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Tablets from cystitis during pregnancy. Treatment of chronic cystitis. Cystitis during pregnancy: symptoms and treatment

Inflammation of the genitourinary system is very common in women. It is widely believed that cystitis is a non-serious disease, like a runny nose. When he appears, he is treated on his own, and then forgotten for a while. Through certain period the disease returns, because it has already passed into a chronic form.

This disease should not be underestimated. Especially dangerous is cystitis in the early stages of pregnancy, when the fetus is forming. In the second and third trimesters, due to inflammation, there are risks of intrauterine infection of the child and premature birth.

What is cystitis and what are its symptoms?

Cystitis is an inflammatory process in the bladder that disrupts its normal functioning. It mainly affects women because of their physiological features- The urethra is shorter and wider than in men, which is why pathogens can easily enter the bladder.

The disease can occur in acute and in chronic forms. If acute cystitis is not cured, it will turn into chronic, which is characterized by the frequency of attacks. Only after a complete cure of cystitis can pregnancy be planned.

Some women first experience this unpleasant disease during the period of bearing a child. It poses a threat not only to the mother, but also to the baby. That is why, having discovered the first signs acute cystitis during pregnancy, you should immediately consult a specialist and start treatment.

Signs of acute cystitis during pregnancy:

  • frequent urination (up to several times per hour) with small amounts of urine;
  • pain and pain when urinating;
  • false sense that bladder not emptied;
  • pain in the lower abdomen;
  • cloudy urine, the presence of blood or pus in it;
  • hyperthermia;
  • fever.

An increase in body temperature to high values ​​​​suggests that urgent treatment is needed, since the inflammation has turned into dangerous form. Signs of chronic cystitis are identical to the acute course. Only the intensity of their manifestation differs. Pain during urination is not so pronounced, but discomfort may be permanently present in the urethra.

Causes of cystitis during pregnancy

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The causative agents of the disease are Escherichia coli, staphylococci, chlamydia and fungi. During pregnancy, the hormonal background changes, which cannot but affect the microflora of the mucous membranes. This also applies to the genitals, from where the infection occurs.

The provoking factors for the occurrence of pathology are:

  • reduced immunity, in which pathogenic microbes easily enter the body;
  • prolonged stay in the cold - it is important to keep the legs, lower back, kidney area warm;
  • taking certain medications that, when excreted through the bladder, irritate its mucosa, causing inflammation;
  • allergic reaction to drugs intimate hygiene, condoms, food, etc.;
  • warming procedures in a sauna, bath or bath contribute to a change in the composition of the microflora of the genital organs;
  • non-compliance with daily hygiene;
  • other diseases of the genitourinary system, which are subsequently joined by cystitis.

In the first months of pregnancy, a woman experiences a physiological decrease in immune forces. This is necessary so that the body does not reject the embryo, which consists not only of maternal cells, but of their alien paternal ones. Decreased immunity is often the cause of the development of cystitis and other ailments in pregnant women.

Progesterone, which is produced in the body of a pregnant woman, helps to relax muscles, including the bladder. As a result, pathogenic microorganisms penetrate the genital organs, and inflammation begins.

IN last trimester Pregnancy women are even more prone to developing cystitis. This is due to the fact that the uterus presses hard on the bladder, and urine can stagnate in it.

Why is cystitis dangerous for the fetus and women in an “interesting position”?

Timely and adequate treatment of cystitis during pregnancy avoids serious complications. If untreated, cystitis during pregnancy can pass to the kidneys, causing pyelonephritis. This disease is dangerous for all categories of patients, especially for pregnant women. The body temperature rises to critical values, and severe pain appears in the kidney area. Pyelonephritis is treated exclusively in a hospital.

Subsequently, violations of the kidneys threaten such complications of pregnancy as preeclampsia and eclampsia (complicated toxicosis in the later stages). These diseases occur in pregnant women and pose a serious danger to them. Arterial pressure reaches high levels and threatens not only the health, but also the life of the patient. Convulsions may occur, contributing to the death of the fetus and the occurrence of serious injuries in the mother.

The fight against inflammation leads to the fact that the child does not receive enough of the necessary substances, he has a low body weight. Cystitis provokes intrauterine infection child. What will be the consequences of infection, it is difficult to predict.

Any infection is a risk factor for miscarriage early in pregnancy. In the 2nd and 3rd trimesters, preterm labor may occur. That is why at the first signs of cystitis, you should immediately consult a doctor. If the course of the disease is neglected, the body temperature has risen, you need to go to the hospital. In no case should you let the disease take its course, self-medicate and practice the use of traditional methods of therapy. During pregnancy, such actions will have sad consequences.

Diagnosis of cystitis in pregnant women

During pregnancy, a woman regularly gives a general urine test. If she visits a doctor on time, identify cystitis on early stage won't be difficult. Changes in urine parameters (elevated leukocytes, impurities of blood and pus, protein, bacteria) will alert the gynecologist leading the pregnancy, and he will prescribe additional examinations.

