Allergy at pregnant
in the conditions of a modern civilization as sad to recognize it, it is even difficult for healthy person to keep a necessary stock of health and forces. And so far as concerns origin of new life, this problem becomes sharper. And if the XX century was declared a century warmly - vascular diseases, then XXI, according to forecasts of WHO, will become a century of an allergy.from
Already today an allergy more than 20% of the population of Earth, and in areas with an adverse ecological situation - 50% and more suffer. In Russia prevalence of allergic diseases in different regions makes 15 - 35%.
For the last 30 years incidence of an allergy increases by 2 - 3 times each 10 years. Fault to that sharp deterioration in ecology, acute and chronic stress, intensive development of all types of the industry without sufficient observance of nonconsumptive measures, uncontrolled application of medicines, wide use of cosmetics and synthetic products, strong introduction in life of means of disinfection and disinsection, change of nature of food, emergence of new allergens.
the Allergy is an expression of immune (protective) reaction of an organism at which its own fabrics are damaged; in medical terminology it is called allergic diseases (sharp allergoza also belong to them). Unfortunately, pregnant women occur among patients with sharp allergoza (OAZ) in 5 - 20% of cases. These figures for the last 20 years increased by 6 times. The most widespread age of the pregnant women having an allergy - 18 - 24 years. According to the forecast of a current and risk of development of the menacing states all OAZ (see the tab. 1, 2) are divided into lungs (allergic rhinitis, allergic conjunctivitis, the localized urticaria) and heavy (the generalized small tortoiseshell, Quincke, anaphylactic shock swelled).
As the disease
So what mechanism of emergence of allergic reactions develops? In development of a disease allocate three stages.
First stage . Allergen gets to an organism the first time. In this quality pollen of plants, hair of animals, foodstuff, cosmetics, etc. can act. Cages of immune system identify alien substances and start the mechanism of formation of antibodies. Antibodies are attached to walls of so-called corpulent cages which in large quantities settle down under mucous and epitelialny fabrics. Such combinations can exist over a year and wait for the following contact with allergen.
Second stage . The allergen which is again getting to an organism connects antibodies on a surface of a corpulent cage. It starts the mechanism of opening of corpulent cages: from them biologically active agents are emitted (a histamine, serotonin, etc.) which cause the main symptoms of an allergy, they still are called mediators of an inflammation or pro-inflammatory hormones.
Third stage . Biologically active agents cause expansion of vessels, increase permeability of fabrics. There is hypostasis, an inflammation. In hard cases when allergen gets to blood, perhaps strong expansion of vessels and sharp falling of arterial pressure (anaphylactic shock).
|of Easy OAZ|
|of of OAZ||of Clinical manifestations|
|of Allergic rhinitis||Difficulty of nasal breath or a congestion of a nose, hypostasis of a mucous membrane of a nose, allocation of a plentiful watery mucous secret, sneezing, a burning sensation in a drink.|
|of Allergic||Hyperaemia (reddening), hypostasis, a konjyuktiva injetsirovannost (vessels on a white of the eye are visible), an itch, dacryagogue, a photophobia, puffiness a century, narrowing of an eye crack.|
|of the Localized urticaria||Suddenly arising defeat of part of skin: the formation of sharply outlined roundish blisters with raised edges and the pale center which is followed by the expressed itch.|
|of Heavy OAZ|
|of of OAZ||of Clinical manifestations|
|of the Generalized small tortoiseshell||Suddenly arising damage of all skin with formation of sharply outlined roundish blisters with the raised eritematozny (red) edges and the pale center which is followed by a sharp itch.|
|of Quincke||Hypostasis of skin, hypodermic cellulose or mucous membranes Swelled. Develops in areas of lips, cheeks, a century, a forehead, hairy part of the head, a scrotum, brushes, feet more often. Simultaneous hypostasis of joints, mucous membranes, including throats and zheludochno - an intestinal path can be noted. Hypostasis of a throat is shown by cough, a voice osiplost, asthma. Hypostasis mucous zheludochno - an intestinal path is followed by belly-aches, nausea, vomiting.|
|of Anaphylactic shock||Arterial hypotonia (lowering of arterial pressure) and an oglushennost at not heavy current, loss of consciousness at a heavy current, violation of breath owing to throat hypostasis, belly-ache, urticaria, a skin itch. Manifestations develop within an hour after contact with allergen (more often - within the first 5 minutes).|
the Most widespread displays of an allergy at pregnant women are an allergic rhinitis, the small tortoiseshell and Quincke swelled.
Influence of an allergy to a fruit
So, what mechanism of emergence of allergic reactions? In development of a disease allocate three stages. At emergence at mother of allergic reaction of own allergoz at a fruit does not arise as reacting to allergen - an irritant specific immunocomplexes (anti-genes - the substances which caused an allergy, and the antibodies developed in response to anti-genes) do not get through a placenta. But nevertheless the child who is in a womb is influenced by an illness under the influence of three factors:
- change of a condition of mother;
- possible effect of medicines on blood supply of a fruit (the medicines applied at an allergy can cause decrease matochno - the placentary blood-groove which is completely providing fruit life);
- the harmful effect of drugs (about it it will be told below).
Treatment of an allergy
the Main objective of immediate treatment - effective and safe elimination of symptoms of OAZ at the pregnant woman without risk of negative impact on a fruit.
It is valid, reaction of the person to use of medicines depends on its physiological condition, character of pathology and a type of therapy.
