Dexamethasone may be administered during pregnancy only for health reasons or if a large number of male sex hormones in the blood interferes with a woman to bear a child. Method of use of dexamethasone for the purpose of correction of hormone use is not the first decade.
Why is a woman's blood can be raised maintenance of male sex hormones
Male sex hormones (androgens) in women are produced in the adrenal cortex and ovaries. Increased secretion of androgens (hyperandrogenism) can only be in one of the bodies or both at once. Male sex hormones compete with women, and if they are too many, this leads to disruption of the menstrual cycle, infertility in women, and the emergence of external features, typical for men - the broad shoulders, narrow pelvis, male pattern body hair, deep voice, and so on. Typically, such women can not get pregnant.
With little hyperandrogenism pregnancy can occur, but the woman bear a child is difficult, because it is the female sex hormones such as progesterone and
Progesterone - norm and pathology
help maintain pregnancy, but in this case their effect is inhibited by androgens.
Adrenal hyperandrogenism often congenital in nature and developed in congenital hyperplasia (overgrowth) of the adrenal cortex. Similar changes can occur in tumors of the adrenal cortex. These disorders are called adrenogenital syndrome (AGS). Ovarian hyperandrogenism generally occurs on the background of polycystic ovaries. Often there are also mixed forms of hyperandrogenism.
Identify which body was the cause of hyperandrogenism is very important for the proper management of pregnancy, as this will depend on the tactics of treatment.
How to identify hyperandrogenism
Characteristic signs of hyperandrogenism in time cause a woman to seek medical care. In this case, it has enough chances to give birth to a healthy baby. To reveal hyperandrogenism explores woman's blood for the presence of androgens and biologically active substances - their predecessors. The urine is determined by the number of decay products of androgens - 17-ketosteroids. Simultaneously, ultrasound examination of the adrenal glands and genitals of the woman.
On the basis of these data revealed not only the presence of hyperandrogenism, and its origin.
Women with hyperandrogenism has no pronounced signs are often faced with the problem of miscarriage
Miscarriage - why you lose the most precious thing?
So today recommended a planned pregnancy with prior complete examination of both spouses and their treatment when necessary.
Treatment with dexamethasone hyperandrogenism
Dexamethasone is used in all kinds of hyperandrogenism, but for different schemes. Treatment of adrenal hyperandrogenism before pregnancy is carried out over a sufficiently long period of time, up to three months under the supervision of laboratory tests. Typically, during this time it may be an unwanted pregnancy.
When ovarian hyperandrogenism to suppress the effects of androgens are appointed usually synthetic versions of progesterone (progestin) that do not have androgenic activity. When mixed types of hyperandrogenism prescribed stages progestins and dexamethasone
Dexamethasone - one of the most effective glucocorticosteroids
. The treatment also lasts for three months.
With early detection and treatment of hyperandrogenism it before pregnancy in women is completely restored menstrual cycle, which contributes to normal fertility. In most cases, women receive hormonal support in the form of dexamethasone and during pregnancy. When adrenal hyperandrogenism appointed dexamethasone throughout pregnancy, ovarian - up to 16-18 weeks, with mixed - up to 35-36 weeks.
If hyperandrogenism revealed already during pregnancy, it is also treated with dexamethasone, but less successfully. At the same time than in the earlier stages of pregnancy, she was identified and treatment is started, the more likely women are to inform pregnant.
The most common complication in the first trimester of pregnancy when androgen is a spontaneous miscarriage in the second - placental insufficiency, and in the third - the lag in the development of the fetus.
Regarding side effects of dexamethasone, the dosages are given to pregnant women are small and normally not cause complications. Much more harm to the fetus brings an increased content of androgens in the blood of the mother.
Women with hyperandrogenism
Hyperandrogenism - if the female body behaves as a male
They are at high risk for complications during pregnancy, so they need special preparatory treatment before pregnancy and continuing it after pregnancy.