Most pregnant women are very wary of any medicines that the doctor appoints, trying to protect the future kid from their impact. The negative attitude towards pharmacy products is quite reasonable, since a prevention warning is written on any box with pills for the fetus or the absence of information about the effect of drug progress. That is why many future mothers relate incredulously even to the appointment of magnesia injections during pregnancy for serious testimony.

Magnesium sulfate in the form of a medicinal solution is successfully used in obstetrics for several decades. Despite this, the injections of magnesia during pregnancy are not suitable for everyone, therefore are prescribed by doctors with extreme caution. Consider what effect the drug is possessed, as well as basic indications for magnesia injections during pregnancy.

Magnesium sulfate for pregnant women: medicine from all ailments?

Even at the beginning of the 20th century, Magnesia was used as a means for the treatment of convulsion. Later, magnesium injections sulfate began to prescribe during pregnancy, since the drug had an excellent tocolithic effect, that is, it was capable of relaxing muscles and reduce the tone of the uterus in the threat of premature birth. In addition, the intravenous administration of Magnesia in modern medicine is one of the priority actions in the development of severe preeclampsia and a hypertensive crisis, as it helps to reduce blood pressure due to the normalization of the tone of arterial vessels.

IMPORTANT! In obstetrics, the purpose of intramuscular injections of the solution of magnesium sulfate is practically no applied, due to the pain and inconvenience of the drug administration in this way. The high therapeutic effect provides magnesia dropper during pregnancy at the rate of: 20-25% solution in an amount of 5-20 ml per 150-200 ml NaCl solution 0.9% for intravenous drip administration for several hours.

Magnesia injections for pregnancy are also prescribed at:

  • edema syndrome, as well as urine delay;
  • epileptic seizures, spitches at eclampsia;
  • poisoning of heavy metals salts;
  • imbalance of trace elements and lack of magnesium in the body;
  • hypertensive crisis.

IMPORTANT! Magnesia injections during pregnancy can be prescribed from 16 weeks to the end of the gestational period.

How dangerous injections of magnesia during pregnancy?

During all this time, large-scale clinical studies of the effect of magnesium sulfate on the fruit was not carried out, but the experience of long-term use of the medication confirms its relative security.

Despite the widespread use of various medicinal substances during the gestation period, we should not forget that any of them is potentially dangerous. Take, for example, a well-known harmless paracetamol, which is prescribed from the first months of life: the drug in many people causes an allergic reaction, up to an anaphylactic shock. That is why the appointment of any pharmacy drug during pregnancy must be justified. Usually, the packaging of magnesia injections for pregnant women write that the medicine is prescribed with caution, and only if the benefits exceed the risk to the health of the fetus.

IMPORTANT! Due to the negative impact of long-used magnesia on the mineral metabolism of the fetus, followed by the development of bone anomalies against the background of calcium shortage, the drug during the gestation period is prescribed a period of three to seven days. The last introduction of magnesium sulfate should not be later than a few hours before the start of the generic activity, since the drug relaxes the muscles of the uterus and prevents its active reduction.

In which cases of magnesia injections for pregnancy are contraindicated?

The main contraindications for the purpose of the drug are directly related to its tocolic, sedative, antispasmodic, anticonvulsant, diuretic and hypotonic effect. These include:

  • low blood pressure (hypotension) and slowdown in heart rate (bradycardia);
  • severe diseases of the kidneys with a violation of the excretory function;
  • violation of the conductivity of the heart, including AV blockade;
  • breathing violation against the background of the oppression of the respiratory center (the consequences of CMT, anesthesia, an overdose of narcotic substances);
  • onbox;
  • acute course of diseases of the digestive system;
  • the probability of the beginning of childbirth in the next 2-3 hours;
  • hypersensitivity to the drug.

What side effects after magnesia injections during pregnancy should be expected?

In rare cases, with the introduction of Magnesia, individual side effects may occur, including the increase in heartbeat, sweating, heat, drop in blood pressure, weakness, headache. As a rule, these symptoms appear with an incorrectly calculated dosage of the drug or its rapid introduction.

The fact that Magnesia is the most frequent drug appointed by pregnant women, almost all have given birth to women. And more than half of them experienced the effect of this drug on themselves. About the painful introduction of the medication and the poor absorption of cones after injections they say almost everything. What is the benefit of magnesia (or magnesium sulfate) for the body of pregnant women, for which it is prescribed, despite the universal dislike?

