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Современный взгляд на проблему запора в период беременности
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Аннотация
В статье освещаются современные представления об этиологии, патогенезе запоров беременных. Изложены принципы диагностики и лечения запоров в период беременности. Обсуждается приемлемость и эффективность современных слабительных средств у женщин в период беременности. Представлен собственный опыт применения препарата из семян подорожника в акушерской практике.
Ключевые слова: запор беременных, слабительные средства, нарушение моторной функции кишечник, псиллиум, семена подорожника.
Ключевые слова: запор беременных, слабительные средства, нарушение моторной функции кишечник, псиллиум, семена подорожника.
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The article highlights the modern views of the etiology, pathogenesis of constipation during pregnancy. Set out the principles of diagnosis and treatment of constipation during pregnancy. We discuss the suitability and effectiveness of modern laxatives in women during pregnancy. Presented own experience use of the drug of the psyllium in obstetric practice.
Key words: constipation of pregnancy, laxatives, violation of the motor function of the intestine, psyllium seeds.
Полный текст
Список литературы
1. Bradley CS et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110: 1351–7.
2. Cullen G, O'Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol 2007; 21: 807–18.
3. Ponce J et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20: 56–61.
4. Meier PR, Nickerson HJ, Olson KA et al. Prevention of iron deficiency anemia in adolescent and adult pregnancies. Clin Med Res 2003; 1: 29–36. Milman N, Byg KE, Bergholt T et al. Side effects of oral iron prophylaxis inpregnancy – myth or reality? Acta Haematol 2006; 115: 53–7.
5. Zygmunt M, Heilmann L, Berg C et al. Local and systemic tolerability of magnesiumsulphate for tocolysis. Eur J Obstet Gynecol Reprod Biol 2003; 107: 168–75.
6. Gill RC, Bowes KL, Kingma YJ. Effect of progesterone on canine colonic smooth muscle. Gastroenterology 1985; 88: 1941–7.
7. Christofides N, Ghatei M, Bloom S et al. Decreased plasma motilin concentrations in pregnancy. Br Med J (Clin Res Ed) 1982; 285 (6353): 1453–4.
8. Zhonghua Fu Chan Ke Za Zhi. Relation between motilin concentration and progesterone level in normal pregnancy and early postpartum. 1993; 28 (9): 524–6, 568.
9. Kiaii B, Xu QW, Shaffer EA. The basis for progesterone impairment of gallbladder contractility in male guinea pigs in vitro. J Surg Res 1998; 79 (2): 97–102.
10. Kern F, Everson GT, DeMark B et al. Biliary lipids, bile acids, and gallbladder function in the human female. Effects of pregnancy and the ovulatory cycle. J Clin Invest 1981; 68: 1229–42.
11. Bani D, Baccari MC, Quattrone S et al. Relaxin depresses small bowel motility through a nitric oxide-mediated mechanism. Studies in mice. Biol Reprod 2002; 66 (3): 778–84.
12. Shah S, Hobbs A, Singh R et al. Gastrointestinal motility during pregnancy: role of nitrergic component of NANC nerves. Am J Physiol Regul Integr Comp Physiol 2000; 279 (4): R1478–85.
13. Xiao ZL, Pricolo V, Biancani P, Behar J. Role of progesterone signaling in the regulation of G-protein levels in female chronic constipation. Gastroenterology 2005; 128 (3): 667–75.
14. Curtis SL, Marsden-Williams J, Sullivan C et al. Current trends in the management of heart disease in pregnancy. Int J Cardiol 2009; 133 (1): 62–9.
15. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. J Obstet Gynaecol Br Commonw 1970; 77 (7): 616–9.
16. Ерофеев Н.П., Радченко В.Г., Селиверстов П.В. Клиническая физиология толстой кишки. Механизмы действия коротко-цепочечных жирных кислот в норме и при патологии. Монография. СПб.: Форте Принт, 2012.
