Why take folic acid?

Daily intake of the vitamin in the first semester prevents the development of intrauterine anomalies in the formation of the neural tube, from which the spinal cord and brain are formed. Possible malformations:

• anencephaly (malformation of the brain);

• malnutrition (delayed fetal development);

• cleft of the vertebral arches.

Folic acid is directly involved in the formation of blood components - leukocytes, platelets, prevents the development of pathologies in the gastrointestinal tract, vascular and cardiac systems. Besides:

• minimizes the risk of miscarriage and premature birth;

• helps to assimilate carbohydrates and amino acids;

• participates in cell division, DNA and RNA synthesis;

• is present in the formation of the structure of the placenta, tissues of the embryo, blood vessels in the uterus.

With its supply, nucleic acids are synthesized that are responsible for the transmission of genetic traits, so that the child receives hereditary traits.

Every second pregnant woman has a vitamin deficiency. First of all, this applies to women who have taken hormonal contraceptives for a long period, have abused alcohol, or have gastrointestinal pathologies.

B9 deficiency is easy to identify by external signs. After 2-4 weeks, depending on the reserve capacity of the body, appear:

• uncontrolled irritation;

• fast fatiguability.

In advanced cases, megablast anemia develops. Pathology of the bone marrow ends tragically.

Dosage of folic acid when planning pregnancy.

What should be the dosage of folic acid when planning a pregnancy for women? As well as the role of folic acid for men.

The body constantly needs vitamins and minerals. During pregnancy, for the normal development of the fetus, it is necessary to take high doses of nutrients. Biosubstances obtained from food and pharmacy packages are not enough for the expectant mother. Of particular importance is attached to folic acid, which belongs to the group of water-soluble B vitamins.

In humans, the reserves of the component are 10-20 mg, however, the reserve must be replenished daily, since it is produced by the body in small quantities in a healthy intestinal flora. Moreover, the component obtained from food is destroyed by 90% during heat treatment. Compared to its natural counterpart, vitamin B9 tablets are better absorbed. In a pregnant woman, its deficiency is fraught with serious consequences. The need for admission increases every month - as the fetus develops.

Dosage of folic acid for women.

To prevent vitamin B9 deficiency and to conceive normally, women are advised to start taking folic acid 3-6 months before conception. During this period, the daily intake of folic acid should be at least 0.8 mg. This will significantly reduce the likelihood of fetal developmental disorders.

Vitamin B9 is prescribed to all women planning a pregnancy. The use of folic acid should continue both during the period of conception and throughout the entire period of bearing a child.

After successful conception, vitamin intake continues.

Recommendations for the use of folic acid.

Folic acid helps to get pregnant, and after that it is prescribed during all trimesters and during breastfeeding. When taking this remedy, it is worth considering contraindications that can nullify all efforts.

Under no circumstances is it recommended to use vitamin B9 together with the following drugs:

• painkillers;

• medicines for seizures;

• cytostatics;

• antibiotics.

Long-term use of folic acid when planning a pregnancy should occur under the strict guidance of a doctor.

  A big plus will be the timely delivery of a blood test for the amount of vitamin B12. It is this component, in combination with folic acid, that organizes the competent functioning of the glands and simulates the production of red blood cells.

Men use vitamin B9 to eliminate problems with conceiving a child. For the treatment of infertility, the drug can be prescribed to both parents.

The most common variant of the pathology leading to the violation is considered to be a downed set of chromosomes. It can be caused by an unhealthy lifestyle and poor diet.

For men, folic acid is prescribed before conception in an amount of 0.7-1.1 mg per day. Reception continues throughout the entire planning period of the child.

Also, additionally, men can be prescribed vitamin E, which stimulates the production of sperm. This interaction of the components will significantly increase the possibility of conceiving a child.

Signs of vitamin B9 deficiency in men:

• poor appetite;

• forgetfulness;

• problems in the work of the gastrointestinal tract;

• a significant proportion of dead spermatozoa.

• folic acid is not the only vitamin needed by the stronger sex during this period.

The benefits of folic acid for conception.

In case of purposeful conception of a child, the couple must undergo a mandatory examination by a specialized doctor. Folic acid before pregnancy is prescribed two months in advance. During this period, you should quit smoking, since this trace element is destroyed due to the components of cigarettes.

The lack of the required amount of this vitamin affects both the embryo and the newly born baby. When planning a pregnancy, folic acid should be activated in both the female and male bodies in advance.

If the lack of a microelement cannot be filled with products, then it is better to seek help from a specialist who will prescribe a suitable drug.

When taking the medicine, the dosage should be observed. Exceeding the norm of vitamin B9 during conception can lead to hypervitaminosis. However, if the component is poorly perceived by the body of future parents, the likelihood of a positive conception of a child is reduced.

Why is folic acid needed?

Folic acid is a B vitamin that is soluble in water. The trace element is not produced in the body, therefore, it needs a regular intake. In turn, you can replenish the element with food.

Vitamin B9 is necessary for the productive functioning of the brain and nervous system, and plays an important role in the process of structuring genetic material. This period must be accompanied by the required amount of the component.

Adverse reactions and contraindications of folic acid.

Vitamin B9 has low toxicity, is sold without a prescription, and is available at every pharmacy. But this should not mislead you that the drug is allowed to be used uncontrollably.

Possible side effects such as:

• bronchospasm;

• rash, itching, urticaria, skin redness;

• nausea, diarrhea, bloating;

• headache;

• temperature increase.

Contraindications for taking drugs with folates are:

• hypersensitivity;

• pernicious anemia;

• bronchial asthma;

• a history of malignant neoplasms in the next of kin;

• hypovitaminosis B12;

• chronic pyelonephritis.

Table of folic acid content in some foods.

 Table of folic acid content in some foods:

Product, 100g. B9, mcg.

Veal liver 269

Beef liver 240

Chicken liver 240

Peanut 240

Soybeans 224

Spinach 204

Egg yolk 154

Asparagus 118

Cod liver 110

Lentil 105

Broccoli 85

Spinach 80

Beans 90

Walnuts 77

Hazelnut 68

Cauliflower 66

Wheat groats 40

White mushrooms 40

Almond 40

Curd 35

Brynza 35

Barley groats 32

Buckwheat 32

Brussels sprouts 31

Kohlrabi cabbage 31

Champignons 30

Rye bread 30

Wheat grain bread 30

Oatmeal 29

Wheat flour of the highest grade 27

Perlovka 24

Manka 23

Cauliflower 23

Wheat bread 22.5

Premium pasta 20

Eggplant 18.5

Green onion 18

Sweet red pepper 17

Peas 16

Pumpkin 14

Beetroot 13

Cod 11.3

Tomatoes 11

Butter 10

How to take folic acid when planning a pregnancy?

Pills and dietary supplements are an easy way to cure folic acid hypovitaminosis. In addition, their bioavailability is higher, since the vitamin is not “hidden” behind fiber and other cells of the product.

Folate deficiency must be replenished by both parents. It is optimal to start 2-4 months before the planned conception.

Standard doses during pregnancy planning are:

• for a man 100–400 mcg per day;

• for a woman 400–800 mcg per day.

During lactation, the dosage is reduced to 300 mcg.

The doctor may increase the dose for a man to 2 g per day, for a woman up to 4 g per day in cases where:

• there were diseases associated with folate deficiency in the family;

• a man wants to improve the quality of sperm;

• the woman had spontaneous miscarriages, or the birth of children with congenital pathologies.

Folate preparations are taken after meals, as they irritate the mucous membranes of the digestive tract.

In case of an allergy to folic acid tablets, the daily amount of B9 must be obtained from food.

Keep in mind that cooking, freezing, or canning will destroy up to 90% of the folate found in raw food.

Pay attention to greens, broccoli, nuts, cereals. Among animal products, the leader in the content of this vitamin will be the liver.

However, at the stage of gestation, offal should be abandoned. They contain an increased amount of vitamin A, the excess of which is unsafe for the fetus.

Why do expectant mothers need folate?

The folate requirement of a woman planning a pregnancy is much higher than that of her partner. Her body is preparing to “build” a new person. Most defects, such as the absence of a brain, an open hernia of the spinal cord, heart disease, are formed in the first trimester of pregnancy. To prevent this, it is necessary to take folates at the planning stage of pregnancy.

Folates are involved in the formation of the placenta. In case of violations, the risk of placental insufficiency and the development of complications increases, such as:

• placental abruption;

• delayed pregnancy;

• intrauterine death of a child.

They are also responsible for hematopoiesis, they are required to build RNA and DNA: they form all the organs and tissues of the baby. Thanks to folic acid, the nervous and cardiovascular systems of the embryo develop normally, which means that there is less likelihood of congenital malformations of the fetus.

A sufficient reserve of vitamin B9 prevents the development of anemia in the expectant mother. Relieves symptoms of toxicity. Prevents postpartum depression by participating in the synthesis of serotonin.

Folic acid for conception - reveal the secrets.

Studies have shown that women who regularly take vitamin B9 are less likely to have anovulatory cycles. It helps to bring the cycle back to normal, participates in the process of maturation of a high-quality egg and its release from the follicle. Prolongs the ovulation period, if necessary. Helps the absorption of other B vitamins.

A man with the help of folates can improve the quality of sperm. More motile sperm with the correct set of chromosomes are more likely to fertilize an egg.

What is folic acid?

Depending on the dosages and forms of vitamin B9, there are names: folic acid, folate, folin, folacin.

Folates support the functioning of the endocrine, cardiovascular, musculoskeletal and digestive systems. Beneficial effect on metabolic processes. Improve mood by participating in the production of serotonin.

The gut microbiome can produce a small amount of this substance, but most of the daily value must come from outside.

The scarcity of the diet, frequent snacks on the go, cause problems of a gastroenterological nature, and therefore the digestive system absorbs fewer nutrients. And B9 itself is water-soluble, which means it is easily excreted from the body naturally. Folic acid deficiency is not uncommon for a modern person.

Hypovitaminosis B9 is expressed in endless fatigue, apathy, irritability, lack of appetite.

How much folic acid to take in preparation for conception?

Based on the foregoing, we can conclude that the use of folic acid when planning conception is a task not only for the expectant mother, but also for the father.

According to current recommendations, women and men planning to become parents should take 0.4 milligrams of vitamin B9 per day. It is best to start taking folic acid six months before the intended conception. However, in practice this rarely happens.

The minimum duration of a course of taking vitamin B9 at the stage of pregnancy planning should be three months.