Magnesia: Indications for use

Magnesium sulfate has a very wide range of action. It lowers the pressure, removes an extra liquid, removes the spasms of smooth muscles, contributes to the elimination of constipation, is applied during convulsions and poisoning. Some features of this drug are widely used in the treatment of complications and diseases of pregnancy. If the woman fell into the hospital with the following diagnoses, Magnesia will be one of the appointments:

    the risk of non-banking and premature birth at elevated ;

    hypertension;

    nephropathy and swelling;

    preeclampsia and eclampsia.

In all these cases, Magnezia has a fast and positive effect: removes spasm, eliminating the uterine tone, expands the vessels, improving blood circulation and reducing pressure, stops convulsive attacks.

In addition, magnesium sulfate is used during placenta detachment; as a sedative; For the prevention of blood clots.

There is an opinion that Magnesia will appoint any pregnant woman for some reason that fell into the hospital does not hurt! Is it so? After all, many doctors oppose such treatment, despite the long-term practice and benefits. Yes, and the future mothers themselves without good reason do not want to "strive" their organism and the child's body with unnecessary medicine.

Contraindications of the use of Magnesia

In domestic medicine, specialists rely more on empirical experience, since data on the effect of magnesia on the fruit is not enough. It is believed that the fruit and the woman will suffer stronger from muscle tone and other complications than from the side effects of the drug. American and European colleagues decided to make accuracy and prevent evidence. Surveying newborn babies whose mothers received long-term treatment with magnesium sulfate, experts revealed a detrimental effect of the drug on the fruit. In some cases, it is short-term and reversible, but there are also serious complications, including a deadly outcome. Therefore, the admission of the drug must be short-term, strictly dosed and directly depends on the period of pregnancy.

The use of magnesia is suitable in the second and third trimesters when the muscles of the uterus get the ability to decline much, and they need to relax. Injections with magnesium in the first trimester are useless, since not muscle spasm rejects fruit, and there are more objective causes (for example, hormonal imbalance). But the influence of the drug on the fruit in the early stages has a proven negative effect.

In the last weeks, and especially before the start of childbirth, Magnesia does not make a fear of reduced generic activities.

In addition to restrictions on pregnancy, this drug is contraindicated in the following situations:

    for ;

    joint use of calcium preparations;

    renal failure;

    individual intolerance, manifestation of allergic reactions to the drug;

    slow pulse;

    dehydration of the body.

When identifying any of these manifestations, Magnesia is canceled.

Complications after the introduction of Magnesia

Mostly the drug is transferred to women well. Various complications or side effects are observed in overdose or with too rapid drug intake in the body. Therefore, from the side of the medical staff and the attending physician, strict control of the procedure conducted and over the amount of medication entering the blood is necessary.

The most frequent reactions of the body on Magnezia are:

    weakness, dizziness;

    difficulty breathing;

    panic, anxiety;

    numbness of limbs, muscle weakness;

    reduction of pressure, arrhythmia;

    nausea;

    flushed face;

    sharp urination (with the duration of the procedure from 1do 2 hours).

In order to prevent side effects on the development of the fetus, the technique of magnesia is limited to 5-7 days. The use of the drug is possible only in the conditions of the hospital and on the recommendation of the doctor.

Magnesia intravenously and intramuscularly

Magnesium sulfate is available in two forms: in the form of a powder, which is divorced by the necessary amount of liquid, and in the form of a solution for intramuscular and intravenous injections.

The most optimal way to achieve a quick and maximum effect is a dropper. When the medicine comes directly into the bloodstream, its action is manifested in 2-3 minutes: convulsions are stopped, the pressure is reduced, the spasm of the muscles of the uterus decreases. Intravenous administration of Magnesia today is most preferable. Yes, and the female organism reacts to droppers without additional pain stress compared to injections. During the procedure, the woman should lie, do not do sharp movements, do not get up. The drug enters the body slowly, in order to avoid unpleasant sensations and side effects. After the procedure, it is recommended to lie down a few minutes.

The intramuscular administration of magnesia is trying to minimize. First, this procedure is painful and unpleasant. Secondly, it requires slow and thorough execution from medical personnel (one injection is entered for several minutes). With incorrect formulation of the injection, hematomas and inflammation in injections are possible. Thirdly, the effect of application begins to manifest in 30-60 minutes.

