Angina during pregnancy in the first trimester

The early stages of pregnancy are characterized by a special period for the fetus. It is in the first months that the organs are laid, the beginning of their development. Any negative influence from external factors or the body of a pregnant woman can lead to serious disorders, the development of intrauterine abnormalities.

For 9 months, a woman's body is exposed to infectious pathogens, which is due to a decrease in the protective functions of the immune system. In this regard, you need to be more attentive to your health, regularly undergo medical examinations.

Influence of sore throat on pregnancy

Depending on the prevalence of the pathological process, angina during pregnancy can take the form of:

• local (limited) infectious focus, when the pathogen and its action are localized only in the tissue of the tonsils;
• a common process is characterized by damage to the surrounding tissues, structures with the formation of abscesses, for example, the soft palate, uvula, posterior pharyngeal wall, regional lymph nodes;
• the toxic form is manifested by the generalization of infection, when pathogenic microorganisms penetrate into the general bloodstream, provoking the development of diseases of distant organs, for example, kidneys, joints, myocardium. This form leads to infectious toxic shock, which is life-threatening not only for the pregnant woman, but also for the fetus (spontaneous abortion).

In the case of a local infectious process, the condition of the unborn child does not suffer, since the immunity of women is able to keep the disease in a limited form, preventing the spread of pathogens.

Early diagnosis and proper treatment prevent complications from angina in early pregnancy.

When does angina lead to undesirable consequences?

In the 1st trimester, the organs of the fetus are laid, on which the development and health of the unborn child subsequently depends. When should you be afraid of tonsillitis?

• If the disease is misdiagnosed, as a result of which the treatment tactics also turn out to be ineffective. Having established the viral origin of the disease, for example, ARVI, a woman begins to take antiviral drugs that have absolutely no effect on bacterial pathogens. As a result, streptococcus continues to multiply, tonsillitis progresses, and generalization of the infectious process occurs.
• Incorrect treatment approach. In the catarrhal form, the use of antibacterial drugs can be avoided, however, provided that the use of local antiseptics is started early. With the progression of the disease, follicular, lacunar tonsillitis develops, which require the use of antibacterial agents. Without antibiotic therapy, the pathogen enters the bloodstream, spreads throughout the body.
• Taking dangerous medications. In the early stages of pregnancy, fetal organs are formed. The use of antibacterial agents that have a toxic effect on the unborn child increases the risk of congenital anomalies. Some groups of antibiotics penetrate the placental barrier, thereby disrupting the laying of organs and systems.

Complications of sore throat

Why do complications develop in pregnant women after a sore throat? The functioning of the immune system consists in the synthesis of antibodies during the penetration of infectious pathogens into the body through the respiratory tract, in an alimentary way. Antibodies are specific proteins that are produced in response to the circulation of foreign antigens in the bloodstream. Their task is to destroy the infection through the interaction of antibodies with antigens.

With the generalization of the infectious process, when streptococcus enters the general bloodstream, the immune system synthesizes antibodies. However, it is worth noting that streptococcus in its structure has a complex of antigens, which is similar to the antigens of the cardiac muscle, joints, renal and other tissues. As a result, the immune system begins to react to its own tissues as to a foreign object.

The production of antibodies in the first weeks of pregnancy against their proteins leads to organ damage and severe complications. All undesirable consequences can be divided into subgroups.

General complications develop as a result of the launch of a cascade of reactions caused by the contact of antibodies with antigens, as a result of which damage to the myocardium, kidneys, and joints is diagnosed.

1. Rheumatic myocardial damage is the most common complication. The development of rheumatic fever occurs due to the production of antibodies against the connective tissue by the immune system. Damage to the heart muscle leads to the formation of valvular heart disease, which is a serious complication. With inflammation of the myocardium, myocarditis is diagnosed. The woman begins to worry about chest pains, shortness of breath, malaise, while the temperature remains within normal limits. With the progression of inflammation, heart murmurs are auscultated, rhythm disturbances occur, and hyperthermia is recorded. In turn, arrhythmias increase the risk of thromboembolic complications. When the inner cardiac membrane is damaged, endocarditis occurs, which cannot be established at the initial stage due to the absence of angina pectoris. Symptomatically, the disease is manifested by hyperthermia, shortness of breath, thickening of the phalanges of the fingers. When distributing of the inflammatory process, pericarditis develops on the outer shell of the heart. A dry type of pericarditis will be manifested by angina pectoris, which intensifies when turning, taking a deep breath, radiating to the left side. In the case of an exudative form, there is an accumulation of fluid in the pericardial cavity, which leads to compression of the heart. From the clinical symptoms, it is worth highlighting shortness of breath, pain in the heart area, and swallowing disorders. With the progression of these complications, heart failure develops.
2. In the period 1-2 weeks after the transferred tonsillitis, the treatment of which turned out to be ineffective, the risk of renal lesion increases. Often, pyelonephritis, glomerulonephritis, registered as the second most common type of complications, develops. Symptomatic pyelonephritis is manifested by high fever, chills, pain in the lumbar region, dysuric disorders (frequent urination). In urine tests, an increased number of bacteria and leukocytes are recorded. With glomerulonephritis, a woman is worried about arterial hypertension, swelling, the appearance of blood in the urine. In urine tests, microhematuria, proteinuria (increased protein levels) are detected.
3. If the time to start treatment for angina is missed, the joints may be damaged. Arthritis is manifested by an increase in the volume of the joint due to tissue edema, pain during movement, redness of the skin over the joints, and limited mobility. Several joints of the legs (knee, ankle) are usually affected. In the case of a rheumatic attack, large, small joints of the upper limbs and other localization are affected (migratory arthritis).
4. Sepsis is much less common, but it must be remembered.