However, we note that the choice of the exact dosage and duration of vitamin therapy is the task of the doctor. If there are indications, for example, with a history of repeated miscarriages, the specialist may recommend the use of an increased dose of folic acid.

Why take folic acid when planning a pregnancy?

Vitamin B9 is a water-soluble substance that enters our body with certain foods, such as green leafy vegetables, cereals, and so on. However, even with a complete and balanced diet, it is far from always possible to achieve the desired content of folic acid in the body.

Why is this vitamin so important?

• Folic acid is involved in the replication of deoxyribonucleic acid (DNA), has an antioxidant effect, improves the absorption of some other vitamins, and maintains immunity.

• It is vitamin B9 that is responsible for the development of the neural tube in the unborn child.

• In addition, he is involved in the formation and maintenance of the functional activity of the placenta, reduces the risk of premature birth, intrauterine death of the baby.

• In 2021, scientists from the NMIC AGP named after. acad. V. I. Kulakov published a work, according to the results of which it was found that in addition to neural tube defects, folic acid intake is associated with a reduced risk of other malformations: esophageal atresia, conotruncal heart defects, cleft palate, urinary tract malformations and omphalocele, frequency some behavioral anomalies, in particular hyperactivity.

As for men's health, vitamin B9 promotes the formation of spermatozoa, increasing their mobility. Also, this substance reduces the risk of mutations in male germ cells, maintains the quality and quantity of seminal fluid.

Thus, taking folic acid at the stage of preconception preparation increases the likelihood of pregnancy, reduces the risk of complicated gestation, and makes it more likely to bear a healthy baby.

What does your baby look like in the second month of pregnancy?

He grew up: the length of his body at 5-6 weeks is about a centimeter, and by the end of the eighth week it is already 2 cm. The weight also increases, by the end of the second month it will already be as much as 3 grams. The embryo more and more begins to resemble a little man, in any case, the beginnings of pens appear in it. They are still very small and short, but even now you can see the elbows, and even tiny fingers. The head is still large and disproportionate to the body. Two flat pigment disks are visible on its sides, which will subsequently move to the front part and become your baby's eyes. The face of the child gradually acquires human features. You can see the mouth, nose and even small nostrils, auricles appear. True, the embryo still has a small tail, but do not worry - it will safely disappear by the 11th week of development.

In the second month of its existence, the embryo begins to make the first voluntary movements, it moves its arms and body, bends and unbends, tilts its head. He lives and is already starting to get used to his mother. Soon he will begin to feel a change in your mood, will worry if you are upset, and rejoice when you are happy.

Baby development during 2 months of pregnancy.

The second month of pregnancy is considered one of the most crucial, since during this period the laying and formation of almost all internal organs of the fetus begin. The health of your baby depends on how accurately this process goes. Smoking, drinking alcohol, poisoning with toxic substances, in other words, any adverse effect can disrupt organogenesis and lead to the formation of malformations of internal organs, often incompatible with life.

In the second month of pregnancy, the child's nervous system continues to form. It is no longer just a tube: in the region of its head end, three noticeable extensions, called brain bubbles, appear. After some time, these expansions turn into five bubbles and give rise to five different parts of the brain. In parallel, the peripheral nervous system also develops. This process begins with the spinal cord, where already at this time it is possible to detect various elements of the reflex arc.

At 4-5 weeks of pregnancy, your baby's pituitary gland is laid - the central hormonal gland located in the brain and controlling the entire endocrine system. The thyroid and parathyroid glands are formed from the tissues of the pharynx at 4-5 weeks of embryogenesis. The adrenal glands are laid at 5-7 weeks from the nervous tissue and epithelium, which subsequently covers all the internal organs of the abdominal cavity.

Already at this stage of development, the stomach is formed in your crumbs, and all its anatomical sections, the liver is formed. At 5-7 weeks, it is already possible to detect the small and large intestines, the rectum. The intestinal tube gives rise to all these organs. From it, which may seem a little strange, the respiratory system also develops. Initially, a protrusion forms below the pharyngeal part of this tube, then it is separated from the esophagus and divided into two independent parts, which in the future will become the lungs of the baby.

The main excretory organ at this stage of intrauterine development of the child is the primary kidney. This is not at all the kidney that we know about, and its period of existence is very short - having appeared in the 4th week, it disappears by the end of the eighth. The laying of the main kidneys known to us occurs at the end of the second month of embryo development and ends only with the birth of the baby. However, the primary kidney does not disappear without a trace. From it, or rather from the genital roller located on it, the sex glands of the child are formed - in boys, the testes, and in girls, the ovaries.

In the second month of pregnancy, the fetus is still connected to the mother's body through the chorion. However, if earlier this shell was continuous and enveloped the embryo from all sides, now the part of it, opposite to the place of attachment to the uterus, begins to thin out. In a month, it will turn into a thin petal - one of the fetal membranes. The remaining part of the chorion, embedded in the mucous membrane of the uterine wall, on the contrary, will grow and later become part of the organ common to the mother and child - the placenta.

In addition to the chorion, another fetal membrane undergoes changes - the amnion, which secretes amniotic fluid, which is the habitat of your baby while he is inside your body. The comfort of the existence of the child and his health depend on how healthy this environment will be. As pregnancy progresses, the amount of amniotic fluid increases, and this process begins precisely from the second month of pregnancy.

The condition of the fetus in the second month of pregnancy.

In the fetus at the 2nd month of pregnancy, the brain, excretory and respiratory systems are actively developing, the rudiments of joints appear, and the bones of the skeleton begin to form. During this period, the limbs develop rapidly, facial features become clearer, the eyes, which were previously located almost on the sides of the head, approach each other, and even the rudiments of milk teeth appear. The fetus is already making various movements, but you can feel it a little later.

The size of the fetus in the second month of pregnancy is about 2 cm.

Condition of a woman in the second month of pregnancy.

In the second month of pregnancy, your condition no longer raises doubts that you are pregnant. Regular periods do not come, the symptoms characteristic of the state of pregnancy intensify, and pregnancy tests confidently show the presence in your body of the hormone human chorionic gonadotropin (hCG), which is produced during pregnancy. Symptoms of the second month of pregnancy, such as nausea and even vomiting, frequent urination, increased sensitivity to odors, may not occur in all women, but still their presence is typical for most. In addition, the hormonal activity in your body during this period can cause other changes, such as increased hair loss, brittle nails, the appearance of age spots and skin rashes. The second month of pregnancy can also affect your psychological state: frequent unreasonable mood swings are a fairly common occurrence at this stage of pregnancy. You may also feel tired and sleepy.

If all these symptoms of pregnancy in the second month appear in all their glory, try to somehow adapt to your condition: fill your diet with foods that do not make you feel bad, stop using perfume for a while and ask your loved ones about the same, rest more, do not exclude physical activity from your life - this will help keep your body in good shape and have a positive effect on your psychological state.

The stomach at 2 months of pregnancy does not yet make it clear about your pregnancy status, but noticeable changes are already taking place in the chest. The breasts gradually fill up, increasing in size; at this stage of pregnancy, pain in the chest in the form of tingling may disturb. Darkening of the nipple halos is another sign of pregnancy that appears in the second month.

The second month of pregnancy may be accompanied by bloody discharge from the vagina. At this stage of pregnancy, such discharge is observed in about a quarter of pregnant women and is not dangerous. However, in some cases, such discharge in the second month of pregnancy may indicate an ectopic pregnancy or a threatened miscarriage, so if there is any, be sure to consult a doctor to determine their cause. Also, a dangerous symptom at this stage of pregnancy is abdominal pain, it can also signal the presence of any problems and requires immediate medical attention.

If you have not yet registered for pregnancy, then in the second month of pregnancy it is already time to do it. Doctors will conduct the necessary examinations and will monitor the course of your pregnancy, advising you on all emerging issues and providing personalized recommendations.

By the 2nd month of pregnancy, you already have to reconsider your lifestyle somewhat. Toxicosis of pregnancy can make some adjustments to it, forcing you to give up your usual food and change your daily routine. In the second month of pregnancy, rest more, do not lift weights, be attentive to your diet, make sure that it is healthy and contains all the nutrients and vitamins necessary for you and the developing baby. On the recommendation of a doctor, you can take special vitamin complexes for pregnant women. Be especially careful when taking medications: most of them are not recommended for use during pregnancy, so take any medications only in consultation with your doctor. Always remember that the first months of pregnancy is a critical period in the development of the fetus, since at this time all the main systems and organs are laid down, so the influence of harmful substances and factors on this process can be detrimental to the fetus or lead to developmental pathologies.

Necessary examinations in the second month of pregnancy.

The beginning of the second month of pregnancy is the most common period of registration in the antenatal clinic. Immediately after this, the doctor (obstetrician-gynecologist) prescribes a complete examination, which includes a whole list of laboratory and instrumental studies:

• ultrasound;

• general analysis of urine and blood;

• blood chemistry;

• determination of the group and Rh factor;

• testing for potentially dangerous infections for mother and fetus (hepatitis, HIV, syphilis, rubella, herpes, cytomegalovirus and toxoplasmosis);

• vaginal smear for microflora;

• measurement of blood pressure.

In addition to the gynecologist, the expectant mother will have to visit a therapist, an endocrinologist, an ophthalmologist, a dentist and an otorhinolaryngologist. If you do not have complaints of increasing bloody discharge and pain in the small pelvis, there are no other symptoms that cause significant discomfort (severe vomiting), then the first visit to the women's doctor should take place at 8-10 weeks.

The fetus is in the second month of pregnancy.

The state of the child. A child in the second month of pregnancy is actively developing: all internal organs are laid and intensively formed in him. At this time, the child's brain acquires a high speed in the development process. In this period of time, the baby's head occupies 1/3 of the length of his body. The fetus is already having a heartbeat. The baby can already listen to the heartbeat during the ultrasound. Thanks to ultrasound examination, it is possible to determine the arms and legs with developing fingers. If before that cartilage tissue occupied the main place, now bone tissue begins to emerge. By the end of the second month of intrauterine development, the formation of teeth begins.

Condition of the expectant mother. A pregnant woman should eat rationally and diversified, providing the fetus with all the necessary nutrients (proteins, fats, carbohydrates, vitamins and minerals), and also exclude the influence of various harmful factors on the baby: stop smoking immediately, it is advisable not to drink coffee or drink decaffeinated coffee . The fetus at the end of the 2nd month can make single movements, but it is still so small that the woman does not feel movement.

Pregnancy is a time for reinsurance.

