What do they inject for a baby’s lungs during pregnancy? Dexamethasone for maintaining pregnancy and saving premature babies. Hyperandrogenism in women

Termination of pregnancy between 28 and 37 weeks is called premature birth. Termination of pregnancy between the 22nd week and 28 weeks, according to the rules of the World Health Organization, is classified as very early preterm birth. In our country, termination at this stage of pregnancy is not considered premature birth, but care is provided in a maternity hospital, and not in a gynecological hospital, and measures are taken to care for a very premature newborn. A child born as a result of such births is considered a fetus for 7 days; only after a week such a baby is considered not a fetus, but a child. This feature of terminology is due to the fact that children born before the 28th week of pregnancy are often unable to adapt to environmental conditions outside the womb, even with the help of doctors.

Causes of premature birth

Factors leading to premature birth can be divided into socio-biological and medical.

It should be noted that in the autumn and spring months the frequency of this complication increases. This is due to changes in weather conditions, in particular frequent changes in atmospheric pressure, which can affect the frequency of premature rupture of amniotic fluid. Severe colds with a high rise in body temperature and severe cough can increase and cause labor prematurely. An adverse effect on the course of pregnancy of a number of production factors has been noted: exposure to chemicals, vibration, radiation, etc. Premature births are more common in young, student, unmarried women, with a lack of proteins and vitamins in the diet, as well as in women with bad habits.

Medical factors include severe infectious diseases, including those suffered in childhood, abortions, and inflammatory diseases of the genital organs. Chromosomal abnormalities of the fetus - damage to the hereditary apparatus of the fetus under the influence of unfavorable external and internal factors (ionizing radiation, industrial hazards, taking certain medications, smoking, drinking alcohol, drugs, unfavorable environmental situation, etc.) - can lead to premature birth, but more often in In such cases, pregnancy is terminated in the early stages. In most cases, the cause of premature birth is diseases of the endocrine system, for example, dysfunction of the thyroid gland, adrenal glands and ovaries, obesity, which changes the functioning of all endocrine glands. Anatomical changes in the genital organs include genital infantilism (underdevelopment of the female genital organs), malformations of the uterus, traumatic injuries to the uterus during abortion and curettage, and uterine tumors. In almost one third of cases, the cause of premature birth is isthmic-cervical insufficiency, in which, as a result of mechanical effects (cervical trauma after abortion, previous births, other gynecological manipulations) or a lack of certain hormones, the cervix does not perform its obturator function.

Often the cause of premature birth is cervical-vaginal infections (trichomoniasis, mycoplasma, chlamydia, etc.) and viral infections (cytomegalovirus, herpes, influenza, adenoviral infection, mumps), especially those that occur latently. The presence of a chronic genital infection contributes to the disruption of the local protective barrier and damage to the fetus. Severe forms of extragenital diseases (not related to the female genital organs) and pregnancy complications can also lead to miscarriage. Such diseases include, for example, hypertension, cardiovascular diseases, anemia, chronic diseases of the lungs, kidneys, liver, etc.

Symptoms of the onset of labor

When premature labor begins, regular labor and smoothing or dilatation of the cervix appear. The onset of labor is accompanied by the appearance of regular cramping pain in the lower abdomen, which increases in intensity over time, and the intervals between contractions decrease. Quite often, premature birth begins with the rupture of amniotic fluid, and their amount can be from a few drops to several liters. In addition, the appearance in a woman of mucous discharge streaked with blood or bloody discharge during premature pregnancy indicates structural changes in the cervix, i.e. i.e. smoothing it out. The appearance of any of the above symptoms requires urgent hospitalization in an obstetric hospital.

At the slightest suspicion of a deviation from the normal course of pregnancy, you must seek qualified help.

If these symptoms appear, you must immediately call an ambulance, which will take the expectant mother to the hospital. In some cases, it is possible to prolong the pregnancy; If this is not possible, then the hospital creates conditions for a gentle delivery - a birth during which a very fragile baby experiences the least stress possible.

Features of the course of labor

With premature birth, premature rupture of amniotic fluid, weakness and dysfunction of labor, rapid or impaired regulatory mechanisms, and fetal hypoxia are more often observed.

