The early stages of pregnancy (13-14 weeks) – a contraindication for any medications.
In this period the fetus can affect any chemicals. Therefore, the use of many drugs pregnant during this period can cause the development of deformities and defects of the internal organs of the fetus.
However, the presence of comorbidity may be grounds for the appointment of prednisolone during pregnancy.
Prednisolone is appointed in cases where the intended result of the mother’s treatment is much higher than the potential risk to the fetus. In the first trimester of pregnancy prednisone is prescribed only for health reasons. Before the appointment of prednisolone doctor is obliged to explain to the woman the indications for its use, the expected benefits from its use and the potential risk to the fetus.
But treatment with prednisolone during pregnancy can be carried out only with the consent of most pregnant women.
Indications for use of prednisone during pregnancy
Prednisolone prescribed during pregnancy for various indications:
High risk of premature birth – one of the main indications for the purpose of prednisolone in the third trimester of pregnancy.
In this case, glucocorticoids contribute to the maturation of special material (surfactant) to ensure the normal function of the respiratory system in the newborn.
Hyperandrogenism (elevated levels in women of male sex hormones, which are produced in the adrenal glands and the ovaries). This pathology is common in polycystic ovarian disease and congenital female – adrenogenital syndrome.
Hyperandrogenism contributes to the tone of the uterus and pregnancy loss. When the fetus grows, it begins to produce its own male hormones (especially if the fetus is male). fetal hormones further enhance the level of androgens in the body of a pregnant woman, causing a spasm of blood vessels that feed the fruit, and poses a threat to abortion (miscarriage).
Corticosteroids (prednisone) help reduce the formation of male sex hormones, so they prescribe for the whole period of pregnancy. At the same time carry out regular monitoring of the level of androgens in women (determining the level of 17-keto steroids in the urine or blood testosterone).
Autoimmune conditions developing in certain diseases of women (systemic lupus erythematosus, antiphospholipid syndrome, asthma, hepatitis, etc.). As a result, the fetus is perceived as foreign tissue. In the body of the mother begins to produce antibodies to the fetus promoting abortion (miscarriage) or even fetal death. In this case, blocks the production of antibodies prednisolone and contributes to maintaining pregnancy.
Severe allergic reactions in pregnant women may also require the assignment of prednisolone in combination with other anti-allergic drugs. Overseas doctors opinion on the appointment of prednisolone during pregnancy mixed. In Bulgaria, as in Russia, used treatment for miscarriage appointment of prednisolone. appointment of prednisolone for the treatment of habitual abortion is not practiced in the countries of Western Europe.
Effect of prednisolone on pregnancy doctor’s opinion on this issue is ambiguous.
In clinical practice, there are reports about the origin of placental insufficiency, low weight of the newborn, and even death of the fetus in the appointment of a pregnant prednisolone. But there are data to refute damaging and abortifacient effect of prednisone on the fetus.
The number of observations for the development of the pregnancy in the appointment of prednisolone is huge. On the one hand, treatment with prednisolone has enabled women to have children suffering from rheumatism. Women with an increased activity of the immune system able to count on the delivery is on time and only in the suppression of the immune activity of corticosteroids.
Stop the excessive production of male sex hormones (hyperandrogenism) is also possible only with the help of prednisolone. However, long-term use of prednisone were impaired fetal growth, atrophy of the adrenal cortex in the fetus. It was also found that the use of prednisolone poses a threat to the development of placental insufficiency and fetal growth retardation, the threat of the appearance of malformations (cleft palate), the threat of miscarriage.
Observations of local physicians recent years have shown that administration of prednisone in low doses does not cause birth defects in the child, to the psychophysical underdevelopment. Security key to treatment is to clear and strict implementation of all the doctor’s appointments and timely follow-up examinations. The same results were obtained by the insurance company in Michigan Medicaid when analyzing the outcomes of pregnancy in cases of appointment of prednisolone. In general, in the West do not consider safe use of prednisone during pregnancy. It recognizes the possibility of the appointment of glucocorticosteroids only under the threat of premature birth.
Prednisolone used in pregnancy produced in such dosage forms:
tablets (1 mg, 5 mg, 20 mg);
injection ampoules (30 mg and 25 mg in 1 ml) – for intramuscular and intravenous administration;
eye drops (0.5% solution);
ointment (0.5%) – for external use.
Pregnant women may be appointed if necessary, any dosage forms of prednisolone, but only in cases where the expected result is higher than the risk of exposure to the fetus.
Prednisolone administered in case of need in the treatment of the mother and for the effects on the fetus when the threat of premature birth – other corticosteroids (metilpred or dexamethasone). This is due to the fact that placenta is destroyed prednisolone largely, and other drugs – 50%.
Prednisone for long-term use is assigned to the tablets, and in case of emergency – in injections.
Prednisolone prescribed dose should be taken in the strictly same time in the morning after a meal. In no case can not be independently change the dose and time of its reception.
Prednisolone ointment belongs to class 1 of hormonal ointments – that is, weak impact. Ointment is used to treat psoriasis, eczema, atopic dermatitis, neurodermatitis externally. A pregnant woman ointment can be applied when the expected result outweighs the potential risk to the fetus, ie, in exceptional cases.
This may be a situation when the woman before taking such a topical treatment, and its abolition appeared sharp aggravation. This may be a case of acute allergic or inflammatory process in the absence of the effect of other drugs.
The treatment should be limited to small areas of skin and of short duration in time.
Cancel ointment upon receipt effect gradually (to reduce the amount of ointment at a time, the frequency of application of ointment to the skin, lengthening the interval between the application) – as directed by the physician.
According to the instructions, the drug Terzhinan, which includes prednisolone, not dangerous for pregnant women, since it has been found that it is not absorbed into the bloodstream and therefore has no effect on the fetus. Recommendations include Terzhinan Russian medics for the treatment of bacterial vaginosis in pregnant women from the second trimester of pregnancy. It is used in the form of vaginal tablets. Prednisolone eye drops should also be administered during pregnancy with great care and in extreme cases, because of the conjunctival cavity prednisolone can be absorbed into the bloodstream.
Reviews on the use of prednisolone in pregnancy
Available online reviews women taking prednisone during pregnancy, in most cases describe the favorable outcome of the pregnancy and birth of a healthy full-term baby. Such cases are described, even when taking prednisone in the first trimester of pregnancy, during pregnancy. But in a number of comments and referred to cases of miscarriage and premature birth. Although that was the cause of miscarriage (receive prednisolone or the underlying condition of the pregnant woman) – is difficult to judge. We describe a case of a child with an increased growth of hair all over the body. In general we can say that the favorable reviews on the use of prednisolone during pregnancy outweigh the negative. Before use, you need to consult with a specialist.