The diagnosis of "cystitis" during pregnancy is made on the basis of the patient's complaints and the results of laboratory tests:

  • complete blood count (elevated ESR);
  • urinalysis according to Nechiporenko;
  • bacterial culture of urine to determine the type of pathogen;
  • vaginal smear.

If necessary, an ultrasound of the bladder and kidneys, cytoscopy will be prescribed. Then the pregnant woman is sent to a specialist (urologist) or to a hospital.

A woman should be given Special attention the correctness of the collection of material for the study. You need to collect only the average portion of the morning urine. Before analysis, it is necessary to thoroughly wash, and then collect the urine in a sterile jar. It is better to purchase a container for analysis at a pharmacy.

Biomaterial cannot be collected the night before, maximum time its storage does not exceed 2 hours. It is best to send the analyzes to the laboratory immediately after collection.

Features of the treatment of cystitis during childbearing

Many medications are contraindicated for pregnant women. This is due to the fact that chemical substances in their composition are teratogenic in nature, i.e. may harm the fetus. You should be especially careful in the first months, because it is at this time that all organs and systems of the baby are laid. When choosing therapeutic methods, the specialist must take into account the duration of pregnancy and accompanying illnesses women.

Be sure to drink plenty of water, which will help the body quickly remove pathogenic microbes from the bladder. The total amount of fluid consumed should be at least 2.5 liters per day. It is better to use a simple drinking or mineral water recommended by the doctor.

With increased pressure, drink plenty of fluids with caution. It is necessary to limit salt intake so that water does not linger in the tissues. You should definitely discuss this issue with your doctor and follow all his appointments.

Particular attention is paid to the diet for cystitis. Some foods can provoke irritation of the mucous membrane, it is better to exclude them from the diet (spicy spices, seasonings, mustard, garlic, onions, smoked foods, mushrooms). The ban is imposed on strong tea, coffee, sweet soda. The menu necessarily includes diuretic products (watermelons, melons, cucumbers). Meat consumption should be limited until the symptoms of cystitis disappear.

Many physiotherapy procedures are contraindicated for pregnant women. For cystitis, the doctor will recommend only warm compresses and electrophoresis.

Antibacterial drugs

First of all, they are appointed antibacterial drugs, because the source of the disease is often bacteria. Many antibiotics are prohibited for use during pregnancy, others can be drunk with caution. The decision to prescribe certain drugs should be made only by a doctor. He will assess the likely harm and benefit to the expectant mother and child.

More often, experts opt for drugs such as Amoxiclav and Monural. They have fewer contraindications and side effects, they can be taken during childbearing. At the same time, the drugs are quite effective, they quickly remove pain. Antibiotic therapy continues for up to 2 weeks, and symptoms disappear a week after the start of treatment.

A trusted remedy for cystitis is Furadonin. However, drinking it before childbirth is contraindicated. In the last months of pregnancy, Furadonin can provoke anemia in a child.

If the condition of a woman is severe, she is placed in a hospital, bladder instillation can be used. Usually, the procedure is indicated for the chronic course of the disease. In this case, the drug is injected into the affected organ through a catheter.

Herbal medicines

In addition to antibiotic therapy, the doctor will prescribe medication, the action of which is aimed at the complete excretion of urine. Such herbal preparations include Kanefron in the form of tablets. It is shown to women in position, does not negative impact on their condition and development of the fetus.

Kanefron causes a diuretic effect, relieves spasms, inflammation and pain. It has an antimicrobial effect, enhances the effectiveness of antibiotics. The drug is approved for use even in early pregnancy. After a few doses, the patient will feel significant relief, and unpleasant symptoms will be lost.

Folk remedies

Alternative methods can be used in pregnant women only after agreement with the attending physician. He may approve some prescriptions as an addition to the main therapy. It is impossible to self-medicate, use exclusively herbal remedies - this is fraught with serious complications for the expectant mother and child.

Herbal preparations can have a positive effect on the bladder. It is allowed to use plantain, chamomile, bearberry, marshmallow, St.

Dill gives a good anti-inflammatory and antibacterial effect. In addition, it has a diuretic effect, which is necessary for cystitis. Has a similar effect lingonberry leaf, a decoction of it can be drunk during pregnancy. Subsequently, herbal infusions are used to prevent the recurrence of cystitis.

Followers traditional medicine However, attention should be paid to natural pharmaceutical products, in which the components are selected in such a way as to exclude harmful effect on a child. You should not experiment and make your own herbal preparations, because some of them can provoke an allergy or a miscarriage.

Prevention of cystitis during pregnancy

Pregnant women should know and follow the rules for the prevention of cystitis:

  • spend daily hygiene procedures genitals. It is necessary to use special means for intimate hygiene and warm water. In this case, it is better to take a shower rather than a bath.
  • Wear underwear made from natural fabrics. Synthetic shorts can provoke the active reproduction of harmful bacteria in the urinary organs.
  • Avoid hypothermia. Not worth it long time stay in the cold or swim in cool water. Be sure to dress for the weather, the pelvic area should be warm.

