Is it possible to take metronidazole during pregnancy – Doctors

Classification and principle of operation

The active ingredient of the drug, metronidazole, is a chemical derivative of nitroimidazole.
Penetrating into the DNA structure of simple microorganisms, the substance suppresses the synthesis of nucleic acids, causing the destruction of bacteria from the inside. In pharmacies you can purchase the drug without a prescription in the form of:

tablets;
vaginal suppositories;
solution for intravenous administration;
gel.

Depending on the complexity and nature of the disease, the doctor prescribes the optimal form of the drug. During pregnancy, it is preferable to use vaginal suppositories and gel. When using these forms of the drug, a minimal amount of active substances penetrates into the systemic circulation.

Side effects of therapy in pregnant women

Provided that the treatment regimen prescribed by the doctor is followed, pregnant women, as a rule, tolerate the therapy quite well. However, the risk of side effects cannot be excluded. The most common are:

allergic manifestations - itching, rash, urticaria, swelling of the nasal mucosa;
gagging;
attacks of nausea;
stool disorder;
intestinal colic;
sometimes a slightly metallic taste in the mouth is possible when taking the product orally;
stomatitis;
decreased appetite;
disorders of the pancreas;
with intravenous administration, pain, hyperemia, and swelling may appear at the injection site;
dizziness;
ataxia;
excitability and irritability;
insomnia;
headache;
depression;
cystitis;
candidiasis;
incontinence;
temporary change in urine color.

Contraindications to the use of the drug

As noted above, the drug Metronidazole cannot be used in the 1st trimester of pregnancy. In addition, the medicine is not used for:

hypersensitivity to its components;
organic diseases of the nervous system (epilepsy);
leukopenia;
liver failure.
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During pregnancy, a woman’s immunity decreases, this becomes a favorable condition for the penetration of pathogenic organisms into the body, as well as the exacerbation of old infectious and inflammatory diseases. One of the drugs that will help a pregnant woman cope with these problems is Metronidazole.

Metronidazole during pregnancy is prescribed for the treatment of urogenital trichomoniasis and nonspecific vaginosis. If these diseases are detected early, treatment is postponed until a later period - the beginning of the second trimester.

The drug is also prescribed to pregnant women for the following diseases:

diseases of the lungs and pleura;
infectious diseases of the digestive and abdominal organs;
some gynecological pathologies;
maxillofacial infectious diseases;
giardiasis;
osteomyelitis;
thrombophlebitis;
ulcer, presence of Helicobacter pylori bacteria in the body.

When prescribing this medication, you need to take into account the list of contraindications, which is quite extensive. The presence of the following diseases makes it impossible to take Metronidazole:

epilepsy, pathologies of the central nervous system;
leukopenia conditions of the body;
allergies and others.

Metronidazole should not be used by a woman while breastfeeding her baby. When prescribing the drug, the presence of individual intolerance to the active substance and auxiliary components must be taken into account. Metronidazole is prohibited in the first trimester.

The use of Trichopolum has its contraindications, these include:

Hypersensitivity to the components of the drug.
Damage to the central nervous system.
First trimester of pregnancy.
Diseases of the hematopoietic organs.
Lactation period.
Kidney failure.
Liver diseases.
Asthma.
Eczema.

Trichopolum acts not only on harmful microorganisms, but also on beneficial ones that are constantly present in the human body. It reduces acidity, which causes the development of an alkaline environment, which promotes the growth of dangerous fungi. This can cause thrush. When taking the drug, dizziness appears and the reaction slows down, so people working with machines and mechanisms, car drivers should be careful when taking this medicine.

Metronidazole and pregnancy

Bacterial vaginosis and other infections can be eliminated with Metronidazole. If the doctor has prescribed this particular remedy, do not panic and refuse treatment just because it seems to you that the remedy will have an effect on the fetus. To prevent negative consequences, it is important to understand the drug.

Metronidazole is used in different dosage forms during pregnancy. There are tablets and gels on pharmacy counters. The dosage, as well as the type of drug, are determined only by the doctor. Of course, no one will forcefully give pills. A woman must be sure that they will not harm her health and the development of her baby. If you are in doubt, you can see another doctor and get advice on the advisability of this remedy.

