Cystitis is an infectious and inflammatory lesion of the mucous membrane of the bladder.
There are many causes of cystitis. Here are the main and most common causes of inflammation of the bladder mucosa.
The main causes of cystitis during pregnancy:
- Hypothermia;
- Infectious and inflammatory diseases of the genital organs, including STDs (sexually transmitted diseases);
- Untreated urethritis (inflammation of the urethra);
- Incomplete emptying of the bladder, stagnation of urine;
- Cystoscopy (instrumental examination of the bladder);
- Congenital pathologies of the bladder;
- Bladder injuries;
- Wearing tight underwear made of artificial materials;
- Breaking the rules intimate hygiene.
The main symptoms of cystitis during pregnancy
Very often, women do not attach due importance to the symptoms of cystitis, especially if they are short-term. As a result, the sluggish inflammatory process turns into chronic cystitis, which in turn can cause serious kidney disease. You should consult a doctor and take general blood and urine tests if you observe the following symptoms:
- Difficulty urinating (occasionally or constantly);
- Cutting, itching, burning during urination;
- Chills, increased body temperature;
- Nagging pain in the lower abdomen and lumbar region;
- Urge to urinate when the bladder is empty.
Treatment of cystitis during pregnancy
By self-medicating, we may be able (for a while) to relieve painful symptoms, but we will not eliminate the cause of the disease, and the disease will return again. Let's not risk our health, because only a urine and blood test (possibly multiple times) will help establish the correct diagnosis. This is especially true for expectant mothers, because for them regular monitoring of urine and blood tests throughout pregnancy is mandatory.Pregnant women are often diagnosed with cystitis. This may be a consequence of chronic cystitis acquired before pregnancy, or due to specific changes in the body expectant mother. Changes in hormonal levels, daily enlargement of the pregnant uterus, hormonal exacerbation of bacterial urinary tract infections - all this can cause acute or chronic exacerbation of cystitis during pregnancy.
How to avoid cystitis during pregnancy? Here are some safe tips and tricks:
- Disciplined visits to an obstetrician-gynecologist and other specialized specialists (upon recommendation), routine ultrasound examination, and passing all necessary tests.
- Emptying your bladder regularly and promptly. Even if the urge occurs every 15 minutes, you should not endure it in any case - the pregnant uterus puts pressure on the bladder, and the ureters also put pressure, hence the frequent urge. With stagnation, the urine becomes infected, and the inflammatory process will not take long to occur.
- Strictly follow the rules of intimate hygiene. Do not overuse panty liners, which happens quite often among women. Use them only when absolutely necessary, changing them at least every half hour.
- Eliminate fried, smoked and spicy foods from your diet. Surprisingly, such food can cause cystitis!
- Visit the dentist to sanitize your oral cavity. You cannot place fillings, crowns, or remove a nerve during pregnancy (this should be taken care of before pregnancy). The dentist will treat your teeth with fluoride and silver, which will delay the development of caries.
- Avoid during pregnancy nylon tights and tight synthetic underwear. Just forget about thongs for 9 months! It is this narrow strip that carries microbes, bacteria, E. coli (!) to the bladder and birth canal, through which your baby will be born very soon!
- Do not ignore your doctor's recommendations regarding exercise for pregnant women. The specialist will develop individual program taking into account the duration of pregnancy, your physical fitness and existing diseases. But even if you are categorically against physical education for pregnant women, perform one simple and safe exercise recommended by obstetricians-gynecologists and urologists. It's very simple: lean on your elbows and knees ( knee-elbow position or, as urologists call it, “the broken birch pose”) and stay in this position for 5 to 15 minutes 2-3 times a day. After the first attempt, you will feel significant relief in the spine, lower back, and abdomen. The whole secret is that the pregnant uterus, which squeezes the bladder, ureters, kidneys, spine and intestines as it grows, relaxes in this position. All organs of a pregnant woman in this position function normally: the kidneys discharge urine in portions into the ureters, the lesion passes unhindered into the bladder, there is no stagnation of urine, the kidneys breathe, and the spine rests. As for the uterus itself, this position is useful and comfortable for it too - your baby is like in a cradle.
- Avoid hypothermia. Take prenatal vitamins as recommended by your doctor.
- Avoid large gatherings of people during the period of influenza and ARVI (and at any other time), since the expectant mother does not need too noisy and large company.
- When having sexual intercourse during pregnancy, it is advisable to protect yourself with a condom. Do not forget that a condom protects not only from pregnancy, which in this case does not scare you, of course, but also from STDs, bacteria, and fungi that can harm both the expectant mother and the child (including termination of pregnancy). It should be noted that foreign microflora (even healthy ones) can cause irritation and inflammation in a pregnant woman.
What to do if you are diagnosed with cystitis during pregnancy?
Currently, there is a fairly wide selection of medications for the treatment of cystitis in pregnant women. These are mainly drugs based medicinal plants. And yet, the most important thing here is not to miss the one First stage diseases in order to start treatment on time, to prevent complications and the development of a chronic form. Therefore, if a woman feels cramps, pain, burning during urination and, especially, increased body temperature, it is necessary to visit a doctor without delaying it for a day.
The basic principles of treatment for timely detected cystitis are the removal of inflammation, cleansing of the urinary tract and, if necessary, strengthening the immune system. Herbal medicine, anti-inflammatory, antiseptic preparations based on medicinal herbs, as well as vitamin complexes, cope well with all this.
Here is a list of some medicinal herbs that are safe to use during pregnancy:
- Bearberry (bear's ears) has anti-inflammatory and diuretic effects.
- Lingonberry leaves, as well as birch leaves and buds, have anti-inflammatory, mild diuretic and antimicrobial effects. Contains essential vitamins and microelements.
- Horsetail has a similar effect as lingonberry leaf.
- In tablet form, pregnant women are prescribed the drug "Canephron"; its composition includes: lovage root, rosemary leaves and centaury herb. Canephron not only has an anti-inflammatory effect, but also has antispasmodic and antimicrobial effects.
