Betadine during pregnancy in 1, 2 and 3 trimester

An effective local preparation based on iodine with a wide range of antiseptic activity Betadine precisely because of its active substance is not the most desirable tool for pregnant women. Iodine penetrates well into the cells of the tissues and the systemic circulation, accumulates in the body, easily overcomes the placental barrier, and its overabundance can negatively affect the functioning of the thyroid gland. However, Betadine prescribed during pregnancy. Consider when it is appropriate.

The antiseptic properties of iodine have been used for a very long time - the 53rd element of the Periodic Table is capable of destroying not only bacteria and fungi, it is also active against protozoan and intracellular microorganisms. Pathogens are not able to produce resistance to elemental iodine for a very short time before their destruction (less than a minute). Compared with the alcohol solution of iodine, Betadine contains a softer form - povidone-iodine. Connection with the polymer with polyvinylpyrrolidone allows you to stretch the action of elemental iodine, that is, it makes it prolonged and dosed. Iodine, in contact with the epithelium of the skin and mucous membranes, is gradually released in small quantities from the complex with the polymer and destroys pathogenic microorganisms. The irritant effect is minimized, so the drug is usually well tolerated. And speed is one of the positive qualities of the drug.

Betadine when planning pregnancy allows you to get rid of specific and nonspecific mono-and mixed infections of the genital tract. When planning to have a child, a competent woman should go to a gynecologist's appointment, be examined and, if necessary, treated before pregnancy, and Betadine, in the absence of an allergy to iodine and thyroid disease, is quite suitable for this drug.

Conception at the time of treatment with Betadine may not occur, since suppositories inhibit sperm activity, but during the course of treatment, this should not be sought.

Can Betadine during pregnancy?

Sometimes he is appointed and future moms. And they immediately have a question about the expediency of the appointment. There are discrepancies in the instructions, manufacturers warn about penetration through the placental barrier and call for caution. Some prohibit it from use from the second month, others from the third, some from the second trimester. This is due to periods of development of the circulatory system. In the first two weeks of its development (the so-called yolk period), the mother and child still do not have a single circle of blood circulation, so iodine cannot have a significant effect on the child’s body, even if it exists in the mother’s systemic circulation. Then allantoid blood circulation begins to develop, expanding the access of substances circulating in the mother's blood to the fetus. Fully it will work only by the end of the eighth week (second month) of pregnancy. However, the most adequate exchange of all substances, both beneficial and toxic, begins with the onset of placental circulation. This corresponds to the second trimester.

Pregnant women should not use Betadine due to the possible development of iodine-induced goiter and hypothyroidism in the fetus and newborn. The risk is especially high when Betadine is reused.[1], [2]

Therefore, at the very beginning of pregnancy it is better to treat the identified infections, and they often manifest themselves during this period due to physiological immunosuppression. For the child it will be the most secure.

During pregnancy, there can also be different situations, including fresh infections. In this case, it is worthwhile to listen to the opinion of the doctor, although it is possible, and even necessary, to ask him about the advisability of prescribing Betadine. Let him explain his point of view, convince you of the need to use the drug.

As a consolation, we can say that manufacturers nevertheless stipulate the possibility in special cases of briefly under control in the first trimester to use suppositories or to apply ointment (solution) on small areas of the body surface, provided that the woman does not have general contraindications to this drug.

Indications Betadine during pregnancy

Betadine is a local antiseptic, and therefore it is used in the form of a solution in this capacity for disinfecting a small surface of the skin and mucous membranes [3]. As a one-time event in the absence of another safer antiseptic, it is quite acceptable for use by pregnant women. Iodine enters the systemic circulation with prolonged use.

Betadine ointment can be used by itself once for disinfecting small abrasions, scratches and other minor wounds in ophthalmology [4]. For long-term treatment of bacterial, fungal, viral skin lesions, it is necessary to consult a doctor.

The indications for Betadine suppositories may be thrush during pregnancy, the presence of bacterial vaginosis, trichomoniasis, genital herpes, mixed infections [5]. Self-administration for pregnant women is absolutely not recommended.

Release form

Medicines with the trade name Betadine are available in several forms for external use: candles, solution, ointment.

Pharmacodynamics

The active ingredient of all forms of the drug is povidone-iodine. This substance is a combination of iodine molecules with a polymer, which acts as a storage, batch-releasing iodine into the tissues in contact with the preparation, to which it is applied. The antiseptic effect of released iodine extends to bacteria, viruses, protozoa, fungi and their spores. The majority of iodine-sensitive microbes die in the first 15-30 seconds after contact with its molecules, which react with the hydroxyl and sulfide groups of amino acids of pathogenic microorganisms, destroying their protein structures and inactivating the enzymes, which leads to the death of the pathogenic microflora.