Regardless of the fact that the drug is prescribed by a doctor, the instructions for use should be studied especially carefully. This will help avoid many complications.

How to take Metronidazole correctly for pregnant women?

Despite the rather impressive list of side effects, most of them can be avoided if the drug is used correctly. During early pregnancy, Metronidazole is not prescribed, and the treatment regimen for later stages is determined individually. The attending physician pays attention to the clinical picture of the disease and the characteristics of the course of pregnancy. Only after this and a thorough diagnosis of the pathology does he select the optimal dosage.

If there are no special prescriptions, it is recommended to take the tablets orally after or during meals, drinking plenty of milk or water. The duration of therapy usually varies from 2 to 4 weeks.

Vaginal suppositories are inserted quite deeply into the vagina after hygiene procedures. It is optimal to administer suppositories in the evening, before bedtime. For pregnant women, the daily dose is 250 mg, but other prescriptions are possible.

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The gel is applied locally to clean skin or mucous surface in a thin layer twice (morning and evening). In case of positive dynamics, the course of therapy is one week or a month if the result is insufficient. At the discretion of the doctor, the duration of taking the drug can be increased.

Reviews from doctors and pregnant women about the drug

Reviews from women taking Metronidazole during pregnancy are generally positive:

Olga, 29 years old: “I was prescribed Metronidazole gel.” My gynecologist told me that it will have absolutely no effect on my baby. I completed the treatment as prescribed. I was treated during the second trimester and slightly into the third. Then she gave birth to a healthy son at full term.”

Olga, 30 years old: “I was prescribed Metronidazole and some other drug for vaginosis during pregnancy. I was due at the beginning of the third trimester. The course of treatment is very short, only 7 days. Everything went quickly and without side effects. Afterwards I gave birth to a healthy child.”

Maria, 26 years old: “I didn’t know I was pregnant, I had to take Metronidazole.” When I turned to the gynecologist, she established the fact of pregnancy and said that this drug should not be taken in the early stages, it is dangerous for the fetus. She said that many people terminate pregnancy if there is a need for treatment. But I didn’t have an abortion. I myself read a lot online that it is prohibited in the first trimester. Of course, I suffered through fear. We did not change the treatment. The disease was defeated. But perhaps I was lucky. I gave birth to a healthy baby on time.”

Bleeding from the uterus

If the discharge after curettage continues for a long time, more than two weeks, and the woman is bothered by pain in the lower abdomen, it can be assumed that complications have arisen.

Severe bleeding after curettage usually develops in women with impaired blood clotting.

This complication is considered an emergency, and the woman requires emergency hospitalization.

This medicine is also prescribed to women after termination of pregnancy or spontaneous miscarriage. Metronidazole, in these cases, promotes faster regeneration of damaged body tissues, and also prevents the entry and spread of infectious agents in a woman’s body that can cause various diseases.

In such cases, most often, the tablet form is prescribed (1 tablet 3 times a day – 1 week).

Curettage

Abdominal curettage (curettage) in gynecology is performed for diagnostic or therapeutic purposes. The procedure is performed on an outpatient basis, under general anesthesia.

As a diagnostic procedure, curettage is prescribed if a woman experiences prolonged heavy bleeding from the uterine cavity. In this case, the doctor usually examines the organ using a hysteroscope, takes a scraping for histological examination, and determines the possible cause of the pathology: fibroids, polyps, malignant neoplasms.

In case of heavy bleeding, this also serves as a necessary therapeutic procedure for a prolonged monthly cycle, when the endometrium of the uterine cavity occupies a large volume, and normal menstrual flow is not enough to “push” it out.

Therapeutic curettage is also prescribed after a frozen pregnancy, miscarriage, or ectopic pregnancy. This procedure is also known as abortion before 12 weeks, which can be performed according to indications, at the request of the woman.

During the period from 12 to 18 weeks of pregnancy, the procedure is carried out exclusively according to medical indications (frozen pregnancy, severe pathologies of the pregnant woman, fetal malformations).

In what cases is curettage of the uterine cavity also indicated:

To stop severe uterine bleeding.
If, after drug treatment, polyps and hyperplasia do not disappear.
For any bleeding after menopause.