Many modern women, long before pregnancy, begin to take a large number of drugs, often just in case, in order to kill all “hidden” infections, or, for example, swallow progesterone and similar drugs in batches. Not having time to get pregnant, they continue to take medication, also just in case. Such faith in medicines has only one serious reason - fear. Fear arises from ignorance, lack of experience, a lot of rumors and myths gleaned from friends, relatives, colleagues, acquaintances and medical staff. Pregnancy is not a disease. But this condition is accompanied by certain loads on the female body: physical and emotional. Not surprisingly, therefore, the norms that are set for non-pregnant women are often not suitable for pregnant women. It is the lack of understanding or ignorance of this nuance that causes many erroneous diagnoses, which is why unnecessary treatment is often prescribed.

Feelings of the expectant mother in the second month of pregnancy.

Mood. The expectant mother may still be subject to frequent mood swings, prone to apathy or increased fatigue, especially against the background of toxicosis. Emotions in a pregnant woman may become more acute, and this period of time also contributes to changeable mood. Touchiness, irritability, mood swings, tearfulness, anxiety are often manifested. No matter how trite it sounds, first of all, you need to calm down: this is a temporary phenomenon. This is due to changes in the body, i.e. the body adapts to internal changes, primarily to a change in hormonal levels. There is no need to be afraid of this state: after a short period of time everything will return to normal, the body will get used to new sensations, they can even become pleasant.

Change in taste preferences. At the same time, changes occur in the woman's body, sensations begin to appear that have not occurred before. A pregnant woman may stop perceiving her favorite food or demand what she could not eat before pregnancy, that is, taste sensations change. For example, if a woman loved sweets, she can completely stop loving him and greedily eat spicy, salty, etc. At the same time, the consumption of spicy and salty foods should be reduced. You may also experience dizziness or pain in the head. Some women have problems with stool.

Recommendations for the expectant mother in the second month of pregnancy.

In the second month, it is important to control your weight and refrain from eating too much; be in constant motion, do not sit or lie down for a long time; in a sitting position, it is better to raise your legs higher so as not to burden the vessels. Lie on your side with a pillow under your feet or between your knees. It is not recommended to put one leg on the other in a sitting position for all women, and even more so for pregnant women. Don't lift anything heavy. You can not wear tight clothes, stockings and socks if their upper part is elastic. Shoes should be very comfortable, you need to give up heels. Light exercise is great, but don't overdo it. Walking for half an hour is the best exercise option in the second month of pregnancy.

Changes in the appearance of the expectant mother in the second month of pregnancy.

The belly in the second month of pregnancy is still invisible. But in the appearance of the expectant mother, changes can occur. Veins on the chest and abdomen may begin to protrude due to the fact that vasodilation occurs due to an increase in the blood supply to the body in order to satisfy the baby's need for oxygen. Often, spider veins appear on the hips, they are purple in color, which will disappear after the end of pregnancy.

Quite often, pregnant women have problems with the venous system, and this often happens in the second month of pregnancy. First of all, problems capture the veins on the legs and in the area of ​​the external genitalia. This happens on the basis of the fact that the amount of circulating blood in the body increases, the muscle layer in the veins relaxes, which is determined by hormonal disruptions. Signs of such a disease include heaviness in the legs, aching pain near the dilated veins, and enlarged veins can be detected without looking closely.

Signs of the second month of pregnancy.

Often, expectant mothers at this time are faced with unpleasant sensations - nausea and vomiting, which provoke the smells, appearance and taste of even previously loved food. This condition can be overcome. You need to know that you can not brush your teeth on a full stomach, mix liquid and solid food. Dense food should be eaten in small portions and washed down after 15-20 minutes with tea or coffee without caffeine. Usually, toxicosis disappears by the 12th week of pregnancy. In severe toxicosis with frequent vomiting, loss of strength, weight loss and dehydration, hospitalization is necessary. However, such situations are observed quite rarely, most often it is possible to solve the problem at the home level, eating right, walking and getting enough sleep.

Second month of pregnancy.

The second month of pregnancy is very important for the expectant mother and fetus, since in this period of time the formation and development of all the baby's organs takes place. Pregnancy in the second month is accompanied by an active change in hormonal levels. In this regard, a woman may experience malaise, increased uterine tone and a threat of miscarriage. It is important enough to be under the supervision of an obstetrician-gynecologist from the first trimester. It is necessary to apply either to the antenatal clinic at the place of residence, or to a paid medical institution that provides pregnancy management services. In some women, even in the second month of pregnancy, its signs may be absent.

Prevention of ectopic pregnancy.

Examination of the body during the planning period of the child allows you to identify the causes that provoke an ectopic pregnancy. It is also recommended to observe the following rules:

• timely treat gynecological diseases;

• control the state of the hormonal background;

• use condoms to prevent STIs;

• regularly visit a gynecologist.

Ectopic pregnancy has a diverse clinical picture, and therefore time is often lost. Therefore, it is extremely important to consult a doctor as soon as possible even with the slightest symptoms. This will allow you to correctly establish the diagnosis and prevent complications.

Complications of ectopic pregnancy.

If the pregnancy is not detected and removed in time outside the uterus, severe consequences are likely:

• extensive bleeding - occurs due to rupture of the pipe or other tissues, can lead to the death of a woman;

• infertility - occurs after the removal of the pipes or when they become obstructed.

Conservative methods of treatment of ectopic pregnancy.

In rare cases, surgery can be avoided. Conservative-observational tactics of treatment in relation to ectopic pregnancy is used if:

• the clinical picture is erased and does not worsen;

• no signs of intra-abdominal bleeding;

• HCG level drops.

This is possible in the very early stages. In this case, the fetal egg, being in the fallopian tube, ceases to develop, and subsequently calcifies. However, such a tactic requires careful observation of the woman and the readiness to operate on her at any time if the situation changes.

In some countries, methotrexate is used to simulate this process, sometimes in combination with hormone-like substances that neutralize its toxic effect. The medicine is brought to the fallopian tube or taken orally. The drug stops the development of embryonic cells, leading to its death. The fertilized egg self-destructs, sometimes calcified. In Russia, this method is not officially used. It is believed that it is ineffective, and in the event of an error in the diagnosis and subsequent confirmation of uterine pregnancy, it leads to fetal malformations.

Treatment of ectopic pregnancy.

Since the preservation of such a pregnancy and the normal development of the fetus are impossible, the only treatment option for the pathology is the removal of the fetal egg by surgery. There are also conservative methods, but they are not allowed in all countries.

If the condition progresses, the following options for surgical intervention are possible.

• Dissection of the fallopian tube. During the operation, the fetal egg is removed, and after that, the anatomy of the salpingus is restored by plastic correction. Often, patency can be maintained.

• Fimbrial evacuation of the embryo. Possible at the earliest stages of pathology. The embryo is removed under vacuum from the part of the tube that is associated with the ovary. Used extremely rarely.

• Salpingectomy. This removal of the fallopian tube is carried out with an interrupted ectopic pregnancy.

Such surgeries are performed in two ways.

1. Laparoscopy. The least traumatic method using special equipment. It is distinguished by rapid recovery, low soreness of wounds in the postoperative period, and a low number of complications.

2. Laparotomy. The classic version of the operation. In this case, access to the organ is obtained through longitudinal or transverse incisions of the anterior abdominal wall.

Methods for confirming the diagnosis of ectopic pregnancy.

Up to a period of five to six weeks, an ectopic pregnancy often proceeds in the same way as a normal one, without making itself felt with unusual signs. To avoid pipe rupture and serious complications, it is important to diagnose this pathology as early as possible. First of all, the doctor evaluates the clinical data - complaints, anamnesis of the woman. The following research will also help.

• Pregnancy test. Basically shows a positive result, the second strip may not be very bright. Rarely the test is negative.

• Blood for hCG. This is the most reliable way to determine pregnancy and its development trend (by increasing hCG levels). With an ectopic, the readings are usually below normal for a given period. Less often - correspond.

• Ultrasound. It will help to establish that the fetal egg is absent in the uterus. With an ectopic location, you can often find it in the tubes, near the ovary. Also, ultrasound diagnostics helps to determine the free fluid in the retrouterine space in case of a disturbed ectopic pregnancy, if intra-abdominal bleeding begins.

• Puncture. Used for suspected intra-abdominal bleeding. Using a thin needle, the posterior wall of the vagina is punctured, which gives access to the abdominal cavity. The presence of blood in the material is an indication for urgent surgery.

• Laparoscopy. The most informative method of research, however, this is a full-fledged operation and therefore is carried out in difficult cases and with confidence in the diagnosis. Through a puncture of the skin and underlying layers of the abdomen, a special camera is inserted to examine the abdominal cavity. On the monitor, you can see the appendages, the uterus and signs of an ectopic.

Symptoms of an ectopic pregnancy.

The insidiousness of the pathology lies in the fact that until the fourth or fifth week, its symptoms are identical to normal pregnancy. These include:

• early toxicosis;

• delay of critical days;

• swelling of the mammary glands.

It turns out that in the case when an ectopic pregnancy is developing, it is impossible to independently detect it by signs. As the fetal egg grows, the following symptoms occur.

• Pain. They can be cramping, as well as constant, give to the lower back or lower abdomen. If there is a rupture of the fallopian tube, the pain becomes sharp and unbearable, the woman may lose consciousness. In such a situation, urgent medical attention is needed.

• Smearing highlights. Their appearance for a short time against the background of pulling pains in the lower abdomen is one of the first signs. They can be beige, brown, and are also described as "dirty". More often scarce, less often - plentiful. May last for several days.

• Delayed menstruation. Even with an ectopic pregnancy, hormonal changes begin in the woman's body, during which progesterone enhances its effect, which is the reason for the absence of menstruation. A rare exception is the “old ectopic”, when there is no delay, and the fetal egg remains in the tube from the previous cycle.

• Urge to defecate. If the fallopian tube is located near the rectum, then the pain may radiate to the anus, and there is a desire to empty the intestines.

In the case of an acute condition (when a tube, uterine horn or angle is ruptured), blood pressure drops, the pulse quickens, weakness, dizziness, loss of strength occur, a woman may lose consciousness.

The time when the fallopian tube ruptures depends on which part of it the fetal egg is attached to, since in different parts it has a different diameter. Mostly this happens in the fifth or sixth week.

Causes of ectopic pregnancy.

The main reason for the development of pathology is a violation of the patency of the pipes or pathological processes in them. The latter includes the following states.

• Chronic adnexitis. Even inflammatory processes that have been successfully treated often leave behind fibrous structures and adhesions that prevent the passage of the fetal egg into the uterine cavity.