- For aching pain in the lower abdomen, along with the listed remedies, you can use papaverine in suppositories (rectally) up to 5 suppositories per day. Papaverine has an antispasmodic effect, relaxes smooth muscles internal organs, helps with mild constipation.
You need to know that some herbs are strictly prohibited during pregnancy– parsley root leads to uterine hypertonicity, which can cause miscarriage, premature birth. Strawberries and juniper fruits cause uterine contractions, which can also lead to miscarriage.
The drug "Fitolisan" is also based on medicinal herbs, but it contains parsley root. It can be used according to a doctor's indication, but you need to make sure that it is not acute inflammation in the kidneys and uterine hypertonicity. Fruit drinks made from lingonberries and cranberries are very healthy and tasty; they also have anti-inflammatory, antimicrobial and diuretic effects.
Diet for infectious and inflammatory diseases of the urinary system (cystitis) in pregnant women limits the consumption of: salt, spices, fatty and smoked foods. Sometimes dairy products are limited (if protein is detected in the urine). If you haven't ignored alarming symptoms and consult a doctor on time and start treatment - you will overcome cystitis quite easily. Yes, it is possible that after some time you will have to repeat the course of herbal medicine, but this will consolidate the result and prevent inflammation.
If you have already been diagnosed chronic cystitis, it is advisable to plan the pregnancy, and at the same time prepare it in advance for pregnancy and childbirth. Visit a gynecologist, nephrologist and urologist. Check your urine, blood and smear tests. For any identified pathologies, strictly follow the advice of doctors you trust. Take a course of multivitamins “Complivit” and “Triovit”. Your task is to relieve the inflammatory process in the genitourinary system and prevent the infection from spreading to the kidneys.
But even if pregnancy occurs unexpectedly, and prepare the body with chronic diseases If you don’t have time, not a single competent doctor will recommend that you have an abortion just because you have chronic cystitis. There are a sufficient number of drugs available for use during pregnancy. The doctor’s task is to choose the right drug for you (taking into account the duration of pregnancy, tolerance and general condition of the body) to relieve inflammatory processes and consolidate the result (prevention of exacerbations) throughout pregnancy.
Regular observation by an obstetrician-gynecologist, urologist and timely treatment of an exacerbation that has begun will allow you to cure cystitis during pregnancy at any stage!
About 10% of women suffer from urinary tract inflammation during pregnancy. This is due to the high load on internal organs and the tendency to infection. The doctor decides how to treat cystitis in pregnant women; you cannot independently determine the method of therapy. Taking many medications during pregnancy can harm the woman and the unborn baby.
An alarming symptom is pain when urinating; the patient complains of a frequent urge to deurinate. But the disease not only causes inconvenience to the pregnant woman, but is also a serious threat to pregnancy. Cystitis can cause the following complications:
- infectious process in the kidneys;
- malfunction of a paired organ;
- change in placenta;
- abnormal child development.
Methods of therapy
Cystitis during pregnancy occurs at any stage and often occurs in an acute form. It is characterized by pronounced symptoms and causes a deterioration in the condition of the pregnant woman. Pathology is detected using diagnostic studies. A blood test shows an increased ESR and leukocyte level; the urine contains epithelium and harmful microorganisms. Ultrasound examination shows thickening of the walls of the bladder and the presence of residual urine.
In the acute course of the disease, treatment of cystitis is carried out as follows:
- the cause of inflammation is eliminated by affecting pathogenic microflora;
- symptomatic treatment to alleviate the patient’s condition;
- special diet;
- bed rest.
Antibiotics during pregnancy
Such drugs during pregnancy cause changes in microflora, can provoke an allergic reaction, and negatively affect the development of the fetus. Therefore, a woman should not be allowed to take antibiotics during pregnancy according to the traditional dosage regimen.
At the same time, it is necessary to influence the pathogenic microflora, its spread contributes to infection of other organs of the urinary system. Therefore, we still take antibiotics during pregnancy, but in a minimal dosage.
Monural
A broad-spectrum drug is indispensable for infectious diseases genitourinary system, it is recognized as safe. It is taken for cystitis during pregnancy once, the dosage form is powder (3 g.) or granule. Helps destroy pathogenic bacteria and normalize the urinary system.
Amoxiclav
This drug is used somewhat less frequently for the treatment of cystitis, it contains amoxicillin, and is also a broad-spectrum antibiotic. Dosage form– tablets, suspensions, solutions for injections. The treatment regimen is established by the doctor, taking into account individual characteristics.
In some cases, instillation of the bladder and the introduction of antibiotics and antiseptic drugs into its cavity are required. Washing is carried out using a catheter, which is inserted into the urethra.
Treatment of acute cystitis
Acute cystitis during pregnancy occurs abruptly, develops rapidly, and is characterized by severe pain during deurination and in the lower part of the abdominal cavity. A woman's body temperature rises. Treatment for a pregnant woman is aimed at getting rid of pathological bacteria and relieving the manifestations of the disease.
The doctor establishes the treatment regimen, the use of effective and safe means helps prevent the spread of the pathogen and transition to the chronic stage.
Medications
Before prescribing treatment, a pregnant woman must undergo an examination, which allows the type of pathogen to be determined. Taking into account the nature of pathogenic microorganisms, the doctor prescribes treatment:
- Antibacterial drugs. Penicillin group (Ampicillin, Amoxiclav), cephalosporins (Cefazolin), fosfomycin (Monural). They can be used during pregnancy and do not pass through the placenta.
- Antiviral agents. They use drugs from various groups. To improve the body's resistance (Anaferon, Interferon), to get rid of viral bacteria (Acyclovir).
- Antifungal. To combat fungal pathogens, Lamisil and Micomept are used.