Premature rupture of amniotic fluid often occurs with isthmic-cervical insufficiency or the presence of infection. The lower pole becomes infected and, as a result of inflammation, the membranes rupture easily. Normally, the amniotic sac ruptures closer to the full dilatation of the cervix, that is, already during labor. A woman's sensations can vary from a small wet spot on her underwear to a large amount of water leaking from the vagina and flowing down her legs. The waters should be light, but can be cloudy or dark brown (if infection is present). Childbirth that occurs prematurely very often proceeds quickly or even rapidly. The woman experiences rather painful contractions, their frequency increases, the intervals between contractions are less than 5 minutes and quickly decrease to 1 minute, the first stage of labor (until the cervix is ​​fully dilated) is reduced to 2-4 hours. Due to the fact that the head of a premature fetus is smaller, expulsion of the fetus begins when the cervix is ​​not fully dilated. A smaller baby moves through the birth canal faster.

Premature baby

Unlike timely births, there are more complications with premature births. Firstly, the baby’s head does not have time to adapt to the mother’s pelvic bones and configure. The configuration of the head is the possibility of displacement of the bones of the fetal skull during childbirth to reduce its volume as it passes through the birth canal. This mechanism allows you to reduce pressure on the head and cervical spine of the newborn baby. The bones of the skull of a premature baby are quite soft and cannot provide protection to the brain; the risk of trauma and hemorrhages under the membranes into the fetal brain tissue during childbirth increases. As a result, the child may experience hemorrhages, he does not have time to adapt to environmental changes, and his regulatory system is disrupted. Secondly, a woman often suffers ruptures in the birth canal (cervix, vagina and external genitalia), since the tissues do not have time to adapt to the stretching.

When labor threatens and begins, the woman is urgently hospitalized.

Much less common in premature birth is weakness of labor. Weakness may manifest itself as weak, infrequent or short contractions. The labor time increases significantly, the woman gets tired, and the child also begins to suffer. Other anomalies of labor are possible, for example, the strength and frequency of contractions is sufficient, but the cervix does not dilate. All this is associated with a violation of regulatory systems during premature birth; there is no sufficient hormonal preparation for childbirth. Infectious complications during childbirth and the postpartum period are much more common in both the mother and the fetus. Among such complications are suppuration of sutures (if any), postpartum metroendometritis (inflammation of the mucous membrane and muscular layer of the uterus), peritonitis (inflammation of the peritoneum) and the maximum spread of infection (sepsis). This is due to the presence of a latent or obvious infection that the pregnant woman had before giving birth, which is often the cause of miscarriage. An infection can occur during childbirth, due to its duration (with weakness), for example, chorioamnionitis (inflammation of the membranes of the fetus). Premature babies have reduced immunity and, accordingly, are more susceptible to infections.

Prognosis for the child

Due to the peculiarities of obstetric tactics and different birth outcomes for the fetus, it is considered appropriate to divide premature birth into three periods, taking into account the timing of gestation (pregnancy): premature birth at 22-27 weeks, premature birth at 28-33 weeks, premature birth at 34-33 weeks. 37 weeks gestation.

Premature birth at 22-27 weeks (fetal weight from 500 to 1000 g) is most often caused by isthmic-cervical insufficiency (due to trauma in previous births), infection of the lower pole of the membranes and premature rupture of the membranes. Therefore, in this group of women, as a rule, there are few primigravidas. The presence of infection in the genital tract excludes the possibility of prolonging pregnancy in most pregnant women. The fetal lungs are immature, and it is not possible to accelerate their maturation by prescribing medications to the mother in a short period of time. Such children belong to a high-risk group and are more often subject to urgent resuscitation. They are in incubators, under the strict supervision of a neonatologist and qualified nurses. Children almost always need a further stage of nursing and are registered for a long time in perinatal centers or clinics at their place of residence.

Premature birth at a gestational age of 28-33 weeks (fetal weight 1000-1800 g) is caused by more diverse reasons than earlier premature births. There are more than 30% of first-time pregnant women in this category of births.

More than half of women undergo expectant management and continue pregnancy. In such children, the lungs do not have time to “mature”, and the production of surfactant is disrupted. Surfactant is a mixture of fats and proteins that is synthesized in the large alveoli (the building blocks of the lungs), coating them, promoting their opening and preventing them from collapsing during inspiration. In the absence or deficiency of this substance, the child’s breathing is impaired. A surfactant drug can be administered to newborns if necessary, it significantly facilitates breathing, but this drug is very expensive and is not always available. Therefore, in order to prevent breathing problems, women are prescribed glucocorticoids. They stimulate the production of surfactant and the “maturation” of the fetus’s lungs within 2-3 days when there is a threat of premature birth. With the onset of labor, glucocorticoids are administered intravenously at intervals of 3-4 hours.