Curettage is a minor gynecological operation and is not highly traumatic. But after it, the woman must undergo a recovery period, which includes several mandatory procedures.

Recovery period

During this period, a woman should use only pads. The use of tampons is prohibited.

For the first 5 days after the procedure, a woman may feel pain in the vagina and may be bothered by pain in the lower abdomen.

To relieve unpleasant symptoms in the first two days, a woman is recommended to apply an ice pack to her lower abdomen (for half an hour every two hours).

In women after a frozen pregnancy or abortion, the onset of menstruation is delayed. If menstruation does not occur for more than 2 months, a woman should urgently consult a doctor.

What contraindications are possible

Not all women can take Metronidazole during pregnancy.

There are additional contraindications during this period:

individual intolerance to the active substance or additional components of the drug, allergic reaction;
blood pathologies;
impaired renal function (decompensated form of failure);
dysfunction of the central nervous system or its organic damage;
liver problems;
stomach ulcer or other violations of the integrity of the mucous membrane;
epilepsy.

There may be individual contraindications to the use of Metronidazole, so before using it it is better to consult with your doctor.

General recommendations

After the curettage procedure, a woman should abstain from sexual intercourse, not take a bath, not swim in bodies of water, and not visit the pool or sauna.

What else you can't do:

Use vaginal suppositories, tablets, sprays without a doctor's prescription.
Douche.
Use any intimate hygiene products.
Lift weights.

After two weeks, the woman should visit her doctor. By this time, the results of the histological examination will be known. The doctor may prescribe a control ultrasound. Based on the collected data, repeat curettage may be prescribed.

Metronidazole is a broad-spectrum antiseptic drug that effectively fights a large number of pathogenic microorganisms (not including fungal infections). The medicine is prescribed for the treatment of gynecological, pulmonary diseases, and diseases of the gastrointestinal tract. Thanks to its persistent antibacterial effect, the drug copes well with trichomonas, bacteroid and dysentery infections.

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The action of Metronidazole is based on the penetration of the active component - a chemical derivative of the nitromidazole substance - into the structure of the pathogenic bacterium. At the same time, it interferes with the synthesis of nucleic acid, destroying the microorganism.

Contraindications and possible side effects when taking metronidazole during pregnancy

There is no harmful effect of the drug on the fetus if it is prescribed from the 12th week of pregnancy and later.

However, when taking Trichopolum, side effects may develop that are not related to pregnancy:

from the blood system: drop in the number of leukocytes;
allergic reactions;
from the intestines: diarrhea, loss of appetite, constipation, nausea, metallic taste on the tongue, abdominal pain;
from the nervous system: sleep disturbance, convulsions, problems with coordination of movements, irritability, dizziness, confusion, headache;
change in color of urine to red-brown;
stomatitis.

Contraindications to the use of Trichopolum:

Allergic reactions to the components of the drug.
Leukopenia.
Diseases of the nervous system of an organic nature (epilepsy).
Insufficiency of liver functions.
Pregnancy is only in the first trimester.

Important:

It is unlikely that pregnant women need to be reminded of this, but taking Trichopolum is categorically incompatible with alcohol;
During treatment, you must abstain from sexual intercourse;
In the presence of Trichomonas infection, simultaneous treatment of both the woman and her sexual partner is necessary.

Description of the drug

Metronidazole during pregnancy is usually prescribed to treat bacterial vaginosis, which often accompanies trichomoniasis and sexually transmitted infections. However, it also helps well with other bacterial infections, the pathogens of which actively live without oxygen.

The drug is available in numerous dosage forms:

tablets - used for oral administration;
vaginal suppositories and gel - for placing in the vagina;
cream - for lubricating the skin and mucous membranes;
powder - for preparing a solution and performing injections;
suspension - for oral administration.

It is necessary to understand that when taken externally, the concentration of the active substance is much less than when taken internally. Accordingly, oral administration is more effective. The drug can be taken in several ways:

taking loading doses in two doses;
course of taking one tablet twice a day for seven to ten days.

For pregnant women, the second method of using Metronidazole is preferable, since if a single dosage is too large, the antibiotic can penetrate the placental barrier and harm the baby. You can take the medicine with water or milk. If necessary, the course of treatment should be repeated, however, the interval between taking the drug should not be less than 30 days.

