Physicians’ Preferences for Constipation Treatment and Prevention in Pregnant Women: The Comparison within the Russian Federation

Author Name(s): Janna R. Gardanova, Roman A. Bontsevich, AlesyaV. Lysenko, Kristina V. Shchurovskaya, Natalia A. Chukhareva
Author Email: bontsevich@bsu.edu.ru

Abstract

Practical physicians’ preferences in pharmacologic management and prevention of constipation in pregnant women are considered in the article. The obstetrician-gynecologists (OGs) and general practitioners’ (GPs) patient management tactics were analyzed during the research in Belgorod region. The obtained results were compared with the results of the All-Russian Pharmacoepidemiological Study, 2d stage – “The Epidemiology of Drugs Use in Pregnant Women” (February-April, 2015).

Introduction

According to the foreign sources, constipation affects from 11 to 44% of women during pregnancy [1]. Russian studies suggest that up to 66.8% of pregnant women suffer from constipation [2] – the most frequent gastrointestinal tract pathology. Predisposition to constipation during pregnancy is evoked by physiological and anatomical changes in the woman’s body. The increased level of progesterone and its metabolites, which activate inhibitory gastrointestinal hormone and suppress the activity of substances stimulating peristalsis (gastrin, cholecystokinin, enkephalins, substance P), leads to a decrease in the tone of smooth muscles, including musculature of the large intestine. A decrease immobility during pregnancy, use of iron- and (or) calcium-containing drugs, antispasmodicset alias could cause problems associated with normal defecation [3, 4]. In the late stages of pregnancy, passage of feces is also hampered by squeezing the intestine with an enlarged alvus. Constipation during pregnancy causes disturbances in large intestine biocenosis, which leads to the violation of cervical canal biocenosis and, in turn, cause the ascending infection of the fetus and the development of various complications during gestational period [3,5].

The high level of constipation prevalence in pregnant women and the variety of patient management tactics are essential drivers for the conduction of a pharmacoepidemiological study.

Conclusions

The obtained results display that patient management tactics does not fundamentally differ among the obstetrician-gynecologists and general practitioners. More attention ought to be paid to the propaganda of drag-free treatment. Educational activities should be provided for pregnant and lactating women. Drugs administration during pregnancy, including herbal medicines and dietary supplements, has to be under control. Carrying out pharmacoepidemiological studies will provide information needed to develop recommendations for optimal drags use in pregnant women.

References

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