Pregnancy - is a very important period in the life of a woman. From pregnancy and childbirth depends on the health of not only the future mother but also the baby. Equally important during childbearing has qualitative and quantitative status of amniotic fluid or amniotic fluid. For their study used a variety of methods, including the method for determination of amniotic fluid index. To simplify the work of several of the doctor-diagnostician in ultrasound devices there are special programs for calculating the index of amniotic fluid and amniotic fluid standard table. It is for these data we can determine the pathology of amniotic fluid, such as oligohydramnios or polyhydramnios.

Amniotic fluid

The amniotic fluid or amniotic fluid is an aqueous medium in which the fetus develops. In the formation of amniotic fluid are many factors involved. These include: the urinary system of the fetus, amnion (water jacket or bag of waters), the skin of the fruit.

For example, a ten-term, its volume is equal to thirty milliliter of eighteen weeks, he has already reached four hundred milliliters, but by the end of pregnancy is one - one and a half liters. Functions of amniotic fluid are varied and numerous:

• amniotic fluid prevents the pressure from the outside;
• amniotic fluid provide the optimum temperature for the life of the unborn child (about 37 degrees);
• creating an atmosphere of peace;
• amniotic fluid protects the fetus from infection;
• It was in the amniotic fluid the fetus receives the full freedom of movement;
• amniotic fluid involved in the formation of immune Immunity - types and characteristics in children in adults   the child;
• amniotic fluid plays an important role in the generic process (cervix uteri).

Methods of study of amniotic fluid

As noted above, there are methods of amniocentesis as to calculate its volume, and for studying the qualitative composition. These include:

• ultrasound treatment and fruit;
• calculation of the index of amniotic fluid at special tables (for the determination of water scarcity or polyhydramnios);
• Fetal cardiotocography (CTG);
• amnioscopy (inspection of water front, or membranes amnioscopy);
• amniocentesis (puncture of the amniotic sac and water sampling for analysis).

Amniotic fluid index

Amniotic fluid index is calculated to determine the amount of amniotic fluid. It can be defined as an objective way, and subjective.

• Objective definition AFI (amniotic fluid index)

Medical diagnostic ultrasound on by a thorough scan of the uterus in transverse and longitudinal sections of notes the amount of amniotic fluid. For example, about polyhydramnios indicates an increased amount of water located between the anterior abdominal wall and the child.

• The subjective definition of AFI

In this case, also resorted to using ultrasound. The uterus is divided into four quadrants by lines perpendicular to each other (longitudinal line extends along the white line of the abdomen, and the transverse parallel navel). Each quadrant measured maximum upper pocket. The values ​​of these pockets are formed, and the result is an index of amniotic fluid.

These tables amniotic fluid

The data obtained by ultrasound compared with tables of amniotic fluid. For every ultrasound machine has its own table. Example table:

The first column of numbers represents the gestational age in weeks. The second and third are the lower and upper limit of normal AFI (in millimeters).

• 16: 73 - 201
• 17: 77 - 211
• 18: 80 - 220
• 19: 83 - 225
• 20: 86 - 230
• 21: 88 - 233
• 22: 89 - 235
• 23: 90 - 237
• 24: 90 - 238
• 25: 89 - 240
• 26: 89 - 242
• 27: 85 - 245
• 28: 86 - 249
• 29: 84 - 254
• 30: 82 - 258
• 31: 79 - 263
• 32: 77 - 269
• 33: 74 - 274
• 34: 72 - 278
• 35: 70 - 279
• 36: 68 - 279
• 37: 66 - 275
• 38: 65 - 269
• 39: 64 - 255
• 40: 63 - 240
• 41: 63 - 216
• 42: 63 - 192

For example, if within 24 weeks of the amniotic fluid index is 250 millimeters, this indicates polyhydramnios. And if the AFI in the same period is 156 millimeters - it says the normal amount of water.

