Slippery Path
During pregnancy, even in the absence of winter ice, the risk of falls slightly increases. This happens for the following reasons:
• displacement of the center of gravity due to deflection anteriorly;
• difficulty in reviewing what is directly under your feet, due to a large belly;
• changes in the nervous system characteristic of pregnant women due to hormonal changes in the body (sluggishness, self-absorption, absent-mindedness, reduced reaction rates to external stimuli);
• As a result of hormonal changes, the mobility of ligaments and joints increases, which predisposes to tucking in the legs, more easily disturbing the balance.
Thus, it becomes clear that winter with its slippery roads, ice-covered phenomena and snowfall greatly increases the risk of falls and related injuries for pregnant women. Falling on a slippery road can lead to bruises, fractures, sprains. Typical signs of these injuries are pain at the site of the injury, difficulty in moving, swelling of the tissues. If such symptoms occur, it is necessary to create immobility of the injured limb and urgently seek medical attention. To reduce pain before the arrival of the "first aid" you can drink paracetamol, which is allowed for use during pregnancy. In no case should you try to fix the affected limb yourself, if you injure your leg - jump on one leg, make sharp movements, step on the injured limb, or wait in the hope that "it will pass by itself". The fall can also trigger a concussion of the brain, the main symptoms of which are short-term loss of consciousness, headache, nausea and vomiting, disorientation in space or time. In the case of such symptoms, even if not very pronounced, you need to see a doctor - call an ambulance.
The obstetrical complications that can develop as a result of a fall include premature detachment of the placenta, the threat of premature birth, the outflow of amniotic fluid. Premature detachment of a normally located placenta is one of the most formidable complications of pregnancy. Normally, the placenta is separated from the uterine wall in the third stage of labor, after the birth of the fetus. As a result of the action of the damaging factor (drop, abdominal strike on the hard surface), the placenta can separate from the fetus in the uterus, which is accompanied by intrauterine bleeding. Clinical manifestations of premature placental abruption are an increase in the tone of the uterus (periodic uterine compaction, accompanied by a feeling of "heaviness" in the lower abdomen), bloody discharge from the genital tract, abdominal pain, development of fetal hypoxia (oxygen starvation) as a result of partial or complete disabling of the placenta . In severe cases, with an extensive detachment area, intrauterine fetal death may occur. However, the probability of this complication in the fall is extremely small.
The threat of termination of pregnancy can be triggered either directly by a traumatic influence on the abdominal area, or due to a drop in stress (fright, excitement, fear of pregnancy outcome, etc.). Manifestations of a threat of termination of pregnancy are an increase in the tone of the uterus, pulling, aching, cutting pains in the abdomen, in some cases - spotting spotting from the genital tract. Spasm (constriction) of the vessels in the mother-placenta-fetus system as a result of stress and an increase in the tone of the uterus can cause the development of intrauterine fetal hypoxia (lack of oxygen). Intrauterine suffering of the fetus may be manifested by an increase or, conversely, a decrease in its motor activity. It should be noted that in some cases, signs of hypoxia can be diagnosed only by using additional research methods (ultrasound, Doppler - evaluation of the speed and nature of blood flow in the vessels of the mother-placenta-fetus system, CTG monitoring of fetal heartbeats), which dictates the need for a doctor for safety, even if you feel fine after the fall. Premature outflow of amniotic fluid can occur as a result of a sharp jump in intrauterine pressure during fall. When the amniotic fluid is overflowed, moist extracts of varying intensity appear on the laundry - from a small moist spot to very abundant ones.
What to do?
When unusual discharges from the vagina appear (blood, suspicion that water flows), abdominal pain, unusual behavior of the baby (excessive motor activity or, on the contrary, sluggish and weak movements), it is necessary urgently to go to the maternity hospital, preferably located in a multidisciplinary hospital, or call an ambulance. The fact is that with a fall, a combined trauma can be excluded, including obstetric and non-obstetric complications. If there is a suspicion of leakage of amniotic fluid, you should clearly remember the time when you notice the discharge, and take advantage of the gasket made of cotton cloth, ironed on both sides with a hot iron, as it will be easier for the doctor to determine the nature of the discharge.
"Underlay straw"
Leaving in the winter on the street, you must follow the safety rules that will help to avoid serious problems:
• Very responsive to the choice of winter shoes: of course, the boots on the high stud will temporarily have to be forgotten, unwanted shoes on a thick platform, as there is an increased danger of tucking the leg. "Ideal" winter footwear for a future mother should have a low stable heel not more than 3-4 cm high; stable sole with good anti-slip properties - that is, either with deep corrugation or with a special tread coating. Also, when choosing a winter shoe, it is necessary to pay attention that it fixes well not only the foot, but also the ankle joint area, as during pregnancy, as a result of increased joint mobility, it is easy to turn the leg and fall.