Complications of angina provoke fetal hypoxia, as a result of which severe malformations develop. The risk of intrauterine death, fetal asphyxia, and spontaneous abortion also increases..

Local complications are represented by local changes, which are much easier to cope with than in the case of damage to the whole organism.

• Otitis media is often observed after a catarrhal form of tonsillitis, but inflammation of the middle ear is possible in other forms of the disease. Symptomatically, otitis media is manifested by subfebrile hyperthermia, pain, general malaise. With the progression of the pathology, hearing decreases up to a complete loss. Also, the development of mastoiditis is not excluded, when the appearance of an inflammatory focus in the area of ​​the mastoid process is noted. In this case, the soreness is localized behind the ear.
• Abscess, phlegmon of cellulose is recorded after follicular, lacunar sore throat, when pus spreads to the tissues around the tonsils. An abscess is distinguished by clear boundaries of purulent inflammation, which is presented in the form of a cavity, while phlegmon is a diffuse inflammation with a purulent component. Clinically, pathology can be suspected on the basis of febrile fever, intense pain in the throat, enlargement, soreness of closely located lymph nodes. Due to severe pain, swallowing is difficult, appetite decreases.
• Laryngeal edema is a dangerous complication. As it increases, the voice changes, a cough appears, but the woman cannot clear her throat. Breathing gradually becomes difficult (at first, inhale, then exhale), severe shortness of breath worries. The skin becomes bluish. At this time, the fetus experiences a severe lack of oxygen, suffers from hypoxia. Without timely assistance, the risk of mortality increases, both for the pregnant woman and the fetus.
• Bleeding develops against the background of phlegmonous tonsillitis. This occurs as a result of damage to the blood vessels that feed the tonsils through purulent fusion. Bleeding cannot be stopped without qualified medical care.

Side effects of antibacterial agents

Angina in the first trimester of catarrhal pregnancy can be treated without antibiotics. However, strict medical supervision is required over the condition of the woman, the unborn child. A quick start of treatment, adherence to all the doctor's recommendations allows you to avoid the progression of the disease.

Other forms of tonsillitis require antibiotic therapy. The wrong choice of drugs leads to serious consequences for the fetus. Let us examine which antibacterial drugs are allowed to be taken during pregnancy.

The group of safe antibiotics includes penicillins (Amoxiclav, Augmentin), cephalosporins (Cefepim, Ceftriaxone), macrolides (Sumamed). These medicines are prescribed by a doctor in a therapeutic dosage to combat infectious pathogens. The drugs do not harm the fetus, therefore they are widely used for use in obstetrics.

Prohibited drugs include:

• aminoglycosides due to the negative effect on the organs of hearing, kidneys;
• Metronidazole (prohibited when angina is in early pregnancy);
• sulfonamides provoke the appearance of jaundice;
• tetracyclines contribute to the development of dental anomalies, bone structures;
• fluoroquinolones lead to abnormalities of the cartilage tissue of the joints;
• Clindamycin can accumulate in the liver of the fetus.

Gentamicin, Chloramphenicol have many side effects for the fetus, so they are also contraindicated throughout pregnancy. Their use leads to mutations.

How can complications be avoided?

When pregnancy and sore throat are observed in the early stages, the consequences can be very serious, therefore it is necessary to consult a doctor in a timely manner. What is needed to avoid complications after tonsillitis?

• Strict bed rest (at least a week) if you suspect a sore throat, plenty of warm drinks, diet food with the exception of spicy, fatty, solid foods, meals.
• Antibacterial drugs.
• Gargling with antiseptic solutions (Chlorophyllipt, Miramistin, Furacilin), herbal solutions (Rotokan). When using herbal infusions, it should be remembered that some herbs affect the hormonal background, the tone of the uterus, which is fraught with spontaneous abortion.
• Paracetamol-based antipyretics. Aspirin medications are prohibited.
• Multivitamin complexes, fruits, rosehip decoction.

And finally, to prevent the development of complications will allow regular follow-up by a specialist. Strict laboratory control, ultrasound examination of the fetus, and, if necessary, the use of other diagnostic methods are especially important.