When is hospitalization necessary for a pregnant woman?
During a planned hospitalization of a pregnant woman, the antenatal clinic doctor writes out a referral to a hospital or maternity hospital. With this referral, the pregnant woman herself goes to the hospital emergency department. If family and other circumstances do not allow the pregnant woman to go to the hospital right away, then it is quite possible to wait a few days.
Indeed, in the case of planned hospitalization of a pregnant woman, there is no immediate threat to the life of the woman and child, and the general condition of both does not cause concern.
We are talking about planned hospitalization of a pregnant woman when treatment is ineffective, during exacerbation of existing chronic diseases and some other diseases that require constant medical supervision.
Emergency hospitalization of a pregnant woman is necessary for complications that require urgent medical intervention. In this case, refusal to immediately go to the hospital can threaten the course of the pregnancy, and sometimes the life of the expectant mother and baby.
In the latter case, a referral from the treating doctor is, of course, not required. A woman is hospitalized urgently by an ambulance team, which she can call herself or a doctor at the antenatal clinic if, at the next scheduled appointment, he reveals abnormalities that require urgent treatment.
A woman can also independently go to the emergency room of a maternity hospital or hospital for pregnant women.
Early toxicosis
With early toxicosis, when vomiting is repeated more than 10 times a day, dehydration of the expectant mother’s body and metabolic disorders may occur. In this case, the pregnant woman must be hospitalized in a hospital, in a gynecological hospital, and an intravenous infusion of nutrient solutions and fluids is performed.
Isthmic-cervical insufficiency
Isthmic-cervical insufficiency (ICI) is the incompetence of the isthmus and cervix. In this condition, it smooths out and opens slightly, which can lead to spontaneous miscarriage.
Normally, the cervix acts as a muscular ring that holds the fetus and prevents it from leaving the uterine cavity prematurely. As pregnancy progresses, the fetus grows and increases the amount of amniotic fluid. All this leads to increased intrauterine pressure.
With ICI, the cervix cannot cope with such a load. The membranes of the amniotic sac begin to protrude into the cervical canal and become infected with microbes, which can lead to their premature rupture. With this development of events, the pregnancy is terminated ahead of schedule.
Most often this occurs in the second trimester of pregnancy (after 12 weeks).
There are no specific symptoms of isthmic-cervical insufficiency. This is explained by the fact that the dilation of the cervix, which occurs in this condition, is painless for the woman and bleeding or any unusual discharge is usually not observed.
A pregnant woman may feel heaviness in the lower abdomen or lumbar region. However, most often the expectant mother does not worry about anything. In these cases, the pregnant woman requires hospitalization and surgical intervention, which consists of suturing the cervix.
Stitching of the cervix is usually performed between 13 and 27 weeks of pregnancy. After suturing, the woman is observed in the hospital for several days.
Premature rupture of membranes
In the normal course of labor, rupture of the membranes and rupture of amniotic fluid should occur in the first stage of labor when the cervix is 7 cm dilated. If the bladder ruptures before the onset of regular contractions, this is called premature rupture of amniotic fluid.
There are two possible options for rupture of the membranes before birth. In the first case, the membranes rupture in the lower part, and water is poured out simultaneously in large quantities.
In the second case, the bubble ruptures high up, and the water does not leave massively, but literally leaks drop by drop. In such situations, a pregnant woman may not notice the release of amniotic fluid.
In cases of suspected leakage of amniotic fluid, a series of tests are performed to identify amniotic fluid cells in the vaginal contents. If tests confirm rupture of the membranes, urgent hospitalization is required to decide on further treatment tactics. Untimely hospitalization of a pregnant woman can lead to infection of the fetus and its death.
Placental abruption
This is the separation of the placenta from the wall of the uterus during pregnancy. If placental abruption occurs in a small area, then with timely treatment this process can be stopped and then the baby’s condition will not be in any danger.
In the case when the process of detachment continues, acute placental insufficiency develops, characterized by a rapid deterioration of placental blood flow. This means that the baby will lack oxygen and nutrients and his condition may deteriorate sharply. It is clear that this condition requires emergency medical intervention.
