Ginipral: maintain pregnancy and give birth on time. Why is ginipral prescribed to pregnant women?

A woman carrying a child needs to carefully monitor her condition, because in obstetric practice there are various conditions that pose a danger to the fetus. And when they occur, high-quality medical correction is necessary, which includes drug therapy. Among the drugs widely used during pregnancy is Ginipral. And those to whom it was prescribed will most likely want to know what the medicine is, how it works and whether it is safe for the unborn child. It is best to ask your doctor these questions, but some information can also be gleaned from the instructions for use.

Characteristics

The active ingredient of the drug Ginipral is hexaprenaline. It belongs to the group of beta2-adrenergic agonists, stimulating the corresponding receptors in the muscular layer of the uterus and bronchi. This leads to the activation of the enzyme adenylate cyclase and the accumulation of an energy substrate called cyclic adenosine monophosphate (cAMP) in cells. Ultimately, the concentration of calcium in the cytoplasm decreases and the excitability of muscle fibers decreases.

Action

Based on the biochemical transformations initiated by hexaprenaline, Ginipral has the main effect necessary in obstetrics - tocolytic. It relaxes the myometrium, leading to a decrease in the frequency and duration of its contractions. The drug eliminates contractions that occur spontaneously or under the influence of the hormone oxytocin.

In addition to the tocolytic effect, Ginipral has other positive effects. It has a bronchodilator effect, expanding the lumen of the airways by relaxing the smooth muscles in them. At the same time, a slight desensitizing effect is realized - degranulation of mast cells and the release of biologically active substances that increase capillary permeability and are involved in allergic reactions (in particular, leukotrienes and histamine) are inhibited. It has some effect on metabolism, stimulating gluconeogenesis (glucose formation).

Indications

The drug is very popular in obstetric practice. Ginipral during pregnancy is prescribed to women who need to suppress the contractile activity of the uterus. Such treatment is necessary in the following situations:

1. Premature birth.
2. Rapid labor activity.
3. Discoordinated contractions.
4. Complications during childbirth (threat of uterine rupture, prolapse of the umbilical cord).
5. Operations and other manipulations (caesarean section, correction of fetal position).
6. Intrauterine asphyxia.

For the treatment of acute conditions, Ginipral is used in the form of an infusion solution, and later treatment is supplemented with oral forms. Tablets are also used as a prophylaxis against premature birth and when there is a threat (increased uterine tone). In addition, the drug is used in women with concomitant conditions such as bronchial asthma or chronic obstructive bronchitis.

Indications for Ginipral are clearly defined by its therapeutic effects. During pregnancy, it is often used to eliminate and prevent premature and severe uterine contractions.

Distribution in the body

After oral administration, the drug is well absorbed from the gastrointestinal tract. In tissues, it undergoes transformation under the influence of a special enzyme - catechol-O-methyltransferase. Only in this case does hexoprenaline acquire its activity. It is excreted from the body with urine (80% within 4 hours) and bile as metabolites.

Application

The drug can be used only as prescribed by a doctor. The specialist will first examine the pregnant woman, confirm the indications for the use of Ginipral, take into account all the associated issues, and indicate the dosage and course of administration. It is imperative to assess the potential risk to the fetus.

Method of use

Intravenous infusions are carried out in two ways: jet and drip. The first is used to achieve an immediate and massive tocolytic effect. The contents of the ampoule (2 ml) are diluted with physiological solution in an amount of 10 ml and slowly injected into a vein (over 5–10 minutes). In the future, a drip may be prescribed for long-term administration of Ginipral. The dosage and rate of infusion is controlled using an infusion pump or by the number of drops per minute, adjusting according to individual characteristics. If contractions do not resume within 2 days, then treatment is continued in the form of tablets. They are taken with water, first one every 3 hours, and then half as often, so that the total dose is up to 8 tablets per day.

Side effects

The drug is not without undesirable effects on the body. A pregnant woman may experience the following side effects while taking Ginipral:

• Cardiovascular: increased heart rate, pain in the cardiac region, ventricular tachyarrhythmia, decreased diastolic pressure.
• Nervous-vegetative: headaches, dizziness, increased sweating, anxiety.
• Allergic: difficulty breathing, anaphylactic shock.
• Gastrointestinal: nausea and vomiting, intestinal atony.
• Water-electrolyte and metabolic: edema, decreased diuresis, decreased potassium and calcium in the blood, increased glucose levels, transaminases.

