Dangerous infections in pregnancy - Causes, Symptoms and Treatment .MF .
Infectious process - is a pathological process caused by micro-organisms are: protozoa, bacteria and viruses, also called "infection".Most diseases are somehow related with microorganisms and their effects on the human body.The most dangerous infection to the body with a reduced immune response, as in this case, even a slight infection of can lead to serious consequences.
immunity may be reduced for many reasons, such as reduced immunity during pregnancy is a physiological process, necessary for normal development of the fetus and to prevent rejection of his mother's body.Therefore, during pregnancy the mother is extremely vulnerable and susceptible to the action of various microorganisms.
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Bacterial infections that can be the most dangerous for the mother and fetus:
1. Chlamydia trachomatis (chlamydia) - found in 40% of women, pregnant or not.The most frequent manifestation - urethritis.Also in women can cause: Bartolini, endocervite, endometritis, salpingitis, pelvioperitonit.Sometimes it can cause ectopic pregnancy (in the case of long-standing low-intensity process that caused the adhesions in the fallopian tubes and obstruction).It may lead to a termination of pregnancy in the early stages;if untreated, can give a fairly severe complications: fetal malnutrition (his development delay), premature rupture of membranes, chorioamnionitis.Rarely can cause fetal death.Children born to mothers with chlamydia bolevshih occurs: conjunctivitis (chlamydial ophthalmia) in 20% of cases, pharyngitis, vulvovaginitis and urethritis, proctitis, bronchitis and pneumonia.
2. Neisseria gonorrhoeae (gonorrhea) - an infectious disease that affects mainly the mucous membranes of the urogenital tract caused by gonococcus and is transmitted mainly through sexual contact.The disease is manifested in the 3-7 days after infection;It can occur acutely or chronically.It is characterized by mucus, pus, a burning sensation and pain in the terminal portion of the urethral channel, frequent urination very painful.Half of the infected symptoms can not be observed, particularly early in the disease.The most susceptible to such disease flow women.Infection of the fetus most often occurs in utero.The second possible route - during childbirth.The following manifestations in the fetus and newborn: gonococcal sepsis in the newborn, chorioamnionitis;gonococcal conjunctivitis, otitis externa and vulvovaginitis, neonatal ophthalmia - highly contagious and prognostically dangerous for the newborn, which can lead to blindness.Less common in children born to mothers with gonorrhea, meningitis and arthritis.
3. Trichomonas vaginalis (trichomoniasis) - is that they get sick 180 million people every year!Dispatched usually sexually transmitted, and not infrequently combined with gonococcus, chlamydia, ureaplasma, fungal lesions.In women, it causes lesions urogenital organs, causing: vaginitis, vulvitis, urethritis, endocervite.Children possible contamination from sick mothers, often during childbirth.They are characterized by vulvovaginitis and urethritis, non-specific symptoms.
4. Mycoplasma hominis (mycoplasma) and Ureaplasma urealyticum (Ureaplasma) - is the microorganisms without cell walls, making them resistant to antibiotics.They are often isolated in a separate group, standing between viruses, bacteria and protozoa.Immunity is not resistant to them, occurs during pregnancy was more likely than non-pregnant.Mycoplasma in women can cause vaginitis, urethritis and endotservitsitov.There may be a cause of interruption, delay development, the formation of fetal malformations - often with massive infection and acute ongoing process.Ureaplasmosis in women is characterized by a clear discharge from the genital tract, if inflammation of the uterus and appendages, characteristic clinical manifestation of which is pain in the lower abdomen.For the fetus and newborn is especially dangerous at a titer above 104, promoting abortion in early pregnancy, intrauterine growth retardation (VZRP), the development of reactive ureaplasmosis in newborns.
5. Streptococus agalactiae (Group B streptococci) - Representative of the vaginal flora in most women, most often asymptomatic flows.However, during pregnancy they can play quite a serious, negative role.Although it should be mentioned that in most cases this infection does not lead to any serious pathological processes.It can be transmitted to the fetus and newborn.Specific vaccine exists for them.It can cause severe disease, until sepsis.For Mother's dangerous: endometritis, sepsis, urinary tract infection, meningitis, abdominal abscesses, endocarditis, and necrotizing fasciitis.For the newborn: stillbirth, a violation of the respiratory function, the primary focus sepsis without meningitis.
6. Lysteria monocytogenes (Listeria) - can produce serious complications in the body of the newborn, as it can pass through the fetoplacental barrier (the barrier between the mother's body and the child, which prevents the passage of damaging agents to the fetus).
7. Treponema pallidum (Treponema pallidum - the causative agent of Lewis (syphilis)) - in pregnant women does not occur more often than in non-pregnant women.Pretty dangerous to the fetus.In the absence of monitoring of women during pregnancy may occur in 89% of newborns.Transfer to the fetus can proyzoyti transplatsentrano may occur during childbirth (vertical transmission).When zarozhenii possible formation of congenital syphilis - the early and late, characterized by a large number of complications.
8. Mycobacterium tuberculosis (M. tuberculosis, "tubercle bacillus") - most commonly activated in pregnant women with a history of tuberculosis, or being a carrier.
infections caused by protozoa and fungi:
1. Candida albicans - fungal infection, detected in 36% of pregnant women.Most often found in the presence of a diabetes patient, after use of broad spectrum antibiotics in cases immunodeficiency caused by HIV infection.Usually not affect fetal development.Infection is possible with the passage of the newborn through the birth canal.