• Think carefully about your route, avoid narrow icy paths, slides, slippery sidewalks. Look carefully at your feet.
• While walking down the street, do not hold hands in pockets or on the strap of the bag - it's best to take them aside to balance. Walk on the winter road is better small ("semenyaschim") step, with a little bent legs in the knee joints.
• Going down or climbing the stairs, hold on tightly to the railing, choose such a road, walking along which, if necessary, you can grab for any support (fence, rail, etc.).
• In bad weather (a strong blizzard, a recent snowfall, when the tracks are heavily covered with snow, ice, sleet or rain, etc.), it is advisable to stay home for safety reasons. If it is not possible to postpone business, try to have someone accompany you along the way, supporting your hand.
• When dressing on the street, make sure that the abdominal area is well protected by layers of clothing: this can do a good job, significantly softening the impact when falling.
• If you feel that you are falling, you need to do it "competently": group, wrap your arms around your belly (protecting from a blow), bend your knees and "sit down" on your side. This will reduce the height of the fall, and therefore the risk of injury. At falling it is impossible to expose forward the extended hands, as in this case the probability of fractures is high.
• No matter how well you feel, during the pregnancy postpone the traditional winter entertainment - skiing with slides, skates and skis.
We protect ourselves from hypothermia
Another winter hazard is the risk of hypothermia (low temperature effects on the entire body) or frostbite (prolonged cold action on a separate area of the body). The probability of subcooling increases with high humidity, strong wind. The frostbitten limbs (especially the fingers, which are related to the peculiarities of their blood supply) are exposed most quickly, as well as the skin of the open parts of the body - the face, nose, ears. During pregnancy, the intensity of metabolic processes in the body increases, which leads, on the one hand, to excessive sweating, and on the other - to a decrease in the sensitivity of pregnant women to cold: they often complain that they are hot, less likely to freeze, which to some extent increases the probability of freezing . Manifestations of general hypothermia of the body are the pallor and coldness of the skin, a decrease in body temperature below 36 ° C. general weakness, lethargy and indifference, lowering blood pressure and increasing heart rate, drowsiness and disorientation may develop. The initial signs of frostbite are a feeling of numbness in the affected area of the body, a burning sensation and aching pain, the skin acquires a pale, waxy appearance.
With the general supercooling of the body, the expectant mother should be placed as soon as possible in a warm room, warmed up - preferably with a warm bath or shower (with a duration of 40-40 minutes) or covered with a warm blanket, cover with warmers, give hot hot tea and hot food. It is important to remember that the use of hot water to warm the frostbitten skin is unacceptable, as a sharp warming of tissues leads to excessive activation of metabolic processes, which may result in necrosis - necrosis of tissues, which significantly worsens the prognosis and hinders treatment. With gradual warming, the restoration of the circulation of the affected tissues goes in parallel with the normalization of their vital functions, which avoids the severe adverse effects of frostbite. When frostbite, it is necessary to carefully remove the affected limb from clothes or shoes and warm it gradually and slowly, for which the best way is warm (not hot!) Water, the temperature of which needs to be increased gradually from 30 to 40-45 ° C. In no case can you rub the affected finiteness, since in the tissues microcrystallites of ice are formed which, when rubbed, injure the affected organ, which aggravates the situation and worsens the further healing. After warming, the affected area is wiped dry, wiped with alcohol to prevent infection and apply a warm dry bandage (a thick layer of cotton wool and a sterile bandage). If there is a growing pain when warming up, the skin remains pale and cold, you need to urgently go to the department of thermal lesions, purulent-surgical or traumatologic department of the hospital, since these symptoms indicate a deep frostbite.
Negative influence of hypothermia on the organism of a pregnant and future baby can manifest, firstly, as an exacerbation of chronic or the emergence of acute inflammatory diseases (such as pyelonephritis - inflammation of the kidneys, sinusitis - inflammation of the maxillary sinuses, tonsillitis - inflammation of the tonsils, cystitis - inflammation of the bladder, etc.), and secondly, in the form of development of hypoxia (oxygen starvation) of the fetus due to violations of uteroplacental blood circulation.
In order to prevent overcooling or frostbite:
• When the air temperature is below -20-25 ° C, try not to leave the house. In case of emergency, ask that relatives or friends take you to the place by car, call a taxi.
