Appendicitis is an acute inflammation of the appendage of the cecum, requiring immediate surgical intervention. This disease often becomes the reason for surgery in a pregnant woman. Appendicitis during pregnancy is not the most common occurrence, occurring in 5% of pregnant women. However, as soon as the first symptoms appear, especially during the second trimester, you should consult a doctor. Few people actually do this, mistaking abdominal pain for simple poisoning.

There are many other factors leading to the disease. And this is especially dangerous at the time of gestation, since it is unknown how inflammation will affect it, being in close proximity to the fetus.

Stages of development of appendicitis

Appendicitis during pregnancy has several stages of changes. The inflammatory process is considered catarrhal at first, but gradually turns into a purulent form:

  • phlegmous - acute inflammation that develops within a day;
  • ganggenous - tissue necrosis. The form develops in two days;
  • perforative - the walls of the organ break through, the inflamed contents fall on healthy organs.

The first stage is the simplest - the beginning of inflammation. Symptoms appear that make it easy to diagnose the disease.

Clinical picture

Signs of appendicitis in pregnant women have a specific course, in contrast to the usual form of inflammation. The main symptoms are as follows:

  • severe pain of a cutting nature in the right abdomen;
  • high temperature;
  • nausea accompanied by vomiting bile;
  • the pain becomes stronger if you try to feel the sore spot.

A sign that is detected only during the clinical diagnosis of appendicitis in pregnant women is that the level of leukocytes in the blood increases significantly.

The danger is that at the very beginning the pain syndrome is not severe, the pregnant woman simply does not pay attention to it. However, the pain intensifies significantly after 2-3 hours. At the very beginning, it is difficult to diagnose appendicitis - the entire abdominal cavity hurts, but gradually the pain intensifies on the right.

One of the reasons for inflammation of the appendix is ​​the enlarged uterus, due to which it moves out of its place. In this regard, pain may manifest itself in the form of discomfort in the right hypochondrium, in the side or in the lumbar region.

A febrile symptom is not a strict sign of inflammation of the appendix. The temperature rises 4-5 hours after the onset of pain, so it can be considered a symptom of appendicitis during pregnancy. If the fever was present before the abdominal pain, then most likely this is a sign of another disease. In any case, you need to go to the hospital.

The temperature rises as a natural reaction of the immune system aimed at fighting the inflammatory process. A sharp jump to high levels will indicate the progress of inflammation.

Vomiting and nausea in some cases occur to the point of painful discomfort. In this case, they are quite easy to mistake for toxicosis or food poisoning typical of pregnant women. If these symptoms accompany severe and acute pain, you should immediately seek medical help.

Appendicitis shows obvious signs in the last stages. The woman feels weak, cannot speak coherently, her consciousness becomes cloudy - this means that the inflammatory process is so strong that it can lead to death for both the pregnant woman and the child.

Diagnosis of appendicitis in pregnant women

Appendicitis in pregnant women is difficult to diagnose, but how quickly it is done is greatly influenced. The faster, the less likely the occurrence of acute consequences that complicate the disease.

The first examination includes a medical history. The doctor asks the pregnant woman when and how the pain began, and which symptoms were more pronounced.

The next step is a direct examination, which includes three signs for diagnosing appendicitis in pregnant women:

  1. The surgeon presses on a certain area of ​​the body on the right in the iliac region, after which he sharply moves his hand down - pain syndrome with inflammatory process intensifies.
  2. Next, light tapping is performed throughout the abdomen, which again intensifies the pain.
  3. The abdominal muscles located above the cecum and directly above the appendix are palpated.

These symptoms are not always expressed in pregnant women when diagnosed, but surgeons mainly rely on them.

Clinical studies are required to confirm the diagnosis. The following examinations are carried out: a general blood test to detect the level of leukocytes, as well as the rate of erythrocyte sedimentation. A urine test may also show an increase in white blood cell levels.

Additionally, an ultrasound is performed to identify the inflamed appendix in pregnant women. One of the illustrative studies is laparoscopy, however, this method is accompanied by surgery, which is not always good for pregnant women.

Medical therapy

When treating appendicitis, only one method is used - surgery. The method was called "appendectomy". In addition, in recent years Endoscopic surgery, performed through punctures and monitored from a monitor, is gaining popularity.

Drug therapy is used - the patient is given antibiotics that will prevent the development of possible consequences in the form of suppuration of wounds or sutures. Each time, antibiotics are selected individually, so as not to harm the fetus and the health of the pregnant woman.

The traditional operation - “appendectomy” involves a thin incision in the skin and layers of muscle tissue of the abdomen directly under the area where the appendix is ​​located. The incision should be no more than 10 cm and made with extreme precision. The doctor examines the process of the cecum, the surrounding organs and tissues for widespread suppuration or necrosis. Only after making sure that the surrounding tissues are clean does the surgeon begin to remove the appendix - this part of the cecum is simply cut off. If there is suppuration, drainage therapy and lavage are performed. After this, the incision is carefully sutured.