2. Toxoplasma gondii (toxoplasmosis) - a common and widespread infection.The relevance of this infection is the possibility of serious damage to the fetus, since light penetration through the placenta of the fetus.This often occurs in utero fetal death, neonatal death as a result of the generalization of infection;the surviving children with congenital toxoplasmosis identified serious defects of the nervous system, the retina of the eye and horioidnoy.
3. Malaria, particularly Plasmodium Falciparum - is especially dangerous for young nulliparous women who had no contact with the infection.More severe in pregnant women, often fatal for the mother.
infections caused by viruses:
1. Rubella - for primary pregnancy by more than 65% of cases there is a transfer to the fetus, causing severe birth defects, often incompatible with life.The risk to the fetus depends on the period of pregnancy in which the mother was infected.If infection has occurred in the first trimester of pregnancy, fetal injury frequency was 80%, with infection at 13-14 weeks - already 70%, with infection in 26 weeks.- 25%.When infected mothers after 16 weeks of pregnancy, the risk to the fetus is minimal, manifesting a rare development of deafness.Symptoms of congenital rubella syndrome are divided into three groups: 1. The states are directly related to a viral infection, manifested during the during the first weeks of life, light weight, damage to bones, enlargement of the liver and spleen, generalized lymphadenopathy, and meningoencephalitis;2. Defects that appear much later - deafness, cataracts, congenital glaucoma, congenital heart defects (uncovered Batalov flow, ventricular septal defects), mental retardation and microcephaly;3. Long-term infringements - deafness, insulin-dependent diabetes mellitus, mental retardation.
2. Cytomegalovirus (CMV) - is dangerous, especially for the fetus, causing congenital defects.The frequency and severity of clinical congenital CMV infection depends on the frequency and nature (primary or reactive) CMV infection during pregnancy.Sensorineural hearing loss is the most common consequence of congenital CMV infection.In addition, about 7% of cerebral palsy are the result of congenital CMV infection.It can also be the cause of multiorgan disease, the clinical manifestations of which include: enlargement of the liver and spleen, thrombocytopenia, chorioretinitis, microcephaly, etc.It should be noted that less than 10% of newborns have congenital CMV infection from mothers sick by it, but more than 50% suffer quite heavily.
3. Herpes simplex virus - an infection caused by the herpes simplex virus 1, (HSV-1) and No 2 (HSV-2) types.As a general rule is hidden.Risk for the transmission to the newborn, especially genital herpes during delivery.In rare cases, herpes transmission is possible through the placenta, increasingly during the third trimester of pregnancy.With the defeat of HSV1 virus in infants usually are asymptomatic process or infection flows not hard, not giving serious complications.If it affects the type of HSV2 develop severe neurological complications in children.The most typical manifestation is encephalitis, which can occur extremely hard and cause the death of the newborn or the development of severe neurological sequelae in survivors.
4. Hepatitis - characterized by lesions of the liver tissue, and other organs and systems, usually called as hepatitis A, B, C, the D, E, G and F. Of these the most dangerous and prevalent B, C & D, fromthey hepatitis D, usually accompanies and complicates the previous two.In the case of hepatitis B virus, many infants and children may be in a situation of asymptomatic carriage.Children with chronic viral hepatitis B to develop ugrozhaemy exacerbation of chronic hepatitis, liver cirrhosis and primary hepatocellular carcinoma.The course of hepatitis C in children is poorly understood.Liver may increase in size, the development of symptoms of hepatic failure, and in rare cases, symptoms of multiple organ failure and hepatocellular carcinoma.
5. HIV infection - a topic on many extensive, which requires a separate article.It can only be noted that in HIV-infected children at an early age there are non-specific symptoms.About a quarter of them develop AIDS.Current HIV in infants more prone to rapid progression than in adults.It is necessary to say that with proper management of pregnancy and childbirth is possible to completely eliminate or minimize the possibility of children contracting HIV from infected mothers.
6. rubella, chicken pox - usually it perebolevayut in childhood, gaining immunity to infection.Severe cases of the disease during pregnancy occur in women carrying this infection for the first time.The frequency of deaths is significant.Maybe cause fetal malformations and fetal death, as the virus is able to penetrate through the placental barrier.
7. ARVI (acute respiratory viral infection) - a large group of viral pathogens, which to some extent may complicate the course of pregnancy, to give unwanted complications and affect the fetus and its health.The most dangerous flu.When infected in the first trimester of pregnancy is possible the formation of gross malformations.Up to 12 weeks of infection with influenza virus can cause defects on the principle of "all or nothing" - a group formed malformations incompatible with life, or nothing will happen and the pregnancy will proceed normally.In the period after 12 weeks of serious complications can not be, however, it is the likelihood of placental insufficiency, fetal hypoxia, increased risk of preterm birth.Notwithstanding the above we must remember one thing - the vast majority of women suffer from acute respiratory viral infections during pregnancy and the further development of the fetus, as well as on the health of the mother is in no way affected.
Obstetrician-gynecologist Kupatadze DD