The disease at first glance is harmless, but extremely unpleasant. agonizing frequent urges urination can bring anyone to tears and fatigue, and even more so a pregnant woman, whose load on the body already exceeds the usual, and the state of the nervous system is usually far from ideal.

The special importance of treating cystitis during pregnancy is not exaggerated - and it's not just about discomfort and pain. The danger of inflammation of the bladder is that the so-called ascending infection is not excluded, that is, the entry of microorganisms from the bladder through the ureters into the kidneys, which will provoke the development of pyelonephritis, a condition that seriously complicates pregnancy. Therefore, when the first signs of cystitis appear during pregnancy, treatment should begin immediately. Undoubtedly, the universal rule for pregnant women also applies here: “Just a little - run to the doctor!” But this is not always possible, so you can start treatment yourself.

How to treat cystitis during pregnancy, when almost nothing is possible? Do not despair! In the arsenal of modern pharmacies there are both quite effective herbal preparations and modern synthetic preparations.

The basis of the treatment of cystitis during pregnancy is, of course, antibiotics. Antibiotics are ideally given after susceptibility culture. But, firstly, it will take a long time to wait for the results, and time is running out and the inflammatory process is aggravated. And secondly, there are not so many antibacterial agents that a pregnant woman can take.

We will not touch on the treatment of specific cystitis associated with tuberculosis and STDs (gonorrhea, mycoplasmosis, chlamydia and others) - their management has its own characteristics. But in any case, the course of treatment should be carried out completely. Of course, the desire of a woman to stop treatment at the first sign of improvement is understandable, but such an approach can end, at best, with a resumption of inflammation, and at worst, with chronic cystitis, when the disease becomes a lifelong nemesis.

Antibacterial therapy

In order to effectively act on cystitis during pregnancy, the treatment must have a strictly directed effect, which means that the concentration of antibacterial agents that destroy the cause of the disease - pathogenic microorganisms - should be maximum in the bladder. This can be achieved in two ways:

    use such an antibiotic in tablets, which will be retained in the bladder as much as possible;

    inject funds directly into the bladder by instillation.

In the first case, the choice of drugs is very limited. Perhaps of all synthetic medicines for pregnant women, only two drugs remain: monural and amoxiclav.

Monural widely used for the treatment of cystitis - it is effective and, when used correctly, is safe for both the pregnant woman and the fetus. Monural is also attractive in its treatment regimen: in uncomplicated conditions, it is enough to take just one sachet of the drug.

Amoxiclav- a combination drug that can also be prescribed for cystitis in pregnant women. In the medical literature, one can often find an opinion about the dubious effectiveness of amoxiclav for the treatment of infections of the genitourinary system, but practice shows the opposite - in most cases, the drug has good results.

Instillations carried out exclusively under medical institution. Through the catheter into the bladder enter the compositions with antibacterial action ( medicinal oils, rivanol, boric acid, silver nitrate and others). The advantages of such treatment are obvious: the drugs are injected directly into the diseased organ, which, firstly, increases its content in the bladder, and secondly, excludes its general effect on the body. True, you will have to put up with some discomfort during the introduction of the catheter, and also endure the urge to urinate for an hour.

Phytotherapy

Herbal medicine is one of ancient ways getting rid of diseases. But herbs are also poisonous, so pregnant women should strictly adhere to the recommendations and take into account contraindications for taking herbs. For the treatment of cystitis, a pregnant woman can use horsetail, asparagus roots, unpeeled oat grains, mountain ash, lingonberries, rose hips, dill and others. medicinal plants. The most effective are special collections, consisting of a whole complex of herbs, which, of course, increases their healing effect. There are also tablet forms of herbal remedies, for example, kanefron.

Kanefron different enough quick action, which is explained by the variety of its effects - kanefron has antimicrobial, diuretic and antispasmodic effects. There are practically no contraindications for its use (with the exception of individual intolerance).

Physiotherapy

The use of physiotherapy during pregnancy is very limited. Heat on the bladder area and electrophoresis can be used to treat cystitis.

Do not forget that only your doctor knows exactly how to treat cystitis during pregnancy for you. And only he will prescribe the safest and most effective treatment.



Women who experience such an unpleasant disorder as cystitis during pregnancy are worried about whether it is dangerous, what complications can occur and how to avoid them. The disease is characterized by very unpleasant manifestations, upon detection of which, the pregnant woman should immediately go to the clinic, undergo a full examination and begin treatment. Cystitis is dangerous not only for a pregnant woman, but also for the fetus.

Cystitis is an inflammatory or infectious disease of the bladder. It is accompanied by violations of the functionality of the body. The main cause of the development of the disease is considered to be the impact of pathogenic microorganisms. Considering that in pregnant women the immune system is weakened due to the fact that all forces go to protect the fetus, they most often suffer from pathology.

Another question that worries the fair sex is whether it is possible to get pregnant with cystitis. It is possible, but doctors do not advise doing this. First of all, you should completely cure the disease, and then plan to conceive, otherwise there is big risk harm your unborn baby.

