Treatment and prevention of influenza during pregnancy in different trimesters. Flu and cold medicines during pregnancy

This is less stress for a pregnant woman, in her usual home conditions she will be able to lie down, and drink the necessary medicines, and gargle, and read her favorite book.

It is important that the room in which the pregnant woman lies is ventilated every day and the floor is washed with disinfectants, as well as door handles and furniture. The dishes of a pregnant woman with the flu should be rinsed with boiling water after each meal.

How to eat during pregnancy during the flu?

During the flu, the body of a pregnant woman loses a lot of strength and requires twice as many vitamins to restore them. Therefore, the diet should be saturated with a maximum of vegetables and fruits. It is desirable that milk-carbohydrate foods predominate in the diet of a pregnant woman, but there should be less salt. Sour cream, cottage cheese, cheese, milk - this is a very good food during the flu, supporting the body. But what about those who do not like dairy? There are vegetables and fruits - they have all the necessary substances that will support and strengthen the immune system.

During the flu, you need more warm drinks, but not only teas and decoctions from medicinal plants (sage, linden, rose hips, rich in vitamins). It is also important to drink freshly squeezed juices, compotes, fruit drinks, mineral water without gas. These drinks will help remove toxins from the body, which is oversaturated with them due to the active activity of influenza viruses.

How to treat a pregnant woman with a high temperature?

If the future mother has a temperature above 38 degrees, which is accompanied by headaches and muscle pain, you need to give her paracetamol or medicines with it to drink. But, like any antipyretic, it is not necessary to abuse it.

Paracetamol, like any other means that reduce fever, is taken no more than 2 times a day with a break of 4 to 6 hours. As much as possible, you can take an antipyretic up to 4 times a day, that is, 2 tablets during the day and two at night are acceptable.

At temperatures below 38.5, antipyretics should not be taken - high temperature contributes to the rapid death of viruses.

Home rinses for pregnant women

To reduce fever and get rid of viruses as quickly as possible, you need to gargle often - in case of an acute inflammatory process, at least 1 time per hour. To do this, it is good to use a solution of furacillin. It is bought in a pharmacy ready-made or prepared by yourself, diluting 0.5 cups of this solution and the same amount of water. There is another option: 800 ml of warm water and 4 tablets of furacillin, which must be diluted in it. In order for the tablets to dissolve well, they can first be poured with a small amount of boiling water, and then add the rest of the water.

It is very good to gargle with soda and salt (you can take iodized salt or sea salt). Dilute them in a ratio of 1 teaspoon of salt or soda to 1 glass of water. To make the effect of rinsing more significant, the nose is instilled with drops that constrict blood vessels. If a cough is also added to the sore throat, the doctor will prescribe a cough medicine for the pregnant woman. It can be a remedy with marshmallow root, which helps very well with this kind of disease. It is drunk 1 tablespoon four times a day for a week.

Flu rinse options during pregnancy

Chamomile infusion - 1 tablespoon of chamomile, poured with a glass of boiling water, boiled over low heat for 10 minutes and cooled. This infusion must be filtered and gargled with it every hour for 5 days.

An infusion of calendula can be prepared in the same way as chamomile, and gargle with it at the same frequency.

Sage infusion is also very good for the destruction of various pathogens, the preparation method is the same, only it needs to be insisted longer - up to half an hour.

Very good for influenza as a rinse infusion of elderberry. Dried flowers can be purchased at a pharmacy. 4 tablespoons of elderberry flowers should be poured with a glass of boiling water and boiled over low heat for another 10 minutes, then cooled, strained and used as a rinse.

Can pregnant women take antibiotics for the flu?

Influenza is a viral disease. If the causative agents of the disease were viruses, then antibiotics will be useless - they only affect bacteria. Viruses live in the very nucleus of cells, so antibiotics are simply not able to penetrate there.

Even if a doctor prescribes an antibiotic, its effect will be directed not to a viral infection, but to the treatment of bacterial diseases associated with influenza. It can be bronchitis, sinusitis, pneumonia, encephalitis, otitis media. It is with these diseases that it makes sense to take antibiotics for a pregnant woman. But only on doctor's orders!

In order for the disease to be tolerated more easily by both the mother and the child, it is necessary to influence the body with immunomodulators. These drugs will powerfully support the immune system and significantly reduce the duration of the disease. But the issue of taking immunomodulators must be discussed with the doctor, since it is very controversial: what exactly should a pregnant woman take, how much and how.