The potential risk to the fetus must be taken into account. But he still exists. If massive treatment with the drug was carried out during childbirth, the child may develop bronchospasm, anaphylaxis, hypoglycemia and acidosis. In case of an overdose of Ginipral, a woman may experience symptoms such as severe tachycardia, tremors, headaches, heart pain, and shortness of breath. In this case, it is necessary to use antagonists - non-selective beta blockers (for example, propranolol).

The side effects of the drug are quite varied. They affect not only the woman’s body, but also her child, but appear mainly when using high doses.

Restrictions

The drug must be used carefully. Even at the examination stage, the doctor is interested in the medical history and conducts the necessary tests to exclude concomitant conditions that are an obstacle to prescribing the drug. The patient should also indicate which drugs from other groups she is taking, as they may interact with hexoprenaline.

Contraindications

Like many drugs, Ginipral has a number of contraindications for use. All of them are indicated in the instructions and are familiar to the attending physician. Therefore, before starting therapy, the following conditions are excluded:

1. Diseases of the heart and vascular system (tachyarrhythmias, coronary artery disease and hypertension, valve defects).
2. Severe renal and hepatic pathology.
3. Diseases of the thyroid gland (thyrotoxicosis).
4. Glaucoma (increased intraocular pressure).
5. Obstetric complications (premature abruption of a normally located placenta, bleeding, endometritis).
6. Early pregnancy (first trimester).
7. Breastfeeding a baby.

In these cases, the drug cannot be taken, since the risk of adverse effects on the body (both mother and child) is high. Then the doctor will replace Ginipral with a safer medicine.

Interaction

The effects of hexoprenaline are weakened by the influence of adrenaline receptor blockers, and an increase in the effect is observed when taking its agonists (dopamine, norepinephrine) or methylxanthines (aminophylline). Ginipral should not be used in conjunction with tricyclic antidepressants, mineralocorticoids, monoamine oxidase inhibitors, calcium and vitamin D supplements.

special instructions

While using the drug, it is necessary to monitor some indicators of the body’s functioning: pulse and pressure, water balance (fluid administration and diuresis), blood electrolytes and glucose, bowel movements. Monitoring the condition of the fetus and placental complex (cardiotocography) is mandatory. If side effects occur, you should inform your doctor. The medication may need to be stopped or its dosage reduced.

Ginipral is often prescribed to pregnant women for the treatment and prevention of conditions manifested by increased uterine tone, strong and premature contractions. But when using it, it is important to take into account all the features of the action and the state of the body. This will help minimize the risk of developing undesirable manifestations, including for the fetus.

If your gynecologist had enough time and desire to comment on his prescriptions to you in at least a few words, then perhaps you would not be looking for information on the Internet now. If you and your doctor had a fairly friendly and trusting relationship, then you would call him back and clarify everything that you doubt or that worries you. But, most likely, you are not one of the small percentage of pregnant women who do exactly this.

It’s a shame, but most doctors don’t consider it necessary to explain anything to their patients. But sometimes just a few words are enough for the patient to make sure that the doctor knows what he is doing. But she buys the Ginipral prescribed for her, studies the instructions for the medicine and is horrified!

Was this the case with you too? Then you probably have a lot of exciting questions: why is Ginipral prescribed to pregnant women, what can replace it, is it harmful to the fetus, from when until when can it be taken, and many others. Let's look for answers together.

Why is Ginipral prescribed during pregnancy: indications

This is a drug from the pharmacological group of sympathomimetics. In short, these are substances that affect the sympathetic nervous system. For example, the same group of drugs includes amphetamine, ephedrine, tyramine, and atomoxetine. The means are quite serious, and therefore are not widely used. But with the help of such medications, many health problems can be solved.

So, as for Ginipral, it was created specifically for women, moreover, mainly for pregnant women. This remedy inhibits the contractile activity of the uterus, which makes it possible to prevent and even stop miscarriages and premature births in pregnant women when the uterus is in hypertonicity. That is, Ginipral is prescribed if there is an existing threat of miscarriage.

In addition, due to the vasodilating effect, therapy with Ginipral helps improve uterine-placental blood flow, so the drug is prescribed when it is disturbed, when there is a risk of intrauterine hypoxia of the fetus: thus, the fetus is better supplied with oxygen and other necessary substances (blood circulation of the fetus, placenta and uterus improves ).