Premature birth at a gestational age of 34-37 weeks (fetal weight 1900-2500 g or more) is caused by even more diverse reasons, the percentage of infected women is much lower than in previous groups, and primigravidas - more than 50%. However, due to the fact that the fetal lungs are practically mature, administration of drugs that stimulate the maturation of surfactant is not required.

Children are less likely to be transferred to the intensive care unit, but round-the-clock care and observation are necessary in all cases until the child’s condition is completely stabilized.

Features of nursing

Tactics for managing premature birth

In case of threatening and beginning labor - when there is no dilatation of the cervix or it is insignificant - tactics are aimed at prolonging pregnancy. The woman is urgently hospitalized, placed on strict bed rest, prescribed sedatives, and the causes that led to premature birth are eliminated (if possible). For example, suturing the cervix for isthmic-cervical insufficiency, treating vaginal infections, restoring the natural microflora of the vagina or prescribing antibiotics in the presence of an infectious process, treatment is carried out together with a therapist or endocrinologist (if necessary). An obligatory component is drugs that reduce the tone of the uterus (tocolytics), improve the functioning of the placenta, increase immunity, vitamin therapy, as well as drugs that improve the intrauterine nutrition of the child and accelerate the “maturation” of the fetal lungs.

In each case, an individual approach is required, however, the efforts of doctors do not always lead to the desired results, and the process progresses to the onset of premature birth.

Round-the-clock care and observation are necessary in all cases until the child’s condition is completely stabilized.

Premature birth requires the presence of a qualified obstetrician-gynecologist, nurse and neonatologist. Constant monitoring of the woman and the condition of the fetus is necessary. The woman is regularly examined, her blood pressure and body temperature are measured, and urine and blood tests are monitored. In addition to cardiac monitoring data, the development of labor is monitored, the fetal heartbeat is listened to, and the position of the fetus is determined. Fetal cardiac monitoring is the study of heart rhythm. It is performed on a special apparatus at rest, with the pregnant woman lying on her side for 30-60 minutes. Recording sensors are placed on the anterior abdominal wall of the pregnant woman using an elastic band, which record the fetal heartbeat, as well as the frequency and strength of contractions.

Most complications during childbirth, both on the part of the mother and the fetus, are caused by a violation of the contractile activity of the uterus. To identify the characteristics of the contractile activity of the uterus during premature birth, it is recommended to maintain a partogram (a graphical representation of the frequency and strength of contractions) and record the contractile activity of the uterus. The partograph can be carried out without any equipment, by touch, with a stopwatch, recording the frequency, strength and duration of contractions, and then depicting them on a graph. However, all specialized centers have cardiac monitoring, which clearly displays the condition of the child during the birth process, as well as the tone of the uterus and the effectiveness of contractions in dynamics, which allows timely correction and provision of qualified medical care in case of any deviations.

To determine the degree of dilatation of the cervix, the doctor examines the woman on a gynecological chair. Due to the possible negative impact on the condition of the fetus, labor stimulation or inhibition of labor is carefully considered, and often the issue must be resolved within a short time, with the decision being made by several doctors. Hypoxia (lack of oxygen) of the fetus is prevented; in most cases, narcotic painkillers are avoided (as they adversely affect the fetal respiratory center). Childbirth is carried out in the lateral lying position, because it is easier to control labor in this position, the head does not move quickly along the birth canal, the health of the woman and the fetus remains satisfactory, in contrast to the supine position, in which the pregnant uterus compresses large venous vessels and worsens blood circulation of mother and fetus. Anesthesia and epidural anesthesia accelerate the process of dilation of the cervix, which is often too fast. The fetal head does not have time to adapt to the birth canal, and often a poorly distensible perineum aggravates the situation, so it is approached individually.

It is within the power of the woman herself to reduce the likelihood of premature birth. There is no need to hide previous abortions and inflammatory processes in the past from the doctor with whom the woman is registered. You must immediately inform your doctor about any changes in your body and attend special classes to prepare for childbirth. If a pathology is detected, you should not refuse the treatment prescribed by the doctor. It is necessary to limit physical activity and monitor your diet, which should be varied and well-balanced. Excessive consumption of spicy, salty or fatty foods leads to exacerbations of chronic diseases of the digestive system, which can cause premature birth. If symptoms of pregnancy appear, you should avoid sexual activity during the last two months of pregnancy. If you have the slightest suspicion of a deviation from the normal course of pregnancy, you must seek qualified help.