The newest technique for performing surgery is to use a laparoscope. Laparoscope is a system of optical fibers combined with a mini-camera. One small puncture is enough abdominal cavity, where the optical fiber is introduced. After identifying the inflamed area, several more punctures are made, through which instruments are inserted, and the appendage is removed directly in the abdomen.

The new method has many advantages over the traditional one: less pain, recovery after surgery is much faster, and no cosmetic defects. In addition, the surgeon can conduct a preventive examination if the diagnosis of appendicitis has been questioned.

Laparoscopic surgical technique is considered the best for pregnant women because the damage is minimal.

However, any operation is performed under general anesthesia. The dose must be strictly adjusted so as not to harm the child.

Rehabilitation period

Pregnant women require careful monitoring after surgery. Preventive measures are being taken against possible complications, as well as their therapy.

After surgery, it is not necessary to apply weights or cold compresses to the abdomen, so as not to provoke pregnancy complications. A special diet is prescribed, most of which are aimed at normalizing the functioning of the digestive tract and intestines.

A widespread method of physiotherapy is aimed at improving bowel function. In addition, physical therapy is necessary for the prevention and general maintenance of pregnancy.

Antibiotics are used to prevent possible postoperative complications. Drug therapy is selected individually for each woman in order to avoid the possible consequences of the effects of antibiotics on the growing fetus.

As a preventative measure, it is recommended to lie down much more, maintaining complete rest. This is easily achieved because postoperative period Pregnant women are hospitalized under the close supervision of doctors. Medicines are used to calm the fetus and prevent frequent uterine contractions.

A pregnant woman who has undergone surgery to remove the appendix is ​​considered to be at risk due to possible miscarriage. Prevention is aimed mainly at preserving the fetus, since consequences can occur in the long term. The threat of miscarriage that arises is supervised by the attending physician until the birth.

The developing fetus is subjected to more thorough examination. The number of standard appointments with the gynecologist is increasing, all measures are being taken to monitor the development and condition of the fetus, as well as the integrity of the placenta. The studies carried out may be the following: hormonal, Doppler, ultrasound.

One of the possible complications is placental insufficiency, which occurs when developing child does not receive sufficient oxygen and lacks nutrients. In this case, the pregnant woman is immediately hospitalized and the necessary measures are taken to preserve the fetus.

If childbirth occurs several days after the operation, the abdomen is tightly bandaged. This allows you to avoid sutures coming apart. At the same time, a full range of painkillers is also used to relieve painful sensations, strengthened due to surgical intervention.

Due to increased pressure inside the abdominal cavity, the stitches may come apart. To prevent this, an incision is made in the perineum to speed up labor and relieve the effects of pushing.

Childbirth can always be complicated. Abnormalities in labor and severe bleeding in the postpartum period are possible. That is why increased monitoring measures are used to monitor the progress of labor in a woman in labor who was operated on while pregnant.

Appendicitis - very dangerous pathology for any person, and if it appears during pregnancy, you should immediately consult a doctor. In this way, a pregnant woman can avoid serious consequences for herself and her child.

Chickenpox is a disease that usually affects children under the age of 8 years. For the virus to enter the body, all you need to do is communicate with an infectious person.

If you get chickenpox in childhood, you will develop immunity against the virus for life. This virus poses a danger only to those who have not had it. It is especially necessary to prevent chickenpox during pregnancy.

Why - the answers are in the article.

Description for each trimester

When registering a pregnant woman, the gynecologist will initially find out and give advice on how to protect herself from the virus and how it should be treated. It is prohibited to get the chickenpox vaccine if you are already pregnant.

A woman who has not had chickenpox runs the risk of becoming infected with this virus during pregnancy and thereby harming her unborn child. However, chickenpox in adulthood is a very rare occurrence.

Even the statistics are not so sad - out of 1000 women, only 1% actually catch this virus while expecting a child. So the danger of becoming infected is very small (if you do not come into close contact with the carrier of the disease).

To find out and already be calm whether you have immunity to herpes type 3, you need. Doctors state that 2 out of 3 women who do not remember whether they had chickenpox in childhood or are sure that they did not have chickenpox have antibodies to the disease. 90% of women planning pregnancy have immunity to chicken pox.

However, there are still 10% of those at risk during pregnancy, or rather, the fetus is at risk.

First trimester

This is the most dangerous period of pregnancy. The first 20 weeks are in the process of forming a little man; there is still no placenta that will protect the child.

As for the chickenpox virus itself, it is early stages is able to penetrate inside the embryo and subsequently affect the baby’s skin or even the cerebral cortex. It is worth repeating that the percentage of these deformities remains equal to 1 in 100.