In the form of a suspension during powder dilution, magnesium sulfate is taken inside as a laxative and choleretic agent. In the blood of the intestine, it is almost not absorbed. Therefore, the treatment of the main complications of pregnancy is impossible in this way.

Despite all contraindications and side effects, the possible fears of future mothers for their health and health of their child, the use of Magnesia is still considered the most relevant way to treat complications of pregnancy. Judging by the reviews of women who passed the course of magnesial therapy, their well-being was significantly improved, even despite some negative manifestations. Pressure, convulsions, muscle spasms succumbed to treatment. And the negative influence of Magnesia on the native children was not mentioned.

Periodically arise situations when a woman under pregnancy is needed. It may be connected with the health of the mother, the state of the fetus and the pregnancy itself. Very common to therapeutic drug, which is appointed pregnant women, is magnesia. There are cases when dripped or tolting magnesia is quite a long time. There is a natural question - why are Magnesia sulfate (Magnesia) prescribe pregnant women?

Magnesium sulfate, or magnesia has certain properties, thanks to which a number of diseases are treated in pregnant women. Also, this drug contributes to preventing complications and miscarriages. Magnesia relaxes the walls of the vessels, normalizes blood pressure, relaxes muscle muscles, speeds up the removal of fluid from the body. This drug is prescribed in case of such diseases as: gestosis with nephropathy, eclampsia, hypertension (increased pressure), swelling and predisposition to thrombophlebitis. If there is a threat of premature genera and lack of magnesium in the body of a woman, then it is also prescribed.

Magnesium effectively acts only in the case when it is administered intravenously or intramuscularly. If you take it in the form of a powder, then no result will be, because it does not fall into the blood from the intestinal treatise.

The concentration and amount of magnesia depends on the state of a pregnant woman. As a rule, 25% magnesia once a day is prescribed. If the woman has the first degree of nephropathy, then prescribe twice a day if the second stage is four times.

It is very important how this drug is administered. The introduction of magnesia is a very painful thing. And with incorrectly administration, inflammation may occur and subsequent motion at the injection site. Before making an injection, liquid magnesia must be warm and used only a long corner. It is necessary to enter it very slowly, not in a hurry. This applies to both intramuscular administration and intravenous.

Is Magnesia dangerous for pregnant women? On this issue, the opinions of doctors are diverged. Some speak out against the treatment of Magnesia, others, and most of them believe that such treatment is very effective. However, clinical studies were not carried out in order to find out what effect the drug has on the fruit. Obviously one thing - for the fetus, hypertonus uterus has greater harm and danger, rather than the drug itself. Nevertheless, there is some share of risk in the admission of magnesia into the body. First of all, a large number of side effects, among which you can distinguish such as: sweating, tide of blood to face, weakness, headaches, drowsiness, anxiety, vomiting, drop in blood pressure, violation of speech. It should be known that with low arterial pressure, the introduction of the drug is strictly pressed. If the pressure decreases after its introduction, then Magnesia must be excluded. Combining Magnesia with the reception of biological food additives and calcium preparations is prohibited.

It is important to know the measure and dosage of the drug. With a lot of quantities, it is like drugs. There may be a violation of the operation of the cerebral cerebral center. A small amount of the drug is not harmful for mom and fetus, but excess contributes to the disruption of breathing and the fetus. It can not be applied immediately before childbirth. As soon as Magnesia leaves blood, it does not interfere with the opening of the cervix.

Remember that in the first trimester, the treatment of magnesia is categorically unacceptable. During pregnancy, treatment should be treated under thorough and strict control and supervision of the doctor.

Thus, magnesia is a preparation of magnesium sulfate. It is used to reduce the tone of the uterus, withdrawal of excess fluid and stimulation of kidney work, reduce hypertension and convulsion, reduce swelling, reduce gestosis and eclampsia, extension of vessels, has a slight sedative effect. It is very important not to overdo it with a dosage that bad will affect the health of the future mother and the fetus itself. Enter intramuscularly or intravenously. Do not deal with independent treatments. Self-medication can inflict the health of a pregnant woman irreparable consequences. The use of magnesia has some risk, because before starting treatment with this drug, it is necessary to refer to a qualified gynecologist. If you do not have those diseases in which the treatment of magnesia is forbidden, then you may well begin treatment by it.