Ginipral helps relax the uterine muscles, relieving spasms of muscle tissue. Therefore, in addition to obstetrics, it is also used simply in gynecology - as a preparatory agent before certain operations, when it is necessary to relax or “calm” the uterus so that it does not tense or contract. For the same purpose, the drug can be used during a caesarean section.

How to take Ginipral during pregnancy: instructions, dosage

Despite the absolutely clear indications for taking the drug, it can be used for treatment only according to indications. Only a doctor is able to assess whether there is such a need and correctly establish the dosage and treatment regimen.

In each individual case, the treatment method will be different. If the threat of miscarriage is small, then Ginipral tablets are usually prescribed, the daily amount of which often does not exceed 4 pieces, but according to indications it can be 6-8 pieces. (maximum!). The tablets should not be combined with caffeine-containing drinks and foods (in particular, coffee or tea).

The doctor can create almost any dosage regimen: 1/4, 1/3, half a tablet, or even a whole one; with a dosage frequency of 3-4 times a day or even every 3 hours. The therapeutic regimen depends on many factors, that is, only a specialist can prescribe treatment with Ginipral correctly.

If the situation is critical, the stomach continues to harden and hurt, the uterus is very spasmodic and the threat of pregnancy is increasing, then treatment is carried out only in a hospital, and Ginipral is administered intravenously (that is, droppers are placed), which are then supplemented or replaced with tablets.

The course of treatment continues for a long time, but if the condition of the expectant mother significantly improves, the dosage can be reduced. It should be noted that you cannot suddenly stop taking Ginipral: the drug is always discontinued gradually, by reducing the frequency of administration and the daily dose of the drug. Otherwise, all dangerous symptoms return sharply - there is a high risk of miscarriage.

Why is Ginipral dangerous during pregnancy: side effects, effects on the fetus

It is the long list of side effects that most frightens women who are prescribed this treatment:

• headache, dizziness;
• increased sweating;
• trembling in the limbs;
• feeling of anxiety, fear;
• nausea, vomiting;
• decreased blood pressure;
• increased heart rate, heart rhythm disturbances, heart pain;
• increased blood glucose levels;
• intestinal atony;
• decreased urination;
• decreased levels of calcium and potassium in the body (at the beginning of treatment).

Severe allergic reactions are possible (shortness of breath, shortness of breath and difficulty breathing, loss of consciousness) up to anaphylactic shock.

The likelihood and degree of side effects increases if you drink coffee and strong tea during treatment with Ginipral. In addition, it is recommended to reduce the amount of liquid and salt in your diet to avoid the appearance of edema (Ginipral impairs urine excretion by the kidneys).

Due to the increased dangers, the health of the expectant mother and child must be constantly monitored: heart rate, blood pressure must be measured daily, and ideally (if the clinic has such capabilities) a CTG must also be performed. If a woman has diabetes, then daily measurement of blood sugar levels is also necessary.

The cardiovascular system suffers the most from taking Ginipral, and therefore, for preventive purposes, against the background of such treatment, drugs that support the heart and blood vessels are simultaneously prescribed (perhaps the most well-known combination is Ginipral and Verapamil / Finoptin / Isoptin), as well as potassium supplements. But there are a number of medications with which Ginipral cannot be combined!

If the drug is not discontinued in a timely manner, during childbirth there may be a need to stimulate labor and other complications. The pregnancy itself, under the influence of the drug, can be prolonged (that is, delayed), which has certain negative side effects for the fetus.

Of course, there are a number of contraindications to taking Ginipral, including heart and vascular diseases, increased intraocular pressure, thyrotoxicosis, premature placental abruption, endometriosis, the first trimester of pregnancy and lactation, bronchial asthma, etc.

How much can you take Ginipral during pregnancy?

Having become familiar with the possible adverse reactions from the medicine, women, of course, are puzzled by the question of how long they can take such “dangerous” pills. But the fact is that without them it is sometimes impossible to bear a child. Therefore, if there is such a need, then Ginipral can be taken for a long time.

Restrictions exist regarding the timing of when such therapy can be started and when it must be completed.