In order not to face an unpleasant disease during pregnancy, you should familiarize yourself with the factors that provoke its development. Depending on the cause, the violation is divided into types.
Many women do not know why cystitis is dangerous, so they do not attach any importance to the first manifestations, but go to the doctor when the signs are already very disturbing.

  • infectious cystitis. Its occurrence is provoked by pathogenic bacteria, in particular E. coli. Reasons for the development of the disease: non-compliance with personal hygiene;
  • Drug cystitis develops as a result of taking a woman in position different kind medicines. Decay substances are excreted in the urine, irritate the mucous membrane;
  • Allergic cystitis can develop as a reaction to food, cosmetics;
  • Thermal cystitis occurs due to the fact that the patient is supercooled or overheated, so women during pregnancy should give up short skirts and dresses in the cold season.

Pregnant women are especially susceptible to various diseases in the early stages, since their immunity is weakened, the hormonal background is disturbed, pathogenic microorganisms easily penetrate inside, where there are favorable conditions for development and reproduction.

Symptoms

Inflammatory bladder disease should not be started, especially during pregnancy. This can cause the most serious complications. If you find even the slightest malfunction urinary tract, you should immediately seek help from your doctor and do not waste time. Cystitis, like any other disease, is easier to cure on initial stage than when the disease is already running.
The main manifestations of cystitis during pregnancy include the following:

  • Increased urge, especially at night;
  • Urination accompanied by burning;
  • Bloody impurities in the urine;
  • Urine cloudy and with a strong smell;
  • Body temperature is slightly elevated;
  • Pain in the pelvic region.

If a woman has chronic cystitis or has been worried about this disease before, it is likely that during pregnancy it will flare up with new force therefore, preventive measures should be taken, and when the first signs appear, go to the clinic.

Danger

Of course, mothers are worried about how inflammation can affect the health and development of the fetus. The baby in the womb is in a dense shell that is not exposed to microorganisms, so the disease itself, especially if it is detected and treated early, does not threaten the child. The danger is elsewhere. To be cured, a woman must take medications, antibiotics, and they already have a bad effect on the baby's condition.

Often, with inflammation, a reverse outflow of urine occurs. This affects not only the bladder, but also the kidneys. Inflammation of the urinary tract often provokes:

  • Miscarriage;
  • premature birth;
  • Water leakage;
  • intrauterine infections.

Women diagnosed with cystitis should not think about pregnancy. First you need to undergo a full examination, cure all existing disorders, and then think about conceiving a child.

If you failed to prevent and avoid the disease, consult a doctor, let him prescribe a treatment. It is strongly not recommended to take any measures on your own.

Folk remedies that can be effective for cystitis are often contraindicated in pregnant women. Any careless action can provoke a miscarriage.

To determine whether the patient really has cystitis, a series of examinations should be carried out. The first thing the doctor prescribes is a complete blood count. With its help, you can detect if there are pathogenic microorganisms in the urine. For diagnostic purposes, cystoscopy may be prescribed. Tests such as x-rays and ultrasounds are also helpful. They allow you to determine not only cystitis, but also other diseases that can pose a danger to the health of a pregnant woman and her unborn child.

When cystitis is diagnosed, the doctor must first determine what factors provoked its development. The methods and drugs that will be used during treatment will depend on this. If it is an infectious cystitis, a woman is prescribed antibiotics, and they, in turn, do not have a very favorable effect on the condition and development of the fetus. Antibiotics are contraindicated in pregnant women, so you have to approach the treatment of an inflammatory disease differently.
Doctors may prescribe the following drugs to their pregnant patients:

  • Pain medications;
  • Means that help to relax the muscles of the inflamed organ;
  • Anticholinergics.

To cure cystitis faster, you should drink plenty of fluids, in particular still water.

Do not eat spicy foods, fried foods, too fatty. Should be completely abandoned alcoholic beverages limit the consumption of sodas.

With cystitis during pregnancy, it is necessary to adhere to bed rest. Positive emotions and good mood have a positive effect on the condition of a pregnant woman.

It is much easier to prevent any disease than to treat it later, especially during pregnancy. Preventive measures very simple, but effective, they prevent not only cystitis, but also a number of other pathologies.

A prerequisite is compliance with the rules of personal hygiene. Wash daily with soap and warm water or use special means for personal hygiene. Taking a bath is better than a shower. During pregnancy, it is strongly recommended to abandon the thong, and replace them underwear from natural fibers.

Cystitis develops against the background of reduced immunity, so you should take care of the condition immune system. You can take special vitamins for pregnant women as prescribed by a doctor, eat a lot of fruits, walk in the fresh air.

For women in position, it is common frequent urination, especially in the later stages. This is due to the fact that the fetus presses on the urinary organs. You can’t endure it for a long time, but go to the toilet, even if you don’t really want to. So the microorganisms that are in the urine will not be able to penetrate the mucous membrane and cause inflammation.