However, if the baby has intrauterine chickenpox, then, alas, it is inevitable. The central part may be affected nervous system, vision, underdevelopment of limbs. All these consequences can be diagnosed only in the second trimester after an ultrasound. If all suspicions are confirmed, then the pregnancy should be artificially terminated.

Second trimester

This period is the safest. The placenta is already formed, the herpes virus type 3 will not harm the baby. Even if the expectant mother is seriously ill, the child will remain healthy and undamaged.

Third trimester

The most dangerous two weeks before childbirth and the process itself. The baby can become infected with the virus during delivery. This is very dangerous because the baby may develop congenital chickenpox, which will be severe. In this case, all damage to organs and the central nervous system is more likely.

The consequences will be dangerous.

Symptoms in expectant mothers

The course of the disease in an expectant mother is no different if a woman who is not carrying a child were infected with this virus. The incubation period of the disease ranges from 10 to 20 days. The onset of the disease will be accompanied by:

  • high temperature;
  • headache;
  • lack of appetite;
  • general weakness of the body.

After a few days, small red spots will begin to appear on the skin, which will turn into. Every day their number will grow. The rash period usually lasts from 3 to 7 days.

Due to the fact that during pregnancy a woman’s immunity is significantly reduced, chickenpox can occur in a somewhat severe form. Symptoms will be more pronounced.

More than a third of pregnant women with chickenpox may experience complications such as pneumonia. In this case, it may be that the blisters will begin to spread to the mucous membrane -.

It is rare to see downright abnormal progression of chickenpox in adults - or a severe rash. However, this is 1 in 1000 cases.

Treatment

If the disease proceeds normally, then special treatment no need. You should not take strong medications, but rather resort to folk medicine- decoctions and tinctures. Blisters can be lubricated, with severe itching, with brilliant green or.

It will disinfect erosions and prevent the formation of new ones, since the ointment is antiviral.

At the first signs of the disease, you must immediately warn your gynecologist who is seeing you. You should not go to the antenatal clinic - you will infect other mothers in line: in this case, you need to call a doctor at home.

The condition must be constantly monitored. Don't allow high temperature so as not to cause more harm to the fetus.

How dangerous is the disease for pregnant women?

In the early stages of pregnancy, type 3 herpes is fraught with spontaneous miscarriages, stillbirth, or deformity of the baby. Also, a child may be born with scars on the skin, mentally retarded, with growth retardation, and with hypoplasia of the limbs. However, the percentage of all these deformities is too small and does not exceed 1%.

Often the body simply begins to reject the fetus and a miscarriage occurs. This can cause great psychological harm to the expectant mother.

In pregnant women, chickenpox occurs without any complications. Just like the average person. Such an interesting condition of a woman will not cause the disease to worsen, much less cause a more serious form of progression.

However, type 3 virus is very dangerous, all because it has a strong effect on the embryo. Doctors say with absolute certainty that the consequences of the disease will depend on the period at which the woman was infected.

In general, the most dangerous periods of pregnancy are the first trimester and the last weeks before childbirth. Everything is obvious - in the early stages the baby has not yet formed and any diseases during this period adversely affect the development of the fetus. Therefore, all expectant mothers are advised to abstain from any medications.

If a woman gets chickenpox early - before the 14th week, then the possibility of infecting the unborn child is 0.5%. And if the period is up to 20 weeks, then the risk increases to 2%. After 20 weeks, the probability of infection of the child is 0.

But in the last stages, just before childbirth, you need to be extremely careful. This is the critical point. It is better to take great care of yourself at this time. Because the consequences can be very serious.

Is it possible to contact someone with chickenpox?

Those expectant mothers who do not have immunity against chickenpox, of course, should be wary of such contacts with patients. This is airborne, so it is worth limiting contact with infected people.

If there is a kindergarten, then you should not take your child there. Even small contact with sick people can lead to infection. Moreover, if you catch the chickenpox virus, you will find out about it only after 2 weeks.

Those who have immunity can communicate with sick people. However, doctors recommend taking care of yourself and your unborn child and avoiding such contacts in every possible way. The baby will be protected by the placenta, but it is better to refrain and wait until the person ceases to be a carrier of the type 3 herpes virus, which is dangerous for pregnant women.

You should also avoid communicating with people who are sick. This is the same herpes type 3 that provokes the development of this virus.

Chickenpox in a nursing mother

Another problem that a mother may encounter is chickenpox while breastfeeding. In this case, it is necessary to stop contacting the child, otherwise he may become infected from the mother. The child needs to be isolated and transferred to artificial food - mixtures and porridge.

If the child is also infected, and such an infection is simply inevitable, then he also needs to be switched to formula and immediately seek help from a doctor who will prescribe treatment. Then the mother will be able to start therapy with any drugs, and if she continues breast-feeding, then no medications should be taken.