Thus, Ginipral is never used in the early stages of pregnancy in the first trimester. Usually the drug is prescribed to expectant mothers from 20 weeks, but in some cases doctors consider it justified earlier, at 16-18 weeks. However, you have the right to know: according to some studies, until 26-27 weeks of pregnancy, Ginipral is not able to have any positive effect due to the absence of receptors in the uterus that respond to this medicine. Meanwhile, these data are not confirmed, unlike the effectiveness that the drug demonstrates at earlier stages.

3-4 weeks before the expected date of birth (that is, at a period of 36-37 weeks), Ginipral begins to be discontinued. This is completely understandable due to the fact that the medicine suppresses labor.

Who took Ginipral during pregnancy: reviews

If you are in doubt about whether you should take Ginipral, then the reviews are unlikely to help you decide, because they are all quite contradictory. Many of them (if not most) indicate that the drug is quite difficult for women to tolerate. The most common manifestations are tremors of the limbs, disturbances in heart rhythm and acceleration of the heartbeat, instability of the emotional and nervous state. If such “side effects” occur, you must notify your doctor: most likely, he will reduce the dosage or change the regimen of taking the pills (for example, he will prescribe taking a quarter of a pill 4 times a day instead of twice a half).

But it also cannot be said that many women admit that it was thanks to Ginipral that they were able to carry a pregnancy to term. Therefore, everything is determined by each individual situation.

How can you replace Ginipral during pregnancy?

The active ingredient of this medicine is hexoprenaline, there is a medicine with the same name. Ginipral is its analogue.

But if you are looking for more gentle methods of therapy, then this issue should only be discussed with your doctor. There are many ways to relieve increased uterine tone. Perhaps the doctor will advise you to take soothing herbal teas or prescribe pharmaceuticals - motherwort or valerian, Papaverine, No-shpa or Magne B6. But, unfortunately, such therapy is not always effective. If the pregnancy is under serious threat, then it is likely that it will not be possible to do without Ginipral.

Especially for - Margarita SOLOVIOVA

Few pregnancies go as normal, when nothing worries you, all tests and indicators are stable or do not cause concern. Increasingly, women are experiencing unexpected problems during pregnancy in different trimesters. If complications arise with pregnancy after 15 weeks, then Ginipral will help during pregnancy, serving as a guarantee that this difficult period in a woman’s life will end successfully and she will successfully give birth to a healthy child.

Ginipral during pregnancy - what is it prescribed for?

Many women are afraid to use hormonal medications while pregnant, thinking that it will harm them and the baby. However, Ginipral is a panacea for pregnant women if they want the pregnancy to go well and the baby to be born without serious pathological abnormalities. A huge threat to mother and baby is uterine agitation and hypertonicity, which, if nothing is done, leads to the uterus “pushing out” the fetus, contributing to miscarriages, spontaneous abortions and premature births.

What is the drug? Gynipral is a drug that affects a woman’s body at the cellular level, suppressing the activity of the stomata of cells located on the uterus and placenta. At the same time, the muscles of the uterus relax, blood and oxygen supply to the fetus are restored, and the threat of hypoxia of the embryo, which is fraught with the fading of its development, ceases. You must understand that the medication is effective only when the necessary cells have formed in the placenta and uterus; in the early stages of pregnancy it is not only useless, but also harmful. Ginipral is available in the following forms:

• tablet packages;
• liquid for intravenous administration;
• powder for the preparation of solution for injection.

Pills

If at the next examination the gynecologist discovered that a woman’s uterus is hypertonic during pregnancy, but she feels satisfactory, then she is prescribed Ginipral tablets, which can be taken on an outpatient basis during pregnancy, following the doctor’s instructions. One package contains 20 white round tablets, the active ingredient of which is hexoprenaline sulfate with a concentration of 1 tablet. 500 mcg. In addition to it, Ginipral tablets contain the following auxiliary components:

• corn starch;
• lactose, glucose;
• glycerol stearate, magnesium;
• disodium edetate dihydrate;
• talc.

Droppers

If, along with threateningly high hyperfunction of the uterus, pregnancy in the second and third trimesters is complicated by poor health, bleeding, and alcohol consumption, then the pregnant woman is immediately hospitalized. In the hospital, doctors prescribe Ginipral therapy, which may consist of a simultaneous single injection of a dose of the drug 5-10 mcg into a vein (1-2 ampoules), intravenous administration of a diluted Ginipral concentrate per 1 ampoule of 500 ml of sodium chloride. In addition to hexoprenaline, 1 ampoule of Ginipral contains the following components:

• sodium chlorine (saline solution);
• distilled water;
• Edetate disodium dihydrate.