If acute placental insufficiency develops, it is necessary to perform a cesarean section as quickly as possible to save the life of the baby and mother.
Chronic placental insufficiency
With this pathology, the uteroplacental and fetal-placental blood flow is disrupted. This results in less oxygen and nutrients reaching the fetus, which causes stunted growth and development.
There are currently no specific methods for treating fetoplacental insufficiency, since there are no drugs that selectively improve uteroplacental blood flow.
If the doctor detects initial disturbances in the supply of oxygen to the baby, the pregnant woman requires hospitalization in order to receive treatment in a hospital setting aimed at increasing the flow of blood and oxygen through the placenta.
Since the baby’s condition can sharply deteriorate, it is necessary to frequently check how he is feeling by performing Doppler measurements and cardiotocography, and therefore it is better if the expectant mother is in the hospital under the supervision of doctors.
Preeclampsia
This is a serious complication of the second half of pregnancy, in which the functioning of vital organs is disrupted. It manifests itself as edema, the appearance of protein in the urine and increased blood pressure. However, the severity of these signs may vary. A combination of two of the three classic symptoms is possible.
Preeclampsia is a critical but reversible condition that precedes the most severe form of gestosis - eclampsia, when brain damage occurs.
Preeclampsia is a very dangerous condition of increased convulsive readiness of the body, when any irritant (loud sound, bright light, pain, vaginal examination) can provoke a convulsive attack with all possible adverse consequences for the mother and fetus. The only treatment for severe forms of gestosis is delivery and removal of the placenta.
They resort to it in the interests of preserving the health of the expectant mother and the life of the fetus. The method of delivery depends on the viability and maturity of the fetus and the readiness of the pregnant woman’s body for childbirth. If blood pressure rises above 140/90 mm Hg. Art. and the appearance of protein in the urine requires hospitalization of the pregnant woman in a hospital.
Hemolytic disease of the fetus due to Rhesus conflict
If the blood of the mother and fetus is incompatible according to the Rh factor (the mother is negative and the child is positive) and when fetal blood cells are transferred through the placenta into the maternal bloodstream during pregnancy, hemolytic disease of the child may develop.
Fetal cells that enter the woman's bloodstream cause a reaction from the immune system, and the produced antibodies (proteins) penetrate back into the baby's bloodstream, causing the destruction of red blood cells (erythrocytes). Hospitalization in this case ensures dynamic monitoring of the fetus - doctors monitor the blood flow in the vessels of its brain.
In severe cases, an exchange blood transfusion is given to the baby in utero.
Threatening premature birth
Premature births are considered to occur between 22 and 37 weeks of pregnancy. If a pregnant woman experiences regular cramping pain in the lower abdomen or prolonged painful tension of the uterus, she should immediately consult a doctor.
Only during an examination will the doctor be able to identify signs of a threat of premature labor or its onset. In these cases, hospitalization in a hospital is necessary.
With the help of special medications, doctors can stop the onset of labor, administer special drugs to accelerate the maturation of the fetal lungs, and carefully monitor the baby’s condition.
Hospitalization of a pregnant woman: necessary things for hospitalization
Emergency hospitalization of a pregnant woman always requires a minimum of time for getting ready. Therefore, the most important item on your list is the availability of documents, especially when an unexpected situation requiring urgent medical attention occurs outside the home.
In this regard, it is recommended to store all the necessary papers in one place and always have them with you when going out. If such a situation occurs at home, then before the ambulance arrives, you have a little time to put a toothbrush, soap, a large towel, a change of shoes, a nightgown and a robe in your bag.
Everything else can be brought to you later by one of your relatives.
If we are talking about the planned hospitalization of a pregnant woman, then it is clear that you can carefully pack a bag with everything you need.
You will need a comfortable change of clothes - a robe or light sports set, 1-2 nightgowns or cotton T-shirts, underwear, socks, slippers that can be treated, shower slippers.
For hygiene items, don’t forget a toothbrush and toothpaste, a towel, a roll of toilet paper, paper or wet wipes, soap, shampoo, a washcloth, as well as deodorant and a comb. It is also better to take your own cup, spoon, plate, and drinking water.