As a result, the mother will have two options: - then do not breastfeed the child, or get treatment folk remedies and not take any painkillers, which is very problematic with this disease. Itching can be relieved with warm baths, after which it will be necessary to blot the body with soft paper. Chamomile and various pharmacy infusions will also help relieve unpleasant symptoms.

Only with a doctor’s prescription will a mother with breastfeeding be able to start taking children’s medications, such as paracetamol and antiallergic drugs.

Wiping the blisters will need to be done regularly, while avoiding touching the nipples.

What do experts say about this?

Any infectious disease while expecting a child will be dangerous. You need to know that chickenpox can bring a lot of problems to women in an interesting position. But this happens quite rarely. If you keep yourself in an interesting position and visit public places less, you can avoid problems that usually do not end well.

There may be no consequences, but medicine is an exact science, and it says that there is a danger, so you should not neglect the usual rules.

We have collected several opinions and reviews on this topic from doctors:

In my practice, I encountered chickenpox during pregnancy only a few times. And several times the ultrasound confirmed the child’s abnormalities caused by the virus that had entered the mother’s body. Recommended termination of pregnancy. It's sad to make such diagnoses. All cases were in early pregnancy. It was difficult for those patients, but after that we carried out certain therapy and they already have their own children. I advise everyone to protect themselves from such “innocent” childhood diseases in an interesting situation.

Karimov A.A. therapist

It's sad that our women are skeptical about. If everyone, without exception, did not neglect vaccinations, then many problems could be avoided. There is a vaccine for chickenpox. And it has been confirmed that all viral diseases have a bad effect on the development of the fetus. Stage 3 herpes virus in pregnant women occurs in every 5 women. Therefore, I recommend that everyone who comes to see me do everything against known infections.

Lyubov G.V. gynecologist

Not a sentence

It has been proven that chickenpox is not a death sentence for expectant mothers. Of course, the early and late periods are dangerous, but the probability at this time is 1 in 100. Luck has not yet been canceled.

Protect yourself from various viruses, especially in an interesting situation. This will help you not to face such problems.

Expecting a child is a pleasant and exciting process. During this period, a woman tries to protect herself from possible diseases. However, this is not easy to do if the older child attends kindergarten or school and at any moment can bring home some virus, for example, the well-known chickenpox. How dangerous is such an infection during pregnancy? How can it affect the health of the fetus?

What is chickenpox

Chickenpox (or chickenpox) is an acute viral disease. It is caused by the microorganism varicella-zoster, which is a close relative of the herpes virus. He's afraid of open sun rays, dies from disinfectants, but is well preserved in damp and cold conditions. The virus spreads by airborne droplets, and together with droplets of saliva it can be transported over considerable distances - up to 20 meters.

Interestingly, chickenpox was first described in medicine by the Italian physician G. Guidi (Vidius) back in the 16th century. However, until the mid-19th century, the disease was regarded as a type of smallpox. The term “chickenpox” was introduced only in 1872 in Hungary.

The disease goes through three stages:

  1. Incubation period (latent) – from the moment of infection (contact with a sick person) to the initial manifestations. In children and adults up to the age of thirty, it is approximately two weeks; after 30 years, it can last up to three weeks.
  2. The prodromal period (or the “harbingers” stage) begins a couple of days before the formation of the first papules.
  3. The period of rash is the immediate appearance of the rash. This stage lasts 7–9 days, after which the papules dry out and disappear.

A rash is the main symptom of chickenpox. Papules on the body form chaotically (episodically - every two to three days during the first week after their detection, a new “wave” of them appears, while old and new elements coexist simultaneously), they do not affect the inner layers of the skin, and when they disappear, they do not leave scars ( unless you comb them too hard). The rash is accompanied by itching, which can be simply unbearable.

Initially, the rash appears on the head and face, then gradually falls lower (torso), but it affects the limbs less often.

Each element of the rash goes through a number of stages:

  1. A papule is a red bump that rises slightly above the skin.
  2. Vesicle. The tubercle is filled with serous fluid.
  3. Pustule. A burst bubble turns into scales and becomes covered with a crust, which falls off over time. This process speeds up scratching, although it may subsequently leave scars (bacteria enter the wound).

 The rash lasts about a week, after which it gradually dries up.

In addition to the main thing, other signs of the disease are observed. The degree of their manifestation depends on age and individual characteristics sick.

  1. Increase in temperature. In children, it, as a rule, does not exceed subfebrile values, but in adults it can reach 39 ° C. This symptom usually precedes the appearance of the rash by several days.
  2. General malaise, headache, lack of appetite.
  3. Sometimes there is minor abdominal pain that lasts 1-2 days after the infection is discovered.