Pathogenic microorganisms do not produce resistance to iodine, even with prolonged use. The complex of povidone-iodine does not have a pronounced local irritating effect inherent in the alcohol solution, and therefore has a better tolerability. It is hydrophilic and easily washed off with water. The intensity of the color of the drug changes as it interacts with the affected surface - discoloration indicates a decrease in antiseptic ability.

Long-term therapy and / or use of Betadine with extensive damage surfaces is not suitable for treating pregnant women, because in such cases a large amount of iodine may enter the systemic circulation, delay it and increase the blood concentration rapidly, which can cause significant changes in thyroid hormonal status baby Therefore, the use of all forms of the drug in pregnant women should be short-lived and cover a small area.

Pharmacokinetics

The drug is more intensively absorbed from the mucous membranes and damaged skin. The average half-life of the intravaginal suppository is on average about two days. But the rate of absorption and excretion by the kidneys depends largely on the molecular weight of povidone-iodine, and it varies considerably, so that iodine can be delayed in the body.

Dosing and administration

Future mothers are most often prescribed Betadine suppositories for treatment of colpitis during pregnancy. Unlike many other drugs that are prohibited in the first trimester, Betadine is used in early pregnancy (according to the instructions - in the first eight weeks). During this period there is still no large abdomen, half-open uterine pharynx and other features inherent in later periods. Therefore, the question: how to insert the Betadine suppository during pregnancy is irrelevant. Answer: as usual.

These are intravaginal suppositories, that is, they are inserted deep into the vagina. It is more convenient to do this procedure lying.

Betadine in the first trimester of pregnancy is prescribed in the minimum effective dose, that is, once a day at night. The course of treatment is usually a week, but may be even shorter. For example, in case of candidiasis, one-time application is sometimes enough. Due to color discharge (elimination of candle residues), it is recommended to use disposable sanitary pads during the treatment period.

In severe cases, as prescribed by a doctor, twice daily administration may be prescribed in the morning and evening. In this case, in the morning after the injection it is necessary to lie in bed for at least an hour.

Suppositories before the introduction of the release of packaging and, according to the instructions, moistened with water. According to many women, not soaked candles are better inserted.

Betadine in the 2nd trimester of pregnancy can no longer be categorically prescribed. During this period placental blood circulation was formed (shared with the mother). The accumulation of iodine in the blood of the mother can have negative consequences for the health of the unborn child, for example, to cause a sensitization reaction in the fetus or iodine-induced hyperthyroidism.

Betadine suppositories in the 3rd trimester of pregnancy are not prescribed for the same reason.

Lubricate with ointment or solution abrasion (scratch) for disinfection is allowed at any time.

Contraindications

Betadine in all forms does not apply to the treatment of pregnant women, starting from the third month of pregnancy. It is contraindicated in nursing mothers because it penetrates into breast milk and there its concentration is much higher than in the blood. It is not recommended to prescribe the drug to children of infancy, because their iodine is well absorbed through the skin and quickly enters the bloodstream, which increases the risk of developing hypothyroidism. [6]Betadine is prohibited for patients with hyperfunction and thyroid neoplasms, autoimmune thyroiditis, thyrotoxicosis and its other pathologies, bullous polymorphic dermatitis, impaired renal function, and an allergic reaction to iodine.

Side effects Betadine during pregnancy

Allergic reaction to drugs with iodine is not so rare. It can manifest itself in most cases by the appearance of itchy rashes and / or edema at the site of application, but some rare cases of anaphylaxis are also recorded [7]. In addition, people with sensitive skin may develop a reaction resembling a chemical burn [8]. In such cases, Betadine treatment is immediately stopped.

The instructions say that in adult patients with normal thyroid function, iodine retention in the body does not cause clinically significant symptoms of hyperthyroidism, and only long-term treatment causes a delay and accumulation of this element. However, judging by the reviews, this is an understatement. Many women who used the Betadine suppository quickly began to feel a rush of blood to the head, tachycardia, causeless anxiety, a metallic taste in the mouth, their blood pressure rose, their hands trembled, and problems with sleep began. Some had symptoms of hypothyroidism. Given that in pregnant women in general, the thyroid gland can falter, the likelihood of side effects on its part increases.

In the same instructions indicated such a side effect as a violation of the kidneys, that the future mom is completely useless. Disorders of water and electrolyte balance, acidification of blood may occur.

Of course, side effects do not arise from a single use of an ointment or solution for disinfecting scratches. They are caused by course use of Betadine suppositories.

Many reviews that there was a discharge after Betadine during pregnancy. Normal discharge when applying suppositories should be in the morning. The manufacturer warns and recommends the use of gaskets during treatment. The suppository dissolves in the vagina, but its components, mixed with mucus, flow onto the linen or pad in the form of a reddish-brown substance with a specific iodine odor. The norm is also some enhancement of itching during the period of treatment with vaginal suppositories.