While waiting for the birth of a small miracle, any expectant mother knows how important it is to monitor her health, because the new life inside is still very fragile, so the advisability of taking even ordinary vitamins must be discussed with a doctor, not to mention more serious medications.

The pregnancy period is a time during which it is better to abstain from any medications or drugs at all, since the body of a pregnant woman can react completely unpredictably. However, what to do if taking medication becomes simply a necessary measure?

One of the most controversial drugs, the benefits and harms of which are constantly debated by gynecologists and obstetricians, is Dexamethasone. If you look at the instructions for this medicine, you will find that it is contraindicated during pregnancy.

But the paradox is that sometimes taking it helps prevent and save the life of a child. How does this happen?

Very often, the descriptions of drugs indicate that use in certain cases is possible, but only if their therapeutic effect, which is predicted by the doctor, will be many times higher than the potential risk for the woman or baby that may arise during treatment.

When prescribing Dexamethasone, doctors try to evaluate and compare these categories in order to make the right decision.

A little about the drug

Dexamethasone is a fluorinated homologue of hydrocortisone, a glucocorticoid intended for local and systemic use, or simply a hormonal agent.

Being a synthetic analogue of adrenal hormones (normally, this substance should support the normal functioning of the human body), the drug is able to effectively combat numerous acute and chronic inflammatory processes, autoimmune diseases and even allergic manifestations.

In addition, Dexamethasone has anti-shock, glucocorticoid and immunosuppressive effects, affecting carbohydrate, protein, water-electrolyte and lipid metabolic processes.

The range of its application is very wide. When American scientists discovered these hormones almost 100 years ago, they had no idea how much their area of ​​effective action would expand. However, the research, which lasted about half a century, was not without unpleasant cases and scandals: the extremely negative effect of steroid hormones on pregnancy was proven (children were born with serious pathologies and developmental disorders).

However, Dexamethasone is prescribed to women who are at risk of miscarriage or for chronic miscarriage. The main reasons for doctors making such a decision are the following factors.

• The expectant mother has hyperandrogenism.

That is, increased production and an increase in the amount of androgens or male hormones in the female body. Hormonal imbalances are a fairly common occurrence during pregnancy, because hormonal levels change very dramatically. Therefore, instead of what is necessary, testosterone is produced by the ovaries and adrenal glands, which does not allow a woman to bear and give birth to a child (and sometimes even become pregnant).

To determine whether it is indeed hyperandrogenism, the doctor must conduct various tests (usually, you will need to do a blood and urine test for hormones).

Sometimes, when carrying a male child, the situation may worsen, since his own hormones are added to the androgens produced by the mother and further increase their number.

• Chronic diseases of the mother.

The second important factor for prescribing the drug is some diseases of the expectant mother, as well as the need to maintain the normal state of her health. We are talking about kidney diseases, hepatitis, lupus, arthritis, which cause overactivity of the immune system (or an autoimmune condition).

This diagnosis means that the body is actively producing special antibodies designed to prevent the development and maintenance of pregnancy, that is, the child is perceived as a danger and all efforts are directed towards getting rid of it. "Dexamethasone" by its action is able to block these antibodies, thereby saving pregnancy from danger.

In addition, the drug is prescribed to normalize hormonal levels when planning pregnancy, and is also used in some cases of premature birth (“Dexamethasone” is often used to open the baby’s lungs).

It should be noted that the medicine is absorbed quite quickly from the gastrointestinal tract, and it is excreted through the intestines and kidneys. One of the significant disadvantages of the drug is that it can easily penetrate the placental barrier and enter breast milk.

All decisions about dosage, duration and regimen should be made only by your doctor, depending on the indications and other factors. Under his control, therapeutic or preventive therapy will be carried out.

The medicine can be found in tablet form, as well as in the form of injections (they can be prescribed for intravenous, intramuscular and intra-articular administration). In addition, drops are also used - locally or conjunctivally.

The benefits and harms of the drug for the expectant mother and child

As you may already understand, Dexamethasone is prescribed during pregnancy if the medicine is necessary for vital signs, that is, only in cases where, without therapeutic therapy, the health of the mother or baby is in mortal danger.