Antiprotozoal drugs (Ordinazole, Metronidazole) are also used. It is strictly prohibited to independently select medications; some of the above medications are not used in the first months of pregnancy. If a woman is bothered severe pain– antispasmodic drugs are prescribed (No-shpa, Papaverine). Non-steroidal drugs (Nurofen, Ibuprofen) are also used for these purposes. For acute cystitis, it is recommended to increase the volume of fluid you drink to quickly eliminate the infection.
The use of certain medications during pregnancy - sulfonamides and tetracyclines - is strictly prohibited. They can cause developmental deviations in the child. Also, in acute forms of cystitis, you should not wash the bladder.
Folk remedies
As an additional treatment, decoctions and herbal infusions prepared at home can be used. Herbal remedies can reduce inflammation, improve the condition of the mucous membrane, prevent the growth of bacteria and are safe during pregnancy. Treatment folk remedies carried out over 1–2 months.
To remove urine, drink teas based on bearberry and plantain. The following herbs have an anti-inflammatory effect:
- chamomile;
- horsetail;
- St. John's wort.
When treating cystitis during pregnancy, review your diet, remove spicy foods, and eliminate salt intake. Drink drinks based on cranberries, rowan, birch leaves, lingonberries, and marshmallow roots. Regarding the use of warming procedures during pregnancy, consultation with a doctor is required.
Treatment of chronic cystitis
This form of the disease is a consequence of untreated acute cystitis. The symptoms are vague, treatment is aimed at preventing relapses of the pathology and getting rid of the infection. It is very important to strengthen the body’s defenses during chronic cystitis due to the possible activation of existing pathogenic bacteria or the penetration of new ones.
Medications
It is quite difficult to completely cure chronic cystitis during pregnancy. The main actions are aimed at eliminating relapses. A woman should take medications prescribed by a doctor, adhere to a diet, and drink more fluids.
Chronic cystitis is diagnosed in the early stages of pregnancy. During this period, the use of many drugs can harm the woman’s health and cause developmental disorders in the child. That is why instillations are used, which prevents the components from reaching the fetus. To treat cystitis during pregnancy by rinsing, the following agents are used:
- rivanol;
- dioxidine;
- silver nitrate;
- boric acid;
- chlorhexidine.
If the causative agent is harmful bacteria, bacteriophages are used. Rinsing the urea allows you to destroy pathogenic microorganisms that are located in the thickness of the mucosa.
The procedure is carried out after preliminary emptying of the bladder. To prevent infection, the passage of the urinary canal is treated with an antiseptic. Next, the drug is administered through the urethra. This method acts locally on the source of inflammation, which helps destroy the pathogen and rapid recovery normal operation organs.
Plant-based medications for cystitis during pregnancy with an anti-inflammatory effect are also used.
Chronic cystitis during pregnancy is treated with the following drugs:
- cystone;
- Monurel;
- phytolysin;
- canephron N.
To prevent exacerbations of cystitis, vitamin therapy and the use of probiotics are required.
Folk remedies
If you have chronic cystitis in pregnant women, you can use herbal medications that will help avoid exacerbations:
- a mixture of pine nuts and honey;
- tea based on marshmallow and black currant roots;
- diuretic decoctions of horsetail, dill seeds, birch leaves;
- bearberry infusions;
- a mixture of honey and black radish;
- cranberry, rowan, lingonberry fruit drinks.
Prevention
Infectious inflammations of the urinary organs during pregnancy can cause serious complications, so it is important to take everything necessary measures to prevent cystitis.
Before becoming pregnant, a woman needs to undergo a comprehensive examination, if any gynecological diseases or infections - get treatment. To strengthen the body's defenses, take vitamins, eat fresh fruits and vegetables.
Follow the rules of personal hygiene to prevent infection from entering the urinary ducts. During pregnancy, wear cotton underwear, keep your lower back and legs warm, and stay away from drafts.
Many women face the problem of cystitis during pregnancy. According to some data, from 10 to 50% of expectant mothers are susceptible to this pathology.
Due to the anatomical proximity of the urinary and reproductive systems in women, the infection can very easily spread from the bladder through the urethra, external genitalia (vulva) to the vagina and uterus, where the fetus is located. The situation is greatly aggravated by a decrease in the immune defense of women. As a result, cystitis during pregnancy can threaten the well-being of not only the mother, but also the small developing organism.
Causes of cystitis during pregnancy
The causes of cystitis during pregnancy are pathogenic microorganisms that actively multiply and lead to inflammatory changes in the bladder.
Before pregnancy, some of them could be in the woman’s body, however, thanks to immune system, did not lead to the development of the disease. During this crucial period, the mother’s protective forces are significantly reduced so that the child can fully develop, which leads to the activation of the so-called conditionally pathogenic microflora.
However, in some cases, cystitis in pregnant women is a consequence of infection from outside. Therefore, a special role must be given to the prevention and treatment of sexually transmitted infections not only during pregnancy, but also before it.
In addition, factors contributing to the development of bladder inflammation during pregnancy are:
- Anatomical features of the female body. The urethra of the fairer sex is much shorter than that of men. Its diameter is also larger. This promotes the free and rapid penetration of pathogenic microflora from the external genital area into the urethra and bladder. Also next to the outlet of the urethra is the opening of the vagina and rectum. If there is an infection in these organs, it can easily penetrate into the bladder;
- Previous surgical operations on the genitourinary system, in particular on the bladder, as well as injuries to these anatomical formations;
- Poor circulation and congestion in the pelvic organs caused by excess pressure of the pregnant uterus, which manifests itself especially clearly in later;
- Hormonal changes. Due to the fact that the child is a “stranger” for the mother’s body (since it has a different set of genes), nature has provided for an increased release of hormones that are responsible for reducing the woman’s immune defense so that the fetus has the opportunity to fully develop;
- Previous gynecological, venereological or urological diseases inflammatory nature, especially if they were not cured before pregnancy;
- Excessive hygiene. During pregnancy, women produce more secretions from the genitals and, therefore, have a desire to wash themselves more often than usual. Usage hygiene products if taken regularly, it can provoke a disruption of the normal microflora, which will lead to the development of dysbacteriosis and candidiasis of the genital organs. This fact significantly increases the risk of cystitis.