• Violation of the innervation of the pipes. Deficiency of nerve endings in the tubes follows inflammation and leads to the death of the mucous villi. As a result, the transport function of the organ is disrupted, due to which the fertilized egg cannot enter the uterine cavity.

• Anomalies of development. They occur even during the formation of the genital organs in girls in utero. Most often, there are additional fallopian tubes, as well as additional holes in the area of ​​their gaps.

• Hormonal imbalance. It leads to the loss of normal peristalsis of the smooth muscles of the tubes.

• Postponed operations. Surgical interventions contribute to the formation of adhesions in the tubes, which makes it difficult for the fetal egg to move.

• One pipe. If ovulation occurs from the side of the removed tube, then the egg will take much longer to reach the target through the second one, so it can be implanted elsewhere.

Classification of ectopic pregnancy.

The localization of the embryo is taken as the basis for the classification of ectopic pregnancy.

• Ovarian. The fertilized egg is located in the follicle on the surface of the ovary.

• Interconnective. The embryo attaches in the fallopian tube, but grows laterally between the sheets of the broad ligament. Pathology can progress asymptomatically up to four months.

• Abdominal. It is divided into primary, when the embryo is fixed on the peritoneum in the region of the omentum, spleen and even the liver. And also secondary, when the embryo is implanted in the tissues after it is ejected from the fallopian tube.

• Cervical. The fertilized egg implants in the cervix. One of the dangerous options for ectopic, since it is difficult to diagnose such an arrangement, and pregnancy can progress up to 20-30 weeks, manifesting itself in the future with bleeding that threatens the life of a woman.

• In the vestigial horn of the uterus. Possible in the case of a rudimentary uterus, the body of which is connected to the tube, but does not communicate with the vagina. With further development of the fetal egg, tissue rupture and massive intra-abdominal bleeding occur.

• Interstitial. The fertilized egg is located in the tubal angle (interstitial section of the tube), close to the body of the uterus.

According to the stage of development, pathology is classified into the following types:

• progressive;

• intermittent;

• interrupted.

A separate type of ectopic pregnancy is heterotopic. In this case, two embryos develop, one of which is implanted naturally inside the uterus, and the other - outside it. The condition is difficult to diagnose, since the examination, including ultrasound, confirms the presence of a fetal egg in the uterus.

In whatever area the embryo is fixed, it is doomed to death, since only the uterus is able to provide it with the conditions for full development and life.

Mechanism of formation of ectopic pregnancy.

During ovulation, the egg is released from the follicle on the ovary and travels to the fallopian tube. Under favorable circumstances, there it is fertilized by a spermatozoon - conception occurs. Further, with the help of contractions of the muscular membrane of the fallopian tube and wave-like shocks of the villi on the mucosa, the embryo moves into the uterine cavity. The journey takes three or four days. At this time, pinopodia are formed on the outer cover of the embryo - special structures with which it is attached to the endometrium. This is how normal conception and implantation of the blastocyst into the uterus occurs.

Under adverse circumstances, obstacles are formed on the way of a fertilized egg, due to which it does not reach its destination and attaches itself in places unsuitable for this. Most often this occurs in the fallopian tube from the side of the ovary where the egg matured. Further, the embryo begins to develop, but this happens incompletely, since there are no appropriate conditions in places atypical for pregnancy. Nevertheless, the embryo increases in size, in parallel with this, it destroys the underlying tissues, which can provoke their rupture and intra-abdominal bleeding.

What is an ectopic pregnancy?

In an ectopic pregnancy, the embryo implants and develops outside the uterine cavity. The causes of abnormal localization of the fetal egg can be inflammation, congenital and acquired pathologies of the fallopian tubes, hormonal disorders. The child cannot be saved. Treatment is surgical removal of the fetal egg, often with a fallopian tube. It is important to detect the pathology in a timely manner, otherwise the life of a woman may be in jeopardy.

An ectopic (ectopic) pregnancy at the beginning of the course is no different from a normal one, so it is difficult to suspect it on your own. However, the further development of the fetal egg in an atypical place leads to intra-abdominal bleeding, which requires immediate surgical care.

How to determine an ectopic pregnancy in other ways?

To determine such a pathology, the following activities are carried out:

1. Examination by a gynecologist on a chair, palpation in the lower abdomen. The doctor may suspect a pathology according to such signs during examination and palpation - soreness, abdominal tension. In the place where the fetal egg is attached, a seal in the form of a tumor is felt. The uterus is enlarged, but does not correspond in size to the expected gestational age.

2. Ultrasound examination. With the help of this diagnosis, it is possible to determine where the fetal egg is fixed. Also, the procedure will show the presence of blood in the abdominal cavity, rupture of the fallopian tube. It is better to conduct a vaginal ultrasound.

3. Blood test for human chorionic gonadotropin. In the normal course of gestation, these figures double daily. And with ectopic gestation, the level of hCG does not correspond to the timing.

4. Diagnostic laparoscopy. It is a microsurgical intervention, with the help of which an examination of the uterine cavity is performed. During this procedure, the location of the fertilized egg is determined, if necessary, it is immediately removed.

If there is a suspicion of internal bleeding, a diagnostic procedure such as puncture of the posterior vaginal fornix is prescribed. The fact that there was a rupture of the fallopian tube is evidenced by dark blood, in which clots are present.

Signs of an ectopic pregnancy.

With the stability of the menstrual cycle, the first sign of conception is the delay in critical days. In the early stages of gestation, the signs will be the same as in the normal physiological process. Early symptoms of a possible pathology include:

• pain in the lower abdomen of a aching or pulling nature, which is constantly present, may increase;

• cramps in the lower abdomen;

• the appearance of spotting spotting from the genital tract;

• frequent bouts of nausea and vomiting;

• swelling and soreness of the mammary glands, discoloration of the areola, increased sensitivity and soreness of the nipples;

• frequent urge to empty the bladder;

• there may be a bowel disorder.

Such signs appear around the third week. At this time, the test will be positive. Sometimes the second strip is less clear or smeared.

6 weeks after conception with an ectopic pregnancy, the fallopian tube ruptures. In this case, the clinical picture is pronounced. Initially, there is a sharp pain in the lower abdomen, it radiates to the back, to the perineum and to the anus. The pain is pronounced, associated with internal bleeding and accumulation of fluid in the abdominal cavity. The following symptoms also appear:

• severe weakness and trembling in the legs;

• sweating increases;

• mucous membranes and skin become pale;

• blood pressure decreases;

• pulse rate increases;

• there is a severe bowel disorder;

• fainting.

On examination, a strong bloating of the intestine, soreness is determined. This condition requires urgent medical attention.

Is it possible to determine an ectopic pregnancy without a test?

The pregnancy test is the very first diagnostic method. Without it, only by indirect symptoms can one suspect that conception has occurred. These signs include:

• weakness and increased fatigue;

• increased sensitivity of the mammary glands, their increase in size, soreness;

• increased sensitivity to strong odors;

• there are bouts of nausea;

• the lower back begins to hurt;

• there are imperative urges to empty the bladder.

Only instrumental methods of research and a blood test for hCG will be reliable. You can use other methods at home, but their reliability is questionable.

You can determine that conception has occurred by checking the basal temperature. A woman can control her basal body temperature during her menstrual cycle. If pregnancy occurs, the basal temperature exceeds 37 degrees. You need to measure in the morning without getting out of bed. A thermometer is inserted into the rectum for several minutes. Then the scores are checked.

Sometimes women also use non-traditional methods of verification:

1. With the use of iodine. Collect morning urine, drop it on a sheet of clean paper. Drop iodine on the same area, then observe. Normally, urine turns purple upon contact with iodine. When pregnant, it will be brown.

2. Using soda. There are suggestions that during conception, the alkalinity of urine increases. Collect morning urine, add a teaspoon of soda to it. If there are bubbles and the soda sinks to the bottom of the container, the woman may be pregnant.

3. With ripple. There is an assumption that during pregnancy, a pulsation appears just below the navel. You need to take a horizontal position and relax. Then press down two centimeters below the navel. If a pulsation is felt, there is a possibility of conception.

Also, some women try to determine their interesting position, given the emotional state and changes in well-being. It is believed that even before the delay of menstruation, pregnancy can be suspected by the following signs:

• frequent dizziness, flashing flies before the eyes;

• increase in body temperature to 37 degrees for no apparent reason;

• nasal congestion, swelling of the mucous membranes of the nasal passages, which is not associated with a viral or catarrhal disease;

• enlargement and swelling of the breast, discoloration of the areola, increased sensitivity of the mammary glands;

• feeling of heaviness and soreness below the navel;

• nausea, exacerbation of taste and olfactory receptors;

• weight gain;

• frequent changes in emotional state;

• constant drowsiness;

• unusual taste preferences;

• a sharp increase or decrease in libido.

These folk methods are not reliable. The test will help to accurately determine the presence of pregnancy at the initial stage. And to confirm such a physiological process is possible only with the help of instrumental studies. These signs may be associated with hormonal disorders, inflammatory processes in the body.

What will the test show with an ectopic pregnancy?

Many women are interested in the question of whether the test will show an ectopic pregnancy or not. Doctors say that the test results for an ectopic pregnancy will be positive, since the determination mechanism depends on the amount of human chorionic gonadotropin in the urine. With any pregnancy, the amount of this hormone increases. But it is impossible to reliably determine exactly where the fetal egg was attached using the test. It is also impossible to determine such a pathology only on the basis of symptoms in the early stages of gestation.

After the fertilized egg is attached to the walls of the fallopian tube, the same symptoms appear as in the normal physiological process. Menstruation stops, the mammary glands increase in size and become painful, feel sick, and there are bouts of dizziness.

A month after the fetal egg is attached to the walls of the tube, it is damaged. This is preceded by aching or pulling pain in the lower abdomen, discharge from the vagina appears mixed with blood, during intimacy there is discomfort and pain. You can not ignore such symptoms, it is important to visit a gynecologist as soon as possible. Only with the help of ultrasound can such a pathology be detected and appropriate measures taken before the fallopian tube ruptures with severe bleeding.

An ectopic pregnancy is not detected on the test. Sometimes the second line on the test may not be as bright as the first.

Causes and complications of ectopic pregnancy.

The reasons for this pathology lie in:

• abnormal structure of the fallopian tubes;

• inflammation of the genitourinary organs;

• violation in the hormonal sphere;

• previous abortions, curettage, miscarriages, complications of which are adhesions and obstruction of the tubes;

• violations in the transmission of nerve impulses in the tissues of the tubes;

• chronic diseases of the pelvic organs;

• prolonged use of the intrauterine device as a contraceptive;

• adhesions, synechiae;

• frequent douching;

• polycystic ovaries.