Also, people turn to the drug if other medications that are more acceptable during pregnancy do not help. As a rule, the doctor prescribes pills to the woman, but in severe or critical conditions, intravenous or intramuscular injections can be prescribed (in the case of an acute rheumatic condition, intra-articular injections are also used to help the patient get rid of painful shock).

The drug is prescribed if the following indications exist:

• in some forms of oncology (if the patient suffers from leukemia or has lymphoma);
• in severe neurological conditions (for example, if there is swelling of the brain or a tumor appears);
• for hematological diseases;
• in cases of complex diseases of the gastrointestinal tract (ulcers, etc.);
• for severe respiratory diseases (for those who suffer from pulmonary tuberculosis, bronchospasms or asthma);
• for acute rheumatic conditions;
• for disorders of the endocrine system;
• in acute cases (such as anaphylactic shock);
• for severe ophthalmological and infectious diseases.

In addition, if a diagnostic test - 17 KS analysis (a special test that checks the level of seventeen ketosteroids) - shows that the level of male hormones is elevated, Dexamethasone will be prescribed for the entire duration of pregnancy in order to save the child.

Another common reason for prescribing the drug for a long course is the presence of antiphospholipid syndrome (APS) in a woman, which contributes to the occurrence and development of placental insufficiency and its negative consequences. Dexamethasone is usually prescribed for suspected various immune disorders.

Dexamethasone is also used to stop contractions, as it can suppress the contractile activity of the uterus and prevent the birth of a premature baby.

The baby’s body perceives the appearance of the active substance of the medicine as a signal of preparation for birth, and its respiratory organs (lungs) mature faster so that when it is born, it can breathe on its own.

Pregnant women who are forced to take the drug naturally ask how dangerous it is for the unborn child. Studies have shown that Dexamethasone can have the greatest negative effect on the fetus in the first and third trimesters, especially if a woman takes it by injection.

In the latter case, the newborn will have to undergo replacement therapy, since he will also have complications with the production of hormones.

Contraindications and possible side effects during pregnancy

Dexamethasone is taken by a doctor in a adjusted dosage, practiced in gynecology and endocrinology, which allows minimizing all possible risks.

However, the treatment regimen is calculated and adjusted individually, after diagnosis, analysis of the problem and determination of the woman’s current condition.

Typically, therapy begins with injections (the first few days of treatment). Admission may initially be in large doses, and then gradually reduced to the minimally effective level. Then the pregnant woman is transferred to the tablet form of the drug, dividing the daily dose into three doses.

Hormonal treatment is a rather complex process that requires careful monitoring, analysis and self-discipline. During therapy, you will have to take tests again and again (every 2-4 weeks) so that the doctor understands the effectiveness of the treatment and adjusts it.

If any side effects occur, you should seek medical attention immediately. Be sure to consult your doctor if you experience the following symptoms:

• problems with the gastrointestinal tract and digestion (decreased appetite, vomiting, bloating, pancreatitis);
• general deterioration in health (, severe migraines, irritability, excessive sweating);
• some disorders of the central nervous system (convulsions appear, you may begin to suffer from hallucinations and disorientation, depression);
• pronounced allergic reactions;
• suddenly your sensitivity to sugar consumption has increased, you have noticed that you have suddenly begun to gain weight or swelling has appeared (this may be due to problems in the endocrine system and metabolic disorders);
• deviations in the functioning of the cardiovascular system (the appearance of arrhythmia and acute heart failure, thrombosis).

To reduce the occurrence of some side effects, doctors advise adjusting the diet: it should contain a maximum of foods rich in vitamins, nutrients and proteins, but it is better to limit the content of carbons, fats and table salt.

Despite the effectiveness and benefits of the drug, unfortunately, it is not suitable for everyone. Dexamethasone is not prescribed if the patient has serious contraindications:

Sometimes, if the drug is abruptly discontinued, the so-called “withdrawal” syndrome may develop, when the patient develops weakness, nausea, musculoskeletal pain and the condition for which the drug was prescribed worsens.

Is it possible to replace the drug with something?

In case of individual intolerance to Dexamethasone or other factors due to which it cannot be prescribed, doctors turn to its analogues and similar medications:

• "Prednisolone" or "Methylprednisone";
• "Dexamed";
• "Decadron";
• "Dexazon";
• “Dexamethasone sodium phosphate (and just phosphate);
• "Maxidex";
• "Dexaven";
• "Fortecortin."