Anna Sozinova

The instructions to trentalu developed by the manufacturer (Indian farmatsevitcheskoy Aventis Pharma) stated that trental during pregnancy is contraindicated. However, this drug is widely used for the treatment of various circulatory disorders from occurring in this difficult for women period.

Circulatory disorders that may occur during pregnancy

Any violation of blood circulation during pregnancy may pose a risk to the fetus. In the second half of pregnancy in women can begin this complication as late toxicosis of pregnancy or preeclampsia. This condition is closely related to the stagnation of blood in the very small blood vessels - the capillaries, causing first swelling (fluid propotevaet through the walls of blood vessels), and then changes in the kidney (high blood pressure and protein in the urine), and finally by the head brain (headache, convulsions, coma).

Today, all pregnant women are under the constant supervision of an obstetrician-gynecologist of female consultation, so severe gestosis are very rare, they are usually treated at the stage of edema.

Another cause of circulatory disorders during pregnancy is fetoplacental insufficiency (FPI). It is poor circulation in the mother - placenta - fetus. Usually, it is caused by persistent spasm of blood vessels of the placenta, which is why the fetus does not receive oxygen and nutrients. Moreover, against the stagnation of blood in the blood vessels of the placenta may form thrombi. With little FPN child may be perinatal damage the nervous system and a mild developmental delay, with significant blood circulation in the placenta - severe brain damage, premature birth and stillbirth.

For what purpose trental administered during pregnancy

During pregnancy are particularly important drugs that restore normal blood circulation, one of these drugs is trental. The manufacturers of this drug is not recommended for use during pregnancy due to the fact that it is not carried out adequate clinical studies of its effects on pregnant women. However, in practice, the drug is widely used, as in this case, the potential benefits from its use exceeds the potential risk to the fetus. Of course, this drug appoint a pregnant woman (like all drugs) should be a doctor.

Trental promotes vasodilation placenta, prevents platelet adhesion (prevention of thrombus formation) and reduce the blood viscosity returns erythrocytes normal configuration, whereby they can carry more oxygen to tissues.

This action helps reduce circulatory disorders and gestosis, and fetoplacental insufficiency. Trental is usually administered in a long-acting tablets (trental - 400), which is enough to take once a day. The duration of treatment prescribed by a doctor.

With fast-paced circulatory failure in pregnant women trental can be administered intravenously.

In some cases, pregnant women are not trental appointed

Trental pills not prescribed to pregnant women with peptic ulcer disease - it irritates the stomach lining. In addition, it trental not indicated for increased bleeding or suspected internal bleeding (such as bleeding in the retina of the eye). After 33 weeks of pregnancy trental try not to prescribe, as it can lead to bleeding during delivery or cesarean section. Not appointed trental well as porphyria (inborn errors of metabolism, which is accompanied by photophobia) and hypersensitivity to trentalu and other xanthine derivatives (eg caffeine).

For intravenous trental contraindications include cardiac arrhythmias, marked atherosclerosis Atherosclerosis - a chronic disease of the arteries   cardiac or cerebral arteries, very low blood pressure.

Side effects

In most cases trental well tolerated, but there are side effects. Especially dangerous for a pregnant woman from the side effects of the cardiovascular system, such as a sharp drop in blood pressure Blood pressure - dangerous if his swing? , Tachycardia, cardiac arrhythmias, heart pain Pain in the heart - always consult a doctor Progression of angina.

Less common side effects on the central nervous system - headache, dizziness Dizziness - if the ground is slipping from under his feet , A constant feeling of anxiety, insomnia, sudorzhnaya readiness.

Most changes occur from the gastrointestinal tract, liver and biliary tract, which appear dry mouth, appetite disorders, atonic constipation (violation of motor activity of the intestine, which is poorly tolerated by pregnant who have and so there is a tendency to constipation), exacerbation of diseases of the gall bladder and bile ducts of the liver.

There are also visual disturbances, changes in the blood (decrease in the number of blood cells and reducing its clotting ability), redness of the skin in the form of a "tide", swelling, allergic reactions.

Galina Romanenko