Ginipral - instructions for use

Being a selectively acting ß-2-adrenergic agonist, it acts on the uterus during pregnancy, relaxing it and helping to eliminate contractions. The medicine is a hormonal drug that should not be used independently, without a prescription or indications from the treating gynecologist. In the early stages of pregnancy, Ginipral is useless because there are no cells in the uterus on which it could act. Ginipral is used in the following cases:

• in the second and third trimesters of pregnancy, when there is a significant threat to the life of the fetus from frequent and strong uterine contractions;
• during normal childbirth, when a woman is exhausted by frequent and ineffective uterine contractions with an undilated cervix, and she needs to rest a little;
• to stop labor pains if you need to urgently do a caesarean section.

Dosage

To urgently suppress uterine contractions during pregnancy, drip intravenous administration of Ginipral is used (per 1 ampoule of 500 ml sodium chloride) based on the following calculations:

• 1 ampoule is dripped at a rate of 2 drops per second;
• 2 ampoules – at a rate of 1 drop per second;
• 4 ampoules - at a speed of 1 drop in 2 seconds.

Ginipral droppers are placed in case of acute threat of pregnancy for two days in a row every 4 hours. If during this time the tone of the uterus has not returned to normal, then additional tablets are prescribed at the rate of 1 tablet every 3 hours for two days. For the next 2 days, take 1 Ginipral tablet every 4 hours. If the indicators have stabilized and the acute threat of miscarriage in late pregnancy has passed, then the number of tablets is reduced to 1 every 6 hours. After this, the course of treatment with the drug is determined by the attending physician depending on the condition of the pregnant woman.

Contraindications for Ginipral include the following ailments:

• complicated glaucoma;
• high blood sugar;
• Graves' disease;
• chronic ischemic diseases;
• infectious sexual diseases;
• individual intolerance, allergies.

Effect on the fetus

Women who are afraid that Ginipral will harm the fetus do not realize how serious the consequences of constant strong uterine contractions during pregnancy are. When the muscles of the uterus contract, nutrients and oxygen cease to flow to the embryo, it suffocates and may die. The effect of the drug before childbirth is enormous - by promoting relaxation of smooth muscles, it stimulates the supply of oxygen to the baby, saving him from hypoxia.

Those who during pregnancy followed all the doctor's recommendations regarding the complex course of Ginipral withdrawal - hormonal medications are withdrawn very slowly, carefully and gradually - gave birth to completely healthy babies, since Ginipral has no pathological effect on the intrauterine functional development of the fetus during pregnancy.

Side effects

Smooth muscle in the body is present not only in the placenta and uterus, so Ginipral has a lot of side effects. These include:

• From the side of the heart muscle - increased upper pressure, rapid heartbeat, uneven contraction of the ventricles, pain behind the sternum.
• From the gastrointestinal tract - sluggish peristalsis of the intestines, stomach, nausea, constipation, possible intestinal obstruction, renal dysfunction.
• From the side of the central nervous system - constant anxiety, sweating, sleep disturbances, trembling of fingers, dizziness, attacks of bronchial asthma.

Analogue

The main active component contained in Ginipral, hexoprenaline, is also found in other synonymous drugs, so they cannot be called analogues of this hormonal drug. An analogue of Ginipral is a medicine that acts similarly, but with a different active substance, for example, MgSO4 in 25% concentration, called “magnesia,” or suppositories with salbutamol.

Price for Ginipral

The drug cannot be classified as an expensive medicine, for which you may not have enough money during pregnancy. Its cost is quite affordable; the price range in Moscow can be seen in the following table.

Increased uterine tone - it is impossible to insure against such a diagnosis throughout pregnancy. It can be detected during a routine visit to the ultrasound room or manifest as an attack of severe pain in the lower abdomen and lower back. Drug treatment is prescribed by specialists who, after weighing the pros and cons in each specific case, find the best way to preserve the pregnancy. Ginipral during pregnancy has a direct effect on the muscles of the uterus and is used if there is a threat of premature birth.