When is a pregnant woman treated for influenza in a hospital?

• A pregnant woman with influenza is sent to the hospital if the form of her illness is severe or hypersevere.
• If a pregnant flu is complicated by other diseases associated with disorders of the nervous system, respiratory organs or other body systems
• If a pregnant woman does not have the opportunity to be treated normally at home

How to treat influenza in a pregnant woman - only the attending physician should determine. In order for the treatment to proceed correctly, you cannot prescribe medications yourself, because you are responsible not only for your life, but also for the life of the unborn baby.

With the appearance of a sore throat, a runny nose, a pregnant woman hopes that this is just a harmless cold. But, alas, it soon becomes known that she caught the flu virus.

An acute infectious disease of the respiratory tract - in other words, influenza, is caused by different viruses. It belongs to the SARS group.

The flu is caused by a specific virus. For example, if you are too cold in bad weather, you will not catch the flu. But it’s another matter if a person sick with this virus coughed on you. This is called airborne transmission. Literally in a matter of hours, a newly healthy person begins to feel incredibly overwhelmed: the virus multiplies in the body at a high speed and spreads through the blood stream throughout the body, causing intoxication of the body.

The danger of flu during pregnancy

In the period of bearing a child, influenza is a danger due to complications, of which the worst is possible premature birth or miscarriage.

In addition, a pregnant woman’s body weakened by the flu is also threatened by a bacterial infection - for example, staphylococcal, hemophilic, even pneumococcal. With this disease, chronic diseases are often exacerbated - asthma, bronchitis, kidney ailments, heart complications. It is possible that a metabolic disorder will remind of itself (for example, gastrointestinal pathologies like gastritis, etc.)

When the virus destroys the mucous membrane of the respiratory tract, the body loses the ability to perform protective functions. This is fraught with negative consequences, including such complications: acute pneumonia, acute or chronic bronchitis, otitis, sinusitis. The virus has a detrimental effect on the cardiovascular system, in particular, it provokes inflammatory processes in the heart muscles, sometimes developing as a complication of the flu. Cardiovascular insufficiency may occur.

The main symptoms of the flu

With influenza, first of all, the temperature rises sharply, severe chills begin, aching joints and photophobia, sometimes nausea with bouts of vomiting. All this testifies to the most powerful intoxication of the body. Later, on the second or third day, dry cough, severe, unpleasant runny nose and sore throat join the listed primary symptoms.

During the flu, a person's body temperature jumps very strongly - it reaches 40 degrees. Sometimes it subsides a little, in which case the patient sweats very profusely. Herpetic eruptions may occur on the lips.

Some pregnant women with the flu may experience sharp pains in the abdomen, sometimes diarrhea. In addition, a pregnant woman with the flu may experience a mild form of depression.

Anti-influenza therapy has its own characteristics, especially when it comes to pregnant women. It should only be appointed by a competent specialist. It is necessary to contact him immediately after the deterioration of health.

Most anti-influenza drugs are prohibited for pregnant women. For example, aspirin, some cough medicines, vasoconstrictors, and some antivirals are banned entirely. In the treatment of influenza in expectant mothers, emphasis is placed on folk remedies or homeopathic medicines. Drinking plenty of fluids is also indicated for flu in pregnant women - the liquid washes the virus out of the body, fruit drinks, tea with lemon, raspberries, rosehip broth - all these healthy drinks are rich in vitamin C. Of the antipyretics, you can only take paracetamol. With a strong cough, the doctor prescribes chest collections from herbs. In such cases, steam inhalations with infusions of St. John's wort, sage, wild rosemary and many other plants are useful.

and symptomatic medications. Antiviral agents must be taken as soon as possible, literally when the first signs of a viral infection appear, since they have a detrimental effect on the pathogenic microorganism that is the causative agent of a respiratory disease. Symptomatic drugs are needed to stop the painful manifestations of the flu, such as cough, runny nose, fever, and others, but they can be used only if necessary. And antiviral drugs for influenza in a pregnant woman are mandatory.

Currently, the following antiviral drugs are used to treat influenza:

• Orvir;


• Midantan;



• Ribamidil;




• Oseltamivir;


• Zanamivir.

