Author: Zhang Yangxia, Department of Pharmacy, Hubei Province Third People’s Hospital
Recently, a special patient came from the pharmacist clinic of our hospital
A sad pregnant mother
When I was more than 6 months of pregnancy, my palm suddenly began to itch, and my arms began to itch slowly. I thought that forbearing would pass, and I was worried that the medication would hurt the baby. I never came to the hospital for medical treatment.
The medicine prescribed by the doctor is a bear to remove oxygenic acid. It is used to reduce bile acid, which can effectively reduce itching, reduce premature birth, and protect the liver. According to the current research, it is not harmful to the baby to take this medicine.Yes, you can take it with confidence!In addition, the doctor also gives you an external glycrystone washing agent. Remember to shake well before use, apply it to the itching area, and it is recommended not to apply it.
I also have to tell you: The intrahepatic stasis during pregnancy not only makes pregnant mothers discomfort, but also harm the health of the fetus.Therefore, you must insist on taking the medicine and come to the hospital for review on a regular basis, but you can’t stand it again!
Pharmacist science time
In the pregnancy, the intrahepatic cholecass accumulation (ICP) is one of the severe complications unique to women during pregnancy, which can easily lead to hypoxia in the fetus, amniotic fluid pollution, premature birth, newborn respiratory distress, and death.The incidence of ICP in my country is about 1.2%, that is, one of the 100 pregnant mothers will have a unfortunate recruitment.
1. Itching
Itching of skin is the most common first symptom of ICP, and more than 80%occur in the late pregnancy (about 30 weeks).Itching often begins with palms or feet, and gradually spreads to limbs, torso, and even develops to the face; the degree of itching is different.
2. Jaundice
14%to 25%of pregnant mothers will find jaundice 2-4 weeks after itching, and most of them are mild jaundice, and can be faded within 1-2 weeks after delivery.The urine of some pregnant mothers is dark, and the feces are light.
3. Others
A few pregnant mothers have symptoms such as anorexia, fatigue, nausea, vomiting, abdominal pain, diarrhea and other symptoms.A few pregnant mothers have a lack of weight loss and vitamin K related coagulation factors, which may increase the risk of postpartum bleeding.
1. A total of the total bile acid of the aperture of ≥10 μmol /L can be diagnosed as ICP.
2. If the level of total bile acid is normal, but there are unpredictable liver function abnormalities [serum skydamine rigidase (AST) and serum propionate transaminase (ALT) light and moderate increase] can also be diagnosed as ICPEssence
1. Those with basic diseases of chronic hepatobiliary
2. History of oral contraceptive pills
3. ICP family history or previous pregnancy ICP medical history
4. Pregnant women with twins and multi -fetal pregnancy
5. Pregnant women with artificial insemination and pregnancy
1. Basic drugs
_ _ _ 吧 _
Drug name
Dosage
Fetal safety
First -line drug
Bear to remove oxygenic acid
Oral: 15mg/kg/d, divided 3-4 times
Treatment: 7-10d
The maximum dose can be 1.5-2.0g daily
Good safety in the middle and late pregnancy
Second -line drug
S adenosine eggine
Jingdi: 1g/D
Oral: 500mg, 2 times/d
Treatment: 12-14D
Have not found that this medicine has side effects on fetal poisonous side effects
Combined treatment
Bear removal oxygenic acid+ S adenosine eggine
Bear to remove oxygenic acid: 250mg, 3 times/d, oral
S adenosine eggine: 500mg, 2 times/d, quiet drip
Have not found that this medicine has side effects on fetal poisonous side effects
2. Local medication is safer to wash the glyphosite washing liquid; if itching is severe and affects sleep, it can be used for weak and medium -effective hormone ointments, such as Tunaid, hydrogenated loose, bran acid Mamone, etc.(Note: hormone ointment can only be used in a short period of time, not for a long time)
Active treatment
Do not panic if the expectant mother is diagnosed with bile stasis!Actively cooperate with the doctor’s treatment, follow the doctor’s advice, and choose the best childbirth time and method, which can also safely give birth to a healthy baby.
Follow the fetal movement
Specific mothers must insist on counting a few fetal movements during the third trimester!Fetal movement is the simplest and convenient way to evaluate the baby’s state in the uterus.There is less fetal movement and the disappearance of fetal movement is a hypoxia signal from the baby in the stomach.It is recommended to go to the hospital for further testing within 1-12 hours after the fetal movement is significantly reduced.
Light diet
During the treatment, the diet should be light, and eat more low -fat and easy -to -digest foods such as fresh vegetables and fruits and milk; pay more attention to rest, and the left side is mainly to increase the placenta blood flow and give the baby sufficient oxygen.
adjust your mindset
Pay attention to psychological pressure regulation, because psychological factors also affect the human body’s sensitivity to stimuli, and it is more likely to produce itching.During the rash period, skin care should be done, try not to grab it, so as not to aggravate itching or cause bacterial infections.
Review expert: Zhang Mingwei, Third People’s Hospital of Hubei Province
The above is the original work of the "Drug Safety Cooperation Alliance" volunteer. If you reprint, please indicate the author and source!
[Medicine Shield Public Welfare] Public welfare organizations jointly sponsored and established with the China Society of Pharmaceuticals, Chinese Pharmaceuticals, Chinese Medical Association, and the Chinese Medical Association, PSM Media Shield Public Welfare (Public Number: PSMCHINA), Guanghui Resources, condense strength, and promote public medication for medication.Safety.