Composition, release forms and mechanism of action of the drug

The active ingredient of the drug Ginipral is hexoprenaline sulfate - a tocolytic, the action of which is aimed directly at the smooth muscles of the internal organs of a person. Their peculiarity is spontaneous contraction, independent of the central nervous system, and the ability to remain in good shape for a long time.

Contractile function is stimulated by the hormonal and autonomic nervous system. In this case, the action of hexoprenaline is aimed at suppressing nerve receptors that produce substances that work to tension muscle tissue.

The drug is available in tablets containing 0.5 mg of hexoprenaline and excipients. The liquid in ampoules for intravenous injection contains 0.1 mg of active substance per 2 ml of physiological solution, which is part of Ginipral.

Another form of release is Ginipral liquid concentrate for dropper: 5 ml capsules contain 0.025 mg of hexoprenaline sulfate, used after dilution in saline (proportions depend on the rate of infusion). For gradual administration, infusion pumps can also be used - electronically controlled medical pumps, which make it possible to more accurately dosage and change modes.

Instructions for using the drug in different dosage forms during pregnancy

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Before using the drug, you must read the instructions in detail and study the contraindications.

The therapeutic effect of the drug Ginipral differs in the scope of application of dosage forms. Tablets from different manufacturers contain the same amount of active ingredient. How much to drink and with what frequency is determined by the attending physician depending on the patient’s condition. Indications for use: moderate degree of uterine hypertonicity and stabilization of the condition after injection therapy.

Injection or infusion use of the drug is carried out in medical institutions or at home under the direct supervision of a physician. Intravenous infusion of a solution through a drip allows you to suppress uterine contractions to solve problems such as:

• termination of early labor at 20–34 weeks;
• temporary weakening of contractions at the stage of turning the child over;
• reducing the frequency of labor contractions during fetal hypoxia;
• ensuring the immobility of the uterus when suturing the cervix;
• emergency inhibition of labor to transport the woman in labor.

A distinctive feature of Ginipral is the need for gradual withdrawal: after the therapeutic effect, a period of gradual reduction of the daily dose is required while maintaining the frequency of administration, after which the time period between doses of minimal doses (¼ tablet) increases.

Infusion of the drug through a dropper or combining two forms of the drug allows you to establish a smooth dosage regimen. The effect of increasing and decreasing the active substance is more pronounced when the drug is dripped intravenously.

In what cases is Ginipral prescribed to pregnant women?

The prescription of Ginipral is justified after the 1st trimester of pregnancy. In the early stages, muscle cells rapidly multiply, increasing the size and thickness of the walls and fundus of the uterus, and only from the 20th week do tissues form that can respond to hexoprenaline.

Taking Ginipral in the first 3 months after conception will not only not reduce the risk of premature birth, but can also significantly harm the child, whose organs are at the stage of formation. During this period, tension in the muscles of the uterus (high tone), which is manifested by moderate nagging pain, may be within normal limits. Only a doctor can assess the degree of danger of this condition, taking into account anamnesis, questioning and the results of a manual examination using palpation. Doctors usually recommend rest, prescribe vitamins, and in more serious cases, hormonal therapy is indicated.

Regulating labor is another area of ​​application of Ginipral. Relaxation of the uterus using medication is prescribed:

• during rapid or discoordinated contractions;
• in case of complications of the birth process, for example, the threat of uterine rupture or intrauterine asphyxia;
• for performing surgical operations and manipulations to change the position of the fetus.

Contraindications for use

The presence of certain diseases excludes the possibility of using Ginipral, which affects the functioning of the heart, inhibits the removal of water from the body and increases blood sugar levels. List of contraindications according to the instructions:

• all types of arrhythmia and organic heart pathologies;
• liver and kidney diseases;
• glaucoma;
• bronchial asthma;
• uterine infections and bleeding.

Individual intolerance to Ginipral, indicated in the list of contraindications, can cause pulmonary edema, heart failure and other dangerous conditions. The first dose is carried out under the direct supervision of a doctor.

Possible adverse reactions and effects on the fetus

Adverse reactions that may occur at any stage of therapy:

• dizziness;
• increased heart rate;
• changes in blood pressure;
• increased sweating;
• tremor of the limbs;
• headache;
• nausea, vomiting;
• swelling due to fluid retention in tissues;
• stool retention;
• skin rashes.

Due to the presence of side effects of the drug, its use is only possible under the supervision of a specialist.