Unfortunately, not always the pregnancy proceeds perfectly. Every year more and more new pathologies, diseases and difficulties in having to wear a child appear. However, most of them are easily eliminated under the supervision of doctors at day hospital. With modern technologies, many years of experience of doctors, as well as a large spectrum of special preparations, despite all possible arising difficulties, a woman can endure and give a healthy child. In most cases, when the future mother enters the hospital, with whatever disorders, it is prescribed droppers from Magnesia sulfate.

Most girls never heard of this preparation, and can perceive this name rather frightening. Therefore, I would like to make all the fears and fears, and help figure out what it is and what side effects can cause a dropper with magnesia.

Magnesia, or magnesium sulfate is a powdered chemical compound of white. Magnesia crystals make suspensions and fluids for physiotherapeutic manipulations. However, the most common form is a solution for administering intravenously or intramuscularly. The only active substance in this drug serves magnesium sulfate itself. There are no additional impurities, only specially prepared water.

Magnesia has a very large spectrum of therapeutic properties. In addition to gynecology, it is actively used when dealing with constipation, poisoning, arterial hypertension, as well as a choleretic agent. The most active method of using magnesia is intravenous administration. The angry patency of the nerve pulses, the active ingredient quickly penetrates the blood.

The therapeutic effect of magnesium sulfate depends on the method of application. So, when taking inside, it causes a choleretic and laxative effect, without falling into the blood. Those. Magnesia during pregnancy is prescribed only intramuscularly.

Why can making magnesia during pregnancy?

Magnesium sulfate for pregnancy is prescribed in the threat of premature birth. This is an anticonvulsant having a hypotensive effect, i.e. It is a drug for the treatment of cramps and combating arterial pressure. The main function of this medication is to bring to the norm of the tone of smooth muscles. Among other things, for women in an interesting position, Magnesia helps well in the fight against constipation. Below are the most favorable effects of Magnesia reception for a pregnant woman.

So, magnesium sulfate:

  1. Helps reduce pressure on the walls of the vessels.
  2. Rights the tone of the uterine muscles.
  3. It struggles with a hypertonic crisis caused by gestosis.
  4. It has a light soothing effect.
  5. It is a good diuretic.
  6. Displays an extra calcium from the body, thereby relaxing the muscles.
  7. Eliminates muscle pain, weakness, convulsions - the main symptoms of the lack of magnesium.

The main indications for the use of magnesium sulfate intravenously in pregnant women:

  1. Risk of miscarriage.
  2. Convulsive syndrome.
  3. Failures in the work of the heart.
  4. Determining endometrial.
  5. Premature childbirth.
  6. Gestosis.
  7. Very high blood pressure, threatening life and mother and child.
  8. Poisoning salts of heavy metals.
  9. Arterial hypertension, critical condition with a brain edema.
  10. Epileptic attack.
  11. The overall weakness of the body and easy excitability.

The use of magnesia can periodically assign at:

  • constipation;
  • poisoning salts of heavy metals, such as mercury and arsenic;
  • cholecystitis;
  • inflammation of bile ducts;
  • cleansing the intestines before childbirth.

"Note! It is forbidden to accept calcium-containing drugs during the course of admission to Magnesia inward! Since calcium has anti-magnesium, neutralizing its action. "

Dropper with magnesia during pregnancy

Depending on the type of pathologies and the severity of the state of a pregnant woman, the method of treatment of magnesia changes. There are several ways to introduce magnesia during pregnancy.

The most effective method is a dropper treatment. Thanks to it, the active substance penetrates into blood in just a couple of minutes, thereby quickly stabilizing the dangerous state at elevated pressure or threat of miscarriage. It is, so a dropper with Magnesia is the most common method of treatment during pregnancy.

How else can I use magnesia sulphate?

  1. Intramuscularly The injection action begins 30 minutes after the introduction. Prints from a solution of magnesium sulfate are made in the clinics in case of a slightly elevated tone of the muscles of the uterus without a threat to the child.
  2. Intravenously. This method helps to quickly penetrate the acting substance in blood, and see the effect after 3-5 minutes. After a few minutes, the pressure drops in pregnant women, the uterus during taps becomes soft, no longer hurts, and cramps stop.
  3. Powder Easily dissolving in water, the crystals of magnesium sulfate give a light laxative effect. In view of the fact that there is no direct hit in blood, there are no contraindications for taking this solution with pregnant women when dealing with constipation.
  4. Electrophoresis. In the case of frequent epileptic seizures and thrombophlebitis, physiotherapeutic procedures with magnesia are prescribed.