Symptoms of cystitis during pregnancy
Symptoms of cystitis during pregnancy are:
- Frequent urination. When an infection enters the bladder, the body tries with all its might to eliminate it, which is clinically manifested by a frequent urge to urinate. A woman has to get up even at night and more than once to go to the toilet. In severe cases, the urge may occur every 10 minutes. However, the amount of urine produced for each urination is very small. Due to the frequent occurrence of this symptom in most representatives of the fairer sex, many women consider cystitis to be an integral sign of pregnancy;
- Imperative (false) urge to urinate. One of the most typical signs cystitis both in early pregnancy and on the eve of childbirth is the presence of false urges. They appear intense desire urinate, but are not accompanied by urination. These urges deprive a woman of peace, not allowing her to fully rest at night;
- Pain and burning during urination. These unpleasant symptoms appear with every act of urination, especially at the end;
- Change in urine color. If there is blood in the urine, or rather red blood cells, then its color becomes dark. If the inflammation is purulent in nature, then the urine becomes cloudy, which is due to the admixture of protein, leukocytes, and pus in it.
Treatment of cystitis during pregnancy should be carried out exclusively by a doctor.
Only a doctor can give the correct answer to how to treat cystitis during pregnancy. To eliminate pathogenic microflora, it is necessary to take an antibiotic. However not every drug is suitable for the expectant mother, since, penetrating into the blood, it can enter the cells of a growing fetus and cause irreversible changes.
As for herbal preparations for the treatment of cystitis in pregnant women, then in this case Don't rely entirely on safety natural ingredients , since in some cases the illiterate use of homeopathic medicines can also harm the health of the unborn baby.
Widespread method of administration medicines using instillations (infusions) into the bladder. This treatment option excludes a pronounced systemic effect on the mother’s body, and, consequently, the child, but has good clinical effectiveness.
Medicines from cystitis during pregnancy must be combined with, which involves limiting hot and spicy foods, as well as drinking plenty of fluids to speed up the removal of infection from the bladder.
Complications of cystitis during pregnancy
The consequences of cystitis during pregnancy can be very diverse.
However, the most common complication is pyelonephritis– spread of infection to the kidney. Cystitis can become complicated both at the beginning of pregnancy and in the later stages.
Prevention of cystitis during pregnancy
Pregnant women need to know basics of cystitis prevention:
- You need to learn not to tolerate it and empty your bladder as soon as the desire arises;
- Compliance with personal hygiene rules is mandatory. However, hygienic detergents should not be used frequently. Preference should be given to simple washing with warm water.
- Hypothermia must be avoided. In autumn and winter, it is advisable to wear outerwear that completely covers the lumbar region, and it is better to forget about short jackets.
Restrictions should also apply to the diet. It is advisable to completely avoid spicy, hot and fried foods, but it is better to drink more fluids. And of course, you need to worry as little as possible and rest more often.
Pregnancy, whether planned or spontaneous, is always a different state of the female body. The body has new “responsibilities” and the load increases. During pregnancy, a woman may experience various problems, one of them is cystitis. Cystitis is an inflammation of the inner lining of the bladder, which is accompanied by specific symptoms and changes in urine tests and, less commonly, blood tests.
The infectious nature of cystitis occurs in the vast majority of cases. Today we will look at infectious cystitis, given that pregnancy is an immunosuppressive state. Less commonly, cystitis occurs after taking medications or after interventions on the urinary tract)
Causes of cystitis during pregnancy:
1. Changes in hormonal levels.
The hormonal background changes with the onset of pregnancy, the restructuring consists mainly of an increase in the level of the pregnancy hormone - progesterone. Progesterone helps maintain the normal tone of the uterus, that is, it relaxes its muscles and prevents spontaneous miscarriage. In addition to the muscle layer of the uterus, progesterone relaxes all structures that have smooth muscle fibers. The targets of progesterone include: organs of the urinary system (ureters, bladder), gastrointestinal organs intestinal tract(esophagus, stomach, intestines), vessels, and especially veins (veins of the lower extremities and hemorrhoidal veins).
This hormone relaxes the muscles of the urinary system, the ureters become wider, and the mechanism for the return of urine in them is weakened. The bladder is also hypotonic, the sphincter relaxes, which separates the bladder cavity from external environment and the risk of exposure to different flora increases. More often, infection occurs with conditionally pathogenic microflora; in women, the urethra, vestibule of the vagina and anus are located very close to each other. Gut flora may appear inappropriate for the urinary tract. Even the movement of ordinary flora to inappropriate places can cause an inflammatory process; in the case of vaginal dysbiosis or intestinal dysbiosis, the risk increases significantly.
Progesterone also reduces the immune defense of the entire body. This is intended by nature so that the mother’s body does not reject the baby. The child is a foreign organism, since it carries half of the father’s genetic set.
Reduced immunity ensures that microorganisms that enter the urethra (urethra) are not suppressed by protective cells or are not completely suppressed, which entails the gradual development of an infectious process - cystitis.
2. Displacement of the pelvic organs by the pregnant uterus.
As the pregnant uterus grows, the pelvic organs, and in particular the bladder, begin to shift. The possible volume of the bladder decreases as it is compressed by the uterus. For comparison: the bladder capacity of a non-pregnant woman is about 500–700 ml, and that of a pregnant woman is 100–250 ml at different times.
Frequent urination (sometimes up to 10–15 times a day) is normal for a pregnant woman if it is not accompanied by any clinical symptoms or laboratory changes. Frequent trips to the toilet are also a risk factor for infection, because they can often be outside the home, there is less opportunity for personal hygiene and the enormous traffic of toilets in shopping centers or cinemas (which means contamination with various flora).
Chronic cystitis during pregnancy usually worsens. The risk factors and causes of exacerbation are the same as for acute cystitis.