Such a pathology can be provoked by the in vitro fertilization procedure and any other interventions in the internal organs of women.

Complications can be:

• heavy bleeding;

• rupture of the fallopian tube;

• removal of the fallopian tube, after which it is very difficult to get pregnant;

• hysterectomy;

• repeated pregnancies can also be ectopic.

It is very important to consult a doctor in time, who will send you for an ultrasound examination and determine the location of the fetal egg.

Why is an ectopic pregnancy dangerous?

An ectopic pregnancy is a pathology that is fraught with serious consequences and a condition that threatens the life of a woman. In this condition, the fetal egg is attached not to the walls of the uterus, but outside it. There is a risk of developing such a pathology in women of childbearing age. Tubal, ovarian and abdominal pregnancy is diagnosed. Most often, with an ectopic attachment, the fetal egg is fixed in the cavity of the fallopian tubes.

The danger of pathology is that rupture of the fallopian tubes can occur with the development of intra-abdominal bleeding. Therefore, in this condition, urgent surgical intervention is necessary. It is the leading cause of death among women in the first trimester of gestation. Initially, its development is similar to a normal physiological process, therefore it is not easy to recognize the pathology only by symptoms.

In the normal course of gestation, the embryo, after fertilization of the egg by the sperm, is attached to the walls of the endometrium in the uterus and further develops. And during tubal pregnancy, such processes are violated - the fertilized egg is fixed in the cavity of the fallopian tubes, without moving towards the uterus.

What is an ectopic pregnancy?

An ectopic pregnancy is a rather serious pathological process. It poses a danger to the health and life of a woman. With such a pathology, there is a threat of intra-abdominal bleeding, this condition is dangerous not only for the woman's health, but also for life. Therefore, a visit to a doctor should be mandatory. An ectopic pregnancy must be terminated. Next, you can find out if the test shows an ectopic pregnancy and how to determine it in the early stages.

Prevention of ectopic pregnancy.

You can avoid this pathological condition if you carefully monitor your health. It is necessary to visit a gynecologist every six months, treat inflammation of the genitourinary system in time, eliminate infections, and not overcool. With a delay in menstruation with all the characteristic symptoms, it is better to immediately donate blood for hCG and undergo an ultrasound diagnosis to confirm the fact of a healthy pregnancy.

Consequences of ectopic pregnancy.

In case of untimely seeking medical help, a woman expects such consequences as:

• Rupture of the organ in which the fertilized egg was implanted.

• Internal bleeding, carrying a threat of death.

• Pain shock.

• Infertility.

If an abnormal pregnancy is terminated in time, then the chances of saving life and reproductive health are much higher. This can be done in a conservative way with the help of special drugs, for example, Methotrexate. Such medicines are harmful to the body, so their use is possible only as directed by an experienced gynecologist. Active substances stop the growth of the embryo and promote its natural excretion along with menstruation.

The level of hCG in the blood during an ectopic pregnancy.

As already mentioned, an ectopic pregnancy is confirmed by clear results in home diagnostics, if the test is highly sensitive, or the period is already long enough. At the same time, the woman's state of health gradually begins to worsen, abdominal pain is increasingly disturbing, vaginal bleeding is noted.

According to statistics, tubal pregnancy often ends in miscarriage than cervical or intra-abdominal. Naturally, women are very afraid of this diagnosis, especially if they have problems with the health of the organs of the reproductive system. If home testing, combined with unpleasant symptoms, is in doubt, then it is best to donate blood for hCG. This can be done both for a fee in a private clinic, and with a referral from a doctor in a district clinic.

In a normal pregnancy, hCG levels double every two days. But if the fetal egg is fixed in an unnatural place, then the growth of this hormone will be unstable. However, it is impossible to predict at what rate its concentration will change, since everything depends on the individuality of each specific case.

The hCG examination consists of several stages. This is the only way to find out for sure whether the embryo is in the uterus or is it outside of it. The diagnosis is confirmed by ultrasound (after 6 weeks). At the first blood test, the level of human chorionic gonadotropin usually turns out to be low.

The next study is carried out in a few days. And when evaluating the results, factors such as:

• the total level of gonadotropin in the blood (with an ectopic pregnancy, it is below normal);

• how much it has increased compared to previous indications (if the embryo is not in the uterus, then the increase in chorionic gonadotropin occurs very slowly, unlike in cases with normal pregnancy).

The concentration of hCG during an ectopic pregnancy is much lower than normal. Therefore, pregnancy tests show a barely noticeable second strip. The reagent on the test reacts specifically to hCG, if it is small, then the reaction will be weak.

Is it possible to suspect an ectopic pregnancy with a test?

When a fertilized egg is fixed outside the genital organ, a pregnancy test will be negative if it is carried out shortly before the delay. When tested after a few days, the results may be positive, but in doubt, because with a clear control strip, the second one will be faintly colored or even barely noticeable.

Using the test in the future will also not give convincing results, since the second strip will still differ in color saturation from the control. This is due to the fact that the level of hCG in the body grows very slowly.

With such a home diagnosis, attention should be paid to the sensitivity of the test itself. Usually, the mMe range number is indicated on the packaging, and the lower it is, the more accurate the results. You also need to remember that attempts to detect pregnancy using tests at an early stage often give false positive answers. Therefore, it is better to wait for a delay in menstruation, and only then carry out diagnostics.

Here's what you need to know when trying to determine an ectopic pregnancy at home:

• Even with positive results, the second line is unclear or barely noticeable.

• Using the test, an ectopic pregnancy can only be suspected, and it is possible to find out the exact diagnosis after an examination by a gynecologist.

• As the time increases, the test strip becomes brighter, but still remains undersaturated compared to the control.

• A negative test result is possible even if your period is late and if you have all the main symptoms of pregnancy.

• Alternating positive and negative responses.

Electronic pregnancy tests.

Electronic tests also cannot boast of accurate detection of ectopic pregnancy. In pharmacies, in addition to standard inexpensive test flats, electronic devices are also sold. When using them, you need to be especially vigilant, because usually, even with an ectopic pregnancy, they show clear results, indicating the emergence of a new life. Therefore, if there is a suspicion that the fertilized egg is not in the uterus, it is better to buy an electronic test, which provides for determining the exact date.

Thus, with the help of this device, it will be possible to verify that the level of chorionic gonadotropin does not correspond to the gestational age in weeks.

What will a pregnancy test show for an ectopic pregnancy?

The results of home testing for early ectopic pregnancy can be either negative or positive. In general, the level of hCG in the female body will increase in any case if fertilization has occurred. But when the fetal egg is attached outside the uterus, the level of chorionic gonadotropin rises more slowly. Therefore, an ectopic pregnancy can be suspected by a weak and dim second strip, which does not become clear with the development of pregnancy.

But still, the test does not always show a positive result, sometimes with its help it is not possible to make sure that conception has occurred. Based on all this, it should be concluded that you should not completely trust this device. Even if the test shows that pregnancy has occurred, it will not be possible to reliably determine the place of attachment of a fertilized egg with its help. The test, or rather the reagent applied to its surface, only reacts to the growth of hCG. The test cannot with 100% guarantee show an ectopic pregnancy at the beginning of the term. An indirect sign that the egg is fixed in the wrong place is a weak (dim) second strip on the test.

To accurately determine the developing ectopic pregnancy, you need to do an ultrasound. This is what the test shows for an ectopic pregnancy at the beginning of the term. Please note that the second line is very dull from days 1 to 10 after conception. With such a test result, you should immediately consult a doctor.

The main signs and symptoms of an ectopic pregnancy.

Symptoms of an ectopic pregnancy at first are the same as in a normal one. This is drowsiness, and an increase in the mammary glands, and nausea with a slight deterioration in general well-being.

It is recommended to carry out the test only after a delay in menstruation. With the development of abnormal pregnancy, the clinical picture becomes more pronounced:

• drawing pains in the lower abdomen, as during menstruation;

• uncharacteristic brown discharge, breakthrough bleeding;

• back pain;

• a positive pregnancy test that could have been negative a little earlier;

• increase in leukocytes in the blood (immune reaction).

An ectopic pregnancy is very dangerous for the life and health of the mother.

Why is an ectopic pregnancy so dangerous?

An ectopic pregnancy poses a threat not only to a woman's health, but also to her life. The only way out in such cases is an abortion, and the sooner the better.

If you seek medical help in time if you suspect such a diagnosis, then medical termination of pregnancy is possible. And in more advanced cases, surgical intervention is indicated.

In the absence of timely detection and elimination of an ectopic, there is a rupture of the fallopian tube (as a result of the growth of the embryo) and massive internal bleeding. A fertilized egg may attach in the abdomen, cervix, or ovary, but in most cases it remains in the fallopian tube. This happens under the influence of several risk factors:

• Spikes.

• Use of an intrauterine device.

• Previous operations on the uterus or on the abdominal organs.

• Hormonal imbalance.

• Inflammatory processes of the organs of the reproductive system.

• Infectious diseases.

• Tumors.

• Congenital defects in the structure of the uterus.

• Frequent abortions.

• Endometriosis.

• Frequent stress causing spasms of the fallopian tubes.

Does the test show an ectopic pregnancy?

A pregnancy test is a simple device with which you can quickly find out if conception has occurred. It must be used from the first day of missed menstruation. But according to statistics, in every hundredth case, a fertilized egg is attached outside the uterus, and most often in one of the fallopian tubes.

It is very important to diagnose this condition in the early stages, otherwise there is a risk of serious consequences for the woman. Most expectant mothers express doubts about the fact that a conventional test can detect an ectopic pregnancy. In reality, a pregnancy test can only give an indirect sign of the incorrect location of the fertilized egg.

No pregnancy test can show an ectopic pregnancy. But it can show an indirect sign that something has gone wrong.

What is the trimester of pregnancy?

The word "trimester" in Latin means "three months". This division of the gestational age allows you to break 40 weeks into shorter periods. On each of them, certain changes occur in the body of a woman.

The first trimester lasts approximately from the 1st to the 12th week from the first day of the last menstrual cycle. At this time, the fetus is developing rapidly, its main organs and systems are being formed. The size of the fetus is increasing, but so far only slightly.

The second trimester lasts approximately from the 13th to the 26th week of pregnancy.

The third trimester starts at 27 weeks. By this time, the unborn child is already mature enough to survive outside the womb. The fruit increases significantly in size. By the end of the 3rd trimester, he is ready to be born as a chubby, healthy baby.

Why do doctors calculate the gestational age in weeks?