Cystitis is a complex disorder, especially for pregnant women. If it is not cured in time, you can face very backfire. At the first signs of the disease, immediately contact your doctor, let him prescribe an adequate and safe treatment for the duration of pregnancy. The disease can be prevented by adhering to simple rules.

Pregnancy, planned or spontaneous, is always a different state. female body. The body has new "duties", the load increases. During pregnancy, a woman may experience various problems, one of them is cystitis. Cystitis is an inflammation of the lining of the bladder that is accompanied by specific symptoms and changes in urine and, less commonly, blood tests.

The infectious nature of cystitis occurs in the vast majority of cases. Today we will consider infectious cystitis, given that pregnancy is an immunosuppressive state. Less often, cystitis occurs after taking drugs, or after interventions on the urinary tract)

Causes of cystitis during pregnancy:

1. Change hormonal background.

The hormonal background changes with the onset of pregnancy, the restructuring consists mainly in increasing the level of the pregnancy hormone - progesterone. Progesterone helps maintain the normal tone of the uterus, that is, it relaxes its muscles and prevents miscarriage. In addition to the muscular 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), organs of the gastrointestinal 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, they weaken the mechanism of reverse reflux of urine. The bladder is also hypotonic, the sphincter that separates the bladder cavity from the external environment relaxes, and the risk of entering different flora increases. More often, infection occurs with conditionally pathogenic microflora; in women, the urethra, the vestibule of the vagina and the anus are located very close to each other. The intestinal flora may seem unacceptable to the urinary tract. Even the movement of normal flora to inappropriate places can cause an inflammatory process, in the case of vaginal dysbiosis or intestinal dysbacteriosis, the risk increases significantly.

Also, progesterone reduces the immune defense of the whole body. This is conceived by nature so that the mother's body does not reject the baby. The child is a foreign organism, as it carries half of the paternal genetic set.

Reduced immunity contributes to the fact that microorganisms that have entered the urethra (urethra) are not suppressed by protective cells or are not completely suppressed, which entails gradual development 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 squeezed 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 and laboratory changes. Frequent trips to the toilet are also a risk factor for infection, because they can often be out of the house, there is less opportunity for personal hygiene and the enormous foot traffic in toilets. shopping malls or cinemas (which means seeding with various flora).

Chronic cystitis during pregnancy, as a rule, worsens. Risk factors and causes of exacerbation are the same as in acute cystitis.

Predisposing factors:

Excessive sexual activity

Concomitant diseases (especially type 1 or type 2 diabetes mellitus, because with these diseases local mucosal protection is significantly reduced, and the infection spreads easily),

Irrational nutrition (an abundance of fried, smoked and overly spicy foods),

constipation (long stay stool in the intestine may be accompanied by translocation of microorganisms),

Prolonged sitting in a non-stop position

Non-compliance with the rules of personal hygiene (improper washing, wearing tight and synthetic underwear, thong panties).

Symptoms of cystitis in pregnant women

Frequent urination in small portions.
- Pain and cramps when urinating. Pain may disturb the lower abdomen, the suprapubic region (it is necessary to differentiate with the threat of termination of pregnancy and other pathologies), there may be cramps at the beginning of urination, or, conversely, at the end, when the last portion of urine is excreted. Pain intensity varies from mild pulling sensations to excruciating cutting pains.
- False urge to urinate.
- The appearance of blood in the urine.
- Urine changes color and transparency, becomes cloudy, may acquire an unpleasant odor.
- Increase in general body temperature.

Diagnosis of cystitis

1. Clinical manifestations. You tell the doctor about your complaints, thermometry and a general examination are carried out.

2. General analysis urine 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). According to OAM, a primary diagnosis is made and then the course of treatment is monitored.

3. Complete blood count. In the CBC, we look for signs of systemic inflammation, an increase in leukocytes and an erythrocyte sedimentation rate (ESR). Usually starting acute infection urinary tract does not give a pronounced inflammatory picture in the blood. If there are in the blood significant changes, this means that the inflammatory reaction is pronounced 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 abortion.

5. Examination by a urologist. Urinary infections are treated by a urologist, so the examination should be joint. Initially, the urologist examines the patient, evaluates the test results and prescribes treatment. Further control of the treatment process can be carried out by an obstetrician - gynecologist of the antenatal clinic. A 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, erythrocytes and cylinders is evaluated (hyaline cylinders 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 in 1 ml, erythrocytes are less than 1000 in 1 ml, cylinders (hyaline) are less than 20 in 1 ml.

Urinalysis 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. Start collecting urine at 8 am, before that at 6 am you should urinate (night urine is not needed), and then urinate every 3 hours in a separate jar. 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 is collected per day, protein losses with the kidneys per day are analyzed.

Urine culture for flora and sensitivity to antibiotics. Sowing urine is carried out on special nutrient media, the growth of the flora is monitored after 5-7 days. When a pathogenic flora is detected, its pure culture is grown and tested for sensitivity to various antibiotics. Based on the results, you will be given the conclusion that a certain type of pathogen is sensitive, for example, to penicillins and gentamicin, but insensitive to cephalosporins.

