ARVI during pregnancy is a set of infectious-viral respiratory diseases with similar clinical course. The disease develops rapidly and is characterized by catarrhal symptoms: stuffy nose, runny nose, dry cough, sore throat and hoarseness. General signs of intoxication: symptoms such as an increase in body temperature, headache, general weakness, myalgia, arthralgia also appear.
The disease is diagnosed with the help of general blood analysis, IFA, PSR tests. Antipyretic, expectorant, mucolytic, anti-inflammatory, bronchospasm-relieving drugs are prescribed in the treatment of ARVI diseases, and in severe cases, immunoglobulins, interferon, and antibiotics are also prescribed.
55-82% of common infectious diseases in the field of obstetrics and gynecology are caused by STDs. Influenza and other infectious respiratory diseases are more common in pregnant women and are severe and last for a long time. In case of ARVI, especially women who are infected with influenza and suffering from toxicosis should be treated in the hospital, these conditions may pose a danger to the life of the fetus and mother. Respiratory diseases are characterized by seasonality, these diseases increase between December and March.
Causes of ARVI during pregnancy
Pneumotropic microorganisms are the causative agents of acute respiratory diseases. They are transmitted mainly by airborne droplets. Currently, more than 300 non-cellular pathogens that cause disease in the respiratory tract during pregnancy have been identified. Almost more than 50% of acute respiratory infections during pregnancy are caused by viruses (parainfluenza, type A and B viruses, adenovirus, enterovirus, rhinovirus, coronovirus). However, in most cases, the causative agents of the disease are several.
The severity and complication of the disease during pregnancy is related to the weakening of the woman's body. Most obstetricians and gynecologists note that the following factors play an important role in the development and severity of STDs during pregnancy:
Decreased immunity. The reason for the decrease in the activity of the immune system during pregnancy is to save the fetus, which is foreign to the woman's body. The decrease in immune system activity occurs under the influence of progesterone and cortisol hormones. The cellular level of the immune system also slows down, and the body of a pregnant woman becomes susceptible to pathogenic microorganisms.
Hyperventilation of the lungs. In order to provide enough oxygen to the growing fetus, a pregnant woman's breathing changes from chest to belly. As a result of the active work of the diaphragm muscles, the oxygen saturation of the alveoli increases. This creates favorable conditions for pathogenic microorganisms and viruses to enter the lower parts of the lungs.
Tumor of the mucosa of tracheobronchial trees. Due to the increase in circulating blood volume and arteriole dilatation in the body of a pregnant woman, capillary blood vessels are filled and swellings appear in mucous membranes. This factor is also a favorable environment for pathogenic microorganisms.
Pathogenesis
Most catarrhal infections of the respiratory tract are anthroponotic, and in rare cases, mammals and birds can also spread these microorganisms (swine flu, bird flu). The main way of transmission of ARVI is the airborne method, which means that the virus and bacteria can be transmitted during close contact with an infected person. Sometimes the disease is transmitted through household contact (hand-to-hand contact, various objects). The nose, pharynx, larynx, bronchial epithelium, and mucous membrane of the eye play an important role as the entrance gate of microorganisms. The infection adheres to the epithelial cells, then enters the cell and replicates. The breakdown of epithelia facilitates the spread of viruses. The introduction of ARVI pathogens into the blood causes the appearance of general signs of intoxication.
T-lymphocytes against viral antigens are produced in large numbers and interferon release increases. Complete removal of viruses from the body and complete cleansing from epithelial tissues indicates that the disease will pass without complications.
As a result of decreased immunity, the alveoli of the lungs are damaged, and the mucous membrane of the nasopharynx is also inflamed. In severe cases, as a result of damage to the placenta, fetoplacental blood flow may be impaired, the development of the fetus may be delayed, and even the fetus may die.
Symptoms of acute respiratory disease during pregnancy
Due to weakening of immunity during pregnancy, the incubation period of the disease is reduced to 2-3 days. In cases of high virulence of the causative agent, symptoms of the disease appear within 3-4 hours after infection. Symptoms of all catarrhal infectious diseases are almost identical. Symptoms develop more quickly during pregnancy: pregnant women experience symptoms such as the flu, runny nose, sore throat, dry cough, and hoarseness.
As a result of infection with the flu virus, strong intoxication symptoms such as dizziness, headache, general weakness, pain in muscles and joints are also manifested. In addition, loss of appetite, nausea, vomiting, as a result of adenovirus infection - fear of light, pain in the eyeball, enlargement of the neck and submandibular lymph nodes are observed. During 3-5 days, body temperature increases, body temperature from 38 oC to 40 oC is noted. Redness of the skin of the face and neck is also evident in influenza infections. The acute course of the disease includes the period from 7 to 10 days. During the recovery period, wet cough and sputum movement are bothersome.
Complications of ARVI (wind) in pregnancy
Constant coughing and wheezing increase intra-abdominal pressure. This increases the tone of the enlarged uterus and is complicated by natural abortion or termination of pregnancy in 25-50% of cases. As a result of stuffy nose, impaired air circulation in the lungs, swelling of the mucous membranes, oxygen saturation in the lungs decreases, and as a result, fetal hypoxia may develop. Infection of the placental tissue with viruses causes fetoplacental insufficiency, premature maturation of the placenta. 3,2% of women with catarrhal infections may experience early placental abruption, slow labor, and bleeding during childbirth.