According to the recommendations of the World Health Organization, during pregnancy, antiviral drugs of choice against influenza are agents containing oseltamivir or zanamivir as active substances. Currently, an antiviral drug containing oseltamivir is sold on the domestic market under the commercial name Tamiflu. Thus, pregnant women, when the first symptoms of influenza appear, without waiting for the results of the tests, should start taking Tamiflu. It is recommended to take Tamiflu as follows - 1 capsule 75 mg twice a day for 5 days. If the drug has not been taken from the very beginning of the flu, you can drink a five-day course at any time while the active course, especially severe, of a viral infection continues.

The second drug of choice for pregnant women is Zanamivir, which is used in the form of inhalations of 5-10 mg twice a day for 5 days. Both Tamiflu and Zanamivir are classified as group "C", which means there are no clinical trials in pregnant women. Such tests are currently not carried out for obvious reasons. However, in animal experiments, it was found that the drugs do not affect the course of pregnancy and fetal development, so they are considered safe for women who are "in position." In addition, the effectiveness of antiviral agents is much higher than the danger to the health of the mother or child.

Today, homeopathic remedies such as Arbidol, Oscillococcinum and others are very popular for the treatment of influenza. However, these drugs do not have scientifically proven efficacy, so they are not recommended for the treatment of pregnant women.

In addition to antiviral drugs that act directly on the cause of the flu, pregnant women can use symptomatic medications needed to stop the painful manifestations of the infection. So, with influenza, the following symptomatic drugs can be used:

• Antipyretics;


• Antihistamines (stop allergic reactions, relieve swelling);


• Antitussive drugs (stop dry cough);


• Expectorants;


• Decongestants (vasoconstrictor nasal drops).

Consider which drugs from each pharmacological group a pregnant woman can take to treat a cold.

Antipyretics

Pregnant women can use medications containing paracetamol, acetylsalicylic acid or ibuprofen as active ingredients to lower the temperature. Moreover, you should start to “knock down” the temperature with taking paracetamol or acetylsalicylic acid preparations. If these funds are ineffective, then it is necessary to use drugs with ibuprofen. Various drugs with paracetamol, acetylsalicylic acid and ibuprofen approved for use in pregnant women are shown in the table.

Preparations with paracetamol	Preparations with ibuprofen	Preparations with acetylsalicylic acid
Akamol-Teva	Bonifen	Coplavix
Aldolor	Brufen	Trombopol
Apap	Burana	Aspirin Complex
Acetaminophen	Ibuprofen	hl payne
Daleron	Ibuprom	Upsarin UPSA
Panadol	Ibusan	Alka-Seltzer
Ifimol	Ibufen	Aspro Vitamin C
Kalpol	Iprene	HL Cold
Xumapar	Deblock
Lupocet	MOMENT
Meksalen	Nurofen
Pamol	Solpaflex
Paracetamol
Prohodol
Efferalgan

Antihistamines

Pregnant women can use third-generation antihistamines, which include the following drugs:

1. Piperidine derivatives - Fexofenadine, Telfast, Gifast, Allegra, Allerfex, Dinox, Rapido, Feksadin, Fexofast;

2. Derivatives of imidazole - Norastemizol, Seprakor;

3. Azatidine derivatives - Desloratadine, Erius, Lordestin, Desal, Ezlor.

The safest are drugs containing piperidine derivatives (fexofenadine) as an active substance, for example, Telfast, Gifast, etc. These drugs can be used even in pregnant women with severe liver and kidney diseases.

Antitussives

Antitussives necessary for the relief of dry cough. Pregnant women can safely use various antitussive preparations containing dextromethorphan as the active substance. Currently, the domestic market has the following drugs with dextromethorphan approved for use in pregnant women:

• Akodin;


• Grippostad Good Knight;


• Padevix;


• Paracetamol DM;


• Tussin plus;


• Fervex for dry cough.

Expectorants

Pregnant women can use medicines containing guaifenesin as active ingredients and

• Galazolin;


• Grippostad Reno;


• For nose;


• Influrin;


• Xylene;


• xylometazoline;


• Xymelin;


• Nosolin;



• Rhinonorm;


• Rhinorus;


• Rinostop;


• Sialor;


• Suprima-NOZ;


• Snoop


• Rhinomaris;


• Tizin xylo;


• Farmazolin;


• Evkazolin Aqua;


• Espazolin.

Among drugs based on oxymetazoline, the following nasal products are currently available on the domestic market, approved for use in pregnant women:

• Afrin;


• Vicks Active Sineks;


• Nazivin;


• Nazol;


• Nasospray;


• Nesopin;


• Knoxprey;


• Oxymetazoline;


• Sanorin.

