. "004.006" . . "T\u011Bhotenstv\u00ED:\nInhibice synt\u00E9zy prostaglandin\u016F m\u016F\u017Ee m\u00EDt ne\u017E\u00E1douc\u00ED vliv na t\u011Bhotenstv\u00ED a fet\u00E1ln\u00ED/embryon\u00E1ln\u00ED v\u00FDvoj. Data z epidemiologick\u00FDch studi\u00ED nazna\u010Duj\u00ED zv\u00FD\u0161en\u00E9 riziko potrat\u016F a kardi\u00E1ln\u00EDch malformac\u00ED po u\u017E\u00EDv\u00E1n\u00ED inhibitor\u016F synt\u00E9zy prostaglandin\u016F v po\u010D\u00E1tku t\u011Bhotenstv\u00ED. Absolutn\u00ED riziko kardiovaskul\u00E1rn\u00EDch malformac\u00ED se zv\u00FD\u0161ilo z m\u00E9n\u011B ne\u017E 1% na p\u0159ibli\u017En\u011B 1,5%. P\u0159edpokl\u00E1d\u00E1 se, \u017Ee se riziko zvy\u0161uje s d\u00E1vkou a trv\u00E1n\u00EDm terapie. U zv\u00ED\u0159at se prok\u00E1zalo, \u017Ee pod\u00E1n\u00ED inhibitor\u016F synt\u00E9zy prostaglandin\u016F vede k zv\u00FD\u0161en\u00ED pre- a postimplanta\u010Dn\u00EDch ztr\u00E1t a k fet\u00E1ln\u00ED/embryon\u00E1ln\u00ED letalit\u011B. Nav\u00EDc byla hl\u00E1\u0161ena zv\u00FD\u0161en\u00E1 incidence r\u016Fzn\u00FDch malformac\u00ED v\u010Detn\u011B kardiovaskul\u00E1rn\u00EDch po pod\u00E1n\u00ED inhibitor\u016F synt\u00E9zy prostaglandin\u016F zv\u00ED\u0159at\u016Fm v pr\u016Fb\u011Bhu organogenetick\u00E9 periody.\nV pr\u016Fb\u011Bhu prvn\u00EDho a druh\u00E9ho trimestru m\u016F\u017Ee b\u00FDt ibuprofen pod\u00E1n pouze tehdy, je-li to nezbytn\u011B nutn\u00E9.\nPokud je ibuprofen pod\u00E1v\u00E1n \u017Een\u00E1m, kter\u00E9 cht\u011Bj\u00ED ot\u011Bhotn\u011Bt, nebo v prvn\u00EDm a druh\u00E9m trimestru t\u011Bhotenstv\u00ED, mus\u00ED b\u00FDt d\u00E1vka co nejni\u017E\u0161\u00ED a doba l\u00E9\u010Dby co nejkrat\u0161\u00ED.\nB\u011Bhem t\u0159et\u00EDho trimestru t\u011Bhotenstv\u00ED v\u0161echny inhibitory synt\u00E9zy prostaglandin\u016F mohou vystavovat\nplod:\n-kardiopulmon\u00E1ln\u00ED toxicit\u011B (p\u0159ed\u010Dasn\u00FD uz\u00E1v\u011Br duktus arteriosus a pulmon\u00E1ln\u00ED hypertense);\n-ren\u00E1ln\u00ED dysfunkci, kter\u00E1 m\u016F\u017Ee progredovat v\u00A0ren\u00E1ln\u00ED selh\u00E1n\u00ED s\u00A0oligohydramnionem;\nmatku a novorozence na konci t\u011Bhotenstv\u00ED:\npotenci\u00E1ln\u00EDmu prodlou\u017Een\u00ED krv\u00E1cen\u00ED;\ninhibici d\u011Blo\u017En\u00EDch kontrakc\u00ED vedouc\u00ED k\u00A0opo\u017Ed\u011Bn\u00ED nebo prodlou\u017Een\u00ED porodu.\nProto je ibuprofen kontraindikov\u00E1n ve t\u0159et\u00EDm trimestru t\u011Bhotenstv\u00ED.\nKojen\u00ED:\nIbuprofen a jeho metabolity p\u0159estupuj\u00ED do mate\u0159sk\u00E9ho ml\u00E9ka pouze v\u00A0extr\u00E9mn\u011B n\u00EDzk\u00FDch koncentrac\u00EDch (0,0008% d\u00E1vky podan\u00E9 matce). Vzhledem k\u00A0tomu, \u017Ee mno\u017Estv\u00ED ibuprofenu v\u00A0mate\u0159sk\u00E9m ml\u00E9ce je minim\u00E1ln\u00ED, jeho elimina\u010Dn\u00ED polo\u010Das kr\u00E1tk\u00FD a dosud nebyly zji\u0161t\u011Bny ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky u kojen\u00FDch d\u011Bt\u00ED, je ibuprofen pova\u017Eov\u00E1n za l\u00E9k prvn\u00ED volby k\u00A0l\u00E9\u010Db\u011B bolesti a p\u0159\u00EDznak\u016F z\u00E1n\u011Btu u koj\u00EDc\u00EDch matek, zejm\u00E9na p\u0159i kr\u00E1tkodob\u00E9m pou\u017Eit\u00ED. Bezpe\u010Dnost p\u0159i dlouhodob\u00E9m pod\u00E1v\u00E1n\u00ED nebyla stanovena.\n"@cs . " T\u011Bhotenstv\u00ED a kojen\u00ED"@cs . . . . . . . .