Conclusion

In general, reviews about the use of the medicine are positive, but remember that prescribing it yourself or treating yourself without the guidance and supervision of a doctor is strictly prohibited.

Although the drug has been used in gynecological practice for quite a long time, each case is individual, therefore, knowing all the properties, benefits and consequences of taking the drug, the doctor will make a decision that is optimal in your situation. You should not be afraid in advance and refuse treatment, which can save the life of the child and allow you to successfully carry out the pregnancy.

Pregnancy does not always go smoothly. There is often a threat of premature birth or late miscarriage. The doctor, having compared all the facts, weighed all the pros and cons, can prescribe quite strong drugs aimed at preparing the fetus for premature birth and increasing its chances of survival. One such drug is Dexamethasone. Why is such a strong hormonal drug prescribed, and what consequences can be expected from it?

It has already been said above that the main indication for the use of Dexamethasone injections is the threat of premature birth. If such a problem is detected, this drug will help the child's lungs open faster. After the baby is born, he has every chance to breathe on his own, because the respiratory system will be developed and ready. Otherwise, there is a risk that the baby will not be able to breathe on his own, he may have respiratory arrest, and his death. Dexamethasone injections cause general stress in the mother's body. The baby feels this, and already in the womb prepares for the fact that he may have to be born earlier.

The drug is also prescribed for increased testosterone production. By the way, if it is known that a woman is expecting a boy, the drug can be prescribed until the end of pregnancy in order to preserve it: when carrying a boy, additional testosterone can be produced. Sometimes there are situations when the mother’s body tries to reject the fetus. Dexamethasone slightly suppresses the mother's immune system so that she stops trying to reject the fetus. Thus, in many cases it is also possible to avoid miscarriage, carry the child to term and give birth.

The drug is very strong and the instructions say that it cannot be used during pregnancy. However, it is often prescribed when there is a serious threat. First of all, the drug is difficult to tolerate by the woman herself, because there are a huge number of side effects. But it also has an effect on the child, because the placenta does not block it. Therefore, no doctor will prescribe such a drug “just like that.” We need serious reasons.

Instructions for use of ampoules intramuscularly

The average daily dose ranges from 0.5−0.9 mg. On the first day, the maximum dose (4−20 mg) is administered, and on subsequent days it is gradually reduced. The exact dosage is prescribed by the doctor. Injections are given intramuscularly both in a medical facility and at home, if the woman is definitely able to do this.

Detailed instructions for the use of Dexamethasone injections intramuscularly do not imply self-administration of the drug without consulting a doctor and good reason.

Side effects and contraindications

The drug has many contraindications:

A complete list of contraindications can be found in the instructions. When prescribing these injections, the doctor must take them into account. Dexamethasone also has many side effects. Therefore it is considered very heavy:

• disruption of the endocrine system;
• metabolic disorders;
• problems with the cardiovascular system;
• problems with the gastrointestinal tract;
• dysfunction of the central nervous system.

You should definitely inform your doctor about side effects, especially if they are severe.

How much does Dexamethasone cost in ampoules?

The drug is relatively inexpensive. The price of a package of Dexamethasone with 25 ampoules of 4 mg each is on average 130-200 rubles, depending on the city and the pharmacy chain where it is purchased.

The drug Dexamethasone is an artificial analogue of hormones produced by the adrenal glands. The purpose of this substance is to maintain the normal functioning of the human body.

Dexamethasone is often used during pregnancy, to prevent miscarriage, to maintain a woman’s condition in other diseases, and during premature birth to open the baby’s lungs. Despite the fact that this drug causes debate among doctors, it has been used in gynecology for half a century.

Instructions for use of the drug Dexamethasone provide the following indications for use:

• rheumatic diseases;
• ulcerative colitis;
• oncological diseases;
• respiratory disease (tuberculosis);
• hematological diseases;
• diseases of the visual organs;
• severe neurological conditions.

Dexamethasone is prescribed in tablets during pregnancy, but if the situation is critical, then injections are used, which are administered intramuscularly or intravenously. If the patient’s situation is difficult and associated with rheumatic diseases, then the substance is injected into the joints to relieve pain. The use of this drug is quite widespread in medicine.