In the XNUMXst trimester of pregnancy, the infection of ORVI affects the fetus at the cellular level and leads to the development of various defects in the fetus. Such complications are especially likely to occur when the flu virus is infected. In the XNUMXnd and XNUMXrd trimesters of pregnancy, the infection of ARVI causes pathologies in various organs of the fetus (meningitis, encephalitis, pneumonia). After birth, the child is weak, inactive and suffers from various breathing problems.
During pregnancy, ARVI aggravates the course of toxicosis, gestosis, and can be complicated by secondary infections. Often, acute sinusitis, purulent otitis media, bronchitis, and bacterial zotiljam also develop. In this case, attacks of chronic infectious and somatic diseases occur, for example, rheumatism, pancreatitis, cholecystitis, pyelonephritis, glomerulonephritis.
The most severe and rare complications of ARVI include: myocarditis, pericarditis, myositis, meningoencephalitis, polyneuritis, neuralgia, Reye's syndrome, and toxic-allergic shock.
Diagnosis of acute respiratory disease
Diagnosing pathology during the season of acute respiratory diseases is not difficult. In such cases, it is enough to pay attention to catarrhal symptoms, which are the main clinical signs of the disease. In addition, the following examination methods are used to diagnose the disease:
General blood analysis. At the time of SARS infection, leukopenia, normal ECHT or a slight decrease can be seen in the general blood analysis. An increase in the number of leukocytes and an increase in ECHT indicate the presence of a secondary infection in the disease.
Serological examination. In order to detect influenza A, B, parainfluenza, adenovirus, respiratory syncytial viruses, IFA and PSR diagnostic methods are carried out. In this, the genetic elements of the causative agent of the disease are determined.
X-ray of lungs. It is performed only when secondary pneumonia is suspected by vital signs. CTG, fetometry, phonocardiography examinations are also prescribed to check the state of the fetus. UTT (UZI) and dopplerography of blood flow in the uterus and placenta help to check the state of the placenta.
Viral diseases (measles, rubella, scarlet fever), bacterial diseases (angina, acute pharyngitis, laryngitis, tracheitis, bronchitis, inflammation of the lungs) should be differentiated. According to the instructions, a pregnant woman should be examined by an infectious disease specialist, a pulmonologist, an ophthalmologist, an otolaryngologist, and a neuropathologist.
Treatment of colds during pregnancy
In the treatment of the disease, attention is paid to the peculiarities of the duration of pregnancy, the severity of the disease and its course. The disease of ARVI cannot be an indication for artificial termination of pregnancy. In the treatment of pregnant women, first of all, non-medicinal treatment measures are used: physical and emotional calmness, bed rest, 7-8 hours of sleep, inhalation using medicinal plants is recommended. To eliminate the symptoms of intoxication, it is necessary to drink at least 1,5-2 liters of liquid per day, to increase the consumption of products rich in protein and vitamins (vitamin C is especially abundant in citrus fruits, cabbage, currants, apples).
For the purpose of etiotropic treatment, drugs with less negative effects on the fetus and pregnant woman are prescribed. In cases of severe flu, immunoglobulins are used. In order to reduce the progression of the disease and complications, the following treatment procedures are carried out:
interferon. Due to the high risk of termination of pregnancy, interferon proteins are prescribed from the 32nd week, and this indication is used only in severe forms of ARVI.
Immunomodulators. During pregnancy, if there are no rhesus-conflict cases, immunofan-based drugs can be used. These substances have an antiviral effect, eliminate intoxication, ensure the integrity of the epithelial membrane. It is also possible to use polyvitamin complexes as immunostimulating agents.
Depending on the clinical signs, symptomatic treatment measures are also used in pregnant women, that is, antipyretic, expectorant, antitussive, mucolytic, anti-inflammatory and anti-bronchial obstruction drugs are also prescribed. Antibiotics are recommended only if a bacterial infection is involved.
HCV disease cannot be an indication against natural childbirth. It is necessary to take preventive measures in advance to prevent bleeding during childbirth, development of purulent-septic complications, and exacerbation of catarrhal symptoms in pregnant women. Anesthetization is possible during childbirth, antibiotic therapy is used for prevention after childbirth. Cesarean section is performed according to the instructions of obstetricians and gynecologists.
Consequences and prevention of the disease
If the disease is uncomplicated, it will pass on its own within 7-10 days. If the disease is complicated, the course of the disease will be prolonged. During an epidemic, it is necessary to prevent infectious factors from entering the mucous membranes of the respiratory tract during an epidemic, i.e. not to be in crowded places for a long time, to protect the mucous membranes of the nose with oxolin ointment, to wear gauze masks, to rinse the throat and nose, and to observe the rules of personal hygiene. . If the flu vaccine is given before pregnancy, its effectiveness is 55-90%. In order to increase the general resistance of the body, it is recommended to normalize the daily routine, sleep and rest time, avoid stressful situations, improve the diet and take vitamin and mineral preparations.
