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Follow these measures and basic treatments for frequent conditions that may occur during pregnancy, are safe for the baby (Medications class AC of the FDA, former classification). You can take them at any time of the day according to your taste, except the Thyroid Hormone (if you use it), which is suggested to take 1 hour before lunch.
I recommend following this link to obtain detailed and scientifically valid information about many medications and their use during pregnancy.
Whenever there are doubts about the severity of the condition you should contact your specialist.
Viral conditions induced by mosquitoes: Dengue , Chikungunya
The usual and initial treatment of these conditions are rest, hydration and antipyretics / analgesics (acetaminophen). It is recommended to perform hematological and serological studies to arrive at an appropriate diagnosis and to monitor the risky hematological disorders (platelet alterations, for example). These conditions do not structurally affect the fetus but can cause neonatal problems if they occur near the birth of the baby
Vomiting
If you experience annoying nausea and vomiting during the day you may use METOCLOPRAMIDE (PRIMPERAN or IRTOPAN) of 10 mg VO 30 minutes before each meal or ONDANSETRON (ZOFRAN): a 4 mg tablet every 6 to 8 hours. Then you can use some option 2-3 days in a row, when necessary. Doxylamine with vitamin B6 (10 mg / 10mg) is considered the first line therapy in some centers and has been very effective since we rediscovered it.
Acidity
MYLANTADOS or MAALOX, suspension: one tablespoon 30 minutes after meals RANITIDINA 300 mg (ZANTAC) or LANSOPRAZOL 30 mg: one capsule daily until acidity is controlled and when necessary
Headache (headache)
ACETAMINOFEN (ATAMEL, TACHIPIRIN) 500 mg: 1-2 tablets every 4-6 hours. Acetaminophen with codeine (ATAMEL-CO, ACUTEN) is also an option but requires special medical indication. If the headache is throbbing, you can take a cup of coffee with each dose of Atamel. ATAMEL PLUS already has caffeine so it is another option, 1-2 tablets every 4-6 hours. Specialized medications (SUMATRIPTAN and some of your family) may be used in case of chronic or severe migraine. Ibuprofen can be used before week 32, 400 mg every 6 hours – with obstetric monitoring -. THE USE OF METHYLERGONOVINE – METHERGYN, WAS DISAPPEARED FROM THE VENEZUELAN MARKET-
Flu or Catarrh, Allergies, Asthma
ACETAMINOFEN 500 mg: 1-2 tablets every 6 hours + LORATADINE 10 mg or DESLORATADINA 5 mg: 1 (one) daily. Use for 3-5 days. TONIMER OR NARICLEAR spray every 2 hours. If the fever or discomfort does not subside, secretion or greenish sputum, call, probably refer to an ENT or Pneumonologist. If there is a cough you can add LOVISCOL OR MUCOSOLVAN syrup 2 teaspoons every 6 hours. Use 3-5 days. Drink a lot of liquid. You can use Halls Mento Liptus to your liking.
In case of RHINITIS or ALLERGIES you can use loratadine or desloratadine daily for the necessary time (5-15 days). The MONTELUKAST (SINGULAIR) is also safe in pregnancy, 10 mg a day.
The asthmatic crisis is managed similar outside or within pregnancy. I usually use an inhaler with B2-agonists + steroids (VENTIDE) two inhalations every 6 hours, prednisone 5 mg (30 mg daily for 5 days), montelukast 10 mg and occasionally some form of theophylline (Teobid) to control nocturnal symptoms. In case of asthma crisis you should contact me to assess the severity of the clinical picture and adjust the treatment to your needs.
I avoid the use of medications containing PSEUDOEPHEDRINE because they could have a vasoconstrictor effect on the fetus and there are some reports of fetal defects when used in the first trimester. It could be used after week 13, apparently without risks and for a short time (3-5 days). In the presence of Preeclampsia should not be used because they could raise blood pressure.
Constipation
Adequate hydration during pregnancy decreases the risk or severity of constipation during pregnancy. SENOSIDOS (SENOKOT DOCUSATO): 1-2 tablets with dinner + 2 glasses of water. It is advisable to start with a tablet to avoid abdominal cramps, if necessary, raise the dose to 2 tablets. You can use any other medication of your choice (AGIOLAX, METAMUCIL SENLAX EVALAX MILAX) or foods that historically have helped you: plum, bran, etc. Drink water during the day.
Diarrhea
The object is to limit the number of evacuations and dehydration. Most of these events are self-limited (1-3 days), do not affect the baby and may have a viral, alimentary or bacterial colonization cause. You must hydrate yourself very well and avoid dairy products during the acute process. Occasionally I indicate medications that limit intestinal motility (LOPERAMIDE) accompanied by a dose of antibiotic and some prebiotic (ENTEROGERMINA). In some cases you can suffer amebiasis, salmonellosis, giardiasis, etc. and more specialized measures are required.
Hemorrhoids
SCHERIPROCT: suppositories; one daily, especially at bedtime; The cream can be used 2-3 times a day. It can be used for a long time. Other options: PERMUCAL, PROCTOGLIVENOL, BARGONIL in cream or suppositories as it suits you. Treat constipation so as not to stimulate the varicose hemorrhoidal development.