• Do not stay in the open cold air for a long time, especially in windy weather. On the way, go to the store, cafe, do not allow hypothermia.
• It is important to dress properly: if the clothes are too warm, go in a transport or room, you can sweat. Unacceptable and too light clothing, which is dangerous hypothermia. Be sure to wear a hat, gloves, scarf, winter clothing should be at least the mid-thigh level.
• To prevent freezing and excessive sweating will help special thermal underwear (T-shirts, T-shirts, socks, leggings), in a sufficient range presented in stores.
• Shoes must be well sized (tight boots or boots, as well as shoes with a narrowed toe, contribute to the occurrence of frostbite as it increases the circulation of the lower limbs). In properly selected shoes, you can easily move your fingers. It is also important that your feet do not get wet. When you get home, carefully dry your shoes.
• When going out, use special face and hands protection creams. To achieve the effect of applying the cream against frost is better in advance, for z ° ~ 4 ° minutes before going out. The effect of protective creams against frost is based on the formation of a protective film on the skin surface, effectively protecting against damaging effects of cold and wind, and on deep moistening of the skin. In order for the cream to work effectively, absorbed into the deep layers of the skin and formed a film, it is necessary to apply it in advance.
How to avoid SARS and influenza?
Typical diseases of the winter are ARVI (acute respiratory viral infections), a considerable part of which is influenza. The source of the disease becomes a sick person, the path of transmission is airborne. The patient is contagious within 5 days of the onset of the disease (especially the first 2 days after the onset of symptoms), when coughing and sneezing along with droplets of mucus viruses are actively released into the external environment. Pregnant women are at high risk for influenza and ARVI, as the immunity of expectant mothers is reduced, which is a prerequisite for successful pregnancy. This fact leads to a high risk of infection, as well as dangerous in terms of severe course of influenza and acute respiratory viral infection with the development of complicated forms (pneumonia - inflammation of the lungs, bronchitis - inflammation of the bronchi), exacerbation of existing chronic diseases in pregnant women, etc.
The flu is characterized by two groups of symptoms: symptoms of intoxication (fever, chills, headache, weakness, pain in the muscles and joints) and catarrhal phenomena (perspiration and dryness in the throat, the appearance of liquid mucous discharge from the nose, dry painful cough). Especially unfavorable for pregnant women, the virus infection in the first trimester (up to 12 weeks), as during this period there is an active laying of all organs and systems and the penetration of the virus, as well as an increase in body temperature above 38 ° C lasting more than 3 days may be teratogenic impact on the fetus (to provoke the formation of congenital malformations), which can result in spontaneous miscarriage. Influenza at a later date can cause placental insufficiency, premature termination of pregnancy. If symptoms of acute respiratory viral infection or influenza occur, consult a doctor so that the necessary treatment is prescribed for you. Given the unfavorable impact of influenza on the fetus, it becomes evident the importance of carrying out preventive measures aimed at preventing infection with this infection:
• During the epidemic of influenza and SARS, avoid being in crowded areas (public transport, cinemas, shops). If for reasons beyond your control you can not avoid meeting more people, you can use a one-time mask. In order to protect the mask from infection was effective, it must be changed every 2 hours.
• Wash your hands as often as possible, since it is on your hands that we carry the virus particles (from door handles, elevator buttons, etc.) that enter the body. With the same purpose, wash the nasal passages: for this purpose it is good to use drops with sea water (Aquamaris, etc.).
• Onions and garlic, rich in phytoncides, are well known for their antimicrobial properties. For the purpose of prophylaxis, it is useful in moderate amounts, both the use of these foods for food, and the inhalation of their odor.
• To prevent disease, you can lubricate the nasal passages with oxolin ointment, Viferon ointment, Infagel, and also use Grippferon drops. These drugs are approved for use at all stages of pregnancy. Drops Grippferon can also be used for emergency prevention of influenza (when there was a contact with a sick person), since this drug prevents the multiplication of any viruses that get on the mucous membrane of the nose.
• Also, a homeopathic Ocillococcinum preparation is also a remedy for the prevention and treatment of influenza and ARVI in pregnant women.
• If someone from your family who is living in one apartment is ill, it is desirable to isolate him or you for 5 days. If this is not possible, use a mask to prevent the disease (let the mask wear on the patient). It is desirable for healthy people and the diseased to be in different rooms. It is necessary to frequently ventilate the premises, daily to produce wet cleaning, to provide the patient with individual dishes, a towel, disposable handkerchiefs. To prevent infection, use the drugs listed above. Now we know what a cold is dangerous during pregnancy than it threatens the future mother.