Some complain of exacerbation of thrush - white thick discharge with a sour smell. Suppositories are intended for the treatment of candidiasis, and the appearance of such secretions is due to repeated infection, the cause of which could be sexual contact with an infected partner during treatment. Not too abundant whitish discharge without odor and itching are considered a variant of the norm.

For the treatment of trichomoniasis and some other combined infections, only Betadine suppositories are not enough; therefore, greenish-gray, frothy, purulent discharges can be a manifestation of a non-treated infection or re-infection. With this problem you need to consult a doctor.

Overdose

Acute toxic reaction to iodine excess in the body is manifested by the following symptoms: [9]

• the digestive tract - hypersalivation, metallic taste and pain in the mouth, heartburn, dyspeptic symptoms;
• organs of vision - lacrimation, redness, itching in the eyes, eyelid edema;
• all sorts of skin reactions (usually vesicular rash and swelling, accompanied by itching);
• kidneys - urinary retention, hypernatremia, metabolic acidosis
• anaphylactic shock and malfunction of various organs.

The probability of an overdose in a pregnant woman who complies with a doctor’s recommendation is negligible. However, when the first symptoms of an overdose are manifested, first-aid is to drink milk or starch diluted in water, as well as an appeal to doctors.

Interactions with other drugs

The active ingredient of suppositories Povidone-Iodine exhibits antiseptic activity only in an acidic environment (pH value from 2 to 7).

When treating the wound surface, ointment or Betadine solution should not be applied immediately after hydrogen peroxide or antiseptics with silver ions, cyclo-taurolidine, since they mutually inhibit each other's activity, and sequential use with antiseptics, which contain octenidine, results in the appearance of combined use of dark necrosis spots.

The active substance is incompatible with drugs containing mercury, it is undesirable its appointment to patients who take mood stabilizers containing lithium salts.

The oxidative properties of povidone-iodine distort the results of urinalysis for the detection of blood traces or glucose, as well as analysis of fecal occult blood, some tests for the functioning of the thyroid gland.

In addition, for the effectiveness of Betadine dosage forms, storage conditions must be observed: the ointment and solution should be stored at room temperature for no more than 25, suppositories should be stored in the refrigerator’s medium-temperature chamber (above 0). The expiration date of the drug is indicated on the package. These data also should not be neglected, especially pregnant women.

Analogs

Reviews of Betadine suppositories are very different, and it is not surprising. Reactions to drugs depend on the individual sensitivity of the woman, and iodine very many can not tolerate. Doctors, judging by reviews of pregnant women, often prescribe these suppositories during periods when the manufacturer already prohibits the use, for example, on the 12th or 15th week. If we consider that the pharmacological company is not a benefactor, and even she considers the use of the drug after the third month to be dangerous, then you should not hesitate to ask the doctor why he prescribes a suppository during the prohibited period.

In addition, many doctors believe that Betadine during pregnancy is the last century: too many intolerances and side effects. There are safer and hypoallergenic counterparts. For example, suppositories Pimafucin are considered safe for pregnant women, many prefer to prescribe Suppositories for pregnant women Hexicon with the active ingredient, the antiseptic chlorhexidine. They do not irritate, and seem to be a clinically significant systemic. They are also used with caution, but at any time. However, from thrush they are not effective.[10], [11]

Suppositories with miramistin during pregnancy are recommended from thrush on the forums, although the instructions say that no studies confirming their safety have been conducted. Manufacturers write in the instructions that suppository with miramistin, for example - Tamistol, it is better for future moms to use rectal. This active ingredient is effective against many pathogens and treats thrush well.

In general, a lot depends on the individual tolerance, so all the same questions the treatment of a pregnant woman must be solved by a doctor. Maybe - and not one. You can apply to both a homeopath and a phytotherapist. In addition, the main thing - do not overdo it. White discharge may indicate a “too clean” vagina, where only lactobacilli alone, which, having no restraining factors such as 5% of conditionally pathogenic flora in the microbiocenosis, begin to multiply rapidly. Such a vaginal ecosystem is called cytologic vaginosis or Doderlein syndrome [12]. There is no specific treatment for the syndrome. His therapy is aimed primarily at normalizing (reducing) the acidity of the vaginal environment. In this case, the use of antimycotics is inappropriate. Suppositories with lactobacilli and intimate hygiene products with a high level of acidity, dairy products (for some time) are excluded. Sessile baths with a solution of baking soda can be prescribed - a weak alkali neutralizes the increased acidity (with candidiasis, such treatment will not bring results).

In general, pregnant women are better to follow the commandment "do no harm." If the smear is clean, then you can reduce the speed, wash more often (do not douche) and change the laundry, stop inserting different candles, stick to a diet - eliminate spicy, salty, limit sweets. And after a while the discomfort will decrease by itself. By the way, adequate gynecologists give such recommendations.