Metronidazole is a fairly strong drug; its components penetrate into all body fluids, and with them into all organs, leaving pathogenic microorganisms no chance. However, according to doctors, Metronidazole does not have a pathological effect on the course of pregnancy. But before using it, the doctor must prescribe a bacterial culture to determine sensitivity to the drug.

The medication is active against harmful protozoan microorganisms (giardia, trichomonas, leishmania, trypanosomes) and pathogens (numerous bacteroides, streptococci, gardnerella). After swallowing a tablet or administering a suppository, the medicine very quickly reaches the source of inflammation and is integrated into the DNA of the pathogenic microbe, as a result of which the process of its division (reproduction) stops. Thanks to this, pathogenic microorganisms die and recovery occurs.

Danger of disease during pregnancy

The causes of bacterial vaginosis have not been fully established by science. The main causative agent of the disease is the anaerobic bacterium Gardnerella vaginalis. When the vaginal flora is disrupted due to pregnancy or taking antibiotics, the microorganism begins to actively multiply. Unprotected sex with an infected partner and the presence of intrauterine contraceptives are also considered risk factors.

Medical studies of the effect of the disease on the female body have shown that it is the root cause of inflammation of the pelvic organs and the development of infections in the vagina.

Very often the disease takes a chronic form, periodically exacerbating. If left untreated, bacterial vaginosis contributes to inflammation of the mucous layer of the uterus and appendages. Serious illnesses such as vaginitis and colpitis, in which a woman suffers from purulent discharge, pain in the female organs, and increased body temperature, are also the cause of inattention to her health. The infection also affects the urinary system. For example, cystitis may develop.

During pregnancy, infection may penetrate into the amniotic fluid and membranes, which can cause miscarriage or premature birth.

There is a risk of infection of the child, as a result of which he may be born premature, have insufficient body weight and suffer from congenital pneumonia. When the placenta is infected, the child inside the mother's womb experiences oxygen starvation, which is fraught with subsequent neurological pathologies. In the postpartum period, such children are often susceptible to skin diseases, as well as inflammation of the umbilical wound.

Bacterial vaginosis can cause endometritis in the postpartum period, especially after cesarean section. The likelihood of purulent mastopathy and poor suture healing is several times higher than in healthy women.

The insidiousness of bacterial vaginosis is that it is often completely asymptomatic. Therefore, special attention is paid to pregnant women with a history of stillbirth, premature birth, or prematurity. In such cases, the diagnosis of the disease is carried out at an early stage of pregnancy for a period of 12-16 weeks.

Instructions for use

The prescription of Metronidazole during pregnancy is carried out by a doctor, taking into account the age and body weight of the patient, as well as the gestational age. Metronidazole tablets can be taken regardless of meals, but to reduce unwanted effects on the gastrointestinal tract, it is better to take the medicine immediately after a meal with water or milk. The daily dose is divided into 2-3 doses to reduce undesirable effects on the digestive system of the expectant mother.

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Depending on the disease, the dose may vary, for example:

For trichomoniasis - one tablet twice a day for a course of 10 days. The acute form involves increasing the dose to 400 ml (course - 8 days) in parallel with the use of vaginal suppositories.
For dysentery, the therapeutic course lasts 6-10 days. It is necessary to take 2.25 g of medication per day, dividing the dose into several doses throughout the day.
For giardiasis, a weekly course of Metronidazole is prescribed at 0.75-1 g per day.
For stomatitis with the presence of ulcers in the mouth, the course of treatment is 5 days, two pills twice a day.

Treatment of trichomoniasis and vaginitis is accompanied by vaginal use of the drug once a day for a week or 10 days, depending on the prescription of the obstetrician-gynecologist. Parallel sanitization of the sexual partner and the exclusion of intimate intimacy for the period of taking the drug are considered mandatory. The maximum permissible duration of treatment with Metronidazole is 10 days. It is possible to conduct 3 courses per year, no more.

Metronidazole solution for intravenous administration is used only in hospital settings - 100 ml is administered on the first day of treatment, and 1 g per day in the next 3 days. If the patient has kidney problems, the time between droppers should be increased to 12 hours.