It is important to remember that intravenous injections are prescribed with pregnant women with elevated uterine tone only in the period 2 and 3 trimester. This procedure is affected and also takes a lot of time. A solution for intravenous administration must be heated, and then slowly enter the patient into Vienna. This process takes from 10 to 15 minutes.

It should be noted when the unusual sensation is detected during the procedure for entering the drug, it is imminently necessary to notify medical personnel. As soon as a nurse learns about this, measures will immediately be taken to stop the supply of the drug. An inspection of the doctor will also be carried out to eliminate the manifestations of an allergic reaction or the rapid development of side effects of magnesia.

Side effects

Magnesium sulfate is one of the most not dangerous, but at the same time effective drugs for treatment during the tooling of the fetus. However, being a drug can not have no contraindications.

In these cases, Magnesia treatment is unacceptable:

  • intolerance to the very substance itself;
  • arterial hypotension;
  • prepar period;
  • pronounced bradycardia;
  • appendicitis;
  • intestinal obstruction;
  • kidney disease;
  • low blood pressure;
  • oncology.

Despite the fact that Magnesia is actively used in gynecology for more than a dozen years, it is not proven to fully prove its full safety for the embryo. For this reason, magnesium sulfate is rarely used during the first trimester. This will help avoid a negative impact on the initial development of the fetus systems and bodies. It has long been known that the magnesia solution is quickly absorbed into the blood, penetrates through the placenta, and falls to the child on a row with other substances. Because of this, the doctor recommends this method of treatment only in cases of a serious threat of miscarriage. When prescribing this drug, it is necessary to carefully monitor the content of magnesium in the blood of a pregnant woman.

Yes, rarely, but still there are side effects when taking Magnesia in pregnant women. Most often, it is an overdose of magnesium that is the cause of poor female well-being, for this reason the duration of treatment is under strict control of the attending physician.

Side effects of magnesia during pregnancy:

  1. Antispasmodic pain in the head.
  2. Sweating.
  3. Lowering blood pressure.
  4. The emergence of an inexplicable anxiety.
  5. Drowsiness.
  6. Nausea and vomiting.
  7. Lowering body temperature.
  8. Dyspnea.
  9. Diarrhea.
  10. Thirst.
  11. Blurred consciousness.
  12. Infertility of the heart.
  13. Allergic reactions (rashes, swelling).

"Note! Before resorting to the treatment with a solution of magnesium sulfate, consult with the genius-gynecologist to avoid negative influences on the embryo. The increased tone and the threat of a breakdown of pregnancy, of course, are unpleasant and dangerous, but do not forget that there is no information about the results of research on the effects of magnesium sulfate on the fetus. "

The main thing is that it is worth knowing when the treatment of pregnant magnesia

In case of intravenous treatment of pregnant Magnesia, it is worthwing that the rate of entering the drug should not exceed 1 ml per minute.

  • The course of droppers should last no longer than the week. The recommended dose is considered to be 5-20 mg of 20% magnesium sulfate solution. All the time, while entering the drug through a dropper, the future mother should be in a horizontal position. If you make sharp movements, dizziness and nausea may appear. A very fast injection of medication can lead to a fainted state and a failure of the heart. The duration of the procedure depends on the danger of the state of pregnant.
  • In cases of eclampsia (acute gestosis with elevated blood pressure), an intramuscular administration of 10 ml of a 25% solution of magnesia once every 4 hours is prescribed. The duration of the procedure is determined individually by the doctor.
  • To combat constipation, 10-30 g of dry powder or 1 tablespoon of the solution of magnesium sulfate are pressed before meals (30 minutes).

Note! The experience of scientists from the research center in America showed that the long use of magnesium sulfate (more than 7 days in a row) or the excess of the prescribed dose can cause calcium washing from the kid's body. And this in turn leads to the problems of the formation of the musculoskeletal system of the embryo and numerous injuries during childbirth.

