DYSENTERY IN PREGNANCY

This appears as amoebic dysentery or bacillary dysentery; the former is more commonly encountered in this country. This appears in acute form or relapsing mild form during pregnancy; relapses are frequently encountered during pregnancy. Mucus diarrhoea, alternating constipation, gas distension of abdomen, griping during defaecation, anorexia are common symptoms in the mild form. The condition is one of the important cause of abdominal cramp and pain in pregnancy in this country. Nutritional anaemias form common association. The condition while acutely severre can predispose to abortion or premature labor. Clinical manifestation along with microscopical identification of different forms of entamoeba histolytica in stool are diagnostic. In some cases, intestinal amoebiasis may be complicated by amoebic hepatitis. For acute intestinal amoebiasis, emetine hydrochlor 60 mg given intramuscularly daily for 6 days is the drug of choice as pregnancy is no contraindication to emetine therapy; this is followed by enteroquinol 1 tablet t.d for ten days. Metronidazole is avoided during first three months of pregnancy. The diet should comprise bland high protein along with isafgul and bael. Amoebic hepatitis in pregnancy can be treated by a course of chloroquine (Nivembin one tab t.d.s. for ten days ). Bacillary dysentery commonly caused by Sh. sonnei in the country is diagnosed mainly on clinical evidences although positive culture report of stool confirms the diagnosis. The condition while severe, causes abortion and premature labor.