If these signs appear, you should immediately consult a doctor. Assessing the risks and benefits of a medication is the prerogative of a specialist at the perinatal center. To avoid adverse reactions, dosage adjustments are made and additional medications are prescribed.

Mandatory medical support includes:

• Carditocography (CTG) – continuous hardware recording of the heart rate of the pregnant woman and fetus;
• monitoring the regularity of bowel movements and urination;
• checking blood glucose levels;
• prescribing a diet to correct water metabolism;
• regular monitoring of key indicators of urine analysis.

With long-term use, a tocolytic can smooth out (hide) the clinical picture of placental abruption, therefore, if this problem exists, it is recommended to switch to alternative means to maintain pregnancy. There are also a number of rules for doctors regarding the combination of a course of treatment with Ginipral with other medications and supporting agents.

In some cases, the gynecologist may prescribe an analogue of Ginipral

If taking Ginipral continued until delivery, the newborn may experience low blood sugar and increased acidity in the gastrointestinal tract. Taking Ginipral, the effect on the fetus is due to the vital need to extend the period of intrauterine development. Possible complications are eliminated with auxiliary stabilizing agents and therapy after the birth of the baby.

How does childbirth go in pregnant women after using Ginipral?

The use of hexoprenaline solution for tocolysis (control of labor pains) takes place in a clinical setting. The decision is made by the doctor situationally if there is a need to suppress the contractile function of the uterus to preserve the life and health of the woman in labor and the child.

The use of Ginipral during the prenatal period to maintain pregnancy raises many questions. After positive dynamics appear, anxiety arises about the upcoming birth, because aggressive suppression of the muscular activity of the uterus can lead to degradation of its contractile function.

This statement is not confirmed theoretically, since the drug is quickly absorbed and excreted from the body and does not have a prolonged effect. In most cases, the drug is stopped a month before the due date, which, depending on the condition of the fetus and mother, can be set at 36 weeks.

It is almost impossible to establish a statistical relationship between taking Ginipral and complications during childbirth. The characteristics of labor and the health of the fetus are determined by many factors, and indicators of uterine tone are only one of them. Pregnancy prolonged with the help of tocolytics can result in either a normal and easy birth, or a cesarean section or premature birth, but there is no direct relationship between successful and complicated labor after taking Ginipral.

If there is a threat of premature birth, the expectant mother is treated in a hospital setting

Hypertonicity of the uterus, against which the drug fights, poses a serious threat of miscarriage, so its side effects are perceived as the lesser of two evils. The correct selection of medications helps not only eliminate pain, but also reduces the risk of losing a child, and much depends on the competence of the doctor.

Distrust of prescriptions leads to two extremes - patients either refuse treatment, ignoring prescriptions, if this contradicts their ideas about the normal course of pregnancy, or, conversely, exaggerating the degree of danger, resort to unauthorized use of tocolytics. Both approaches have serious consequences. Information on the Internet presented in popular language and the provisions of the instructions cannot replace consultation with specialists.

Cost and analogues

The cost of Ginipral is determined by the manufacturer and dosage form. The price of a package of 20 tablets starts from 160 rubles, 5 ampoules – from 220 rubles. The production of tablets has declined sharply in recent years. The risk of self-medication and overdose at home forces manufacturers to limit themselves to dosage forms in the form of ampoules and containers with solution, which are used only in clinical settings.

The medicine Ginipral can be replaced with Hexoprenaline or Ipradol, which are similar in composition. Its analogues have a similar therapeutic effect in suppressing uterine hypertonicity: Fenoterol, Terbutaline, Partusiten, Indomethacin.

The period of bearing a child does not always go well; sometimes various complications arise during it. Some of the most unpleasant pathologies of pregnancy include spontaneous miscarriages (before the 22nd obstetric week) and premature birth (after the 22nd obstetric week). These processes are characterized by an increase in the contractile function of the uterus - its hypertonicity.

Ginipral during pregnancy is used to eliminate uterine hypertonicity (tocolytic effect), it can stop or premature birth. This drug should be used under the supervision of a physician; it is a strong medication with strict dosages and contraindications.

Composition and release form

When the drug combines with the receptors of the uterus, relaxation of its muscles is observed, due to which the frequency and intensity of contractions of the organ decreases. Ginipral is able to stop spontaneous contractions and labor that began due to an increase in the hormone oxytocin (a stimulant of labor). Also, in small doses, the drug can inhibit too strong contractions of the uterus during childbirth.