Negative consequences of magnesia for a child

There are really some contraindications for the embryo when taking Magnesia. However, a positive result that it can give, much more weighty, because this drug can save life.

Probable complications for the kid:

  1. Newborn can observe symptoms of intoxication by magnesium, such as breathing difficulties. This may manifest itself if directly before the birth of the future mother did dropper from Magnesia.
  2. The introduction of the drug longer than the designated deadlines may cause the development of Rakhita at the embryo.
  3. It is possible to inhibition of respiratory processes in newborns, in cases where magnesia and gentamicin were simultaneously taken.
  4. Studies of some scientists led to the conclusion that the use of magnesium sulfate can become a causal reduction of blood flow through the brain tissue in premature babies. But the level of danger is not as high even with a substantial exceeding magnesium in the blood of newborns.

Thus, magnesium sulfate has a negative impact on the mother than the child.

Whatever scientists and physicians say, whatever the side effects of Magnesia during pregnancy, magnesium sulfate at the moment almost the only means that helps appear on the light of a new life.

And since for each pregnant woman, this is the most important thing, all these negative consequences are nothing compared to the joy that they experience, pressing their child to his chest. In addition, the experience of real women who took Magnesia, states that there are no significant deviations from their newborns, despite all the terrible prejudices.

At any time, on any gestation period, the future mother may have a lot of situations when treatment is extremely necessary. At the same time, it is not only about the health of the future mother, but also about the state of the baby, and directly pregnant: often medical prescriptions are aimed at preserving it.

What is magnesia or magnesium sulfate?

This drug is appointed pregnant women almost most often. If you are lying in the hospital, then you will definitely introduce magnesia. It happens that it is riveted or drip enough for a long time. How safe is it for the health of the future mother and the enhanced fetus?

What are making magnesia during pregnancy?

Magnesium sulfate or magnesia has properties that help to treat various diseases and conditions of pregnant women, and also prevent the development of pathologies and miscarriages.

Magnesium sulfate leads to normal pressure, there is a relaxing vessels on the walls and muscles, speeds up the process of removal of fluid from the body. Late toxicosis, gestosis, accompanied by nephropathy and convulsions, swelling, hypertension, predisposition to thrombophlebitis - these are the diseases in which magnesia is indispensable during pregnancy. It is introduced by lack of magnesium in the body, to prevent premature labor.

Treatment of magnesia during pregnancy

It should be emphasized that the introduction of magnesia is possible only intravenously or intramuscularly. Magnesia powder will cause a stomach disorder, since magnesium in blood does not fall from the gastrointestinal tract.

How concentrated must be magnesia and how much to enter it? It depends on the state of a pregnant woman and the complexity of its problem. As a rule, doctors prescribe 25% magnesia with a one-time dose of 20 ml. We put it, with the first degree nephropathy - twice a day, with the second - four.

The introduction of the drug is a rather painful process. Incorrect administration is fraught with inflammation and dying of the tissue in the injection zone. Before entering, liquid magnesia is warmed, but shed a long needle. It is introduced very slowly. The same applies to intravenous administration - it is dripping for quite a long time.

Magnesia - side effects during pregnancy

Some doctors, such treatment seems more harmful than helpful. But basically, magnesium sulfate is prescribed to almost all future mommies, for various reasons entering the hospital. Clinical studies on the effect of magnesia were not conducted, but it is believed that its use is quite acceptable, as evidenced by many years of experience in its use.

Meanwhile, admission to the body of pregnant magnesium sulfate is associated with certain risks. First of all, these are available side effects: increased sweating, migraine, tides to face blood, weakness, drowsiness, anxiety, violation of speech, sharp drop in pressure.
In addition, in hypotension, introducing magnesia is strictly prohibited. It is immediately canceled if the pressure decreases.

Magnesia therapy is incompatible with the reception of calcium and dietary supplements of food.

It is necessary to be careful and when dosing: Magnesia in large numbers acts as a drug. This leads to the breath of breathing at the kid.

During when a woman enters a pre-soda state, magnesia is contraindicated. Before the very kind, it should be canceled. However, when it is excreted from the blood, its action is suspended, and it no longer reuses obstacles to the opening of the cervix.

You should not forget that during the child tooling the child, magnesia therapy should be carried out only under the strict observation and control of the specialist. And in the first three months, this drug is simply contraindicated.