For a successful onset and course of pregnancy, it is necessary to properly prepare.

Preparing for pregnancy in chronic cystitis.

1. Laboratory research urine (OAM, analyzes according to Nechiporenko, Zimnitsky, urine culture for flora)

2. Ultrasound of the kidneys and bladder in a filled state. An ultrasound is needed to make sure that the infection has not spread higher and there is no damage to the kidneys (pyelitis or pyelonephritis)

4. Treatment of chronic inflammation or exacerbation according to generally accepted standards (antibiotic, herbal medicine). Pregnancy is resolved 3 months after reaching a stable remission. After achieving remission, you can continue to take herbal remedies from among those that are allowed during pregnancy for a preventive purpose (so as not to cancel them in the early stages and not harm the baby if you manage to get pregnant right away).

5. Examination for STIs of both partners (chlamydia, gonorrhea, ureaplasma, mycoplasma, trichomonas). If infections are detected, the wife is treated by an obstetrician - gynecologist, the husband by a urologist. Pregnancy is allowed after control of cure by 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 on a par with antibiotics and other potent drugs. In some sense, the region of the kidneys and urinary tract is "easily accessible" for medicines 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 collection, bought from the hands, is much more dangerous than an injectable antibiotic with a known composition and well-studied properties and consequences.

Self help for cystitis

Washing (NOT DOUCING!) of the external genitalia with decoctions of herbs (helps relieve itching and inflammation from the outside, and prevents re-infection. Used warm water or decoctions of herbs (chamomile, calendula, string). These techniques are used for self-help at the first signs of the disease, in order to ease your well-being and reach the doctor.

Herbal preparations

Kanefron N is a phytopreparation that includes centaury herb, lovage roots, rosemary leaves. It is used 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. Applied in complex therapy and as a follow-up drug.

Brusniver is herbal collection, which includes lingonberry leaves, St. John's wort grass, rose hips and tripartite grass. It is used internally as a fresh decoction or infusion. The broth is prepared as follows: 1 briquette of powder is poured into 0.5 liters hot water and boil for 15 minutes, then insist 45 minutes. The infusion is prepared a little differently, 1 briquette of raw materials is poured into 0.5 liters of boiling water and infused in a thermos for 2 hours.
It is taken orally 1/3 - 1/4 cup 3 - 4 times a day from 1 to 4 weeks.
Brusniver is also used for complex treatment cystitis, one herbal collection it is very difficult to defeat the infection.

Zhuravit is a phytopreparation based on cranberry extract, also includes ascorbic acid. Zhuravit is available in the form of capsules, taking 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.

Cystone is a tableted phytopreparation. There are 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 preparation includes: extracts of stalk bicarp flowers, reed saxifrage stalks, heart-leaved madder stems, rough strawflower seeds, aerial parts of the flowering osma, an extract of the whole plant of ashen vernia, purified mummy powder. Apply 2 tablets 2 times a day until the inflammatory process stops.

On your own, in addition to the main treatment, you can take decoctions of unpeeled oat grains, dill seeds, mountain ash, wild rose, 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 you don’t need it, but a decoction of oats will be useful.

Antibiotics

Amoxicillin is a penicillin antibiotic used in a variety of cases, including the treatment of urinary tract infections. The dosage and duration of use is determined only by the doctor. Use during pregnancy always involves an assessment and balance of risk to the child and benefit to the mother. There are no absolutely harmless antibiotics. But if there are indications, then they will have to be applied, 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 II trimester, only under the supervision of a physician. Dosage and duration of administration is regulated by a doctor.

Monural (fosfomycin) refers to new antibiotics of the phosphonic group. Now it has gained wide popularity due to the convenient multiplicity of reception and the effectiveness of the action. It is applied once at 3 grams (1 powder). But it is necessary to further monitor the analysis of urine, since the cystitis clinic may subside, it will not hurt to urinate and general state will improve, but bacteria and other signs of inflammation will remain in the urine, which means that after a while the infection will flare up with renewed vigor and it will be more difficult to defeat it.

Antispasmodics

At the first stages of the disease, very pronounced pains in the lower abdomen, above the bosom, may be disturbing. You don't have to endure them. pain provoke the release of stress hormones and can increase the tone of the uterus.

A common advice about a heating pad or, conversely, a cold on the stomach for pregnant women is NOT categorically also suitable because of the risk of uterine hypertonicity.

Drotaverine (no-shpa) taken situationally to relieve pain of a spastic nature. You can take up to 3 tablets per day. Data on the toxic effect on the fetus is not provided, however, long-term use of the drug is not recommended.

Bladder instillations- this is an invasive method of treatment, which is indicated in extreme cases, when the course of cystitis is persistent, does not respond to medical treatment and threatens with complications. The essence of the procedure is the introduction through the catheter into the cavity of the bladder antiseptic solutions. This achieves big square contact of the affected mucosa and the treatment solution, but the constant introduction of the catheter can damage the urethral mucosa. Such treatment is carried out by a urologist.