The drug stimulates adrenaline receptors located in the bronchi, expanding them. The effect of Ginipral on the respiratory system is less pronounced than the effect on the uterine myometrium. The drug also dilates peripheral blood vessels and leads to a drop in blood pressure and improves cardiac activity. The last two effects of Ginipral are weakly expressed, since the drug is selective.

Attention! The use of Ginipral in pregnant women is possible only under strict indications under the supervision of a specialist.

One tablet of Ginipral contains 0.5 mg of Hexoprenaline. Basically, the medication leaves the body through the intestines within three days, a smaller part is excreted in the urine. Ginipral for pregnant women in tablet form begins to show its effect half an hour after oral administration, the highest concentration in plasma is observed after 2 hours.

During pregnancy, Ginipral is prescribed for the following indications:

• acute tocolytic therapy - rapid suppression of contractions during cesarean section, prolapse of the umbilical cord, abnormal presentation of the child, etc.;
• massive tocolytic therapy - slowing down contractions, accompanied by a closed or slightly open cervix;
• long-term tocolytic therapy – prevention of premature birth or spontaneous miscarriage.

Instructions for use

For acute tocolytic therapy, an ampoule of Ginipral is injected into a vein within 7 minutes either in a jet or using an automatic device. Before infusion, you need to mix the drug with 8 milliliters of 0.9% sodium chlorine. Typically, this method of using Ginipral is necessary at 40 weeks of pregnancy during childbirth, when an emergency situation occurs (the child is entangled in the umbilical cord, fetal distress).

With massive tocolytic therapy, the doctor prescribes the first simultaneous intravenous administration of one ampoule of the drug. Then the treatment uses a dropper containing 2-10 mcg of the active substance, which is diluted in 0.5 liters of a solution of glucose and sodium chloride. The maximum dose is 420 mcg per day.

Sometimes the doctor immediately prescribes a drip infusion of the drug. Typically, massive tocolysis with Ginipral is used at 37-38 weeks of pregnancy to prolong it.

The dose of Ginipral in tablet form is selected by the doctor for each individual woman. Begin therapy with 1 piece every 4 hours, then every 7 hours. The largest daily dose of the drug is 8 tablets. The medicine should be taken with a glass of clean water, without chewing. Long-term toclolytic therapy is used from the beginning of the second trimester to maintain pregnancy and can be used until delivery.

The shelf life of Ginepral in ampoules is five years, in tablets – three. It is recommended to store the medicine in a cool, dark place and keep it out of reach of children.

Contraindications and side effects

• Central nervous system – headaches, irritability, convulsions, deterioration of concentration, drowsiness, anxiety, insomnia, high sweating, apathy, depressive disorders;
• CVS - acceleration of heart rate, presyncope, ventricular extrasystole, hypotension, decreased cardiac output;
• Gastrointestinal tract - digestive disorders, constipation, diarrhea, flatulence, intestinal dyskinesia, dilation of hemorrhoidal veins;
• others - disturbances in water-salt balance, increased blood sugar, allergic reactions, disturbances in liver function, decreased urine output, increased bilirubin in the blood;
• in the fetus - a drop in blood sugar, acid-base balance disorders, allergic reactions.

Also, treatment with Ginipral is prohibited if a woman has vaginal bleeding, frozen pregnancy or intrauterine infection.

Ginipral is contraindicated in the early stages of pregnancy - up to 16-20 obstetric weeks. Persons with low blood pressure, diabetes mellitus, intestinal dyskinesia, extensive edema, myotonia, severe concomitant diseases, and hereditary pathologies associated with metabolic processes should be especially careful when using the drug.

Ginipral's analogs

An analogue of Ginipral in tablets is the drug Aloprol. It belongs to the group of beta-2 adrenergic agonists and contains the active substance Salbutamol. The drug is indicated for long-term tocolytic therapy in the second and third trimester of pregnancy, after infusion therapy. The drug must be used under the supervision of a physician and according to strict indications.

A stronger analogue of Ginipral is the drug Nifedipine. It has a tocolytic effect on the uterus, both drugs can be used together. Nifedipine is able to lower blood pressure, improve heart function, and relieve symptoms of coronary artery disease. The drug can be used according to strict indications, since it has a negative effect on the fetus.