The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty since 2001.
Constipation is meant a condition where the broken passage digested food masses on the colon, resulting in bowel movements reduced to 3 times a week or less. Constipation - frequent condition in pregnancy and usually occurs from 17 to 36 weeks gestation.
Causes of constipation in pregnancy
The reasons that cause constipation during gestation, mainly associated with the gestation:
1. Hormonal changes
The increased production of progesterone during pregnancy relaxes the uterine muscles, thereby preventing spontaneous abortion. But other than that, progesterone relaxes the muscles of the gastrointestinal tract, particularly the colon, which weakens its peristalsis and the passage of food masses.
2. Increasing the size of the uterus
As the progression of pregnancy the growing uterus compresses the abdominal organs, including the colon, which leads to stagnation of feces and the weakening of peristalsis.
3. Reduction of motilin
Motilin is responsible for the motility of the digestive tract, but during pregnancy reduces its concentration. Also weakens the sensitivity of the intestinal receptors for serotonin and acetylcholine, which activate the bowels.
4. Stress and emotional lability
Pregnant women are different emotional instability, prone to stress and anxiety, which causes weakening of neurogenic bowel motility.
5. Reduced uterine excitability
During pregnancy, the uterus is in a relaxed state, which prevents abortion. A uterus and intestines have a common blood circulation and neurohumoral regulation system, so along with the relaxation of the uterus weakens and intestinal peristalsis.
6. Taking certain medications
During the period of gestation, women often take iron and calcium supplements, antispasmodics with the threat of interruption and other drugs, resulting in weakened intestinal peristalsis (antispasmodic drugs and progesterone), and the stool become denser (calcium preparations and gland).
7. Restriction of motor activity
The longer the pregnancy, the lower the motor activity of women (enlarged abdomen does not predispose to physical exercise). In addition, in some cases, the woman is prescribed limit physical activity until bedrest (interrupt threat), which leads to slow and weaken peristalsis motility bowel.
8. Fluid restriction
Pregnant women, especially in the later stages of gestation some gynecologists recommend limiting your fluid intake because of the risk of edema. Also cause decrease in fluid intake in early pregnancy is morning sickness. Owing to the small intake of fluid into the intestine and in particular fecal compacted, and their progress is hampered by the large intestine.
9. malnutrition
Often during pregnancy altered taste preferences, the woman begins to use such illegal and especially not recommended for constipation products, such as salting, smoking, fatty and fried food, dishes, spiced with pepper and seasonings.
symptoms
As a rule, constipation during pregnancy is associated with a decrease in stool frequency up to 1 times per week and less. This changes the consistency of feces, pain and discomfort (usually left in the abdomen), feeling of incomplete emptying.
In case atonic constipation initial portion of stool consistency very dense and larger diameter, and at the end of defecation poluoformlenny cal.
Sam defecation process is very painful and difficult on the stool there are streaks of blood due to tears the rectal mucosa.
When spastic constipation cal becomes "sheep" (fragmented stool). There are problems with the discharge of gas, there flatulence, nausea and bitterness in the mouth.
Treatment of constipation in pregnancy
Treatment of constipation in pregnancy starts with the normalization of lifestyle and nutrition.
Recommended (if possible)
- increase in motor activity,
- special exercise therapy during pregnancy,
- diet, aimed at improving the motor function of the intestine.
Food
In clinical nutrition products limit the operating states: chocolate, coffee, tea. Excluded products, increasing the load on the intestine, delaying the evacuation of feces causing flatulence and decay: legumes cabbage, pickles and marinades, spicy food, fatty meat and poultry, soups, broth of fish, meat and poultry, radishes and radish, spinach and onions.
It is recommended to consume more of fiber (vegetables, fruits and berries in the raw and boiled, bran cereal or wholemeal, cereals: buckwheat, millet, wheat in the form of crumbly cereals). Useful in salads, dressed with vegetable oil.
Increase fluid intake due to the juice and jelly, green tea, yogurt, fruit drinks and fruit compotes.
Read more about diet for constipation in our special article
Therapy
From traditional therapies constipation pregnant possible to use infusion of flax seeds and prunes, a mixture of dried prunes, raisins, dried apricots, and honey.
Medications for the treatment of constipation in pregnant women are appointed with extreme caution. Safe during pregnancy candles with glycerin, processing anus with petroleum jelly to facilitate bowel movement, osmotic laxatives, have a mild laxative effect: Duphalac and macrogol.
Mukofalk allowed reception, fitomutsila and eksportala (safe during pregnancy).
Forlaks tranzipeg and do not cause more bowel stimulation, that is, do not irritate the uterus, so their intake during gestation also allowed.
Important! Preparations based on senna, buckthorn, castor oil and bisacodyl strictly prohibited pregnant.
Consequences and complications
Long-term constipation and running, not only for its unpleasant symptoms, but dangerous for both the woman and the fetus.
Because of reduced motility of the colon fecal stagnate in it, undergoes a process of putrefaction and fermentation. Whereby toxic substances produced as a result of these processes, are absorbed into the blood, which worsens the woman's condition, causing intoxication, and through the utero-placental blood flow to the fetus fall, contributing development placental insufficiency, Development and fetal hypoxia, premature aging of the placenta.
In the first trimester of constipation can cause a threat to interrupt, and later - miscarriage.
Impaired intestinal microflora constipation causes a disturbance of the vaginal microbiocenosis that is fraught with development kolpitov, Infection of the membranes with the development of chorioamnionitis and premature rupture, the occurrence of septic obstetric complications (inflammation of the joints on the perineum, endometritis).
In addition, constipation in pregnancy increase the chances of occurrence hemorrhoids, cracks anal passage.
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Amniocentesis.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.