Features of pregnancy in chronic cystitis:

Periodic intake of herbal antiseptics under the supervision of a physician.

Quality certified drugs are not cheap, and it makes no sense to take them continuously. When you register, tell us in detail about your problem, how often you suffer from exacerbations, what provokes them, what you took earlier and how the drugs helped (this will allow you to make a preliminary conclusion about the sensitivity of the flora).

Taking into account clinical picture Your doctor will decide which drugs to take and how long to take them. Phytopreparations can be alternated and combined, but only under the supervision of a physician.

Plentiful warm drink (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, leg edema and preeclampsia.

A salt-restricted diet (this includes limiting all salted and canned foods, smoked meats and marinades).

If during pregnancy an exacerbation of chronic cystitis occurs, then treatment is carried out with the same drugs as in the case of an episode of acute cystitis, only its duration will be longer. For the aftercare period, diuretic herbs are prescribed, herbal remedies for a long time.

Complications of cystitis for a pregnant woman:

The development of pyelonephritis,
- chronization of cystitis in acute cystitis.

Complications for the fetus:

- delayed growth and development of the fetus in utero,
- the birth of small children,
- increased risk of premature birth and spontaneous abortion in the early stages.

All these consequences are due to the infectious process, which disrupts the blood supply to the placenta.

Prevention of cystitis

Avoid hypothermia
- urinate when the urge arises, do not tolerate,
- observe personal hygiene.

Washing the external genital organs should be done 2 times a day with warm water without soap in the direction from front to back (to prevent the microflora from the vagina and anus into the urethra, and from the anus into the vagina).

Consume a sufficient amount of fluid, the average norm is 1.5 liters per day, if there are no restrictions (edema, arterial hypertension, preeclampsia).

Engage in dosed physical activity(in the absence of contraindications).

At the first signs of the disease, contact your doctor, do not self-medicate.

Forecast

With timely initiation of treatment, the prognosis is favorable. With irregular or delayed treatment, acute cystitis can turn into chronic cystitis or pyelonephritis, which significantly worsens the prognosis.

Pregnancy is often accompanied by various problems, but this is not a reason for frustration. During the planning period of pregnancy, visit an obstetrician - gynecologist and ask about the minimum examination that you and your partner need to complete before conception. If any problems are identified, then you will have time to resolve them and be treated. 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 kinds of errors. Do not be afraid of additional tests and prescribing drugs, because we, like you, are interested in a successful pregnancy and the health of the baby. Look after yourself and be healthy!

During an exacerbation of cystitis, most expectant mothers try to help themselves without using medications. This is due to the fact that many drugs should not be taken during pregnancy.

Disease Definition

In women, during the period of expectation of a baby, various diseases urinary system. The most common is cystitis during pregnancy. Symptoms and treatment are best determined in conjunction with a gynecologist. He will give a referral for tests, refer you to a specialized specialist if necessary, or prescribe the appropriate therapy himself.

It is worth knowing that the appearance of pain and burning during urination, pain in the lower abdomen and a feeling of incomplete emptying of the bladder are the main signs that you have acute cystitis during pregnancy. Treatment will help to quickly eliminate all these unpleasant symptoms.

If at the same time the urine becomes cloudy, an admixture of blood appears in it, then a visit to the doctor is indispensable. This is a sign serious problems, and in some cases may even indicate the onset of cancer.

Causes of the disease

Cystitis is an inflammation of the walls of the bladder. The disease can be caused by opportunistic pathogens. It can be streptococci, E. coli, staphylococci. Also, microorganisms that cause ureaplasma, mycoplasma, trichomoniasis, chlamydia can provoke cystitis during pregnancy. Treatment will directly depend on the identified pathogen.

But there is also a non-infectious form of the disease. Cystitis can occur due to chemical or mechanical irritation of the mucous membranes of the bladder and urethra.

But most often the cause is a change in the hormonal background and a weakening of the immunity of the expectant mother. Because of this, infectious agents begin to multiply faster, which leads to the development of the disease.

Possible diagnosis and prescribed treatment

Having noticed unpleasant symptoms in yourself, you can, of course, self-medicate, remembering all the folk methods of getting rid of such an ailment. But if you do not remove the cause, then the disease will constantly worsen. Also, cure launched form it will be much more difficult.

To make a diagnosis and identify the causative agent of the infection, doctors recommend undergoing a general examination, passing a urine test according to Nechiporenko and doing bakposev. In addition, they check the microflora in the vagina and do an ultrasound of the organs related to the genitourinary system.

The test results obtained allow the gynecologist or urologist to choose the most suitable drug.

Chronic form

Many women delay treatment until the disease becomes their constant companion. Its chronic course is characterized by the fact that exacerbations occur at least 2 times a year. At the same time, a common cold or even slight hypothermia can provoke the appearance of symptoms. Also, the cause of acute cystitis can be poor hygiene, sexual activity, swimming in open water or infrequent urination.