Colic
Abdominal discomfort, discomfort on the pubis and mild uterine contractions without bleeding or loss of fluid by genitals, you can take ANALPER PLUS OR BUSCAPINA PLUS (hyoscine – acetaminophen), one tablet every 6-8 hours.
If abdominal cramps do not improve quickly or become more frequent, are accompanied by bleeding or loss of fluid by external genitalia could be a labor (premature or term, depending on your gestational age) and should contact your specialist .
Insomnia
It is very common at the beginning and end of pregnancy. It is possible that at the beginning it is due to the abrupt increase of the hormones proper to pregnancy and the associated discomforts. In fact there is insomnia during the night and drowsiness during the day, little by little the cycle is restored and the patient returns to sleep properly. At the end of pregnancy many women can not sleep well due to the discomfort of a very large abdomen and a very active baby with sudden and painful movements.
I usually use naturopathic medicines (lemon balm, malojillo, lime, some teas and infusions) and occasionally benzodiazepines and minor sedative medications with a prescription
Leucorrhoea, vaginal discharge
It is very common due to the hormonal stimulation of the vagina and cervix and the replacement and maintenance of the mucous plug. If the vaginal discharge becomes pruritic or fetid yellowish it is considered abnormal and some suitable treatment is indicated. The most indicated are vaginal ovules that contain clindamycin or metronidazole with or without clotrimazole (Gynotran, Clinfol or Clinfol DUO, Klifer, Flegyl) or pure antifungals (Canesten, Gynozalain). I often use Diflucan (fluconazole) orally for the treatment of vaginal mycosis to treat the patient and her partner. Occasionally the amount is such that the patient thinks she has “broken sources”
Edema, Swelling
The accumulation of fluid, notorious and progressive since the second half of pregnancy, is a normal event in the vast majority of cases. To improve the edema of the limbs, elevate them. In the case of the upper limbs and hands, the treatment is identical, but the use of a medicine ball can be added to intermittently tighten it with the arms held high to help drain the fluid from the hands, improve function, reduce the sensation of pressure local and avoid Carpus Tunnel Syndrome. Yoga, gym-oriented training and swimming significantly improve all the discomfort associated with pregnancy.
If you become very upset or want to try something nice you can practice a lymphatic drainage or similar massage by a qualified therapist.
Chronic hypertension
Control of chronic hypertension that precedes pregnancy or that is diagnosed before week 20 is achieved through the use of safe medications for the mother and her fetus. Most women will be treated with Methyl-Dopa (Adomet) and many patients will have to stop their medication to change it to this product. Other options are Metoprolol, Acebutolol, Propranolol, Pindolol, extended-release Nifedipine and Hydrochlorothiazide; Atenolol has been linked to fetal growth disorders. In Venezuela there is severe shortage.
Diabetes
The diabetes that precedes pregnancy is a major risk factor for the health of the fetus and its mother. Usually the same medication is kept as the patient used to use but we take special care in its dosage and side effects. The clinical management of the diabetic pregnant woman is multidisciplinary and usually involves the obstetrician, an endocrinologist and a specialist in nutrition and dietetics with experience in pregnancy. We emphasize adequate daily hydration and exercise.
Preeclampsia
When there is a risk of Preeclampsia due to any of the following criteria, the use of Aspirin 81 mg daily from week 12 is indicated, expecting a reduction of 24% of cases. ( Preventive Services Task Force, Ann Intern Med. 2014; 161 -11-: 819-826 ).
- History of pre-eclampsia, intrauterine growth retardation of the fetus, premature detachment of the placenta.
- Pre-existing diseases such as chronic hypertension, nephropathy, long-standing diabetes, autoimmune diseases.
- Multiple pregnancy.
I also indicated it when Uterine Doppler indicates positive risk for preeclampsia. Week 24-28.
-until recently I added Vitamins C (1000 mg) and E (400 IU) but the current literature suggests that it does not prevent-
In my particular case I have had a very low rate of cases and complications of and for Preeclampsia I attributed it to the use of these vitamins in high-risk patients, but in light of the current evidence, I decided to suspend its use and evaluate its impact on my new frequency of hypertensive diseases induced by pregnancy. If the patient wants to use them there is no contraindication.
Safe or acceptable antihypertensives in pregnancy: methyldopa, labetalol, nifedipine, atenolol
Hypothyroidism
TSH, the hormone that governs the thyroid , is the element that determines glandular function. In hypothyroid patients who use hormone (T4) values ??should be maintained at lower ranges than those used in non-pregnant women by certain associations with pregnancy loss and other fetal complications (Subclinical Hypothyroidism or Hypothyroxinemia Treatment in Pregnancy) Casey and Others N Engl J Med 2017; 376: 815-825). If the TSH value is greater than or equal to 4.0 IU / L during the first trimester (less than 13 weeks) the patient will receive treatment with thyroid hormone (T4) throughout the pregnancy to prevent fetal neurological development disorders.
Usually a daily dose of 25 mcg is indicated and then adjusted according to the TSH control values in 4 weeks.