Predisposing factors:
Excessive sexual activity
Concomitant diseases (especially diabetes mellitus type 1 or 2, because with these diseases the local protection of the mucous membranes is significantly reduced, and the infection spreads easily),
Poor nutrition (abundance of fried, smoked and overly spicy foods),
- constipation (long-term presence of feces in the intestines may be accompanied by translocation of microorganisms),
Sitting for long periods of time without breaks,
Failure to comply with personal hygiene rules (improper washing, wearing tight and synthetic underwear, thongs).
Symptoms of cystitis in pregnant women
Frequent urination in small portions.
- Pain and cutting when urinating. Pain may be disturbing in the lower abdomen, suprapubic region (it must be differentiated from the threat of miscarriage and other pathology), there may be pain at the beginning of urination, or, conversely, at the end, when the last portion of urine is released. The intensity of pain varies from minor pulling sensations to debilitating cutting pains.
- False urge to urinate.
- The appearance of blood in the urine.
- Urine changes color and transparency, becomes cloudy, and may acquire an unpleasant odor.
- Increase in general body temperature.
Diagnosis of cystitis
1. Clinical manifestations. You tell the doctor your complaints, thermometry and a general examination are carried out.
2. General urine analysis is the first step laboratory diagnostics urinary tract infections. In OAM we see the specific gravity (density) of urine, the presence of protein and bacteria, the number of leukocytes (inflammatory blood cells) and erythrocytes (red blood cells). Based on OAM, a primary diagnosis is made and the progress of treatment is then monitored.
3. General blood test. In the CBC, we look for signs of systemic inflammation, elevated white blood cells and erythrocyte sedimentation rate (ESR). Typically, the onset of an acute urinary tract infection does not produce a pronounced inflammatory pattern in the blood. If there are significant changes in the blood, this means that the inflammatory reaction is severe and there may be complications.
4. Examination by an obstetrician-gynecologist (both external and vaginal), ultrasound (in particular, cervicometry) are carried out in order to exclude the threat of miscarriage.
5. Examination by a urologist. Treatment urinary infections The doctor is a urologist, so the examination should be joint. Initially, the urologist examines the patient, evaluates test results and prescribes treatment. Further control of the treatment process can be carried out by an obstetrician-gynecologist antenatal clinic. Repeated consultation with a urologist is carried out according to indications, for example, if the effect of treatment is insufficient or a relapse of the disease has occurred.
6. Additional research:
Urinalysis according to Nechiporenko. For this analysis, 1 ml of urine sediment is taken and the content of leukocytes, red blood cells and casts is assessed (hyaline casts are a kind of “casts” of the renal tubules, which indicate the development of an autoimmune process in the kidneys). Normally, leukocytes are less than 2000 per 1 ml, erythrocytes are less than 1000 per 1 ml, casts (hyaline) are less than 20 per 1 ml.
Urine analysis according to Zimnitsky. The process of collecting urine for this analysis is a very responsible matter. You will need 8 clean jars and a timer. Urine collection begins at 8 am, before that you should urinate at 6 am (night urine is not needed), and then urinate into a separate jar every 3 hours. It is also necessary to record the amount of liquid consumed (this also includes soups, vegetables and fruits) and the amount of urine excreted. Based on the results of this analysis, it is possible to determine the density of urine at different hours, the predominance of daytime or nighttime diuresis.
Daily proteinuria. All urine per day is collected, and protein losses from the kidneys per day are analyzed.
Urine culture for flora and sensitivity to antibiotics. Urine culture is carried out on special nutrient media, the growth of flora is monitored after 5 - 7 days. When pathogenic flora is identified, its pure culture is grown and tested for sensitivity to various antibiotics. Based on the results, you will be given the conclusion that certain type The pathogen is sensitive, for example, to penicillins and gentamicin, but insensitive to cephalosporins.
For the successful onset and course of pregnancy, it is necessary to properly prepare.
Preparing for pregnancy with chronic cystitis.
1. Laboratory examination of urine (OAM, tests according to Nechiporenko, Zimnitsky, urine culture for flora)
2. Ultrasound of the kidneys and bladder in a full state. An ultrasound is necessary to make sure that the infection has not spread higher and there is no kidney damage (pyelitis or pyelonephritis)
4. Treatment of chronic inflammation or exacerbation according to generally accepted standards (antibiotic, herbal medicine). Pregnancy is permitted 3 months after achieving stable remission. After achieving remission, you can continue to take herbal medicines from among those that are allowed during pregnancy for preventive purposes (so as not to cancel them in the early stages and not harm the baby if you manage to get pregnant right away).
5. Screening for STIs of both partners (chlamydia, gonorrhea, ureaplasma, mycoplasma, trichomonas). If infections are detected, the wife should be treated by an obstetrician-gynecologist, and the husband by a urologist. Pregnancy is allowed after control of cure using ELISA or PCR.
Treatment of cystitis during pregnancy
Antibiotics and herbal preparations are used to treat urological diseases.
Kidney disease is perhaps the only area where herbal medicine is used along with antibiotics and other potent drugs. In some ways, the area of the kidneys and urinary tract is “readily accessible” for medications, because many substances are excreted through the kidneys. However, not all herbs can be used by pregnant women. Approach the issue of treatment very carefully, sometimes an unknown herbal mixture bought second-hand is much more dangerous than an injectable antibiotic with a known composition and well-studied properties and consequences.
Self-help for cystitis
Washing (NOT DOUCHING!) the external genitalia with herbal decoctions (helps relieve itching and inflammation on the outside, and prevents re-infection. Used warm water or herbal decoctions (chamomile, calendula, string). These techniques are used for self-help at the first signs of illness, in order to make you feel better and get to the doctor.
Herbal preparations
Canephron N is a herbal medicine that includes centaury herb, lovage roots, and rosemary leaves. Use 2 tablets 3 times a day with plenty of water (if there are no contraindications to drinking plenty of water, for example, swelling). The course of treatment is from 14 days. It is used in complex therapy and as a follow-up drug.