Chickenpox is predominantly a childhood disease. In adults, it is usually more severe (which is why many parents even want their small child contracted chickenpox, and they specially take him to kindergarten during the epidemic). The number of waves of rashes is much greater, their reverse development occurs later than in children, all other symptoms are also more pronounced (signs of intoxication of the body). There is also a fairly high probability of joining bacterial infection and complications in the form of pneumonia, arthritis, laryngitis, meningitis, etc. (these pathologies begin with nausea, vomiting, fainting).


 Chickenpox is traditionally considered a childhood infection, because it is easier to get over it without complications in early age than later in severe form

However, there are exceptions to the rules. The author of these lines herself fell ill with chickenpox only at the age of 29, after she sent her child to kindergarten (obviously, contact with children had an effect). Surprisingly, the disease was very mild: the temperature of 38° C lasted only a day, after which it returned to normal, and there were very few rashes (there were almost none on the face). By the way, my son, who was almost three years old at that time, also fell ill two weeks later: and his illness was much more severe than that of his mother: a profuse rash all over his body with severe itching, and the fever lasted for several days.

If in childhood a child may not get chickenpox during an epidemic in a children's group, but in adulthood contact with a carrier of the infection almost always results in infection.

Features of the course of the disease at different stages of pregnancy

In itself, the “interesting situation” does not aggravate the course of chickenpox, does not lead to an increase in complications in the woman: the danger in this case threatens the fetus. After all, the disease is caused by a virus, which, when it enters the blood and tissues of the female body, is able to penetrate the placenta and exert its detrimental effect there.

Pregnant women do not get chickenpox very often (about 1 case per 1000 people). However, if there are small children in the family or the woman herself is an employee of a children’s preschool, then the risk of infection increases many times (of course, if the mother has not had chickenpox before).


 If a pregnant woman has a child with chickenpox, the likelihood of infection increases many times over

The degree of threat that chickenpox poses to the fetus largely depends on the duration of pregnancy.

1st trimester

In the early stages (up to about 20 weeks), complications for the child are approximately 5%. During this period, any infection is dangerous, because the systems and organs of the future baby are being formed. The placenta is still fully formed only by week 20, so it cannot protect the embryo from damage. He may develop intrauterine chickenpox, which means the following consequences:

  1. Fading pregnancy.
  2. Spontaneous miscarriage.
  3. Even if the embryo does not die, it could potentially have problems with the development of the central nervous system, hearing, vision, gastrointestinal tract, bladder, atrophy of the limbs, and scar changes on the skin. Ultimately, these complications will lead to his death.

 If the chickenpox virus infects an embryo in the first trimester of pregnancy, it will most likely die

Chickenpox in early pregnancy is not an unconditional indication for abortion, as is the case, for example, with rubella. After all, if a spontaneous miscarriage did not occur or the pregnancy did not freeze, then, most likely, everything is fine with the embryo.

2nd trimester

After 20 weeks, the risk decreases slightly (to 2%), since the placenta is already fully formed and protects the baby from negative external influences. Complications can arise if the mother’s infectious disease is severe. Pathologies may be the following:

  1. Improper development of bones and muscles.
  2. Scars on the skin.
  3. Visual impairment.
  4. Congenital pneumonia.
  5. Neurological disorders.

A woman with chickenpox must undergo an ultrasound scan to determine fetal malformations. If severe pathologies are detected, the doctor usually suggests artificially terminating the pregnancy.


 If a woman gets chickenpox in the second trimester, she must undergo an unscheduled ultrasound to identify possible malformations in the fetus
  1. Amniocentesis is a fence amniotic fluid. The procedure helps to identify possible genetic abnormalities in the child.
  2. Cordocentesis is the collection of umbilical cord blood from the fetus.

3rd trimester

Towards the end of pregnancy, the risk of serious consequences of chickenpox increases. Infection in the third trimester is dangerous if the mother gets chickenpox 7-10 days before giving birth. The risk of infection of a baby at birth is approximately 50%. The child’s body has not yet produced enough antibodies: the immune system will simply not be able to resist the virus. As a result, the child develops congenital chickenpox (neonatal) with accompanying pathologies of internal organs (encephalitis, liver damage, respiratory organs, etc.). A newborn can even die soon after birth (according to statistics, this is 25% of infected children).
If the mother gets chickenpox about a week before giving birth, then in half the cases the baby is born with congenital chickenpox

If the mother fell ill earlier than three weeks before giving birth, then the prognosis in this case is quite favorable. After all, her body managed to develop antibodies to the virus and pass them on to the baby. Even if he gets sick after birth, everything will be mild.

Treatment of chickenpox in pregnant women

When the first signs of chickenpox appear, the expectant mother should immediately contact her gynecologist. The doctor assesses the severity of the disease, the presence of secondary infections, taking into account the duration of pregnancy.