Doctors ask the expectant mother how her week of pregnancy went. Everyone else is interested in what month she is in. Why such confusion?

In fact, the weekly countdown allows medical professionals to monitor the dynamics of fetal development and describe it correctly. Using the same terminology, doctors know exactly what is at stake and can assess the condition of a patient who has previously been seen elsewhere.

Knowing the first day of the last menstrual cycle, you can set the gestational (intrauterine) age of the child. Doctors agreed among themselves that they would calculate the term this way and not otherwise. However, given that conception occurred about 2 weeks later, your baby's actual gestational age is less.

How long does a normal pregnancy last?

It all depends on what is considered a reference point. Physically, pregnancy occurs at the moment of conception. However, medical professionals consider it appropriate to count the period starting from the first day of the last menstrual cycle (about 2 weeks earlier). The last cycle is considered, after which the delay of menstruation begins.

On average, a normal pregnancy lasts 266 days (38 weeks) from conception and 280 days (40 weeks) from the first day of the last menstrual cycle.

Stop! That's 10 months! How can this be?

If you divide 38 weeks by 4, you get 9.5 months. 40 weeks is actually 10 months. However, by dividing the term by 4, you are calculating lunar months that are shorter than calendar months.

The duration of the lunar month is 28 days, that is, four 7-day weeks. A calendar month is 30-31 days long. Therefore, the gestational age, calculated in lunar months, seems longer than it really is. The 40 week period includes 2 weeks before conception.

Thus, depending on the calculation method, pregnancy lasts 38-40 weeks, or 9 calendar months.

What to do if the expected date of birth has come, but the birth has not?

If the due date has come, but the birth does not occur, there is no need to panic. Come for a consultation with the doctors of the maternity hospital. During this consultation, the doctor will conduct a series of studies to make sure that everything is in order with the condition of the fetus and the pregnant woman. And will determine the date of induction of labor, if labor does not begin on its own. Experience shows that most women start giving birth before this date.

Remember that how many weeks a pregnancy lasts is a very individual value and can vary quite widely.

Planning for pregnancy and the birth of a child are very important periods of life. The maternity hospital will provide informational and practical support. The institution provides professional obstetric-gynecological and non-anthological services that meet international standards. Qualified narrow specialists work here, who will provide support at all periods: from pregnancy planning, conception to postpartum rehabilitation.

How is the estimated date of birth in the maternity hospital determined?

In the maternity hospital, doctors use the first day of the last menstruation, to which we add 280 days, as well as the ultrasound diagnostic method to determine the expected date of birth. The most accurate time to determine the gestational age on an ultrasound scan is 11-13 weeks. During an ultrasound examination, the doctor will measure the coccyx-parietal size of the fetus, and using special tables, determine the gestational age to days and, accordingly, the expected date of birth. And, if the difference between the period calculated from the first day of the last menstruation and using ultrasound is less than 5 days, then we focus on the date according to the last menstruation, and if the difference is more than 5 days, then on the date that turned out during the ultrasound examination .

How often do women give birth on their due date?

It is statistically known that only 4% of women give birth on the expected date of birth, and 70% within 10 days of the due date.

Are there methods for accurately determining the duration of pregnancy?

The team of researchers, in order to more accurately calculate the duration of pregnancy, determined the level of hormones in the urine of women who plan to become pregnant naturally, which made it possible to determine the time of ovulation and implantation of a fertilized egg. Thus, scientists found that the duration of pregnancy was no more than 268 days, that is, 38 weeks. And the duration of pregnancy itself can vary by 37 days. It was also found that previous and subsequent pregnancies lasted approximately the same length as the pregnancy that was investigated.

According to the results of this study, it was found that in the world at the moment there are few mechanisms that allow you to accurately determine the date of birth and how long the pregnancy lasts. And giving the exact due date is not a good idea, because. this causes a woman’s extra anxiety if the birth does not occur on the specified date. The poet, women should be told that you will give birth around this time.

What is term pregnancy?

In obstetric practice, full-term, it is customary to consider a pregnancy lasting from 37 to 42 weeks. Up to 37 weeks is a premature pregnancy, and the birth is premature, and after 42 weeks it is a post-term pregnancy, and the birth is late.

How to calculate the expected date of delivery and what affects how many weeks the pregnancy lasts?

The estimated due date is calculated by adding 280 days to the first day of your last period. However, the duration of pregnancy is influenced by the age of the mother, the time of implantation of the embryo, the weight of the mother herself at the time of birth. It was found that with every year of her life, a woman bears a child for 1 day longer. And for every “extra” 100 grams of weight at birth, we also add 1 day to the duration of pregnancy. During the study, it was also found that embryos require different times for implantation (fixation in the uterus). And those embryos that took longer to implant also require more time from implantation to birth. More precisely, the date of birth can be determined using ultrasound.

How does pregnancy begin?

The development of pregnancy in humans begins with the fertilization of a female egg by a male sperm. Fertilization is possible after ovulation - the release of the egg from the ovary. Usually, ovulation occurs on the 10-16th day of the menstrual cycle (from the 1st day of the last menstruation), but can be significantly shifted. The life span of an egg is about a day, and that of a sperm cell is 3-5 days. After ovulation, the egg enters the fallopian tube, where it meets the sperm and fertilization occurs. Then, within 14 days, the fertilized egg moves into the uterus in order to implant (fix) in the uterine cavity and continue to develop.

Forecast. Prevention of recurrent pregnancy.

With a timely and adequate assessment of the condition of the fetus, as well as the correct choice of delivery tactics, the prognosis is favorable. According to the observations of doctors, the indicators of the physical, neurological and mental development of post-term children do not differ from the state of children born with uncomplicated timely delivery. A less favorable prognosis is possible with severe fetal hypoxia, birth trauma, and meconium aspiration.

Prevention of recurrent pregnancy includes:

• selection of pregnant women who are at risk of possible overbearing;

• determination of the exact gestational age of pregnancy for all indicators - the date of the last menstruation, the date of ovulation, the first ultrasound in the first trimester and ultrasonic fetometry in the later stages;

• prevention of dysfunction of the placenta, hypoxia and the birth of a large fetus;

• timely hospitalization of a pregnant woman to prepare for childbirth and assess the condition of the fetus.

Treatment of recurrent pregnancy.

Pregnancy management during pregnancy has its own characteristics. Close attention should be given to pregnant women with risk factors. Timely hospitalization in the maternity hospital is necessary to examine the pregnant woman and decide on the method of delivery. The choice of method depends on many factors: medical history, readiness for childbirth, condition and estimated weight of the fetus, concomitant diseases of the woman.

Surgical delivery is indicated when the fact of overgrowth is combined with such complicating factors as:

• mother's age (30 years and older);

• very large or very small fruit;

• lack of readiness for childbirth - immature cervix, abnormal position of the fetus;

• fetal hypoxia;

• pregnancy after IVF;

• failures in previous pregnancies and childbirth in history.

In a more favorable situation, but the birth canal is not ready, it is necessary to additionally prepare the cervix for childbirth. Various methods are used for this:

• detachment of the lower pole of the fetal bladder from the walls of the uterus;

• balloon dilatation of the cervix using a Foley catheter - allows you to mechanically expand the cervix;

• dilators of natural (kelp) and synthetic origin - have a relaxing effect, promote the production of endogenous prostaglandins in the cervix;

• it is possible to use prostaglandin E or antiprogestogens (Mifepristone).

Childbirth during prolonged pregnancy without signs of overmaturity of the fetus most often proceed without pronounced complications, but require close monitoring of their progress.

Late childbirth with signs of fetal overripeness is often complicated. Therefore, in order to timely resolve the issue of choosing a method of delivery, it is important to assess each period of pregnancy. During conservative childbirth (through the natural birth canal), it is necessary to constantly monitor the condition of the fetus.

For labor induction, you can use amniotomy - an artificial rupture of the membranes of the fetal bladder. It is carried out exclusively with a mature cervix and a good condition of the fetus.

In the postpartum period, it is very important to take preventive measures to prevent bleeding, which may occur due to the peculiarity of the structure of the uterus, retention of parts of the placenta, rupture of soft tissues and impaired hemostasis (blood clotting system). To do this, a thorough examination of the birth canal is carried out to detect ruptures, accounting for blood loss, clinical and laboratory monitoring of blood tests and the use of uterotonics, which stimulate uterine contractions.

Diagnosis of post-pregnancy.

The diagnosis of a post-term pregnancy is established on the basis of anamnesis data (medical history) and a combination of examination results:

• identification of factors that put a pregnant woman at risk (ovarian dysfunction, genital diseases, abortions and spontaneous miscarriages);

• correct calculation of the date of delivery, ultrasound in the first trimester of pregnancy;

• ultrasonic fetometry (measurement of the fetus) - the absence of an increase in the fetus when viewed in dynamics, the detection of growth retardation syndrome (symmetrical or asymmetric reduction in the circumference of the head and abdomen of the fetus);

• assessment of the volume and structure of amniotic fluid - the appearance of a suspension due to the presence of cheese-like lubricant, vellus hair, epidermis and meconium, a decrease in the volume of amniotic fluid (the smaller their volume, the higher the risk of true pregnancy overshoot);

• ultrasound assessment of the maturity of the placenta: a decrease in its thickness, reverse development of the placenta with a complex of its structural changes (calcifications, cysts);

• cardiotocography (CTG) - with fetal hypoxia, there is a change in fetal mobility (from increased to complete immobility), a change in the number of heartbeats, a decrease in the compensatory capabilities of the fetus during exercise;

• dopplerometry in the uterine arteries and umbilical cord arteries - a violation of blood flow of varying severity is recorded;

• assessment of fetal hemodynamics - blood flow velocity in the middle cerebral artery, aorta, venous duct and inferior vena cava of the fetus is reduced (indicates the degree of centralization of blood flow in the fetus);

• evaluation of the maturity of the cervix;

• amnioscopy - examination of the lower pole of the fetal bladder using an amnioscope (there is a decrease in transparency and a change in the color of the amniotic fluid).

The final diagnosis is established after the birth and examination of the child and the placenta. In histopathological examination of the placenta, fatty involution is observed (replacement of biologically active tissue with non-functioning adipose tissue), calcifications and yellow-green staining of the membranes.

Differential diagnosis:

• delayed delivery of a fetus without signs of overmaturity - characterized by a delay in the onset of labor, the absence of pathology according to the results of ultrasound and CTG, the birth of a child without signs of postmaturity, the absence of characteristic changes in the placenta according to the results of histology.