Brusniver is a herbal collection that includes lingonberry leaves, St. John's wort herb, rose hips and tripartite herb. It is used internally in the form of a fresh decoction or infusion. The decoction is prepared as follows: 1 briquette of powder is poured into 0.5 liters of hot water and boiled for 15 minutes, then left for 45 minutes. The infusion is prepared a little differently: 1 briquette of raw materials is poured with 0.5 liters of boiling water and infused in a thermos for 2 hours.
Taken orally 1/3 - 1/4 cup 3 - 4 times a day for 1 to 4 weeks.
Brusniver is also used for the complex treatment of cystitis; it is very difficult to defeat the infection with one herbal mixture.
Zhuravit is a herbal medicine based on cranberry extract, also includes ascorbic acid. Zhuravit is available in the form of capsules, take 1 capsule 3 times a day in the first 3 days of illness, and then 1 capsule in the morning. The duration of treatment varies greatly.
Cyston is a tablet herbal medicine. There is no clear data on its use during pregnancy, however, use in pregnant women is not contraindicated (if there is no allergy to the components). The drug includes: extracts of flowers of Dicarpus cauliflower, stems of Saxifraga ligulate, stems of madder cordifolia, seeds of rough strawflower, aerial parts of Onosma bractiflora, extract of the whole plant of Vernonia ashy, purified mumiyo powder. Use 2 tablets 2 times a day until the inflammatory process subsides.
On your own, in addition to the main treatment, you can take decoctions of unrefined oat grains, dill seeds, rowan berries, rose hips, as well as lingonberry and cranberry fruit drinks. Before taking these decoctions and fruit drinks, consult your doctor so as not to duplicate the drug. For example, if you take zhuravit, then cranberry juice is of no use to you, but an oat decoction will be useful.
Antibiotics
Amoxicillin is a penicillin antibiotic used in a wide variety of cases, including for the treatment of urinary tract infections. The dosage and duration of use are determined only by the doctor. Use during pregnancy always involves an assessment and balance of risk for the child and benefit for the mother. There are no absolutely harmless antibiotics. But if there are indications, then they will have to be used, since the infection will harm the baby much more.
Cephalosporins (cefuroxime, ceftriaxone, ceftibuten, cephalexin) are used both in capsules and by injection. Approved for use from the second trimester, only under medical supervision. The dosage and duration of administration are regulated by the doctor.
Monural (fosfomycin) belongs to new antibiotics of the phosphonic group. Now it has gained wide popularity due to its convenient frequency of administration and effectiveness of action. Apply once, 3 grams (1 powder). But it is necessary to further monitor the urine test, since the clinic of cystitis may subside, urinating will not hurt and the general condition will improve, but bacteria and other signs of inflammation will remain in the urine, which means that after some time the infection will flare up with renewed vigor and it will be possible to defeat it it will be more difficult.
Antispasmodics
In the first stages of the disease, very pronounced pain in the lower abdomen, above the womb, may bother you. You don't have to tolerate them painful sensations provoke the release of stress hormones and can increase the tone of the uterus.
The common advice about a heating pad or, conversely, cold on the stomach is absolutely NOT suitable for pregnant women due to the risk of uterine hypertonicity.
Drotaverine (no-spa) It is taken situationally to relieve spastic pain. You can take up to 3 tablets per day. No data on toxic effects on the fetus have been provided, but long-term use of the drug is not recommended.
Bladder instillations- This invasive method treatment, which is indicated in extreme cases when the course of cystitis is persistent and cannot be treated drug treatment and threatens complications. The essence of the procedure is the introduction of antiseptic solutions through a catheter into the cavity of the bladder. This achieves a large area of contact between the affected mucosa and the treatment solution, but constant insertion of the catheter can damage the urethral mucosa. This treatment is carried out by a urologist.
Features of pregnancy with chronic cystitis:
Periodic intake of herbal antiseptics under the supervision of a physician.
High-quality certified drugs are not cheap, and there is no point in taking them continuously. When you register, tell us in detail about your problem, how often you suffer from exacerbations, what provokes them, what you took before and how the medications helped (this will allow you to make a preliminary conclusion about the sensitivity of the flora).
Taking into account the clinical picture, your doctor will choose medications and the duration of their use. Herbal medicines can be alternated and combined, but only under the supervision of a doctor.
Drinking plenty of warm fluids (at least 1.5 liters per day) will help the urinary tract to effectively “flush” and prevent stagnation. The amount of fluid should be consumed taking into account the presence of arterial hypertension, swelling of the legs and preeclampsia.
A diet with limited salt (this includes limiting all salted and canned foods, smoked foods and marinades).
If an exacerbation of chronic cystitis occurs during pregnancy, then treatment is carried out with the same drugs as for an episode of acute cystitis, only its duration will be longer. For the period of follow-up treatment, diuretic herbal mixtures and herbal medicines are prescribed for a long time.
Complications of cystitis for a pregnant woman:
Development of pyelonephritis,
- chronicization of cystitis in acute cystitis.
Complications for the fetus:
- delayed growth and development of the fetus in utero,
- birth of low birth weight babies,
- increased risk of premature birth and spontaneous abortion in the early stages.
All these consequences are caused by an infectious process that disrupts the blood supply to the placenta.
Prevention of cystitis
Avoid hypothermia
- urinate when the urge arises, do not tolerate it,
- maintain personal hygiene.
Washing the external genitalia should be done 2 times a day with warm water without soap in the direction from front to back (to prevent the introduction of microflora from the vagina and anus into the urethra, and from the anus into the vagina).
Drink enough fluids average rate- this is 1.5 liters per day, if there are no restrictions (edema, arterial hypertension, preeclampsia).
Exercise in doses physical activity(in the absence of contraindications).
At the first signs of illness, consult your doctor and do not self-medicate.