For a period exceeding 20 weeks, the doctor may prescribe immunoglobulin injections to the woman (sometimes this is done after contact with the patient, even before the first signs of the disease appear).

Also, sometimes pregnant women are prescribed the antiviral drug Acyclovir (it is undesirable to use it in the first trimester due to possible effects on the embryo). It will relieve acute symptoms and speed up recovery. However, in order for the drug to have the desired effect, you need to start taking it within 24 hours after the first papules appear.

Otherwise, treatment of chickenpox in pregnant women is carried out according to the standard scheme (in principle, the same as in children):

  1. Rashes are treated with regular green paint or methylene blue solution.
  2. A gauze bandage soaked in calamine lotion will help reduce itching.
  3. The drug Tsindol (zinc-based) will have an antiseptic effect on the skin and dry out the ulcers.

Photo gallery: drugs for the treatment of chickenpox in a pregnant woman

An antiviral agent will reduce the acute symptoms of the disease, accelerating recovery. Calamine lotion will soothe the skin and reduce itching. Rashes should be treated with methylene blue solution or regular green paint.

If you have chickenpox, a pregnant woman should not overheat: this will only increase the itching. It is better to replace taking a bath with a warm shower. The skin should not be rubbed with a towel, only gently blotted, and a new towel should be used each time. During illness, a woman should drink and consume more healthy food for a speedy recovery of the body.

If symptoms of chickenpox occur in a pregnant woman immediately before giving birth, doctors usually try to delay them for 5–7 days. During this time, the expectant mother will pass on valuable antibodies to the virus to the child, and even if he gets sick, he will cope with everything relatively easily. If it was not possible to delay delivery, then immediately after birth the baby is given immunoglobulin, which will help him resist infection. After this, doctors carefully monitor the baby’s condition for two weeks.
If the birth cannot be delayed, the baby is given immunoglobulin after birth.

If a woman has a rash in the genital area, doctors consider performing a cesarean section.

How can an expectant mother protect herself from chickenpox infection?

Even at the planning stage, a pregnant woman should find out whether she had chickenpox as a child. If this is impossible to find out, then you can take a special test in the laboratory to detect antibodies to chickenpox.

If the expectant mother has never encountered chickenpox, then before conception (preferably three months before) she is recommended to be vaccinated against this virus.


 At the stage of pregnancy planning, it is advisable for a woman to get vaccinated against chickenpox

In our country, vaccination against chickenpox is carried out with the drugs Okavax and Varilix (the first was named after the Japanese boy Oka, from whose rash vesicles the virus was isolated). They contain a weakened herpes virus, which the human body can easily overcome, while developing appropriate immunity. Of course, after vaccination there is still a risk of contracting an infection, but it is very small.

During pregnancy, vaccination against chickenpox is prohibited. Conception can be planned only three months after vaccination. However, if a woman finds out about her pregnancy after receiving the vaccine, this is not considered absolute indication for an abortion.

Vaccination does not exclude additional protective measures:

  1. A woman who is already pregnant must take vitamin complexes (by the way, this will not hurt at the planning stage). This will increase the body's resistance to infections, because when carrying a child, maternal immunity naturally decreases.
  2. If possible, it is better not to take your older preschool child to kindergarten during pregnancy - a potential source of infection.
  3. If older children have not yet had chickenpox, they can also be vaccinated.

Pregnancy after chickenpox

After suffering from chickenpox, a woman can safely plan a pregnancy. After all, her blood contains the necessary antibodies to fight the virus. However, we must remember that the disease suppresses general immunity, and the risk of contracting some other infection (for example, ARVI), which can negatively affect the gestation process, increases.

A woman’s condition does not always allow her to begin planning a pregnancy - the body is often depleted by a debilitating infection. Therefore, it is advisable to restore strength and only then continue conceiving a child.

Berezovskaya E.P.

Pregnancy and chickenpox - this combination frightens many women. What to do? This article discusses the answers to the questions of whether chickenpox is dangerous during pregnancy and how the viral infection affects the developing fetus and the mother’s body.

Danger to the fetus

A small rash all over the body, bursting blisters, elevated body temperature (37.5 - 38.50C), itching, general malaise, intoxication of the body - these are symptoms of chickenpox caused by type 3 herpes virus.

Can pregnant women get chickenpox? They can. Pregnant women have a weakened immune system, so infection with this virus can lead to illness in both the mother and the fetus. A special risk group is represented by expectant mothers (5-6%), who have never been sick and have not been vaccinated. Causes of the disease:

    decreased general immunity, accompanying pregnancy;

    virus mutation, which can lead to a failure of natural immunity.

The route of infection is airborne, and viral particles can travel considerable distances with air currents, maintaining the ability to become infected for 10 minutes. Human susceptibility to chickenpox is very high, almost 100%. The source of infection is patients (the day before the rash appears and until complete recovery). It is especially dangerous for a pregnant woman to encounter these viruses at the beginning and end of pregnancy.

