All about pregnancy
When you need hospitalization of a pregnant woman
There are some conditions and complications of pregnancy, when a doctor insists on hospitalization of a pregnant woman in a hospital. What you need to know if you have to go to the hospital or hospital and in what situations is it really necessary?
Elena Trifonova Doctor obstetrician-gynecologist, Ph.D. honey. Sciences, Moscow
Hospitalization of a pregnant woman can be planned and emergency.
With a planned hospitalization A pregnant female doctor consults a referral to a hospital or maternity hospital. With this direction, the pregnant woman herself goes to the inpatient department of the hospital. If family and other circumstances do not allow the pregnant woman to go to the hospital at once, then it is quite possible to wait several days. After all, in the case of a planned hospitalization of a pregnant woman, there is no immediate threat to life for a woman and a child, and the general condition of both does not cause fear. The question of planned hospitalization of a pregnant woman occurs when the treatment is ineffective, with exacerbation of existing chronic diseases and some other diseases requiring constant monitoring by doctors.
Emergency hospitalization pregnant woman is necessary for complications requiring urgent medical intervention. In this case, the refusal of immediate treatment in a hospital can threaten the course of pregnancy, and sometimes the life of a future mother and baby. In the latter case, the direction of the attending doctor is, of course, not required. A woman is hospitalized immediately by an ambulance brigade, which she can call herself or the doctor of a woman's consultation, if at the next planned admission he identified abnormalities that require urgent treatment. Also, a woman can independently turn to the hospice of a maternity hospital or a hospital for pregnant women.
What complications require hospitalization of a pregnant woman?
1. Early toxicosis
With early toxicosis, when vomiting is repeated more than 10 times a day, dehydration of the future mother's organism and metabolic disturbance may occur. In this case, the hospitalization of a pregnant woman in a hospital, in a gynecological hospital and intravenous infusion of nutrient solutions and liquids is required.
2. Isthmic-cervical insufficiency
Isthmiko-cervical insufficiency (ICN) is an inconsistency of an isthmus and a neck of a uterus. In this condition, it is smoothed and slightly opened, which can lead to spontaneous miscarriage. Normally, the cervix performs the role of a muscle ring, which holds the fetus and prevents it from leaving the uterine cavity prematurely. As fetal pregnancy develops, the amount of amniotic fluid increases and increases. All this leads to an increase in intrauterine pressure. With ICI, the cervix can not cope with such a load. The membranes of the fetal bladder begin to bulge into the cervical canal, are infected with microbes, which can lead to their premature rupture. With this development of events, pregnancy is interrupted before the due date. Most often this occurs in the second trimester of pregnancy (after 12 weeks).
There are no specific symptoms of ischemic-cervical insufficiency. This is due to the fact that the opening of the cervix, which occurs in this state, is painless for women and bleeding, or some unusual discharge, is usually not observed. A pregnant woman can feel heaviness in the lower abdomen or in the lumbar region. However, most often the future mother does not bother. In these cases, the pregnant woman needs hospitalization and surgery, which is to sew the cervix. The application of sutures to the cervix is usually performed from 13 to 27 weeks of gestation. After suturing, a woman is observed for several days in a hospital.
3. Premature rupture of membranes
In normal childbirth, the rupture of the bladder and the outflow of amniotic fluid should occur in the first period of labor when the cervix is opened by 7 cm. If the bladder burst before the start of regular contractions, this is called premature discharge of amniotic fluid.
There are two options for rupture of the bladder before delivery. In the first case, the fetal membranes are torn in the lower part, and the water is poured simultaneously in large quantities.
In the second case, the rupture of the bubble occurs high, and the water does not leave massively, but flows literally drop by drop. In such situations, a pregnant woman may not notice the discharge of an amniotic fluid.
In cases of suspected leakage of amniotic fluid, a series of tests are performed to identify cells of the amniotic fluid in the vaginal contents. If the tests confirm the rupture of the membranes, an urgent hospitalization in the hospital is required to resolve the issue of further treatment tactics. Untimely hospitalization of a pregnant woman can lead to infection of the fetus and its death.
4. Detachment of the placenta
This is the separation of the placenta from the uterine wall during pregnancy. If the detachment of the placenta occurred in a small area of it, then with timely treatment, this process can be suspended and then the state of the baby will not be threatened.
In the case when the detachment process continues, acute placental insufficiency develops, characterized by a rapid deterioration of the placental blood flow. And this means that the baby will lack oxygen and nutrients and his condition can deteriorate sharply. It is clear that this condition requires urgent medical intervention.
In the case of development of acute placental insufficiency, it is necessary to perform the cesarean section as quickly as possible to preserve the life of the baby and mother.
5. Chronic fetoplacental insufficiency
With this pathology, the uteropulmonary and placental-placental blood flow is disturbed. This leads to the fact that the fetus receives less oxygen and nutrients, which causes a delay in its growth and development. Specific methods of treatment of fetoplacental insufficiency do not exist at the moment, since there are no medications that selectively improve utero-placental blood flow. If the physician identifies the initial disturbances of oxygen supply to the baby, the pregnant woman needs hospitalization in order to undergo treatment in an inpatient setting aimed at increasing the flow of blood and oxygen through the placenta. Since the condition of the baby can deteriorate sharply, it is often necessary to check how it feels by doing dopplerometry and cardiotocography, and therefore it is better if the future mother will be in the hospital under the supervision of doctors.