Forecast
With timely initiation of treatment, the prognosis is favorable. With irregular or delayed treatment, acute cystitis can develop into chronic cystitis or pyelonephritis, which significantly worsens the prognosis.
Pregnancy is often accompanied different problems, but this is not a reason for frustration. When planning a pregnancy, visit an obstetrician-gynecologist and ask about the minimum examination that you and your partner need to perform before conception. If any problems are identified, you will have time to resolve them and receive treatment. The rules of nutrition and hygiene during pregnancy are not particularly specific, but it is during this period that a woman’s body is very sensitive to various types of errors. Don't be scared additional tests and prescribing medications, because we, like you, are interested in a successful pregnancy and the health of the baby. Take care of yourself and be healthy!
Cystitis is a fairly serious illness, often diagnosed in pregnant women. According to medical statistics, approximately 10% of expectant mothers suffer from bladder inflammation. Some even consider this disease a nonspecific symptom " interesting situation" And yet, it is necessary to get rid of the inflammatory process, but you should remember that treatment of cystitis during early pregnancy must be carried out under the strict supervision of a doctor. This will help avoid undesirable consequences.
Causes of the disease
Cystitis is a polyetiological disease, that is, it has several causes. The most common of them is the penetration of pathogenic microorganisms into the bladder. Most often, inflammation is provoked by Escherichia coli, somewhat less frequently by staphylococcal bacteria, chlamydia organisms, Pseudomonas aeruginosa and pathogenic fungi.
Why does cystitis become so widespread during pregnancy? The risk of infection in expectant mothers is high due to hormonal changes and associated changes in the microflora of internal organs. Pathogenic microorganisms can enter the ureter after unprotected intercourse or due to poor hygiene after bowel movement.
In the first trimester, cystitis is often a consequence of decreased defenses. The female body, in order not to reject the fetus, suppresses its own immunity, which can lead to the growth of opportunistic microflora, which is already present in the pelvic organs. In addition, inflammation of the bladder in expectant mothers leads to:
Long-term use of certain medications that are excreted from the body in urine and irritate the mucous membrane of the urinary tract;
Allergic reactions in sensitive women to detergents, medications, certain foods, contraceptives, tampons;
Overheating or hypothermia, for example, frequent lying in a bath with hot water, worsens the microflora of internal organs, and overcooling is generally strictly contraindicated for pregnant women.
Stagnation of urine, which occurs due to a relaxed bladder, can also cause cystitis. The hormone progesterone reduces the tone of the uterine muscles to prevent miscarriage, but at the same time relaxes all the smooth muscles in the body. In the third trimester, the likelihood of illness due to congestion increases due to the pressure of the uterus on the bladder.
Malaise can also be caused by:
Permanent negative emotions, depression, stress;
Uncomfortable underwear, also made of synthetics;
Infections localized in nearby organs;
Constant fatigue.
There are many reasons for the development of cystitis, so it is extremely important to understand the possible “provocateurs” in order to be alert in time or even prevent the occurrence of the disease.
Symptoms of the disease
Inflammation of the bladder most often manifests itself abruptly and unexpectedly for a pregnant woman. Already 2-3 days after exposure to a negative factor (for example, infection), a woman feels pain in the lower abdomen. Almost immediately other symptoms of the inflammatory process appear:
frequent urge to urinate (often deceptive), which is accompanied by a small amount of urine output and a feeling of fullness of the bladder;
Burning in the urinary canals towards the end of emptying the bladder;
Cloudiness of urine and a strong odor;
The presence of bloody or purulent discharge in urine;
Fever;
Feeling of pressure in the peritoneum, aching in the lower back.
The intensity of pain can vary, it all depends on the severity of the disease and the level of pain threshold in the pregnant woman. Temperature readings do not always increase; a sharp jump is possible when an infection is added to the inflammation.
Inflammation of the bladder occurs in both acute and chronic forms. Often, it is during pregnancy that a relapse occurs, during which the symptoms listed above occur. When the exacerbation passes, the symptoms become less pronounced.
Is cystitis the first symptom of an “interesting situation”?
A similar opinion can often be found among mothers and even some specialists. However, inflammation of the bladder should not be identified with frequent urination, truly indicating an “interesting situation.”
Cystitis is an inflammatory process affecting the mucous membrane of the bladder, and frequent urges to empty the bowel in expectant mothers can occur for objective “non-pathological” reasons, for example:
With conception, the load on the renal pelvis begins to increase, which work with redoubled force;
Due to increased blood and lymph flow in the female body, the kidneys have to filter more fluid.
Normally, the expectant mother frequent urination does not feel any discomfort or pain, which is typical for the inflammatory process. By the 14th week, the hormonal levels stop “failing”, the uterus returns to its proper place, and the pressure on the bladder gradually stops (until the 3rd trimester). As a result, women will go to the restroom less often.
Thus, cystitis is not characteristic symptom conception has occurred, but also frequent emptying of the bladder, accompanied by pain, temperature, and other negative signs, should not be ignored. The best decision for the expectant mother would be to visit a doctor, who will establish the correct diagnosis.
Diagnosis of the disease
Doctors determine the diagnosis based on the expectant mother’s complaints. To confirm cystitis, the patient is sent for important procedures and tests, the main one being a urine test. It is from these secretions that the specialist determines the presence of inflammation. And, for example, bacterial culture of urine identifies a possible infectious source of the disease.
If you suspect inflammation of the bladder, doctors usually prescribe:
Examination by a gynecologist - a smear of vaginal microflora is taken;
Clinical blood test - most often the indicators are normal, only signs of what has begun in the body are detected inflammation;
General urine examination - the diagnostician assesses the number of red blood cells, and if their number is significant, a conclusion is drawn about pathological processes in the bladder;
The study of urine according to Nechiporenko is a special test that involves a more in-depth study of urine for red and white blood cells;
Urine culture - determines the causative agents of the disease or pathogenic microorganisms connected to the inflammation, helps to determine the type of antibacterial drugs for treatment, that is, this is the main test for choosing treatment;
Ultrasound - prescribed for severe illness to exclude possible deformations, which often become a consequence of the inflammatory process.