You can't start the disease. If you have cystitis during pregnancy, treatment should be prescribed in a timely manner. Otherwise, it can lead to the development of pyelonephritis, cause a small weight of the child and significantly complicate the course of childbirth.

Necessary Therapy

If you have cystitis during pregnancy, the treatment will be selected in such a way as not to harm the baby in any way. In normal situations, therapy consists of taking antibiotics. But in interesting position most antibacterial agents cannot be drunk. Therefore, doctors often use a different tactic.

In order to alleviate the condition of patients, physiotherapy procedures are prescribed. Therapies such as UHF, iontophoresis, inductothermy may be recommended. Therefore, do not be afraid to go to the doctor and say that you have cystitis. During pregnancy, treatment with medication will be prescribed only if the situation is too deplorable. The urologist or gynecologist will be able to choose antibacterial agent made from natural raw materials. It will not have a negative effect on the fetus, but it will help to avoid problems that untreated cystitis could lead to.

For example, a gynecologist may prescribe the drug Monural or Amoxiclav. They are able to concentrate in the urine and thereby shorten the period necessary treatment. They don't have much side effects, they are allowed to be taken by pregnant women and children.

installations

One of the most effective methods installations are considered. This is the name given to the introduction of drugs directly into the bladder through a special catheter. Do not refuse if the doctor offers you such a procedure. It can quickly bring relief if you have cystitis with early pregnancy. Treatment also helps to restore the walls of the bladder and prevent possible relapses.

The procedure is carried out only within the walls of a medical institution. It is done in the following way. A special disposable catheter is inserted into the urethra and all urine is released. After that, an antiseptic is injected through it into the bladder using a Janet syringe. Then it is disconnected, and the injected fluid is poured out through the catheter. The process is repeated several times until the solution that comes out becomes completely transparent. After that, the antiseptic is injected again, filling the bladder halfway. It is important not to urinate 2 hours before the procedure and the same amount of time after it.

Alternative Methods

Doctors often advise expectant mothers on therapies that every woman can use at home. Alternative treatment cystitis during pregnancy is the use of diuretics. Even urologists and gynecologists advise making decoctions of St. John's wort, horsetail, calendula, wild rose, and oat grains. Of course, they are not the main way to get rid of the problem, but they can significantly speed up recovery and reduce the necessary treatment time.

But do not forget that expectant mothers should not use herbs uncontrollably, so before using folk methods, you should consult a doctor. He will tell you how often you can use such decoctions if you have cystitis during pregnancy. Treatment with folk remedies is not always safe.

Useful fruit drinks

Along with drug treatment, often doctors recommend increasing the amount of fluid consumed. For these purposes, they recommend making fruit drinks from cranberries. A properly prepared drink contains a colossal amount of vitamin C. Morse can alleviate the condition a little if cystitis has begun in women during pregnancy. This will make the treatment more effective and necessary period drug therapy may be shortened.

To prepare a healthy drink, you will need 2 cups of berries, 5 tablespoons of sugar and 2 liters of water. Cranberries must be mashed with a masher, put the resulting mass on gauze folded in several layers, and squeeze the juice through it. The remaining pulp is laid out in a saucepan, poured with water and sugar. The resulting mixture is brought to a boil and boiled for 5 minutes. After the broth must be cooled and mixed with the juice squeezed from the berries.

Popular folk recipes

The many ways that proponents suggest alternative methods treatments are also popular among physicians. Urologists recommend drinking cranberry juice, excluding coffee, fatty foods and alcohol from the menu. It is desirable to focus on products that have a beneficial effect on the genitourinary system: parsley, dill, lingonberries, rose hips, carrots, asparagus.

Popular folk method is the use of millet infusion. To do this, it is washed and filled with water in a ratio of 1: 4 overnight. In the morning, the infusion is stirred and filtered. Drink it ½ cup several times a day.

All folk recipes are based on the fact that the patient should take decoctions or infusions from plants that have a diuretic and antimicrobial effect. These include lingonberries, heather, St. John's wort, aspen, bearberry, echinacea.

Among home methods, the following is popular. Healers offer to mix grated apple, horseradish and honey. This mixture is taken in 1 tsp. before meals. You can also insist horseradish in hot milk: for 1 glass of liquid you need 1 tbsp. l. this root. Strained infusion is drunk throughout the day in small sips.

Preventive methods

If you do not want to know how cystitis manifests itself during pregnancy, home treatment is best done as a preventive measure. To do this, you do not need to use pharmaceutical novelties, you just need to follow certain recommendations of doctors.

Among them, the most effective are the following:

Timely and complete hygiene of the genital organs;

Restriction of fatty and fried foods;

Exclusion of hypothermia of the pelvic organs;

Use a large number liquids, including cranberry fruit drinks.

In addition, it is important to lead an active lifestyle (pregnancy is not a disease, so you can and even need to move) and minimize the amount of stress. One of possible causes the development of cystitis can become a permanently crowded bladder. Therefore, expectant mothers should empty it often enough.