The use of this drug without permission is unacceptable, since the dose and frequency of administration are calculated only by the doctor individually for each case. Therefore, there is no single dosage regimen for pregnant women. As a rule, Dexamethasone injections are prescribed in the first 3-4 days of treatment, then the patient is transferred to the tablet form of the drug. Side effects may also be present, namely: nausea, increased blood pressure, arrhythmia, allergic reactions.

Dexamethasone during pregnancy for the lungs

Dexamethasone is prescribed during pregnancy to open the baby's lungs. If the patient begins premature labor, then in order to prevent the birth of a premature baby, the contractions stop. To do this, agents are introduced that can suppress. And to mature the respiratory organs of the child, the mother is administered Dexamethasone. This is the main case why Dexamethasone is prescribed during pregnancy.

The small organism perceives this substance as a signal of preparation for childbirth and prepares for birth. This way his lungs mature and when he is born he will be able to breathe on his own. The medicine is also prescribed when the child lacks adrenal hormones, but this is a very rare disease.

The instructions for Dexamethasone indicate that during pregnancy it is prescribed to reduce the amount of androgens. And although the instructions prohibit the use of this remedy for pregnant women, it is widespread in gynecology. If you reduce the production of male sex hormones with this substance, it goes away.

Dexamethasone during pregnancy at 33 weeks or earlier is used to prevent diseases of the child's respiratory tract, and also prevents miscarriage. The course of prevention or treatment, as well as the dosage, can only be determined and prescribed by the attending physician, since successful treatment is possible with an individual approach.

This substance lowers blood pressure and, if used regularly, will weaken the heart muscle. It increases pressure inside the skull and inside the eyes, causing migraines and other disorders. The patient needs more carbohydrates and the amount of fat increases, so if the woman is sick or obese, she is prohibited from taking this substance. It is not used for vein thrombosis. But in a critical situation that threatens the life of the patient or her child, this substance must be used.

Pregnancy is a period when you can expect anything from your body. Unfortunately, not all women experience it smoothly. Cases of threatened premature birth or late spontaneous abortions are quite common. To help a woman maintain her pregnancy, doctors may resort to unsafe methods and prescribe strong medications. The hormonal drug Dexamethasone is one of these. In what cases is it prescribed to pregnant women and why? How does it affect the expectant mother and the unborn child? This article will tell you about this.

Why is Dexamethasone prescribed to pregnant women?

Despite the fact that the instructions for use of Dexamethasone warn about undesirable use of the drug during pregnancy, doctors still quite often prescribe it to expectant mothers. Experts are confident that if certain conditions are met, taking Dexamethasone is safe. These include:

• treatment of a pregnant woman in a hospital setting under the supervision of medical staff;
• the correct dose of the drug (it is selected individually for each woman).

Dexamethasone is usually used as an injection during pregnancy. Vitamin E is used in parallel. This combination gives a chance to prevent possible miscarriage and helps normalize a woman’s hormonal levels. The main indications for prescribing the drug to pregnant women are:

• eye diseases (iritis, conjunctivitis);
• autoimmune diseases;
• disruptions at the hormonal level;
• threat of premature birth or miscarriage;
• to prepare and open the lungs of the unborn baby.

Hyperandrogenism in women

One of the indications for the use of Dexamethasone during pregnancy is a high level of male sex hormones (testosterone) in pregnant women. This problem is medically called hyperandrogenism. If it is present, expectant mothers in the early stages of pregnancy are at risk of spontaneous abortion.

Hyperandrogenism leads to the fact that the fertilized egg cannot stay in the uterus, as a result of which the pregnancy is terminated. In addition, increased production of testosterone in the female body makes it difficult not only to bear and give birth to a baby, but also to become pregnant in general.

Excessive activity of the immune system leads to the fact that the body begins to produce antibodies that seek to get rid of the fetus, perceiving it as a foreign body. Dexamethasone stops this process by blocking the activity of antibodies.

If it is known that a woman is about to give birth to a boy, the doctor may prescribe her to take the drug until the end of her term, but in short courses. Such actions of a specialist are due to the fact that when a male fetus is pregnant, the amount of testosterone produced in the female body can increase many times. This threatens the development of atrophy of the adrenal cortex in the baby.

Dexamethasone to open baby's lungs

The glucocorticosteroid Dexamethasone can be prescribed to a woman in the last trimester of pregnancy. During this period, the likelihood of premature birth is high. If a woman is diagnosed with this problem, then she is given injections of the drug according to the regimen prescribed by the doctor. The action of Dexamethasone in this case is directed not at the expectant mother, but at the child.