How long will a pregnant woman have to stay in the hospital?
It all depends on the specific situation; some diseases require long-term stay under constant medical supervision. Naturally, if you wish, and more often if you do not understand what is happening, you can refuse hospitalization.
But it is worth understanding that in this situation the pregnant woman takes full responsibility for her condition and the condition of her unborn child, and the consequences of this can be very dire. Therefore, there is no need to be afraid of staying in a hospital and, if the doctor insists on hospitalization, it is better to listen to the recommendations of a specialist and go to the hospital.
Indeed, it is often thanks to inpatient treatment that it is possible to normalize many dangerous conditions and safely carry and give birth to a healthy baby.
What documents are needed for hospitalization of a pregnant woman?
When going for inpatient treatment, you must take the following documents with you:
- passport;
- medical insurance;
- exchange card;
- extracts and conclusions of previous hospitalizations, if any;
- ultrasound results.
Under control
Indications for hospitalization of a pregnant woman in a hospital may be some diseases of the fetus, for example, heart disease - arrhythmia, bradycardia, a tendency to premature closure of the oval window of the heart. In the hospital, as prescribed by a pediatric cardiologist, the necessary medications are administered intravenously and the functioning of the baby’s heart is monitored.
The doctor may also suggest that the expectant mother go to the hospital if she has chronic diseases such as diabetes, hypertension, or heart disease.
Most often, hospitalization is carried out when the course of a chronic disease worsens.
However, in some cases, it may be necessary to go to the hospital as planned at certain stages of pregnancy, most often to correct the therapy, for example, in case of diabetes in an expectant mother.
I'm not afraid of the hospital!
If you are about to be hospitalized, it is very important to prepare yourself psychologically for your hospital stay. Of course, you shouldn’t be upset or worried, much less cry. Firstly, it is pointless, and secondly, it can aggravate problems that arise during pregnancy.
It's worth being positive. While in the hospital, you can relax and sleep, read a lot of interesting books, meet other pregnant women, and perhaps even find friends.
And, of course, it is important to remember that all this is done to ensure that your pregnancy proceeds safely and the baby is born strong and healthy.
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Source: https://www.9months.ru/beremennostbase/5531/kogda-nuzhna-gospitalizaciya-beremennoy
Refusal from hospitalization during pregnancy
However, there is unlikely to be a desire to reject it if you feel unwell and are concerned about the health of the unborn child.
If you are 100% sure that everything is fine and it’s just weight and not swelling, then it’s better not to go to the hospital.
What kind is it? If a woman feels good, why should she lie down all day? It seems to me that this will not contribute to the improvement of labor. I also consider myself a responsible person, but for me, doctors’ recommendations will always remain only recommendations, and I will decide for myself. I refused in both pregnancies. During my first pregnancy I gained 15 kg, and during my second pregnancy 25. I am a doctor myself, but it was difficult for me to find contact with a doctor during my second pregnancy. Indeed, the concern of gynecologists about the excess weight of pregnant women sometimes goes beyond common sense. My child was lying across her stomach, it didn’t bother her, but the 500 grams gained in a week made her grab a pen and write directions.
What hospitalization? I ran for the bus, walked a lot, visited my favorite concerts with my husband, attended his ballet premiere, and traveled alone to the Tver region.
I had a special story with hospitalization. And there was no physical opportunity to refuse. There were sharp pains in the lumbar region, I was two weeks away from giving birth. They brought me to the gynecology department to see the women in labor. They twisted and turned me, they thought I was having contractions. And for me, because... During pregnancy, an exacerbation of illness suddenly caused kidney disease. So they put me in pathology for preservation.
She refused twice. The first time - at 6 weeks a little brown came out. At the residential complex, the doctor, without even examining her, sent me to the hospital; She said that they would do tests there and an ultrasound. As a result, the doctor looked at me only once, without taking a test for progesterone, she prescribed an injection - and that’s all. They didn't do any ultrasound. Yes, they also refused to transfer to daytime.
If the decision to hospitalize is made before 22 weeks, the expectant mother will be admitted to the gynecological department or hospital. Referral to the hospital at a later date means being in a maternity hospital.