• timely birth of a child with signs of overmaturity - may be associated with the peculiarities of the maturation of the placenta and the body of the pregnant woman;

• the birth of a large fetus with gestational diabetes mellitus - the newborn has no signs of postmaturity.

Complications of prolongation of pregnancy.

For the fetus, asphyxia (acute hypoxia) and placental abruption are of great danger. The lack of oxygen inside the womb stimulates the fetus to perform untimely respiratory movements. They lead to the ingestion of water and possible inflammation of the lung tissue - pneumonitis. If there is an admixture of meconium (original feces) in the waters, then there is a high probability of meconium aspiration - the penetration of the contents of the intestine of the newborn into his lungs.

As a result of hypoxia and centralization of blood circulation during intrauterine development, ischemic damage to the myocardium, kidneys and intestines of the fetus is possible - oxygen starvation of the cells of these organs develops and the processes of tissue respiration are disturbed. With prolonged ischemia, a persistent disruption of the functioning of organs is possible, up to their death (intestinal necrosis, renal failure, etc.).

The central nervous system of a post-term fetus also becomes very sensitive to lack of oxygen and possible injury. Therefore, hypoxia can disrupt the functioning of the nervous system and lead to a child lagging behind in physical and neuropsychic development.

Among other things, injuries to the fetus during childbirth are possible. They are associated with the large size of the baby's head, narrow fontanelles and the density of the bones of his skull.

The mother often has a clinical picture of a narrow pelvis, trauma to the genital organs (ruptures of the cervix, vagina or perineum), postpartum hemorrhage (as a result of an overdistended uterus), septic and embolic complications.

With a clinically narrow pelvis, there is a disproportion in the size of the fetus and the mother's pelvis. Childbirth through the natural birth canal in this case is impossible. As a rule, operative delivery is performed.

The occurrence of septic complications is associated with an infection that becomes systemic. Perhaps the development of chorioamnionitis (inflammation of the chorion and infection in the amniotic fluid), postpartum endometritis, sepsis (blood poisoning) and septic shock.

Embolic complications occur when fragments of foreign tissues (blood clots, amniotic fluid, etc.) appear in the woman's bloodstream. In this case, extremely dangerous processes occur, such as PE, amniotic fluid embolism and septic embolism with a high probability of death.

Classification and stages of development of recurrent pregnancy.

Depending on the condition of the child, two types of post-term pregnancy are distinguished:

• Late delivery of a fetus without signs of overmaturity (prolonged pregnancy). Typical for women with ovarian dysfunction under 30 years of age. The baby is born large, but without signs of overmaturity. The cervix is mature. According to ultrasound and CTG, there are no signs of changes in the placenta and fetal disorders. Amniotic fluid is clear, normal color. Histology of the placenta shows no characteristic changes. Often such births are the result of an incorrectly determined gestational age.

• Belated childbirth with an overripe fetus (true gestation). Characteristic of the first pregnancy in women over 30 years of age with sexually transmitted infections, chronic inflammatory diseases of the genitals and a history of delayed childbirth. The cervix is immature or insufficiently mature. According to ultrasound, changes in the placenta and oligohydramnios are detected, according to CTG, signs of fetal hypoxia are noted. After birth, the fetus has signs of postmaturity: a large or small weight of the newborn, wrinkled yellowish or greenish skin with no cheese-like lubricant on it, dense skull bones, long nails. Histology of the placenta reveals its structural changes.

The longer the period of true gestation, the higher the risk of complications and adverse outcome of this pregnancy. Possible:

• injuries of the mother's genitals during childbirth due to the large size of the fetus and the density of the bones of its skull;

• trauma to the child, hypoxic damage to his nervous system and breathing problems.

Pathogenesis of overdose of pregnancy.

The main link in the pathogenesis of post-term pregnancy is changes in the placenta (placental insufficiency). They cause intrauterine oxygen deficiency in the fetus. Such a deviation leads to pronounced changes and a violation of the child's condition. At the same time, placental dysfunction, an imbalance in the fetal endocrine system, and the presence of risk factors for overbearing do not allow childbirth to begin on time, exacerbating existing disorders.

During pregnancy, placental dysfunction is manifested by impaired blood flow in the uterine arteries and / or umbilical cord arteries. In the morphological study of the placenta, signs of reduced blood circulation, the formation of small blood clots, sclerosis of the villi and blood vessels, and a decrease in the number of capillaries are diagnosed. Calcifications can also be found in it - local accumulations of calcium in the focus of impaired blood flow.

For the survival of the fetus with a deficiency of oxygen supplied to it, the body starts the process of centralization of blood circulation. At the same time, in the vital organs of the baby, such as the brain, heart and liver, the blood flow is maintained, and in the muscles, intestines, kidneys and other organs it decreases.

Due to a decrease in blood flow in the kidneys of the fetus, urine output is significantly reduced, oligohydramnios develops. The nature of the amniotic fluid also changes: they lose their transparency, become cloudy, acquire a yellowish or greenish tint due to the admixture of meconium - the first feces of the child.

Due to changes in the composition of amniotic fluid, the production of surfactant is disrupted - a substance that prevents the alveoli from sticking together during exhalation. This causes pathology of the lung tissue and respiratory failure after birth. The protective function of the lungs also decreases: the number of bacteria in the water increases, which increases the risk of infection of the lung tissue.

Against the background of placental insufficiency, the umbilical cord becomes thin. Because of this, the risk of compression of the umbilical cord, the occurrence of hypoxia or asphyxia during childbirth increases. The reduced supply of oxygen to the baby's body leads to the accumulation of metabolic products - acidification of the internal environment of the fetus (metabolic acidosis) develops, against which there is oxygen deficiency in the tissues.

Tissue hypoxia increases the permeability of the vascular walls in the fetus, which leads to fluid retention in the tissues. If fluid accumulates in the brain, cerebral edema may develop. This condition is an unfavorable factor during childbirth: it increases the sensitivity of the brain to the effects of oxygen deficiency and increases the risk of complications with a possible birth injury.

A consequence of intrauterine hypoxia is also a violation of myocardial contraction in the fetus. It affects the metabolism, which ultimately makes it difficult for the newborn to adapt to new extrauterine life conditions.

Symptoms of overdose of pregnancy.

The symptoms of prolonged pregnancy include thickening of the uterus due to oligohydramnios, a decrease in the size of the abdomen, a decrease in the weight of the pregnant woman relative to the last measurements, and discharge from the mammary glands. At the same time, the cervix does not indicate the biological readiness of the birth canal for delivery. There are also signs of deterioration in the condition of the fetus:

• according to ultrasound - oligohydramnios, structural changes in the placenta, its premature maturation, impaired blood flow in the arteries of the umbilical cord or uterine arteries;

• according to the cardiotocographic study (CTG) - a decrease in the compensatory capabilities of the fetus, signs of its hypoxia (lack of oxygen).

At birth, a post-term baby has a characteristic appearance. His skin and mucous membranes, as well as the umbilical cord and placenta, are colored green or yellow. If the amount of protective cheese-like lubricant is reduced, then the skin and mucous membranes of the fetus become dry. In the absence of lubrication, they shrivel due to contact with amniotic fluid. The skin of the feet and palms of the newborn looks steamed, as after a bath. Long nails are visible on the hands and feet.

When overwearing, the child, as a rule, is large, its height and head are enlarged. But another option is also possible, when a baby of small weight is born with a reduced amount of subcutaneous fat (due to fetal growth retardation), but with the above signs of overmaturity. The density of the bones of the skull of the newborn is increased, the fontanelles are small, and the sutures are narrow, which makes it difficult for the fetal head to adapt to the mother's birth canal - as a result, this causes maternal injuries during childbirth.

Pregnancy reversal. Causes of the disease.

The process of pregnancy, conceived by nature, is designed for 287 days. Deviations from these dates are possible, but there is always a good reason for them. If the due date calculated by the doctor has already passed, but the birth has not yet occurred, it should be assumed that the pregnancy is overdue.

A post-term pregnancy is a pregnancy that lasts more than 42 weeks or more than 294 days. It occurs in about 4-14% of cases. Most often it is faced by primiparous women after 30 years. Moreover, every pregnancy that ends in a delayed birth increases the risk of postmaturity in a subsequent pregnancy.

All changes in the placenta that occur during pregnancy lead to prolonged protracted labor and can cause birth injuries to the fetus (clavicle fractures, various hematomas) and other complications. All of them are dangerous for the newborn and disrupt the process of its adaptation to extrauterine life.

The reasons for overshoot are manifold. In most cases, it develops with a combination of causes, risk factors, characteristics of the body of the pregnant woman and the fetus itself. These include:

• insufficient restructuring of the woman's nervous system for childbirth - an incorrect ratio in the work of the sympathetic and parasympathetic nervous system, an insufficiently formed generic dominant (a special reflex system responsible for the timely onset of childbirth);

• endocrine pathologies - diabetes mellitus, obesity, hypothyroidism;

• hormonal imbalance, in particular a decrease in the level of estriol, which is responsible for the readiness of the uterus and genital tract for childbirth;

• complications of pregnancy - oligohydramnios or chronic placental insufficiency;

• mental trauma.

The causes of overdose of pregnancy can be violations of the female reproductive system:

• genital infantilism (underdevelopment of the reproductive apparatus);

• anomalies in the development of the reproductive system - ovarian dysfunction, menstrual irregularities;

• transferred gynecological infections;

• injuries of the genital organs;

• history of induced or spontaneous abortions.

The causes of overgestation on the part of the fetus may be its chromosomal abnormalities (Down's syndrome, polycystic kidney disease) or severe malformations:

• anencephaly (absence of the brain);

• hydrocephalus (increased volume of fluid in the brain);

• microcephaly (small brain).

 

If you experience similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Urinalysis in pregnant women at 17-ks.

This analysis was previously widely prescribed to pregnant women to determine the hormones produced by the cortex of the endocrine glands - the adrenal glands. For analysis, urine was collected during the day, mixed, cast a small part of it, which was delivered to the laboratory with an indication of the total amount of urine collected. An increase in the concentration of 17-ketosteroids in the urine indicated an excess production of hormones in the body of a pregnant woman, on the basis of which the doctor prescribed hormonal drugs. However, at present, the determination of these substances in urine is considered uninformative and is not used during pregnancy.

Urine tests are very simple to perform and very informative for the doctor, they allow you to timely detect the slightest changes in the body of the expectant mother and start treatment in a timely manner, which helps prevent serious complications from the pregnant woman and the unborn baby.

Reberg's test in pregnant women.