All of the above decongestants are safe for pregnant women. However, doctors recommend in the first trimester of pregnancy to refrain from using any remedy for the common cold. Starting from the second trimester of pregnancy, you can safely use these remedies for the common cold.

During pregnancy, a woman's immunity is greatly weakened, so that any, even the most harmless at first glance, the disease can become a real disaster. Despite the fact that the expectant mother is under constant medical supervision, there is a risk of developing severe forms of diseases and then not only the health and life of the pregnant woman, but also the fetus itself inside it will be endangered.

Influenza is doubly dangerous if it starts early in a pregnant woman

Influenza is a viral disease transmitted by airborne droplets. The easiest way to get infected. And it would seem that we all suffer from this disease from time to time. Is it dangerous in this case in the early stages of pregnancy? And if so, what exactly?

There are three types of influenza viruses: A, B and C. Most of them change the structure of their own genes over time, which allows them to affect the body again and again. This is due to the lack of the necessary natural protection of our body - immunity.

At the beginning of pregnancy, the likelihood of contracting the virus is slightly lower than in the later stages. The severity of the course of the disease also progresses along with the degree of development of the fetus, however, influenza poses a great threat to the child precisely in the first periods of the formation of the embryo.

If the expectant mother is still sick, then we should expect an exacerbation of existing chronic diseases. The virus seriously undermines the body's immunity and disrupts the endocrine system, depletes the resources still used to fight other ailments.

For all 9 months of bearing a child, a woman in very rare cases does not get sick at all. If the expectant mother feels unwell, her throat hurts and her nose is clogged, you should not immediately start to worry and panic. ARVI is quite easy to confuse with the common cold, which cannot lead to any serious consequences for the life and health of both. But in this case, you should definitely consult a doctor.

Differences between flu and colds

At first glance, the symptoms of these diseases are very similar (sore throat, stuffy nose, pain throughout the body, fever), but they still have certain fundamental differences. For flu:

1) the patient becomes extremely sensitive to light and loud, sharp sounds;

2) at the beginning of the disease, the temperature rises sharply, then cough and runny nose only begin;

3) severe symptoms last for about a week;

4) high temperature, which lasts long enough, provokes pallor, dizziness, chills and discomfort in the joints.

With intestinal flu, the patient experiences a feeling of nausea, pain in the abdominal cavity and suffers from diarrhea.

To properly treat a cold, it must be distinguished from the flu.

Symptoms

The first signs of malaise may occur within a few days or the first day after the virus enters the body. ARVI is characterized by intoxication of internal systems and structures, together with weak external manifestations.

At the beginning of the course of the disease, the body temperature rises sharply, the fever usually lasts the first 2-4 days, and then the fever also subsides quickly. In the case when the body returns to normal within 1-2 days, a second wave of influenza is possible.

A characteristic feature of SARS is the general intoxication of the body, accompanied by a feeling of aches and pains throughout the body. Redness of the larynx and clogging of the nasal cavity with mucus follows after an increase in temperature.

On examination, the doctor may detect granular formations on the back of the pharynx against the background of its redness and dryness. Such symptoms may appear within a week of illness.

A person suffering from influenza will be distinguished by an unnaturally bright blush on the cheeks with general pallor, possibly blue skin around the lips.

Diagnostics

Before starting the treatment of influenza during pregnancy in the early stages, it is necessary to undergo special laboratory tests, namely: the detection of antibodies on the mucous membranes of the nose and throat and a blood test. Do not rely solely on a visual examination by a doctor. To preserve the health of the woman and the fetus, it is better to achieve a laboratory confirmation of the diagnosis.

However, even these studies cannot give absolute confidence in the condition of the fetus at the time of illness. If any difficulties arise, the patient can be referred for a consultation with a gynecologist and a few more laboratory tests.

Immediately after the recovery of the pregnant woman, it is necessary to again take a blood test for hormones and undergo an ultrasound scan, which can be used to judge the health of the child.

The principle of the virus

Influenza is dangerous due to its toxic processes, affecting mainly the mucous membranes of the respiratory system. Entering the body with air, the virus settles in the trachea and releases toxins that enter the bloodstream of the body. Through the cardiovascular system, the poison spreads throughout the woman's body, including the fetus that has just begun to form.