1st trimester

The first trimester is critical - the laying of all tissues and vital organs occurs. The placenta is not yet formed during this period. Therefore, the penetration of the virus into the body causes severe pathologies:

    hyperplasia, disruption of the formation of fast-growing tissues - muscle, connective;

    organ deformities, underdevelopment of arms and legs, body disproportion;

    damage to the visual and central nervous system;

    violation of the structure of the skin.

The degree of complications depends on the duration of infection of the body. Intrauterine infection of the embryo in the early stages of pregnancy can lead to its death, spontaneous miscarriage. But, despite the high risk of complications, in most cases children are born without pathology, but with congenital chickenpox. In case of severe consequences for the fetus, artificial termination of pregnancy is possible.

2nd trimester

In the second trimester, the likelihood of a child becoming infected from the mother is low - the formed placenta quite reliably protects the child’s body from the penetration of viruses. Medical statistics show that one fetus in a hundred can become infected during this period, and the consequences will be less tragic. The child may develop:

    pulmonary diseases;

    visual impairment associated with underdevelopment of the optic nerve or eyeball (anophthalmia, microphthalmia);

    dysfunction of the excretory system;

    deviations in physical development;

    skin scars or lack of skin epithelium in some areas of the body.

Possible brain damage with signs of mental retardation and neurological symptoms. But deaths are rare.

3rd trimester

The beginning of the 3rd trimester is calmer. During this period, chickenpox is more dangerous for the mother's body than for the fetus. At 7 or 8 months, the child’s body continues to be protected by the barrier function of the placenta, which does not allow viruses to pass through. And the threat to the fetus can occur immediately before birth, starting from the 36th week - the period of possible onset labor activity.

Congenital chickenpox

If the infection occurred a week or two before birth, then the likelihood of intrauterine infection is reduced, and there are practically no deaths. If a woman gets chickenpox a few days before giving birth, her body does not have time to produce the antibodies necessary to fight the infection. This increases the chance of infection to 20%, and about 30% of newborns may die.

In a newborn

Congenital chickenpox is dangerous for the baby, because its own immunity is still weak, so complications can be very serious:

    the skin and mucous membranes are affected;

    the nervous system and internal organs suffer;

    Encephalitis, pneumonia, and atypical hemorrhagic form often develop.

Innate immunity to chickenpox in newborns depends on immunoglobulin transmitted in utero, then through breast milk. Retains its effectiveness for 6 – 12 months.

But, despite such forecasts, the use of the “passive immunization” method minimizes the death of newborns.

Is it possible for a pregnant woman to have contact with someone with chickenpox?

Chickenpox during pregnancy is dangerous for both mother and baby.

The cause of primary infection with the virus may be shingles, which exhibits the symptoms of chickenpox.

Therefore, it is better to prevent infection than to regret later about a lost baby or lost health. The child they are expecting is happy and healthy, which means they are planning a pregnancy.

Before the planned conception, it is necessary to undergo a full examination, take blood tests, check the titer of antibodies to the viral group, and be vaccinated (if the vaccination period is missed or it was not carried out at all). At least two to three months must pass from the moment of vaccination until subsequent conception.

Remember - chickenpox vaccinations are not given during pregnancy.

Contact with a sick child can result in trouble for a pregnant woman. Even with your own. He, just like other children, can “pick up” the virus in kindergarten or school and bring it home. Therefore, no matter what the attachment and mother's love, to preserve the health of the fetus and your own, During pregnancy, you need to limit contact with sick children. Avoid crowds of people public places, attending children's events.

If a pregnant woman comes into contact with a sick child, no later than on the fourth day, it is advisable to give an injection of immunoglobulin. This drug, obtained from a donor's blood, contains specific protein substances - antibodies to the Varicella Zoster virus, which helps protect against infection.

Why is it dangerous for the mother?

Chickenpox in pregnant women is not so common: only one in 1000 women is at risk of becoming infected.

Chickenpox is dangerous not so much for pregnant women as for the child. And it doesn’t matter whether the mother’s entire body is covered in bubbles, or whether there are only a few dozen of them, the danger to the developing fetus is equally great. In pregnant women, the disease occurs in the same way as in other adults.

It all starts with infection. The incubation period can last up to 20 weeks. Then characteristic clinical signs appear:

    there is an increase in temperature (symptoms are similar to a common cold);

    your health worsens, headaches bother you;

    appetite is impaired, nausea may occur;

    after a couple of days, rashes appear on the scalp;

    spots spread throughout the body, transforming into vesicles - bubbles filled with clear liquid;

    temperature rises to 39 C;

    muscle and joint pain appears.

