Book of Medical Disorders in Pregnancy - Tintash

is 2 tablets i.e. (400 mgs) thrice daily for
5 days. When there is history of passing
symptomless cysts only; the dosage is 2
to 4 tablets (400 - 800 mgs) thrice daily
for five da yes.
Metronidazole crosses the plac-ental
barrier. Although it has been given to
pregnant patients without apparent
complication and there is no evidence to
suggest that metro· nidazole is embryopathic,
it is a sound medical principle to
avoid prescribing any drug during the
first three months of pregnancy unless
considered absolutely necessary.
Adverse side effects of Metroni-dazole
are minor and infrequent. These include
metallic taste, furry tongue, dry mouth,
diarrhoea, anorexia, nausea, vomiting,
epigastric distress and constipation.
Flushing and headache can also occur
especially when alcohol beverages are
ingested while the patient is receiving
this drug. Other infrequent side effects
are dizziness, transient ataxia, confusion,
insomnia, rash, vaginal dryness and
dysuria. The urine may be darkened but
this is of no clinical significance. It is
probably due to metabolites of
metronidazole. The drug may produce
leukopenia in some cases. Various trade
names of metronidazole used in different
countries include Novinidazole, Flagyl
and Neotric.
TRICHURIASIS:
Trichuris trichiura is a common parasite
of the human intestine and is common in
warm and moist regions. Man is infected
by ingesting mature embryonated ova
that have developed in soil contaminated
by faeces. The adult nematode lives in
the Caecum, but in heavily infested
159
subjects colon and rectum are also
involved.
Clinical features: Light infections are
asymptomatic. Patients with very heavy
infections may have severe anemia, bloody
diarrhea, diffuse lower abdo-minal
pain, tenderness, and weight loss. Rectal
prolapse with visible worms may be seen.
The exact role of Trichuris in the
production of anemia is difficult to determine,
since multiple infections with
hookworm, ascaris, and other helminths
are often found.
Relation to pregnancy: Infection may
cause a severe iron deficiency anemia.
Diagnosis: Ova can be detected readily
by microscopic examination of a faucal
smear.
Treatment: Dithiazanine Iodide, 200
mg. orally three times daily for 2 weeks.
This drug causes severe nausea and
vomiting. The only valid indication for
the specific treatment of this infection
during pregnancy is a heavy worm load
causing intractable diarrhea and severe
anemia.
Fig12.6: Shows Trichuris Trichiura
OXYURIASIS:
Oxyuris vermicularis is a com-mon
parasite of man in the temperate regions.
Incidence is highest among ur-ban
populations. Transmission is by clo-se
personal contact i.e. in families, sc-hools