Purpose of the study. This test is done to determine the ability of the kidneys to filter urine. It must be carried out for all pregnant women with preeclampsia, with urinary tract infections, with kidney diseases, and with diabetes mellitus.

Rules for collecting urine. Before the test, intense physical activity, strong tea and coffee are excluded. Urine is collected during the day in one container, which is stored in the refrigerator during the entire collection time. After completing the collection of urine, measure the contents of the container, be sure to mix and immediately pour 70-100 ml into a special container or jar and deliver it to the laboratory, reporting the total volume of urine collected per day.

At the time of delivery of urine to the laboratory, blood is taken for creatinine from a vein.

Investigated parameters. The method is based on the assessment of glomerular filtration by the rate of purification of blood plasma from creatinine, a special product of protein breakdown. This indicator can be determined if you know the concentration of creatinine in the blood, in the urine and the daily volume of urine. This indicator is calculated using a special formula and is called creatinine clearance. Normally, the value of this indicator ranges from 75 to 134 ml / min / 1.7 m2. A decrease in the level of renal filtration indicates kidney damage and occurs with severe complications of pregnancy - gestosis, kidney diseases (pyelonephritis, glomerulonephritis), diabetes mellitus, arterial hypertension, urolithiasis.

Urinalysis in pregnant women according to Zimnitsky.

Purpose of the study. This analysis is prescribed to clarify the ability of the kidneys to concentrate and dilute urine, to identify hidden edema. The study may be needed if you suspect the development of preeclampsia, renal failure, infections of the urinary system, as well as diabetes.

Rules for collecting urine. For urine analysis according to Zimnitsky, urine is collected during the day (24 hours) in 8 containers (jars), while the amount of fluid drunk is necessarily taken into account (the pregnant woman writes down how much fluid she drinks during the day, taking into account soups, fruits and vegetables). At 6 am, a woman urinates into the toilet, then all subsequent urine is collected in jars.

8 servings total:

• 1 portion - from 6-00 to 9-00 hours,

• 2 portion - from 9-00 to 12-00 hours,

• 3 portion - from 12-00 to 15-00 hours,

• 4 portion - from 15-00 to 18-00 hours,

• 5 portion - from 18-00 to 21-00 hours,

• 6 portion - from 21-00 to 24-00 hours,

• 7 portion - from 24-00 to 3-00 hours,

• 8 portion - from 3-00 to 6-00 hours.

Banks are signed and delivered to the laboratory.

Investigated parameters. The amount and specific gravity of urine in each portion is estimated. Normal kidney function is characterized by:

• the volume of daily urine is about 1.5 liters;

• the predominance of daytime urination over the night;

• urinary excretion of approximately 70--80% of the liquid drunk per day;

• the specific gravity of urine in at least one of the portions is not lower than 1.020--1.022;

• significant fluctuations during the day the amount of urine in individual portions (from 50 to 400 ml) and the specific gravity of urine (from 1.003 to 1.028).

Deviations from these standards indicate a violation in the work of the kidneys.

Urinalysis in pregnant women according to Nechiporenko.

This is a special urine test that shows the content of erythrocytes, leukocytes and cylinders in 1 ml of urine.

Purpose of the study. This analysis is prescribed if there is a suspicion of an inflammatory process in the organs of the urinary system in a pregnant woman, if there are changes in the general analysis of urine. It gives more accurate results than a general urinalysis, and also allows you to control the ongoing treatment in dynamics.

Rules for collecting urine. Urine for analysis according to Nechiporenko is collected in the same way as for a general urinalysis.

Investigated parameters.

• The number of leukocytes - normally they should be less than 2 thousand in 1 ml. An increase in the number of leukocytes indicates the presence of pyelonephritis (an inflammatory disease of the pelvis and calyces of the kidneys).

• The number of red blood cells - normally less than 1 thousand in 1 ml. An increase in the number of red blood cells indicates the development of glomerulonephritis (inflammation of the renal glomeruli).

• The number of cylinders - normally less than 20 in 1 ml. The detection of an increased content of cylinders indicates arterial hypertension, diseases of the cardiovascular system, and can occur with early toxicosis of pregnant women.

Urine culture (special tests).

It is mandatory if bacteria were detected in the general urine test.

Purpose of the study. It is performed to determine the number of bacteria, their type and sensitivity to antibacterial drugs.

Rules for collecting urine for analysis. To obtain the correct result of this analysis, urine must be collected after a thorough toilet of the external genitalia, covering the vagina with a cotton swab. It is necessary to collect an average portion of urine in a sterile container, screw the lid tightly and deliver it to the laboratory within one and a half to two hours.

Urine culture is prepared on average from 7 to 10 days and allows the doctor to decide whether it is necessary to carry out antibacterial treatment and with what drugs. If there is a clinical picture of inflammation, before the results of the culture are obtained, antibacterial treatment with a broad-spectrum antibiotic (acts on a large range of bacteria) is carried out, and in case of asymptomatic course of the disease or mild inflammation, treatment is not carried out until the results of the analysis are obtained.

What does a urinalysis show and how is the assessment done?

When examining a general urine test, many parameters are evaluated.

COLOR.

Normally, urine has a yellow color of various shades. The shade depends on the degree of saturation of urine with a special pigment - urochrome. A change in the color of urine can occur when taking certain medications (for example, vitamins can give a bright yellow color, aspirin - pink). However, much more often a change in the color of urine indicates the presence of any pathological processes in the body. When blood appears in the urine, which occurs in diseases of the kidneys and bladder, the urine becomes bright red (with renal colic, cystitis) or the so-called “color of meat slops” (with acute inflammatory kidney damage). With increased destruction of red blood cells (erythrocytes), urine acquires a reddish-brown hue. Yellow-brown (or beer-colored) urine occurs with liver diseases.

TRANSPARENCY.

Normally, transparency should be complete. Turbidity of urine can be the result of the presence in the urine of erythrocytes, leukocytes, epithelium, bacteria, fat droplets, precipitation of salts.

RELATIVE DENSITY (SPECIFIC WEIGHT).

This is an indicator that characterizes the amount of trace elements, salts, various compounds. Normally, the specific gravity is 1003 - 1035 g / l. This indicator may decrease in the presence of glucose or protein in the urine, with toxicosis of the first half of pregnancy, dehydration. An increase in specific gravity occurs in chronic renal failure, diabetes insipidus, and heavy drinking.

PROTEIN.

Protein content in urine is one of the most important indicators of kidney function. Normally, it shouldn't be. A small amount of protein in the urine (physiological proteinuria) can also be found in healthy people, while the protein concentration does not exceed 0.033 g / l, in modern laboratories with more sensitive equipment - 0.14 g / l. The appearance of protein in the urine is noted in diseases of the kidneys, inflammatory diseases of the bladder and urinary tract. The presence of protein in the urine, combined with increased blood pressure and edema, is a sign of a serious complication of pregnancy - late preeclampsia, which can lead to seizures and even death of a pregnant woman and fetus.

GLUCOSE.

Normally, there is no glucose in the general urine test. However, in the second half of pregnancy, the presence of glucose in the urine (glucosuria) can normally be detected. This is due to increased filtration of glucose in the kidneys. Since the appearance of glucose in the urine can be a sign of a serious illness - diabetes mellitus, acute inflammation of the pancreas, all patients with glucosuria need an additional examination - blood glucose control, sometimes even a glucose tolerance test with a sugar load - determination of blood glucose on an empty stomach and 2 hours after taking 75 grams of glucose.

BILIRUBIN.

This is a blood pigment that is formed as a result of metabolic processes in the body and is excreted with bile into the gastrointestinal tract. With an increase in the concentration of bilirubin in the blood, it begins to be excreted by the kidneys and found in the urine. This occurs mainly with liver damage or mechanical obstruction of the outflow of bile.

UROBILINOGEN.

It is a product of the conversion of bilirubin. Normally, it is excreted in the bile and practically does not enter the urine. The appearance of urobilinogen in the urine occurs in liver diseases, poisoning, increased decay of red blood cells - erythrocytes.

KETONE BODIES.

These are products formed during the breakdown of fatty acids in the body. Normally, there are no ketone bodies in the urine test. Determining them is very important in diagnosing the adequacy of diabetes therapy. The appearance of ketones can occur in the first trimester of pregnancy with early toxicosis and indicate dehydration.

NITRITES.

These are salts of nitrous acid, they are not normally found in the urine. Their appearance indicates the presence of a urinary tract infection.

LEUKOCITES.

These are white blood cells. Normally, in the general analysis of urine, leukocytes are found up to 5 in the field of view. If the number of leukocytes is increased, this indicates the presence of an inflammatory process in the kidneys, bladder or urethra, while the higher the number of leukocytes, the more pronounced the inflammation. A slight increase in the number of leukocytes can be observed if vaginal discharge enters the urine with a poor toilet of the external genitalia.

erythrocytes.

Red blood cells. Normally, in the general analysis of urine there should be no more than 2 erythrocytes in the field of view. An increase in their number occurs in the presence of stones in the kidneys or urinary tract, inflammation of the kidneys, injuries.

CYLINDERS.

Cylindrical urine sediment elements, consisting of protein or cells, may also contain various inclusions. Normally absent. They are found mainly in diseases of the kidneys.

SALT.

These are inorganic substances that can precipitate when standing urine. Normally, there are no salts in the urine. The appearance of urates in the urine occurs whenkidney failure, as well as in the first trimester of pregnancy with vomiting of pregnant women.

AMORPHOUS PHOSPHATES.

They are also found with vomiting of pregnant women, with inflammation of the bladder, and can occur normally with a predominance of vegetable and dairy foods in the diet.

OXALATES.

They occur with inflammation of the kidneys, diabetes mellitus, as well as with the predominance of foods rich in oxalic acid in the diet (spinach, sorrel, tomatoes, asparagus).

BACTERIA.

Isolation of bacteria in the urine is of significant diagnostic value during pregnancy. The appearance of bacteria in the urine indicates the presence of an inflammatory process in the kidneys, bladder or urethra and requires mandatory treatment, even if the expectant mother is not worried about anything. Bacteria can also enter the urine from the vagina when the toilet of the external genitalia is poor. To determine the number of bacteria, their type and sensitivity to antibiotic therapy, an additional urine culture for flora is mandatory. To obtain the correct result of this analysis, after a thorough toilet of the external genital organs, close the vagina with a cotton swab, collect the middle portion of urine in a sterile container, tighten the lid tightly and deliver it to the laboratory within one and a half to two hours. Urine culture is prepared on average from 7 to 10 days and allows the doctor to decide whether it is necessary to carry out antibacterial treatment, and with what drugs.