Possibilities of pharmacotherapy in the treatment of gastroenterological diseases during pregnancy

The article discusses the possibilities of modern pharmacotherapy of various gastroenterological pathologies of pregnant women. Having revealed the reasons for careful monitoring of prescribing drugs to pregnant women (thalimidomide tragedy), the authors cited the FDA classification of drug safety depending on the possibility of their use during pregnancy (A, B, C, D, X categories). Physiological changes in the basic biochemical parameters in pregnant women associated with neuroendocrine and metabolic processes are listed. Features of treatment of gastroesophageal disease are emphasized: the most optimal is the appointment of alginates and antacids. During pregnancy, Helicobacter pylori eradication therapy is impossible, as well as the appointment of M-anticholinergics, bismuth preparations, therefore, antacids, alginates, sucralfate may be recommended for pregnant women suffering from chronic gastritis and gastric ulcer, duodenal ulcer. The only one proton pump inhibitor proven to be safe during pregnancy is the original omeprazole. Exacerbation of chronic pancreatitis is an indication for hospitalization of a pregnant woman in a hospital with a therapeutic profile, while acute pancreatitis must be treated in a surgical hospital after preliminary delivery. Features of damage to the hepatobiliary system during pregnancy are considered, possibility of bearing the fetus in autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis is emphasized. Indications for the appointment of various hepatoprotectors, glucocorticosteroids are listed. Management schemes for pregnant women with inflammatory bowel diseases are indicated with the primary use of sulfasalazine, 5-aminosalicylic acid, steroids, infliximab.