17. Choijookhuu N, Sato Y, Nishino T et al. Estrogen-dependent regulation of sodium/hydrogen exchanger-3 (NHE3) expression via estrogen receptor b in proximal colon of pregnant mice. Histochem Cell Biol 2012; 137 (5): 575–87, doi: 10.1007/s00418-012-0935-2. Epub 2012.
18. Лоуренс Д.Р., Беннит П.Н. Клиническая фармакология. Пер. с англ. М., 1988. Т. 2.
19. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006; 131 (1): 283–311.
20. Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001; 2: CD001142.
21. Warnecke G. Darmregulation in der Gynakologie durch biologische Verbesserung der Motilitat. Med Welt 1985; 36: 1011–3.
2. Cullen G, O'Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol 2007; 21: 807–18.
3. Ponce J et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20: 56–61.
4. Meier PR, Nickerson HJ, Olson KA et al. Prevention of iron deficiency anemia in adolescent and adult pregnancies. Clin Med Res 2003; 1: 29–36. Milman N, Byg KE, Bergholt T et al. Side effects of oral iron prophylaxis inpregnancy – myth or reality? Acta Haematol 2006; 115: 53–7.
5. Zygmunt M, Heilmann L, Berg C et al. Local and systemic tolerability of magnesiumsulphate for tocolysis. Eur J Obstet Gynecol Reprod Biol 2003; 107: 168–75.
6. Gill RC, Bowes KL, Kingma YJ. Effect of progesterone on canine colonic smooth muscle. Gastroenterology 1985; 88: 1941–7.
7. Christofides N, Ghatei M, Bloom S et al. Decreased plasma motilin concentrations in pregnancy. Br Med J (Clin Res Ed) 1982; 285 (6353): 1453–4.
8. Zhonghua Fu Chan Ke Za Zhi. Relation between motilin concentration and progesterone level in normal pregnancy and early postpartum. 1993; 28 (9): 524–6, 568.
9. Kiaii B, Xu QW, Shaffer EA. The basis for progesterone impairment of gallbladder contractility in male guinea pigs in vitro. J Surg Res 1998; 79 (2): 97–102.
10. Kern F, Everson GT, DeMark B et al. Biliary lipids, bile acids, and gallbladder function in the human female. Effects of pregnancy and the ovulatory cycle. J Clin Invest 1981; 68: 1229–42.
11. Bani D, Baccari MC, Quattrone S et al. Relaxin depresses small bowel motility through a nitric oxide-mediated mechanism. Studies in mice. Biol Reprod 2002; 66 (3): 778–84.
12. Shah S, Hobbs A, Singh R et al. Gastrointestinal motility during pregnancy: role of nitrergic component of NANC nerves. Am J Physiol Regul Integr Comp Physiol 2000; 279 (4): R1478–85.
13. Xiao ZL, Pricolo V, Biancani P, Behar J. Role of progesterone signaling in the regulation of G-protein levels in female chronic constipation. Gastroenterology 2005; 128 (3): 667–75.
14. Curtis SL, Marsden-Williams J, Sullivan C et al. Current trends in the management of heart disease in pregnancy. Int J Cardiol 2009; 133 (1): 62–9.
15. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. J Obstet Gynaecol Br Commonw 1970; 77 (7): 616–9.
16. Ерофеев Н.П., Радченко В.Г., Селиверстов П.В. Клиническая физиология толстой кишки. Механизмы действия коротко-цепочечных жирных кислот в норме и при патологии. Монография. СПб.: Форте Принт, 2012.
17. Choijookhuu N, Sato Y, Nishino T et al. Estrogen-dependent regulation of sodium/hydrogen exchanger-3 (NHE3) expression via estrogen receptor b in proximal colon of pregnant mice. Histochem Cell Biol 2012; 137 (5): 575–87, doi: 10.1007/s00418-012-0935-2. Epub 2012.
18. Лоуренс Д.Р., Беннит П.Н. Клиническая фармакология. Пер. с англ. М., 1988. Т. 2.
19. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006; 131 (1): 283–311.
20. Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001; 2: CD001142.
