, etc.) is not yet a diagnosis. If the doctor sees deviations in the results of urine tests, he issues a referral for a repeat test and other tests during pregnancy in order to confirm or refute the presumptive diagnoses.

General and clinical urine tests are included in the pregnancy management program of the Center for Reproduction and Family Planning. Find out more about it by phone (+7.

The need for laboratory tests

General analysis of blood and urine (CBC and UAM)

A general blood test determines the number of red blood cells and hemoglobin, which are necessary to carry oxygen. The CBC also examines the number of leukocytes and ESR, which are normally slightly increased during pregnancy. Platelets are involved in blood clotting; their determination during pregnancy is also necessary.

In OAM, the content of leukocytes, the presence/absence of protein, the density and reaction of urine and the presence of pathological structures and substances (casts, bacteria, glucose and others) are studied. OAM is the most often performed test that helps to suspect or determine the pathology of pregnancy (it is taken at each appointment).

Blood type and Rh factor

Blood group and Rh factor are necessary in case of emergency blood transfusion due to bleeding (for example, placenta previa); in case of negative Rh, a blood group and Rh factor test is necessary to exclude or treat Rh conflict.

Blood chemistry

Considering the increased load during gestation on all organs of a pregnant woman, a LBC is taken twice during the entire pregnancy (more often if indicated), which allows you to evaluate the functioning of the internal organs.

Blood for syphilis, viral hepatitis and HIV infection

The study is carried out three times during pregnancy and allows us to identify the listed infections, the presence of which adversely affects the development of the fetus, as well as the condition of the woman during pregnancy.

Smear for microflora and cytology from the cervix and vagina

Microflora smears are taken three times during pregnancy and help identify colpitis and cervicitis, which can cause infection of the membranes and fetus. Cytological examination excludes precancerous and cancerous processes of the cervix.

Blood for rubella, toxoplasmosis and cytomegalovirus

Antibodies of the IgM and IgG class to the listed infections are determined and make it possible to identify acquired immunity or its absence, as well as an acute process, the presence of which is unfavorable for the fetus.

Coagulogram

Indicators of the blood coagulation system during pregnancy are slightly increased; analysis of the coagulogram allows one to identify the risk of thrombosis in a woman, miscarriage and premature birth. Also, a blood clotting study is necessary to confirm gestosis and its treatment.

Double and triple test

It is carried out to determine the degree of risk of congenital pathology of the fetus and chromosomal disorders.

Specialists

Petreykov Evgeniy Rafailovich

If you are planning a pregnancy, IVF, or have a history of fetal failure in the first trimester, contact Dr. Petreikov.
A gynecologist of the highest category, Candidate of Sciences, will help determine the risk and cause of obstetric complications, and also prescribe supportive treatment for a genetic predisposition to thrombosis.

Akhmedova Larisa Maratovna

Obstetrician-gynecologist with experience in a famous Israeli clinic, expert in monitoring pregnancy and the postpartum period.
Performs surgical operations: intimate plastic surgery, removal of polyps, treatment of erosion with Surgitron radioknife. Provides consultations and examinations to couples with suspected infertility.

Bitsadze Victoria Omarovna

Gynecologist-hemostasiologist, professor, doctor of medical sciences.
The doctor's profile is management of high-risk pregnancies, including in women with genetic thrombophilia and a tendency to spontaneous bleeding. Develops effective treatment regimens for infertility associated with autoimmune pathologies and hemostasis disorders.

What antibiotics are allowed during pregnancy?

We came to the conclusion that antibiotics during pregnancy in some cases. Now let's figure out which ones and when:

• absolute contraindications (not allowed under any circumstances):
• tetracycline and doxycycline - easily penetrate the placenta, let alone the first months; accumulate in the bones and tooth buds of the fetus, disrupt mineralization processes, and are toxic to the liver;
• fluoroquinolones (ciprofloxacin, ciprolet, nolicin, abactal, floxal, etc.) are prohibited due to the fact that there is still no reliable basis to assert their safety (no evidence base), at the same time, the ability of substances to damage the joints of the fetus has been established;
• clarithromycin (clacid, fromilid, clubax) and midecamycin, roxithromycin (macropen, rulid) - the safety of use during pregnancy is also not known, there is evidence of toxic effects on the fetus in animals;
• aminoglycosides (kanamycin, tobramycin, streptomycin) - also have a high ability to penetrate the placenta; provoke the risk of complications to the kidneys and inner ear of the fetus, and can cause deafness in the newborn;
• gentamicin - its properties are identical to aminoglycosides, but can be prescribed (better, of course, at a later date) for health reasons and in strictly calculated dosages;
• furazidin (furamag, furagin) and nifuroxazide (ersefuril, enterofuril) - their effect is assessed as potentially dangerous due to the lack of data on the effect on pregnancy;
• chloramphenicol (chloramphenicol, synthomycin, olazol) is prohibited because it passes through the placenta very quickly, and even in high concentrations; negatively affects brain development and disrupts blood cell division; dangerous, among other things, in late stages of pregnancy;
• dioxidine - became prohibited for pregnant women after its toxic and mutagenic effects were proven in experiments with animals;
• co-trimoxazole (Biseptol, Bactrim, Groseptol) - again characterized by penetration through the placenta and in high concentrations; its constituent trimethoprim is an active folic acid antagonist; co-trimoxazole increases the risk of congenital deformities, heart defects, and also slows down fetal growth;

After completing the course of the above listed permitted medications prescribed by the doctor, a second appointment is required to assess the woman’s well-being and repeat examinations.