This is a terrible complication of the second half of pregnancy, in which the work of vital organs is disrupted. It is manifested by swelling, the appearance of protein in the urine and increased blood pressure. However, the degree of expression of these signs may be different. Perhaps a combination of two symptoms of the three classic. Pre-eclampsia is a critical but reversible condition, preceded by the most severe form of gestosis, eclampsia, when the brain is damaged. Preeclampsia is a very dangerous state of heightened convulsive readiness of the body, when any stimulus (loud sound, bright light, pain, vaginal examination) can provoke a seizure with all possible adverse consequences for the mother and fetus. The only way to treat severe forms of gestosis is delivery and removal of the placenta. It is used to protect the health of the future mother and the life of the fetus. The mode of delivery depends on the viability and maturity of the fetus, the readiness of the organism of the pregnant woman for childbirth. With an increase in blood pressure more than 140/90 mm Hg. Art. and the appearance of protein in the urine, hospitalization of the pregnant woman in the hospital is necessary.
7. Hemolytic disease of the fetus in the Rh-conflict
If the blood of the mother and fetus is Rh incompatible (the mother has a negative indicator and the child has a positive indicator), and when the fetal blood cells are transferred through the placenta to the mother's bloodstream during pregnancy, the child's hemolytic disease may develop. Penetrating to the bloodstream, the cells of the fetus cause a reaction of the immune system, and the developed antibodies (proteins) penetrate the baby's bloodstream again, causing the destruction of red blood cells (erythrocytes). Hospitalization in this case provides a dynamic observation of the fetus - the doctors control the blood flow in the vessels of his brain. In severe cases, an exchange blood transfusion is administered to the baby in utero.
8. Threatening premature birth
Preterm birth is considered to be from 22 to 37 weeks of pregnancy. When there are regular cramping pains in the lower abdomen or a prolonged painful exertion of the uterus, a pregnant woman should immediately consult a doctor. Only during the examination, the doctor will be able to identify signs of the threat of premature birth or their onset. In these cases hospitalization in a hospital is necessary. With the help of special medicines, doctors can stop the beginning of labor, introduce special drugs to accelerate the maturation of the fetus, carefully monitor the condition of the baby.
Hospitalization of a pregnant woman: necessary things in a hospital
Emergency hospitalization беременной всегда предполагает минимум времени на сборы. Поэтому самым важным пунктом вашего списка является наличие документов, особенно когда непредвиденная ситуация, требующая срочной врачебной помощи, возникла вне дома. В связи с этим рекомендуется все необходимые бумаги хранить в одном месте и всегда иметь их при себе, выходя на улицу. Если такая ситуация возникла дома, то до приезда «скорой помощи» есть немного времени, чтобы положить в сумку зубную щетку, мыло, большое полотенце, сменную обувь, ночную сорочку и халат. Все остальное позже вам может привезти кто-то из родственников.
If it is a planned hospitalization of a pregnant woman, it is clear that you can deliberately collect a bag with everything you need.
You will need a convenient change of clothes - a dressing gown or light sports kit, 1-2 night shirts or cotton T-shirts, underwear, socks, slippers that can be handled, shower slippers.
From the hygiene items do not forget the toothbrush and paste, towel, roll of toilet paper, paper or wet napkins, soap, shampoo, loofah, as well as deodorant and comb. It is also better to take your cup, spoon, plate, drinking water.
How long will the pregnant woman go to the hospital?
It all depends on the specific situation, some diseases require a long stay under the constant supervision of doctors. Naturally, if you wish, and more often if you do not understand what is happening, you can refuse from hospitalization. But it is worthwhile to understand that in this situation the pregnant woman takes all responsibility for her condition and the state of her future child and the consequences of this can be very deplorable. So do not be afraid to stay in the hospital and if the doctor insists on hospitalization, it is better to listen to the recommendations of a specialist and go to the hospital. After all, it is often due to inpatient treatment that it is possible to normalize many dangerous conditions and safely endure and give birth to a healthy baby.
What documents are needed for hospitalization of a pregnant woman?
When going to inpatient care, you need to bring your documents with you:
- medical policy;
- exchange card;
- discharge and conclusion of previous hospitalizations, if they were;
- results of ultrasound.
Indication for the hospitalization of a pregnant woman in a hospital can be some diseases of the fetus, for example, heart disease - arrhythmia, bradycardia, the tendency to premature closure of the oval window of the heart. In the hospital, according to the prescription of a pediatric cardiologist, intravenous administration of necessary medicinal preparations is carried out and the control of the work of the baby's heart is carried out.
Also, the doctor can offer the future mother to go to the hospital if she has such chronic diseases as diabetes, hypertension, heart disease. Most often, hospitalization is carried out with worsening of the course of a chronic disease. However, in a number of cases, it may be necessary to go to the hospital on schedule at certain times of pregnancy, most often to correct the therapy, for example, in diabetes mellitus in a future mother.
I'm not afraid of hospitals!
If you are to be hospitalized, it is very important to be psychologically tuned to stay in the hospital. Of course, do not worry and worry, much less cry. Firstly, it is meaningless, and secondly, it can aggravate the violations during pregnancy. It is necessary to tune in to a positive mood. Being in the hospital, you can rest and sleep, read many interesting books, meet other pregnant women, and maybe even find girlfriends. And, of course, it is important to remember that all this is done to ensure that your pregnancy is proceeding safely and the baby was born strong and healthy.