In private medical institutions Women may be offered rapid screening for cystitis. Express methods allow you to make an accurate diagnosis literally on the day you visit the clinic.
Important! In any case, before diagnostic procedures, a woman needs to wash her vagina to prevent the corresponding secretions from getting into the urine test.
Is cystitis dangerous?
Yes, the inflammatory process, also complicated by infections, can cause harm women's health and a growing child. The risk especially increases if the expectant mother engages in self-diagnosis and self-therapy, delays visiting a doctor and hopes for self-healing.
There are only two main complications and undesirable consequences of cystitis during pregnancy:
1. Infectious inflammation can spread to the kidney tissue and cause pyelonerphitis. This disease is characterized by fever, unilateral pain in the lumbar region. If the disease affects both kidneys, then a threat to the mother’s life begins.
2. In case of incorrectly chosen treatment tactics or refusal of therapy, the disease becomes chronic, that is, the symptoms of the disease will occur in the woman for the rest of her life, worsening not only her well-being, but also her mood.
(reklama2)
An advanced disease that develops into pyelonephritis is also dangerous for the child. When the excretory organs are not functioning properly, toxic substances accumulate in the mother’s body, poisoning the developing fetus. The result may be the baby's underweight or premature birth.
That is why, at the slightest concern, the expectant mother should immediately consult a doctor. This will allow you to choose the safest medications or folk remedies. In addition, the doctor will give recommendations for lifestyle changes.
Drug treatment
How to treat cystitis during pregnancy should only be decided by a doctor. Inflammation of the bladder requires a special approach to therapy, since the use of the vast majority of antibiotics, which are supposed to defeat infectious pathogens, is contraindicated for pregnant women.
Most often, doctors prescribe antibacterial drugs for cystitis, and the drug chosen is the one that reaches the highest concentration in the tissues of the bladder. The most effective and harmless antibiotics for the treatment of cystitis in expectant mothers are drugs such as:
- Amoxiclav– two-component medicinal product, whose active substances destroy various pathogenic microorganisms, causing diseases urinary system. This antibiotic is quite safe, has a minimum of side effects and contraindications.
- Monural– another safe and extremely effective antibiotic. Positive results visible after the first use of the medicinal powder! If the disease has become severe, you will need to take a second sachet of medicine.
Another popular “anti-cystitis” drug is Canephron N tablets. This product contains herbal ingredients that allow you to short time improve the condition of a pregnant patient. Canephron N combines well with other medications, so it is often prescribed in complex treatment inflammation Bladder.
While carrying a baby, they often use modern way– instillation. In this case, antibiotics are administered through a tube directly into the inflamed organ, thereby bypassing the systemic bloodstream. Of course, such a treatment technique is only possible in a hospital setting.
Traditional recipes for cystitis
The most popular “anti-cystitis” plant is, of course, lingonberry. There are ready-made herbal teas, which includes lingonberry, birch, currant leaves, dill, rowan berries and other natural ingredients.
Let's list the most popular unconventional methods treatment of inflammatory processes localized in the bladder.
1. Pour 4 teaspoons of dried lingonberry leaves into 2 cups of boiled water. Place on low heat and simmer for a quarter of an hour. Then the broth is cooled and a little honey is added to taste. Drink the resulting lingonberry infusion in the first half of the day, 100 ml.
2. Brew 2 tablespoons of rosehip berries, 2 tablespoons of lingonberry leaves with boiling water and leave for a couple of hours. Then strain the infusion and drink throughout the day, adding a little honey for taste.
3. One part of lingonberry leaves and 3 parts of red rowan fruits are brewed with 200 ml of boiling water, left for 3-4 hours and filtered. Drink 100 ml infusion 3 times a day, adding a little fresh honey to taste.
Treatment of cystitis during early pregnancy with folk remedies is quite acceptable. However, such treatment methods are still not a priority. It is also worth understanding that non-traditional recipes should be previously agreed upon with the treating doctor.
Prevention of bladder inflammation
Like other ailments, it is better to prevent cystitis during pregnancy than to struggle with it painfully later. Moreover, methods of prevention inflammation bladder have long been known and are not very difficult to implement in practice.
1. First of all, even before conception, it is necessary to fully detect advanced infectious processes and cure them. For example, even caries can provoke the transfer of infectious agents to the urinary organs.
2. Hygiene is also extremely important. The expectant mother should wash herself daily with warm water, avoid hot bath, take a shower to get the ingredients detergents did not penetrate the vagina and did not lead to inflammation.
3. Underwear It is also important to choose correctly. For example, so-called thongs are contraindicated because they do not protect a woman from inflammation. It is best to purchase panties of a standard style made of cotton or linen.
4. A pregnant woman is simply not allowed to become hypothermic. For this purpose, expectant mothers should exclude long stay in the cold and wear warm clothes in the cold season. Of course, short walks will only be beneficial.
5. Frequent visits to the restroom are advisable. With regular emptying of the bladder, pathogenic microorganisms are eliminated more quickly and cannot actively multiply in the body. Therefore, when the urge occurs, a woman does not need to endure.
6. You also need to monitor your diet. The consumption of salty and pickled foods is excluded, especially if cystitis has already made itself felt before pregnancy. Coffee and caffeinated drinks are also prohibited. But a fruit drink made from cranberries and lingonberries, and a rosehip decoction will only be beneficial.
If the expectant mother works in an office, she needs to take care of physical exercises. After half an hour or an hour, you should get up from your chair and walk around a little and warm up. This will prevent congestion in the bladder.
Thus, inflammation Bladder disease is not a disease whose symptoms can be ignored. Treatment of cystitis during early pregnancy at home is carried out using medicines and folk recipes selected by the doctor. The task of the expectant mother is to pay attention to the signs of illness in time and consult a doctor. Thus, she will save herself and the baby from possible negative consequences.