Pregnancy in this sense needs to be considered as a special physiological state. It is necessary to consider that to 45% of pregnant women diseases of internals have, and from 60 to 80% regularly take this or that medicine. On average during pregnancy the woman accepts up to four various medicines, apart from vitamins, minerals and dietary supplements. Whether it is necessary to say that it is not safe for future child? If the woman makes the decision on reception of these or those medicines independently.
we Will review a clinical example. The woman of 31 years on 12 - y to week of pregnancy was taken to hospital with the diagnosis sharp allergoz, the generalized small tortoiseshell. Pregnancy the second, to the appeal to hospital the woman had no an allergy. Ached suddenly, approximately in 1 hour after the use in food of orange juice. There was rash on a breast, hands; the skin itch began. The woman independently made the decision to take the medicine of a Dimedrol , but it did not render due effect. On the advice of the familiar doctor she in addition took 1 pill of a suprastin , also without effect. By the morning rash extended to all body, and the patient caused an emergency medical service. The doctor of ambulance entered intramuscularly 2 ml of a tavegil , effect did not follow. The doctor made the decision to take the woman to hospital in office of the general reanimation. Completely allergic reaction disappeared only in 3 days.
In the given example the woman even before receipt in hospital received three different antihistaminic preparations, one of which (a Dimedrol ) is contraindicated to at pregnancy. Therefore in each case of an allergy it is necessary to see at once a doctor for the help.the Majority of the popular antihistaminic drugs used at treatment of an allergy at pregnancy are contraindicated to
. So, a Dimedrol can become the reason of excitability or reductions of a uterus on the term close to childbirth, at reception in doses it is more than 50 mg; after reception of a terfenadin observes weight reduction of newborns; astemizol possesses toxic action on a fruit; suprastin ( hloropiramin ), klaritin ( loratadin ), tsetirizin ( alleprtek ) and feksadin ( feksofenadin ) at pregnancy are admissible , only if the effect of treatment exceeds potential risk for a fruit; tavegit ( klemastin ) at pregnancy it is necessary to apply only according to vital indications; pipolfen (piperatsillin ) at pregnancy and feeding by a breast is not recommended to .
At for the first time the arisen allergic reaction it is necessary anyway even if this state lasted not for long, to address for consultation the allergist. There is a wish to emphasize that the basic in treatment of allergic states and diseases - not elimination of symptoms of an allergy by means of medicines, and a complete elimination of contact with allergen.
for the purpose of identification of allergen conduct special examinations. Are used determination of content in IgE blood - the antibodies specific to certain allergens, and skin skarifikatsionny tests. For skin tests prepare solutions from potential allergens (extract of herbs, trees, pollen, epidermis of animals, poison of insects, food, drugs). The received solutions enter in the minimum quantities vnutrikozhno. If the patient has an allergy to one or several of the listed substances, then around an injection of the corresponding allergen local hypostasis develops.
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What needs to be done at manifestation it is possible to apply OAZ and what preparations?If allergen is known to
1 generation of H2 - gistaminblokator:
2 generation of H2 - gistaminblokator:Klaritin (loratadin) - at pregnancy application is possible
, only if the effect of therapy exceeds potential risk for a fruit, that is it is necessary to apply a preparation only in that case when the allergic condition of mother threatens a fruit more, than reception of a preparation. This risk in each case is estimated by the doctor.
3 generation of H2 - gistaminblokator:Feksadin (feksofenadin) - at pregnancy application is possible
, only if the effect of therapy exceeds potential risk for a fruit.
Prevention of an allergy
One more very important aspect of a problem - prevention of allergic diseases at yet not been born child. Restriction or, in hard cases, an exception of vysokoallergichny products of the pregnant woman`s diet belongs to preventive measures. Zheludochno - an intestinal path - the main entrance gate for the allergens getting to a fruit. Hypersensibility formation (that is education in an organism of the child of the antibodies ready at secondary introduction of allergen - already in extra uterine life of the kid - to provoke allergic reaction) happens at the known degree of a maturity of immune system of a fruit which is reached approximately to 22 - y to week of pre-natal development. Thus, exactly from now on restriction of allergens in food is justified.
should refer To prevention of allergic reactions also restriction of possible contact with other allergens: preparations of household chemicals, new cosmetics etc.These restrictions, certainly, are not absolute
. The healthy future mothers who do not have an allergy have enough not to use these products daily and at the same time, at the same time their perhaps periodic inclusion in a diet. Completely those future mothers who at least had once these or those displays of an allergy to this product should refuse risky products. If the woman has allergic diseases (allergic bronchial asthma, allergic dermatitis, allergic rhinitis etc.) it should exclude the whole groups of products from a diet.Should emphasize
that for the pregnant woman and the feeding woman smoking is absolutely inadmissible (both active, and passive). The facts confirming that smoking of mother during pregnancy influences development of lungs of a fruit are known, leads to a pre-natal delay of its growth. Smoking of mother - one of the fruit stress reasons. After one smoked cigarette for 20 - 30 minutes there comes the angiospasm of a uterus and intake of oxygen and nutrients to a fruit is broken. At children of the smoking mothers the probability (besides other serious illness) developments of atopic (allergic) dermatitis and bronchial asthma increases.
during pregnancy is recommended not to get pets, more often to air the apartment, to daily do damp cleaning, at least once a week to vacuum carpets and upholstered furniture, to beat out and dry pillows. And one more important remark. Breast milk - the most suitable product for food of children of the first months of life. It has necessary temperature, does not demand time for preparation, does not contain bacteria and allergens, is easily acquired, enzymes for own digestion are its part. Early till 4 months - the termination of breastfeeding increases the frequency of allergic reactions several times.we Will remind
that to the pregnant woman, irrespective of whether she has an allergy, it is necessary to lead a healthy lifestyle, to avoid stresses, to be ill, not to appoint less to itself drugs independently and to be adjusted on the birth of the healthy child.