Along with vaginal suppositories and tablets, the drug is used in gel form. Before use, you need to clean or rinse the mucous membrane well and apply a pea-sized amount of gel on it evenly. The course of treatment lasts 10 days, 2 times a day. This form of the drug provides effective treatment for seborrhea, eczema, hemorrhoidal fissures, and ulcers.

The instructions for Metronidazole indicate that its use is contraindicated in the first trimester of pregnancy. Caution is recommended during the II-III trimesters. Why then is it prescribed for therapy for pregnant women?

Many pharmaceutical companies recommend refraining from taking medications during this period due to insufficient knowledge of its effects on the fetus. But, in fairness, it should be said that, at the moment, only 30% of all manufactured drugs have undergone full scientific research on this issue. This is due to the fact that monitoring the safety of drugs is quite complex and time-consuming.

Dosage

When using the drug "Metronidazole" during pregnancy, you must follow the recommendations for use: take one tablet (250 mg) orally 2 times a day. Take the drug with milk or water. The course of treatment is usually 10 days. If necessary, after laboratory tests, the course of therapy can be repeated. It is necessary to take a break of at least a month between courses. Simultaneously with oral administration of the medication, it is recommended to use Metronidazole vaginal suppositories for a week (1-2 times a day).

Vaginal products

To enhance the therapeutic effect, as well as in case of contraindications for oral administration of medications, the doctor may resort to local treatment. Vaginal products are available in the form of suppositories, gels, and creams containing metronidazole.

This treatment is quite effective for bacterial vaginosis. To administer a dose of gel or cream, use applicators that are included with the medication.

The course of local therapy ranges from 5 to 7 days, when administered in the morning and evening.

After completing the full course, the woman undergoes repeated tests of the discharge to determine the success of the treatment. The doctor monitoring the pregnant woman will periodically order repeated laboratory tests of the vaginal contents. The fact is that relapses of the disease are not so rare. And in order not to miss it, preventive examinations are used.

The medication is an antiprotozoal drug with excellent antibacterial effects. The drug actively gets rid of a large number of pathogenic microorganisms that lead to the development of various ailments. After its use, trichomonas, bacteroides, dysentery and other manifestations can be cured.

During pregnancy, the medication should be taken with caution, as components penetrate into the placenta, which can negatively affect the fetus. The drug is eliminated through the kidneys and intestines.

The drug contains metronidazole, which is an active ingredient. It is a chemical derivative of a nitroimidazole substance. The active component, having entered the body, strives to penetrate the DNA structure of the simplest microorganism, where it suppresses nucleic acid synthesis and also destroys the pathogenic bacterium from the inside.

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Effect on the fetus by trimester and special points

Metronidazole is prohibited for use during the 1st trimester of pregnancy. It affects the formation of tissues and organs of the developing fetus. This is the time when all the most important systems of the human body are laid down. Therefore, use is prohibited in the 1st trimester.

In the 2nd and 3rd trimester, the effect of the substance on the fetus is minimal or eliminated. Therefore, the drug is sometimes used to treat the pathological conditions described above in pregnant women.

The use of a suppository or gel during the second and third trimesters is completely safe. But this does not mean that a pregnant woman can use the product without consulting a doctor. Suppositories and gel have a good local effect, without entering the fetal membranes with the bloodstream.

If the drug is prescribed by a doctor, then all recommendations and dosage should be followed. It is necessary to complete the treatment to cope with the infection and prevent relapses.

It is important to comply with the storage conditions of the drug. Tablets are stored at room temperature, which does not exceed 25 degrees. Candles should be kept in the refrigerator. It is important not to use the drug in any form after the expiration date has expired.

In early pregnancy and lactation, if necessary, an analogue of the drug with less toxic effect on the fetus and child is selected.

After treatment with Metronidazole, the doctor often prescribes rehabilitation therapy. The fact is that this remedy can disrupt the microflora. After administration, a course of probiotics and prebiotics is required. They can be either local (in the vagina) or general (oral). In addition, some hygiene requirements must be observed:

protected sexual intercourse;
appropriate hygiene;
diet;
systematic observation by a doctor.