Influenza threatens not only the pregnant woman, but also her unborn child

The consequences of influenza in pregnant women in the early stages

Complications arising during the course of the disease can affect any functional structure of the body. For example:

1) cardiovascular system - violation of the structure of muscle tissue and integument of the heart and blood vessels, heart failure;

2) reproductive system - violations of the process of embryonic development of the baby, hormonal levels, prematurity, oligohydramnios;

3) respiratory system - otitis, inflammation of the mucous membrane of the sinuses;

4) various allergic reactions are activated and already existing chronic diseases are exacerbated.

Why is the flu most dangerous at the beginning of pregnancy? At the time of the first trimester, the formation and development of the systems of the internal organs of the child falls. Violation of this process threatens with the most serious consequences - up to spontaneous abortion. However, not every such case ends sadly. The expectant mother, with well-designed treatment, recovers. In order to find out how the fetus suffered the disease, ultrasound and blood sampling are performed, which will help to find out the condition and subsequent fate of the baby.

For the treatment of influenza in the early stages, antibiotics are prescribed before 12 weeks of pregnancy only if the benefits that the medicines bring to the woman will put the health of the unborn child at risk to a lesser extent. However, the choice of medications must be approached with extreme caution.

The disease and treatment of influenza in the later stages of pregnancy is not so dangerous and does not lead to such terrible consequences, however, as a result of complications, the child in the future may have certain developmental abnormalities and weak immunity at birth and a little further.

With complications of the disease during the first trimester of pregnancy, thresholds for fetal development or even death of the baby may occur. The virus has the greatest effect on the nervous system of the fetus, so if the child survives, then it is likely that he will remain disabled for life. For this reason, the doctor may even recommend terminating the pregnancy while it is still relatively safe for the woman.

At a later date, there is also a risk of miscarriage, but to a much lesser extent than before.

If as a result of the flu there is a violation of the structure of the placenta, then this leads to problems in the functioning of the placental circulatory system. This problem can be eliminated with the help of medicine. If necessary, then in the last stages of pregnancy, premature birth can be induced. But even here there are risks: oligohydramnios, small weight of the newborn, delays in the development of the fetus.

More than half of children exposed to the influenza virus during pregnancy develop health and post-embryonic developmental problems.

Prevention

1) First of all, a pregnant woman must be protected from potential sources of the virus. To do this, usually when leaving the house during a flu epidemic, they put on a gauze bandage, or smear the nasal mucosa with a special ointment.

2) Do not forget about a healthy lifestyle: moderate social contact, walks in the fresh air, proper and balanced nutrition, adherence to sleep and wakefulness. It is necessary, if possible, to prevent the pregnant woman from being in a stuffy room for a long time.

3) Women from the 14th week of pregnancy can get flu shots.

You can get the flu shot as early as 12 weeks pregnant.

Treatment

If the expectant mother still fell ill with the flu (and it doesn’t matter if it happened at the time of early pregnancy or at the very end), then first of all it is necessary to visit a doctor who, from a professional point of view, will explain exactly how to treat this disease. Self-medication in this situation can lead to very sad consequences for the woman and the child.

In this state, many medicines are contraindicated for the expectant mother, even medicinal herbs and tinctures are not safe to take without consulting a professional.

Most often, pregnant women are prescribed:

1) "Paracetamol" in case it is necessary to bring down the temperature. There are also analogues of this medicine - "GripPo", "Teraflu", etc. But in composition, they differ only in harmless additives and flavorings.

2) Depending on the individual characteristics, the doctor may recommend homeopathic preparations for use.

3) In order to quickly get rid of the flu, constant circulation of fluid in the body is necessary. It is advisable to drink at least 2 liters of water per day. A variety of fruit drinks or teas with additives can go into use.

4) For aromatherapy, you can use eucalyptus or citrus fruit oil. As inhalation, tinctures and esters of various plants are used: sage, chamomile, tea tree, and so on.

5) To relieve pain in the throat, regular rinsing of the cavity is necessary.

6) Healthy sleep, nutrition and the use of vitamins in the form of fruits also contribute to the healing process.

The emotional state of a pregnant woman should always be good so that immunity is strong

The cause of the flu is the penetration of the virus into the body. The virus affects the cells of the body, under its influence they produce viral proteins that cause intoxication. You can get the flu:

• upon contact with the patient (airborne droplets);
• through household items (contact-household way).