The maximum concentration of injectable Dexamethasone in the blood is achieved quite quickly. At the same time, a huge number of changes occur in the woman’s body, which are perceived by the child as stress. This effect of the drug increases the stamina and endurance of children. The drug promotes accelerated maturation and opening of the baby's lungs.

If the child decides to be born earlier than expected, his respiratory system will be fully developed thanks to Dexamethasone. That is, after birth, a toddler has a huge chance to breathe on his own.

If for some reason the medicine is not used, the baby will not have an easy time. After birth, his lungs may not open and he will not be able to breathe on his own. In this case, the medical staff will be forced to connect the newborn to a ventilator, otherwise the possibility of death cannot be ruled out.

During the planning stage

Often, experts prescribe Dexamethasone to women who are unable to get pregnant. However, the instructions for the hormonal drug state that it is harmful for pregnant women and those who are unable to conceive a child. Who to believe?

Modern medicine does not agree with this prescription for the medicine and considers it outdated. Treatment with Dexamethasone has been used for many years in the field of obstetrics and gynecology. The drug acts as an artificial substitute for adrenal hormones.

Dexamethasone takes part in a woman's hormonal metabolism, stopping the production of testosterone, which is the main cause of infertility and miscarriages. Timely drug therapy increases the chances of successful conception and pregnancy. All this is thanks to the control of androgens by Dexamethasone.

As soon as a woman becomes pregnant, she should under no circumstances stop taking the drug. The doctor can only adjust the dosage downward. In some cases, a woman continues to take Dexamethasone until the birth itself. This does not affect the process of delivery in any way, since the dose of the drug taken by the expectant mother is minimal.

The maximum dose of this hormonal drug when planning pregnancy is no more than 1/4 tablet. Therapy can only be prescribed by a doctor after examining the patient and receiving test results.

Contraindications, side effects and possible consequences for mother and child

It is, of course, advisable not to take Dexamethasone during pregnancy. If this cannot be avoided, then treatment should be carried out under the strict supervision of a doctor and in the absence of the following contraindications:

Based on numerous reviews, we can conclude that taking Dexamethasone during pregnancy affects not only its course, but also the well-being of the expectant mother. Pregnant women undergoing drug therapy often complain of its side effects:

• disruptions in the functioning of the endocrine system (decreased efficiency of the adrenal glands, increased sensitivity to consumed sugar);
• impaired metabolism (increased sweating, weight gain, fluid retention in the body, excess calcium, potassium and sodium);
• problems with the digestive system (flatulence, partial refusal to eat, abdominal pain, nausea, vomiting, pancreatitis);
• diseases of the cardiovascular system (bradycardia, thrombosis, cardiac arrhythmia, acute heart failure);
• vision problems (increased eye pressure, atrophy of the optic nerve and cornea, cataracts, blurred vision, sensation of a foreign body in the eye);
• other (allergic reactions, dizziness, osteoporosis, slow wound healing associated with poor blood clotting, overexcitation, lack of coordination, hallucinations, insomnia, convulsions, bruising under the skin, thrombophlebitis, numbness of the skin, development of necrosis at the injection site, withdrawal syndrome).

Despite the fact that Dexamethasone injections are quite effective in certain situations, the presence of side effects makes you think about whether it is worth using. Numerous studies of the drug on laboratory animals indicate its negative impact on the development of the child in the womb. After birth, children may develop serious problems with the adrenal glands and other equally dangerous pathologies. The most dangerous thing in this case is an adrenaline crisis. It can cause death.

To prevent irreversible consequences, you should regularly take your baby for examinations. Especially if the mother was treated with Dexamethasone for a very long time during pregnancy.

Instructions for use of the drug

The instructions for the drug do not contain clear instructions as to how and in what doses this hormonal drug should be taken. Everything depends on the doctor’s decision, which he makes based on the woman’s condition and the results of the tests she has taken.

On average, the daily dose of Dexamethasone ranges from 0.5 to 0.9 mg. The first intravenous (less often intramuscular and intra-articular) injection involves the maximum dose of the drug (from 4 to 20 mg), in subsequent days the dose of the drug is gradually reduced. The duration of therapy ranges from 3 to 4 days. One course of treatment can be carried out no more often than once every 3-4 months. Exceptions are possible, but only on an individual basis and only as prescribed by a doctor.