21. Warnecke G. Darmregulation in der Gynakologie durch biologische Verbesserung der Motilitat. Med Welt 1985; 36: 1011–3.
________________________________________________
1. Bradley CS et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110: 1351–7.
2. Cullen G, O'Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol 2007; 21: 807–18.
3. Ponce J et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20: 56–61.
4. Meier PR, Nickerson HJ, Olson KA et al. Prevention of iron deficiency anemia in adolescent and adult pregnancies. Clin Med Res 2003; 1: 29–36. Milman N, Byg KE, Bergholt T et al. Side effects of oral iron prophylaxis inpregnancy – myth or reality? Acta Haematol 2006; 115: 53–7.
5. Zygmunt M, Heilmann L, Berg C et al. Local and systemic tolerability of magnesiumsulphate for tocolysis. Eur J Obstet Gynecol Reprod Biol 2003; 107: 168–75.
6. Gill RC, Bowes KL, Kingma YJ. Effect of progesterone on canine colonic smooth muscle. Gastroenterology 1985; 88: 1941–7.
7. Christofides N, Ghatei M, Bloom S et al. Decreased plasma motilin concentrations in pregnancy. Br Med J (Clin Res Ed) 1982; 285 (6353): 1453–4.
8. Zhonghua Fu Chan Ke Za Zhi. Relation between motilin concentration and progesterone level in normal pregnancy and early postpartum. 1993; 28 (9): 524–6, 568.
9. Kiaii B, Xu QW, Shaffer EA. The basis for progesterone impairment of gallbladder contractility in male guinea pigs in vitro. J Surg Res 1998; 79 (2): 97–102.
10. Kern F, Everson GT, DeMark B et al. Biliary lipids, bile acids, and gallbladder function in the human female. Effects of pregnancy and the ovulatory cycle. J Clin Invest 1981; 68: 1229–42.
11. Bani D, Baccari MC, Quattrone S et al. Relaxin depresses small bowel motility through a nitric oxide-mediated mechanism. Studies in mice. Biol Reprod 2002; 66 (3): 778–84.
12. Shah S, Hobbs A, Singh R et al. Gastrointestinal motility during pregnancy: role of nitrergic component of NANC nerves. Am J Physiol Regul Integr Comp Physiol 2000; 279 (4): R1478–85.
13. Xiao ZL, Pricolo V, Biancani P, Behar J. Role of progesterone signaling in the regulation of G-protein levels in female chronic constipation. Gastroenterology 2005; 128 (3): 667–75.
14. Curtis SL, Marsden-Williams J, Sullivan C et al. Current trends in the management of heart disease in pregnancy. Int J Cardiol 2009; 133 (1): 62–9.
15. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. J Obstet Gynaecol Br Commonw 1970; 77 (7): 616–9.
16. Ерофеев Н.П., Радченко В.Г., Селиверстов П.В. Клиническая физиология толстой кишки. Механизмы действия коротко-цепочечных жирных кислот в норме и при патологии. Монография. СПб.: Форте Принт, 2012.
17. Choijookhuu N, Sato Y, Nishino T et al. Estrogen-dependent regulation of sodium/hydrogen exchanger-3 (NHE3) expression via estrogen receptor b in proximal colon of pregnant mice. Histochem Cell Biol 2012; 137 (5): 575–87, doi: 10.1007/s00418-012-0935-2. Epub 2012.
18. Лоуренс Д.Р., Беннит П.Н. Клиническая фармакология. Пер. с англ. М., 1988. Т. 2.
19. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006; 131 (1): 283–311.
20. Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001; 2: CD001142.
21. Warnecke G. Darmregulation in der Gynakologie durch biologische Verbesserung der Motilitat. Med Welt 1985; 36: 1011–3.
Авторы
Ю.Б.Успенская
ГБОУ ВПО Первый МГМУ им. И.М.Сеченова Минздрава РФ
ГБОУ ВПО Первый МГМУ им. И.М.Сеченова Минздрава РФ
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J.B.Uspenskaya
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