Influenza can only be caused by a virus, but there are predisposing factors that, when encountered with a virus, contribute to its fixation in the body. The main factor is a weakened immune system. During pregnancy, the female body is more susceptible to infectious diseases, since during this period, for natural reasons, immunity decreases - all the forces of the body are aimed at protecting the child. Concomitant factors include decreased physical activity, prolonged stress, unbalanced nutrition (typical for the first trimester), beriberi. All these factors make the body vulnerable and open the way to infections.

Symptoms

You can recognize influenza in pregnant women by the signs characteristic of the disease. There are no specific symptoms in expectant mothers. With influenza, the clinical picture looks like this:

• an increase in temperature to 38 - 39 (in severe form it is higher);
• headache;
• discomfort in the muscles;
• pain in the eyeballs;
• nasal congestion and runny nose;
• sore throat;
• dry cough (may be either intense or absent altogether).

The acute onset of the disease helps not to confuse the disease with others similar in symptoms. First, general weakness, drowsiness, lethargy is observed, then the temperature rapidly begins to rise, accompanying symptoms appear - cough, runny nose, etc.

Diagnosis of influenza during pregnancy

Only a doctor can diagnose a viral disease. He makes a diagnosis based on:

• clinical signs (symptoms);
• surveys;
• history scores.

There are also rapid tests, smears from the mucous membranes of the nasopharynx are informative, sometimes they take a blood test for antibodies. However, such methods for diagnosing influenza are used in exceptional cases, for example, with an atypical form of the disease. Most often, a description of the symptoms by the patient and examination is sufficient. When making a diagnosis, the therapist also takes into account the epidemiological situation in the region.

Complications

There are several answers to the question of how dangerous the flu is during pregnancy. In the early stages (up to 12 weeks), the disease is most dangerous for the child, because during this period the main organs and systems are laid. Influenza that occurs in the first trimester can cause pathology in the baby, cause pregnancy complications. In the third trimester, the disease can provoke premature birth. The flu carries the least risk in the middle of pregnancy.

At any stage of pregnancy, influenza can occur with complications. This can provoke the occurrence of a number of diseases in the expectant mother:

• tracheitis;
• pneumonia;
• bronchitis;
• cardiovascular diseases;
• kidney disease.

Risks can be minimized only with timely and effective treatment. It, of course, should be carried out under the supervision of a physician.

Treatment

Treatment of influenza during pregnancy is carried out at home. To cure the disease, symptomatic therapy is sufficient. Drug treatment can be carried out only as prescribed by the therapist, because during pregnancy it is undesirable to take medications, and it is strictly forbidden to use them uncontrollably. In some cases, inpatient treatment is indicated:

• if the flu occurs with complications;
• if comorbidities worsen;
• if it is not possible to provide appropriate care at home.

What can you do

At the first symptoms of the flu, you need to call a doctor. It is advisable to ask your doctor in advance what medicines can be used to bring down the temperature during pregnancy. You can take only those drugs that the doctor recommends as safe. Simple rules will help ease the course of the disease:

• compliance with bed rest;
• wet cleaning in the room;
• frequent ventilation of the room;
• proper nutrition (light meals, foods rich in vitamins);
• plentiful drink.

With the flu, pregnant women are forbidden to resort to traditional medicine methods, since their rash use can have consequences for the child. Any action should be discussed with the doctor.

What does a doctor do

Having diagnosed a viral disease in a future mother, the doctor prescribes treatment. It depends on the trimester:

• in the early stages - symptomatic therapy;
• in the later stages (2 - 3 trimester) - symptomatic therapy and safe interferons.

Antibiotics in the treatment are prescribed in very rare cases. They do not act on the influenza virus, however, such drugs may be needed when a bacterial infection is attached. If there is a need, then treatment of placental insufficiency or the threat of termination of pregnancy is carried out.

Prevention

Simple preventive measures can help prevent the flu. They are especially relevant during periods of increased risk of the disease (during the cold season, during the off-season, with a difficult epidemiological situation in the city). In order not to get sick, the expectant mother needs:

• avoid crowded places or at least limit their visits;
• limit contact with sick household members;
• observe hand hygiene (wash your hands often and thoroughly, use soap);
• lubricate the nose with an ointment with interferon or oxolinic ointment when leaving the house;
• take measures to increase immunity (proper nutrition, taking vitamins as prescribed by a doctor, feasible physical activity, long walks, healthy sleep).

Vaccination is an effective preventive measure. The expediency of vaccination and the timing of the need to check with the doctor.