The rash appears in waves - old blisters burst and dry out, forming a crust. New spots and blisters appear on clean areas of the skin. Severe itching causes an irresistible desire to scratch the body. But this should not be done under any circumstances, so as not to spread the infection into the deeper layers of the skin. Inflammation of scratched wounds leads to the formation of scars.

Consequences

Due to reduced immunity, the disease in pregnant women is severe. An atypical course of infection is often observed:

    the hemorrhagic form is accompanied by hemorrhages, nosebleeds;

    gangrenous chickenpox leads to the formation of non-healing ulcers;

    the generalized form causes damage to the skin and internal organs;

    herpetic pneumonia is characterized by respiratory failure and hypoxia.

All these forms require immediate medical attention to avoid death. For a mother whose immunity is greatly reduced, chickenpox is dangerous because it can cause:

    encephalitis (inflammation of the brain);

    pathology of the visual organs, damage to the optic nerve,

    myocarditis (inflammation of the myocardium - heart muscle);

    glomerulonephritis– damage to the renal glomeruli;

    articular abnormalities.

Chickenpox during pregnancy is not as dangerous as you might think based on numerous myths and rumors. But this does not mean that the disease should be ignored. If an infection does occur during pregnancy, you should immediately seek help from your doctor. This will help protect the child’s body from complications and negative consequences.

Chickenpox (varicella) is an acute viral disease that is transmitted by airborne droplets. Chickenpox mainly affects children: they account for about 90% of cases. But sometimes this disease also occurs in adults. Expectant mothers are not at risk for this disease: as a rule, chickenpox occurs in 1-2 women out of 2000 pregnancies. Let's find out whether chickenpox is dangerous for pregnant women, consider what complications there may be after this disease, and determine methods of its treatment.

Is chickenpox dangerous for pregnant women?

Chickenpox during pregnancy is not a medical indication for its artificial termination. According to statistics, the risk to the fetus when infected with the chickenpox virus up to 14 weeks is 0.4%, at 14-20 weeks - about 2%, and after 20 and up to 39 weeks of pregnancy, the risk approaches zero.

At the same time, there is, although minimal, the likelihood of developing fetal pathologies with chickenpox during pregnancy. Sometimes, when a woman is infected with this disease in the early stages, a miscarriage or fetal death fetus It is also possible for a child to develop cataracts (clouding of the lens of the eye), microphthalmia (the presence of pathologically small eyeballs), growth retardation, mental retardation, atrophy of the cerebral cortex, hypoplasia (underdevelopment) of the limbs, and the appearance of skin scars.

It is more dangerous if a pregnant woman gets chickenpox while later pregnancy. The risk of a newborn becoming infected with chickenpox especially increases if a woman is sick with this disease 2 days before the onset of labor or for 5 days after it.

If a mother gets chickenpox during pregnancy 4-5 days before the onset of labor, the probability of infection of a newborn baby is about 10-20%, while the mortality rate of sick children reaches 20-30%.

Congenital chickenpox in children is very severe. As a rule, it is accompanied by damage to the baby’s internal organs and the development of bronchopneumonia (acute severe inflammation of the walls of the bronchioles). At the same time, if the mother was infected with the chickenpox virus earlier than 5 days before birth, chickenpox in the baby does not appear or is mild.

What to do if a pregnant woman gets chickenpox

If a woman gets chickenpox during pregnancy, she should never panic. Modern medicine has enough methods and means to minimize the dangerous consequences of this disease.

First of all, the doctor will prescribe some examinations for the expectant mother. As a rule, a woman donates blood to determine markers of perinatal pathology (PAPP or HGH). In some cases, the doctor may refer a pregnant woman for a chorionic villus biopsy, cordocentesis (fetal umbilical cord blood test), or amniocentesis (amniotic fluid test).

In order to reduce the minimal risk to the fetus, in the case of chickenpox during pregnancy, the woman is given a specific immunoglobulin, which significantly reduces the effects of the chickenpox virus.

If you expectant mother chickenpox occurred in late pregnancy, literally a few days before birth, doctors will try to delay the onset of labor by at least 2-3 days. Otherwise, immediately after birth, the baby is given immunoglobulin and a course of antiviral therapy is prescribed. Naturally, the newborn is immediately hospitalized in the infectious diseases department. The same treatment tactics are carried out in the case of chickenpox in a mother who fell ill during the first 5 days after birth.

How to protect yourself from chickenpox during pregnancy

There are women who do not know or do not remember whether they had chickenpox as children. Therefore, in order to avoid chickenpox during pregnancy, it is best to donate blood to determine the presence of antibodies to the chickenpox virus in the body before planning to expand the family. The detection of such antibodies indicates that immunity to this disease has been formed. In this case, you can be calm for yourself and the health of your unborn baby. The absence of antibodies to the chickenpox virus means that a woman is at risk of contracting the disease and needs to be more careful.